Being told what to write in a pcr?

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Tara_SacCA

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So, long story short....last week I injured my back. Missed 2.5 days of work before being fully released. Worked for my company for 2 years and am a supervisor for them. Now, I am being sent back through training because I injured myself on the job. My "co-supervisor" is doing my training. At the end of the day today she collects my pcrs to review them. She did exactly what I knew she would do, she ripped them apart.

She said that I need to write "na" for no allergies, not "nka" or "nkda". She noted I accidentally wrote the pt was placed in a 1 point restraint, twice. I didn't have stuff listed the exact way she wanted it worded. A facility wouldn't give me a med list, so I wrote list not given, she said I need to write " non contributory staff". I didn't notice a concentrator on the side of a bed for a pt, when the particular facility has O2 hookups, but she then said he has a cpap for night time. (which idk why I would need to notate his cpap machine when it had nothing to do with him returning to a snf after dialysis!) and a few other minuscule items.

At the end of the day she threatened my job by saying that if I do not correct these things on future calls by the end of training day 2 tomorrow, then she won't pass me, therefore I lose my job. She also collected my pcr's at the end of shift to review them not even allowing me the chance to correct any "mistakes".

So after working for the company for 2 years and having always written my pcr's the same way and nothing ever being said to me that what I was doing was incorrect, is my company supposed to script my pcr? I hear two sides, I hear yes they can and no, it's illegal. I'm beyond words at this point an if I keep my job, it makes for a very awkward working situation for us two from here on out.

Or possibly any suggestions on what I should do tomorrow, besides the obvious of doing what she wants to shut her up? I found out they did a full audit of my pcr's when I was injured. And she was instructed to do this. And I feel that at this point they are trying to find a way to get rid of me. After all, the other two people at my station that got injured at work either didn't pass training or were fired within a week or two after being released.

TIA!!!!
 
It is perfectly ok for a company to ask you "script" your PCR by using certain phrases, words, noting certain things in your report, ect. This often makes the billing process smoother. What's not ok is when they request that you do this when the "script" is not an accurate reflection of the patient's condition. That's called fraud.

The other point here is that your supervisor is not scripting billing specific items. She's scripting some odd stuff. While mistakes are an issue (1 point restraint) two days of training then your fired is not indicative of a place interested in its employees. It might be time to seek further opportunity.
 
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It seems offensive that they have manipulated a QA process into an arbitrary, rapidly disciplinary process. It really distorts what the QA goals are.

I think this contributes to people thinking that QA is always a bad thing and that they are just being "dinged" for things that they either missed our did not word correctly. Generally, those of us who do QA, want people to chart better and with greater ease, not to contort the prices into something negative. I have read many charts, and i have never found a perfect chart. It does not exist. My charts are not perfect.

Can they ask you do chart differently? Yup. The reasons can vary, but often it comes down to presenting the factual information of a call that helps Billing justify the charge and more importantly, making your charts more concise and professional looking for hospital staff and future subpeonas.
 
Anyone who thinks that scripting (provided it's accurate) is illegal needs to take a medical coding course. If you think that the little accurate scripting that EMS does is wrong, your head will spin when you find out how the hospital has to script things like admitting diagnosis (hint, no one should ever be admitted to the hospital for simply "CHF").
 
What they are asking you to do is perfectly ok, well, with a caveat. If you are being asked to notate certain things certain ways, then as long as the notation is accurate, they can request that. For example, let's say I have written on my run sheets, "Oxygen by nc @ 4 lpm." It is perfectly ok for the management to ask me to write that as "Oxygen at 4 LPM by N.C." (note capitalization changes, order changes, etc). What is not ok is for them to ask me to write that if I didn't not give 4 liters of O2 by nasal cannula.

One of my services requires me to chart things in what I think is kind of a funny way. But I understand it's for uniformity because it makes it easier for the MD to CQI our reports and how to decide which ones are ALS vs BLS so they can request that.

It sounds like perhaps you have been doing things a different way that what company policy requires for a few years. If so, that doesn't make it right, and the company should have gotten on you a long time ago about this, but for one reason or another they may have let it slide. In any case, you are still responsible for following the company procedures now. Now any reputable company would understand that since this is relatively minor (it's not like you've been violating protocol on narcotics for a year and that needs to be corrected today) that they'll give you some time to make an honest effort to correct it, but IMO, 2 days is too short. Perhaps request a week? You'll be slow at first, but by the end of the week you should be able to get into the swing of things.

Good luck to ya!
 
Go over her head and report this, and ask for a copy of the company's PCR standard for you to learn before you are evaluated. Do this in writing as well as in person. If you have a union rep, have them with you.

I doubt a "co-supervisor" can fire you, but he/she may have some sort of special situation set up by their bosses. Don't get confrontational, don't use the word "you" except to state an opinion (as in "I feel you are not giving me adequate training before evaluation"), stick to asking specific questions and addressing issues. There may be some valuable learning to do here for you as well, it just may be bitter and awkwardly handled.

If this outfit is this bush league, look for a job elsewhere before things get too nasty(er).
 
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Agree with the others. Unfortunately what this looks like is an unscrupulous company not wanting a tainted ( recent back injury ) back in there employ. Do what Mycroft said and get the standards in writing with a written request as it appears as they are using any little thing to try to fail your "retraining"
 
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You hurt your back...

What does that have to do with PCR writing?
 
Tara_SacCA said:
I found out they did a full audit of my pcr's when I was injured. And she was instructed to do this. And I feel that at this point they are trying to find a way to get rid of me. After all, the other two people at my station that got injured at work either didn't pass training or were fired within a week or two after being released.

TIA!!!!
Click to expand...

On all outward appearances, that's what it looks like. The timing appears transparent. If that was the case with two others, then that's a pattern that you don't want to be penalized by.
 
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