My doctor's office staff sent me out....

[MrsWampthang]

Frustrating reasons why people go to the ER (mild rant):

My doctor's office sent me out because they close at 5pm and it is now 3:45, so they don't have any more openings. (Funny how when our ER doc calls that particular doctor will tell them the staff never even told them about the patient's call, or that the patient never called at all.)

I can't go my FMD because I owe them money and they won't see me. (oh, and you think this is free?!?!)

I have an appointment at my doctor this afternoon but I didn't want to feel bad that long. (so now our ER docs are miracle workers that will wave a magic wand and cure what ails ya instantly)

I'm tired of feeling this way and I want to find out what's wrong with me. (again, our ER docs are miracle workers that can wave a magic wand over you and find out instantly what months of tests by FMD and specialists haven't been able to find out)

I am between doctors right now because I just got back on medicaid. (do you realize that medicaid is only going to reimburse the hospital pennies on the dollar for your visit here today to diagnose and treat your rash?)

My doctor's office is closed now. (why no, I didn't know I could call him/her 24/7 through the hospital answering service.)

I don't have a doctor for my 3month old baby. (WTF?!?!?)

I go to the local free clinic and it takes weeks to get an appointment there. (so instead you come here, because, afterall, this is free clinic west)

We were sent here by the FMD to meet the surgeon because my child has side pain. (cause after all, we are the surgeon's out patient clinic)

The ortho surgeon wants to bring a patient down to ER to do a conscious sedation closed reduction (never mind that three ambulances are out on a five car pile-up, and we can spare neither the room nor the nurse)

The ER doc has just told an out of town doc that, sure she would be glad to see a patient he is sending out for a blood transfusion. (at same time the three ambulances are out on the five car pile up. I guess it's easier than calling a doctor with admitting priveleges so the patient can be a direct admit to a holding bed. Nevermind that we still don't have the rooms or the nurses to take care of such a patient.)

I went to work and just didn't feel good enough to stay so I came here. (so all you really want is a work statement? Come on, be honest now.)

I have a bad tooth and the pain is killing me (better that than the meth that caused your teeth to rot in the first place)

Sorry so long, but it was a long day and got really frustrating toward the end of the shift. Just had to let off some steam!

Pam:zzzzz

[Scis]

Comical, but sad. In our ER, though, the nurses must at least

question the patient prior to "shipping them up" to L & D. Let's

face it, some term labor patients can conceal the pregnancy

very well, and others....well. Questioning in the ER might possibly

have prevented this erroneous situation. We always have to

check if crowning is evident, because having a patient give birth

in an elevator with escort personnel is not exactly ethical! If

we peek and there's a certainty of a breech delivery, that patient

MUST be shipped up (i.e. obvious foot sticking out!) as we are

not equiped to handle that kind of birth in the ER if we can

avoid it. A call to L&D is ALWAYS made prior to sending up this

type of patient. Hey, we're fast, but (hopefully, most of the

time) safe! PattyScisRNCEN

[Hellllllo Nurse, BSN, RN]

These stories just knock me out. Gotta admire you ER/ED nurses!

[laughingfairy]

Okay here is one for you guys.

My step son is here on a Friday. He is five. He got real involved in playing with his sister and then I here him calling from the bathroom. "I peed on my underpants." I thought he was too involved and didn't make it or else missed the toilet (He has Elvis hips in the bathroom).

:chuckle But I asked him any way, does it hurt, smell bad, etc.

Then Sat. I actually got off work early and was reading to the kids when he did it again, this time on the couch. This time I thought it was because I told him to plant his back side or go to bed. (you know that literal thinking of kindergartners.) Repeated previous questions.

Sunday right before he is supposed to go home, he does it again. A girlfriend of mine asks him the same questions. He says it hurts when he pees. Okay so his dad calls his mom and says BTW this is what has been going on. My mother-in-law was met in the drive way by his mother. (this is about NOON).

At midnight we get a screaming phone call from idiot mother's idiot husband. "Why didn't you take him to the ER" To which my husband replied "Because you go to your doctor tomorrow for a UTI" Many many explitives later we find out that the little guy had been kicked in the groin on Thursday morning, but mom didn't see fit to tell us. Shoot I'd have taken him to the doctor Friday if I had known it happened and thought it was overkill then. As it was there was still no reason to take him to the ER, no blood, no significant pain, etc.

But this is the same woman who demanded that her OB induced early (by 3 weeks) or she would be in the ER every 48 hours.

[debo_lpnER]

Whenever I triage someone with that line I find out when they called and what they said and then after triage I let them sit in the lobby while I go and call the MD. The girls in the office have become real familiar with me calling. They will check with all staff to make sure if they were told that or not. I will give them the pt c/o and see if I can schedule an appointment.

