"Outpatient Orders"

[TlhRNED]

Does anyone deal with "outpatient orders" in their Emergency Departments? We are constantly receiving orders from family practice/ internal medicine/ peds to give injections, do procedures, etc... in the ED! How do you all handle this???

[debbyed]

In our ER these patients are handled just like any other patient. All patients comming through the ER door must be seen by a physician. If their physician is in house they have to physically come to the ER and write on the ER chart. If not, the ER physician sees the patient and than usually orders what the attending asked for. These patients are charged an ER fee (the same as any other ER patient) and if seen by the ER Doc they are also charged an ER Physician fee.

[Rena RN 2003, RN]

pretty much the same here. FP docs can direct admit patients and they usually roll through our ED to registration. when that happens, we don't touch them. if we have to even so much as look at them, they become an ED patient and we sign them in as such and then go on to treat like a regular ED admission.

now when i take orders for an admission and it's going to be a while before the floor takes that person, i'll sometimes go ahead and start some of the orders for the floor.

[Irwin0111]

personally what i usually do, if the order was made by some other hospital, and they just come in for the introduction of the drug with a paper in their hand to document data about the medication. i usually ask payment where it go directly to my pocket. because i do something that has to do with legal. so,if to say error has been made, and he come running after you for the mistake then it wouldn't be that much hurting for at least you got pais for it. so far, that did'nt happen yet.

Now for on us patients,off course, they wouldn't hear us complaining.

kiwit

[galenight, BSN, RN]

TlhRNED,

Oh yeah.. we do that crap all the time. Also allergy injections. What a pain in the behind. We are a small rural hospital that has 4 ER beds and a 5 bed clinic that we run from 6a-10p. The outpatient orders can be quite a trip. We do blood (now we usually send them to the floor), albumin, pain meds, 1 liter NS over 4 hours, dressing changes, etc. We also are responsible for starting the hep locks for CT. Those aren't too bad, since they are usually early in the morning when we are slower. Sometimes it's those outpatients are a pain, but ya know... it pays the bills.