Reducing misuse of Emergency Departments! - page 3

After reading much of the posts about ED Nursing, my first suggestion would be for people to stop inserting objects where they do not belong!.On a more serious note, i just read an article in the... Read More

  1. by   Carotid
    had a guy get out of the tub early one morning, slipped and fell on the deodorant cap - (+) rectal fb; sent him to the or. checked his history, you guessed it!

    Carotid
  2. by   veetach
    Quote from teeituptom
    I liked the one the other night where a 6 foot 4 inch male came by ambulance after dropping the toilet seat on his external genitalia . I never asked him how he accomplished that.

    OWWWWWWWWWW!!! :uhoh21: :uhoh21: :uhoh21:
  3. by   canoehead
    hey, that's my hospital!
  4. by   petiteflower
    Quote from teeituptom
    Im sure it did but how did he do it
    Well, ummm,

    Maybe he was so endowed of that particular anatomy that it hung down that far?? :imbar

    Or maybe it was just a really tall toity.
  5. by   canoehead
  6. by   ratchit
    Hey, I took care of a lady who had herself brought in by ambulance because she had had no appetite all day. Hct was a little low and she lived alone so she was admitted to the floor.

    Then bumped to stepdown a couple hours later when she got tachy.

    Then bumped to me in the ICU after emergency surgery <18 hours after presentation to the ER. She had ruptured a duodenal ulcer, probably a couple days ago, and had raging peritonitis that will likely be the cause of her death.

    I know you guys get abused, but once in a while...

    On the other hand.. my husband ended up in a local ER not long ago. We went to a small community hospital instead of the trauma center, and the staff were talking about how slow a night they were having. Yes, he was there with just tonsillitis, but... His doc won't prescribe without an office visit and the doc on call said he had to wait 12 hours to even call to see if they could see him the next day- he might have had to wait 2+ days. He couldn't swallow without crying in pain and he's no baby. Yup- we went to the ER. We waited our turn quietly, played no games, apologized for being there but explained he was just in too much pain to wait until the next day (at the very least.) We didn't complain about others being taken back before us, we didn't ask for narcs (although he got them), he didn't ask for pillows or phones or TVs... And the triage nurse literally rolled her eyes at him and tried to get him to leave by telling him how long and awful the wait would be. I have never been more embarassed of my profession.

    I know you guys are abused by frequent fliers. Which just ain't right. And I know I'm going to get crucified for my post here. But sometimes, just sometimes, the person just has no other option and sometimes things aren't what they seem.

    That said- you guys have a brutal job and my hat is off to those who do it well.
  7. by   RNin92
    Quote from ratchit
    Hey, I took care of a lady who had herself brought in by ambulance because she had had no appetite all day. Hct was a little low and she lived alone so she was admitted to the floor.

    Then bumped to stepdown a couple hours later when she got tachy.

    Then bumped to me in the ICU after emergency surgery <18 hours after presentation to the ER. She had ruptured a duodenal ulcer, probably a couple days ago, and had raging peritonitis that will likely be the cause of her death.

    I know you guys get abused, but once in a while...

    On the other hand.. my husband ended up in a local ER not long ago. We went to a small community hospital instead of the trauma center, and the staff were talking about how slow a night they were having. Yes, he was there with just tonsillitis, but... His doc won't prescribe without an office visit and the doc on call said he had to wait 12 hours to even call to see if they could see him the next day- he might have had to wait 2+ days. He couldn't swallow without crying in pain and he's no baby. Yup- we went to the ER. We waited our turn quietly, played no games, apologized for being there but explained he was just in too much pain to wait until the next day (at the very least.) We didn't complain about others being taken back before us, we didn't ask for narcs (although he got them), he didn't ask for pillows or phones or TVs... And the triage nurse literally rolled her eyes at him and tried to get him to leave by telling him how long and awful the wait would be. I have never been more embarassed of my profession.

    I know you guys are abused by frequent fliers. Which just ain't right. And I know I'm going to get crucified for my post here. But sometimes, just sometimes, the person just has no other option and sometimes things aren't what they seem.

    That said- you guys have a brutal job and my hat is off to those who do it well.
    Not crucified...that's very dated!!!

    All kidding aside...we all know that there are people who can have vague or "simple" symptoms that fool you.

    But for those people who abuse the ER...they do not know what tragedy they may be causing.

    While the ambulance is bringing in a 30 something who vomited once today...they may be taking an ambulance out of service for 60-90 minutes. In that time a second call may come in for CVA symptoms and the next closest ambulance may need 20-30 minutes just to get to the pt. That 30 something, who could have either waited it out...best option...or at the very least-drove themselves in...need to understand the danger they are doing.

    And the people who utilize the ER as their own PCP/Clinic...need to understand that they are clogging up the system soooo much that they maycause a CP to be waiting in the triage area for 2 hours or more because there is simply no space available.

    That is the true tragedy of all of this.

    Well...that and the fact that they are usually a PIA as well!!
  8. by   teeituptom
    Quote from RNin92
    Not crucified...that's very dated!!!

    All kidding aside...we all know that there are people who can have vague or "simple" symptoms that fool you.

    But for those people who abuse the ER...they do not know what tragedy they may be causing.

    While the ambulance is bringing in a 30 something who vomited once today...they may be taking an ambulance out of service for 60-90 minutes. In that time a second call may come in for CVA symptoms and the next closest ambulance may need 20-30 minutes just to get to the pt. That 30 something, who could have either waited it out...best option...or at the very least-drove themselves in...need to understand the danger they are doing.

    And the people who utilize the ER as their own PCP/Clinic...need to understand that they are clogging up the system soooo much that they maycause a CP to be waiting in the triage area for 2 hours or more because there is simply no space available.

    That is the true tragedy of all of this.

    Well...that and the fact that they are usually a PIA as well!!
    very nicely put there
  9. by   MrsWampthang
    I guess the best solution is to have a fast track area where patients with minor ills and inj can go to be seen, treated and discharged in a relatively short amount of time. We don't have one currently, but are hoping to get one up and running by the end of the year. I think they are going to look into a PA or NP running it, which is fine with me. Some of the ER docs we have would turn our fast track patients into slow track patients by ordering IV meds, tests and all manner of stupidness for them.

    I just wish I could educate the public on the proper use of EMS. I have had so many patients come in the front door that should have come by EMS that it boggles the mind! I always good naturedly admonish them. :chuckle

    I don't mind seeing the sore throats, and earaches in the ER. I mind seeing people come in because they are using us as their PCP because they are on medicaid and are "between doctors" or "their doctor is too far away to get to." I get frustrated sometimes, but as someone that I work with said, it's job security. As long as we have patients, no matter how stupid we think they are, we will have jobs.

    I think it is sad that insurance is so expensive for people so that most people are either underinsured or uninsured. It's a sad state indeed.

    JMHO,
    Pam
  10. by   teeituptom
    Fast tracks get abused also
    just cant send all abusers there
    think what a bummer it would be to work

    we have a Family Practice docs doing our fast track
  11. by   Uptoherern
    tom..........I like the slap therapy............. :chuckle
  12. by   teeituptom
    It worked 99% of the time
  13. by   z's playa
    Our hospital just recently added a Satellite Unit to the ER. (not a satellite in sight ) Here is where all the "could have gone to the clinic" pts are seen. It speeds things up and keeps the beds open for the more serious cases. Of course if something turns out to be serious, they're immediately transferred to obs right around the corner.

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