90% didn't even call. shocker I know. Now I on;y send the ones to their PCP that are fast track crap. But I love to see their faces when I call the up and they think they are getting back quickly. I hand them a piece of paper with their appointment time and tell them that their MD and I agree that it needs to be seen in the office since this is not an emergency. :imbar

I highly reccommend calling and trying to set up appointments. It takes a little time up front but has cut down with repeat business. They know now that we will call and that this is not a drive thru window.

Deb

[MrsWampthang, BSN, RN]

Whenever I triage someone with that line I find out when they called and what they said and then after triage I let them sit in the lobby while I go and call the MD. The girls in the office have become real familiar with me calling. They will check with all staff to make sure if they were told that or not. I will give them the pt c/o and see if I can schedule an appointment.

Oh my ER would never let us do that, they are too into "customer satisfaction." I get so sick of hearing "our scores are low, we need to improve our customer satisfaction scores" Makes me puke!

I wish I could call the MD from triage and send them out, but it'll never happen. I wish we could charge them a fee for coming in with stupid complaints when they are on welfare, or have no insurance but we can't.

Sorry, but I'm tired of AMIs walking in the front door and toe pain for a month coming in by ambulance.

Pam:o

[Scis]

Calling the PMD and making the appt. may work in some areas of the country and with some complaints, but it does open up the

RN triage officer to liability in the event that the "bul_sh_t" complaint does turn out to be something serious, which does happen quite frequently in emergency medicine. Wouldn't want to be the RN on the other end if a negative event resulted because of this type of unofficial "referral" to the PMD. Legally speaking, once the patient presents to an emergency room triage area, they are entitled to a "medical evaluation" including, but not limited to, an evaluation by a triage RN. Of course you can still call the PMD's office, tell them the patient is there, and then tell the patient that the PMD suggested making an office appt. rather than waiting hours in the ER for a "non-acute" illness. The decision then rests on the patient, lessening the liability for the nurse in the event of a negative outcome. Unfortunately, we are a very litigenous society!!!!

Also, this idea would not work in the many urban area ER's that see patients who have no PMD's and use the ER as their primary care physician. The complaints illicited by this type of clientele are usually those that can be seen in a doctor's office or clinic, but present to the ER simply due to convenience or no other option.

ScisRNCEN

[MrsWampthang, BSN, RN]

I have abd pain, and have had numerous tests to determine the cause without success by my family doc. Now I want relief from my pain, oh and can the doc here do a CAT scan while I'm here, my family doc was going to order one anyway.

I called my child's pediatrician and they couldn't get her in for her fever and vomiting since last noc until 14:30. The time is now 11:35 and I didn't want her have to wait that long.

Yes, I know my doctor has walk in hours but I walked here and I don't have time to get to my doctor's office before walk-in ends. I have a sore throat so I want it looked at.

ARGGGGGGGhHHHHHHHHHH

Pam:(

[JULZ]

I am not a nurse yet but plan on being one in the ER, hopefully soon.

Let me just tell you that I am a childcare provider and it kills me to hear some of these parents tell me they just had their child at the ER last night for a fever or cough. In my experience I can honestly say that it is most of the parents that are on welfare and it is all paid for. As for me, I have 3 boys ages 7, 5, and 2 and only had my 5 year old to the hospital (3 times), he's my daredevil! One time he fell at my mom's house and banged his mouth off her stone fireplace, pushing his two front teeth back an 8th of an inch, and impacting them. Another time for Appendicitis (sp?), and the last time my sister brought him to the emergency room by her house because he fell out of a tree him and his brother were climbing and a twig went through his cheek. Two of these times I was charged $50. I think if they would charge everyone $50 to be seen at the emergency room, people might think twice if they are actually in an emergency or not.

Then again some probably don't plan on paying it anyway so maybe it won't matter. Just my thoughts!!!!!

[athomas91]

just had one tonite - 13 y/o w/ cough x 3 days - didn't go to the doc because they didn't have 20$ (although mommy was smoking 4$ cigarettes) - we have a doc in the area that takes uninsured pt's and charges 20$ - but gives them meds and all - so they didn't have it so they came to us..... perhaps if she stopped smoking for 5 days she could provide more efficient care for her child.

[Scis]

Don't forget the price tag for the ambulance ride. Most of these ER abusers do not drive either, so they call 911 for these bogus complaints. In NJ, ambulances must transport these calls!!!!!

A charge of $5.00 for the ambulance would eliminate these excursions! Then they want transport home when they're done being seen! Amazing!