Does the ED stand for Emergency Department or the Everything Dumpster?

  1. 2
    Why, why, why does it seem like we are the dumping ground for the whole medical community? From primary care providers offices, to nursing homes, to the urgent care it just seems like no one wants to be accountable for taking care of patients, so they dump patients in the ED. It's just very frustrating. It's even going to the extreme where nursing homes are sending dying patients by the transport van, instead of by ambulance. Just a couple of days ago, I had a patient that was sent over to the ED from a local nursing home by a local transport service, for altered mental status. Now why was the patient having altered mental status? Because the patient was in third degree heart block. When this patient was hooked up to the cardiac monitor, it showed that the patient's heart rate was nearly asystole. Now why this nursing home chose to send this patient by a transport van instead of by ambulance is beyond me. What if this patient died while in the transport van? The drivers are not even trained in CPR. And apparently this nursing home has sent very sick patients by transport van many times before. This is just a rant, with no particular focus at all. Just frustration with how the medical establishment sees the emergency department as a dumping ground.
    Jahna and canoehead like this.
  2. 70 Comments so far...

  3. 14
    It's the Exasperated Room, or Everyone's Retarded.

    And by retarded I mean Snookie, or Tom Cruise jumping on Oprah's couch. Nobody have a cow.
    crb613, wildboo, Skips, and 11 others like this.
  4. 9
    I just wanted to mention, as a LTC Nurse, that I seriously have family members who insist on us sending their loved one out. An uncomplicated fall, maybe a resident rolled out of the bed placed to the floor and onto the mat, etc.. Some family members seriously insist that we send them out.

    End stage COPD resident has SOB, we are 'told' to send them to the ER because we want a blood gas, or because we want to see if 'anything else' can be done. Really?!
    dinah77, NutmeggeRN, ktwlpn, and 6 others like this.
  5. 7
    I had a nursing home send a patient by ambulance for insomnia. It was 8 o'clock in the evening, the patient came in fully dressed and was sound asleep on the ambulance stretcher. I had to wake her up to triage her. Turns out the patient had dementia and would get up in the middle of the night and wander the halls. They hadn't even tried to put her in bed yet. They could have at least waited until a little later at night and had her in her pajamas. That may have been a little more convincing about their complaints of "insomnia".
    canoehead, CrufflerJJ, poppycat, and 4 others like this.
  6. 3
    Because the ED/ER always has been the dumping grounds. It always will be. This nursing home sending patients out by transport needs to be talked to....you can't necessarily blame the staff as you have NO idea what they have been told to do. If they have been told by admin that his is what must be done of be fired....in this job market...you do what you are told. Sending out "half dead" patients....if they have had too many deaths recently....and they want their numbers down....guess where they are going to be sent. Some staff at NH will send problematic patients to the ED to give themselves a rest.
    NurseOnAMotorcycle, dinah77, and gonzo1 like this.
  7. 0
    Quote from VioletKaliLPN
    I just wanted to mention, as a LTC Nurse, that I seriously have family members who insist on us sending their loved one out. An uncomplicated fall, maybe a resident rolled out of the bed placed to the floor and onto the mat, etc.. Some family members seriously insist that we send them out.

    End stage COPD resident has SOB, we are 'told' to send them to the ER because we want a blood gas, or because we want to see if 'anything else' can be done. Really?!
    The problem in the OP is that a LTC facility chose to send a sick resident via van instead of an ambulance. If it is a life threatnening emergency than the resident should have been sent via ambulance. I'm sure it is cheaper to use the van however it is not the most prudent.
  8. 0
    Quote from VioletKaliLPN
    I just wanted to mention, as a LTC Nurse, that I seriously have family members who insist on us sending their loved one out. An uncomplicated fall, maybe a resident rolled out of the bed placed to the floor and onto the mat, etc.. Some family members seriously insist that we send them out.End stage COPD resident has SOB, we are 'told' to send them to the ER because we want a blood gas, or because we want to see if 'anything else' can be done. Really?!
    I realize that some LTC patients are sent out unnecessarily by ambulance. I'd rather kvetch about that than rant about how a legitimately sick resident was sent in a transport van. At least the ambulance has equipment needed to monitor patients.
  9. 10
    I thought it stood for emergency drugseeking?
  10. 0
    I too work in LTC and have many of the same issues. Hospice pt, No Code and family still insist that their family member be sent to the hospital or the DON wants them sent out for obvious reasons.
  11. 1
    Unless you truly need the pain meds then you are given less than adequate. Just speaking from personal experience. I broke both legs when thrown from my horse a couple years ago. I stayed in the ED for four hours in agony. When I asked for something for the pain you would have thought I asked for oxycotin. I was given Hydro 5/325mg one and sent home with discharge instructions to see ortho surgeon on Monday. I left the ED Saturday morning at 0200 in a wheel chair praying I could make it till Monday without killing my kidneys on extra strenght apap.
    GrnTea likes this.


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