Reducing misuse of Emergency Departments! - page 5

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   RNin92
    Quote from teeituptom
    I have seen a few get arrested for that over the years
    Wonder if we can write a law about abuse of the healthcare system?!!?
    Hmmmmmm....
  2. by   teeituptom
    Never happen
    would hurt the shysters
  3. by   RNin92
    Quote from teeituptom
    Never happen
    would hurt the shysters
    And that would be bad?!!??!!??
  4. by   newgrad2004
    Quote from petiteflower
    I learned a good way to assess if the syncope is fake or real (of course the more dramatic the faint the less likely it is to be real) Hold their hand up in the air over their face---amazingly the fake faints alway seem to miss their faces. No matter how hard they try to let the hand land on the forehead, they just can't do it.

    I love the diagnosis, near syncopal episode---how many times have ya'll heard that one?
    Haha I love that test, thanks will have to try it someday :P
  5. by   newgrad2004
    I posted this on the "macdondalds not us" thread but I think it is appropriate here as well. So here goes.

    Once we had a pt who came in via EMS who we could see from outside being loaded from a cheap hotel across the street. We were slow so we think cool, someone is coming in, something to do. Guy comes in, "traveling from WA to Texas, No health care coverage, moving no address." how fortunate. He states he has run out of his meds (albuterol etc.) and had only a half tank or 02, had to turn it way down to get through the night and woke up SOB. Comes in demanding breakfast, is pissed there were no eggs delivered, since they ran out, and it was past breakfast yet before lunch. Orders a second tray, and tosses they jelly package at his primary nurse telling her to put the jelly on his cakes. She gets angry because his arms are working and tells him she thinks he can manage himself. The guy is on his call light every 5 minutes, wanting meds and to leave. Im with his nurse inserting and IV and giving an injection so we miss his light because we were busy. I go in after and here the man has out all his inhalers he said he didnt have and tells me. "first off the light doesnt work, second I had an attack and had to use my inhalers to make me feel better." I'm standing there dumb founded looking at this man who said he didnt have any inhalers while he is on 02 and feeling well enough to toss jelly at a nurse. I tell him sorry the light works but we were with another patient, and I will tell your nurse about your episode. Then the man asks where his lunch is. (meals-r-us) 2 breakfasts and lunch with meds, and another tank of 02. Guess his hotel didnt offer the continental breakfast. When I told the nurse she was pissed because he said he had no meds, ran out of everything. This is why health care is expensive were paying for people like this, 3 meals in 3-4 hours and new meds for a "traveler" who didnt stock up before he left, wonder why.
  6. by   BabyRN2Be
    That's just really incredible that people think that if you are inconvenienced by waiting in the ED, that the staff is obligated to bring you a meal. Good grief!

    In my early 20's I had some problems that made several ED trips necessary. Before I left, I made sure that this wasn't an emergency because I KNEW that the hospital wait would be upwards of 5 hours. Not once in all those times I had to wait in ED was I offered any food. Not that I asked or even was expecting anything - even after waiting upwards of 15 hours for a room. I was sick and I figured that if I was well enough to be worried about my next meal, that I wasn't sick enough to go in.
  7. by   newgrad2004
    I would have never thought of it until working in the ED on rotation. But the frequent fliers know all about it and how not to have to pay for thier stay so its just the next best thing to the "Hilton" for them.
  8. by   RNin92
    Quote from newgrad2004
    I would have never thought of it until working in the ED on rotation. But the frequent fliers know all about it and how not to have to pay for thier stay so its just the next best thing to the "Hilton" for them.
    hey...those FF are VERY smart...
    they not only ask for their lunch tray before they are settled onto a cart...but they are asking for samples of meds and a cab voucher, too!!

    for awhile my hospital made an arrangement with a local pharmacy to accept a voucher from the hospital. it was meant for families who were caught between no insurance and medicaid...or had fallen on unexpected bad times.i swear two weeks into it we had every ff in the county aasking us about our free meds!!

    talk about networking!
  9. by   Marie_LPN, RN
    One of my favorite FFs.

    The guy that comes in, ALWAYS says "Gee i hope i don't have to stay the night", gets diagnosed with severe hypotension, and is Admitted. Did i mention that he brings a few days' worth of PJs and a shave kit in a duffle bag when he comes through the door. Hopes he doesn't have to stay the night? Yeah right.

    (We think he's doubling up on his Ativan before he comes in, all labs and tests are normal, and his "hypotension" is mysteriously fine the next morning. And he's the only person i've seen who's visibly disappointed when his vitals are normal)
  10. by   RNin92
    Quote from LPN2Be2004
    One of my favorite FFs.

    The guy that comes in, ALWAYS says "Gee i hope i don't have to stay the night", gets diagnosed with severe hypotension, and is Admitted. Did i mention that he brings a few days' worth of PJs and a shave kit in a duffle bag when he comes through the door. Hopes he doesn't have to stay the night? Yeah right.

    (We think he's doubling up on his Ativan before he comes in, all labs and tests are normal, and his "hypotension" is mysteriously fine the next morning. And he's the only person i've seen who's visibly disappointed when his vitals are normal)
    Yea...

    It's never good when they check in at the triage desk...suitcase in hand!!

  11. by   stretch thin
    We all have good triage stories but jay levan has a point. I know I get very frustrated when the encoder goes off or I see all the people in my town check in. People need to be treated granted, I think what everyone is saying the system is abused. I also agree that our government is not doing anything to change that situation. Look at how well their dealing with the nursing shortage. On the other hand it's the PCP's that aren't doing their job. Example, we had a pt that did the right thing, he went to the after hours clinic for his c/o. They did some lab(which by the way shocked the heck out of me). The labs came back and they were totally screwed up. It read that his hemoglobin was 2. Now if this doctor had looked at the lab closely he would have realized that it was a contaminate specimen. No he sent him to the ER. We finally sent the man home after a 5 hr wait. I ask pt why they didn't they see their doctor for their complaint. Some people say "I didn't think about it" or "they told me to come here". People need to be educated! That's the big problem, because it's not happening. Just my thoughts.
  12. by   teeituptom
    when was the last time you called s MDs office

    you get the answering machine saying they are closed or too busy to come to the phone and that if your really feeling bad either call back or go to the ER


    I hate answering machines
  13. by   Snowy
    i think i may have the solution for this one *says in a sarcastic voice*

    every town has frequent fliers and er abusers...and every town has a walmart, or wm wishing to build in their area. wm stores sell so much already such as automotive stuff, do oil & tire changes on cars, have gas stations, groceries, and then some. how about every time wm wants to build a new store, they're required to build and staff a walmart er dept.

    just think.. people could have near syncopal episodes, be taken to the side of the building to the "walmart emergency department," and they wouldn't need to worry about packing a suitcase of clothing, toiletries and other personal items, there's a food place like a mcdonalds usually, there's a pharmacy and/or otc stuff like tylenol, motrin, etc for the untreated fevers, bandaids for those papercuts, creams for rashes, and even an automated blood pressure machine. the public could become educated and have resources for items
    Last edit by Snowy on May 15, '04 : Reason: (please, I hope my odd sense of humor doesn't offend anyone)

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