[TazziRN]

Originally Posted by chuck1234

If you read from the first post to the last one, the so-called ER nurses give all kinds of reason why they could not prevent the death of Ms. Rodriquez, they seldom mentioned the feeling of Ms. Rodriquez's kids. They are so self centered... What do you think if they are related to Ms. Rodriquez.... I am not related to her, but her death is not needed. Her death is horrible....not to mention that she has to suffer before she died.

Please tell me you're not referring to the ER nurses who responded in this thread, because if you are you just paid us one horrible insult.

[GingerSue]

Originally Posted by chuck1234

"Unfairly criticize the nurses who work in them."
I have never worked in the ER....
Anyhow, Ms. Rodriquez came in and everybody in the ER did not take her seriously. She was discharged....and died.....
you could tell someone did something wrong. As a result of that, Ms. Rodriquez died unnecessarily. ...

but her death is not needed. Her death is horrible....not to mention that she has to suffer before she died.

My question: can a person with a perforation be helped?

This woman was in an appropriate setting to receive help.
Was the help provided?
The people with the assessment skills were present.
Did they use those skills to asses this woman?
Could this woman have been helped?

And I read the link about the hospital (as included above)
http://www.latimes.com/news/local/ki...politics-local
and the place seems to experience an interesting collection of problems.

[cardiacRN2006]

Originally Posted by chuck1234

.... if you have experience in the nursing field....

Uhh, chuck, you have a whole whopping 8 months more experience than me in nursing. Not to mention I was a PCT for 10 years prior (mostly in ICUs and ERs) and actually worked in EMS prior to that.

Originally Posted by chuck1234

If you read from the first post to the last one, the so-called ER nurses give all kinds of reason why they could not prevent the death of Ms. Rodriquez, they seldom mentioned the feeling of Ms. Rodriquez's kids. They are so self centered... What do you think if they are related to Ms. Rodriquez.... I am not related to her, but her death is not needed. Her death is horrible....not to mention that she has to suffer before she died.

Yep, I actually did read all the posts. It's nice of you to assume that I didn't, but whatever. And what does "so-called ER nurses" mean? Now they aren't even ER nurses??? So, not mentioning the pt's kids somehow makes the ED nurses who responded self-centered? That's quite a naive, simplistic and ignorant view.

Her death was horrible..so why did the Dr's miss it? Do they need any punishment?

I guess, until you become a triage nurse (no thanks, for all the reasons listed in the thread, invluding having your fellow nurses throw you to the wolves) then you really can't critize what you do not know...

[passinthru]

Is it not still true that abdominal pain is always triaged as a top priority? No matter how often the same patient presents with the same problem...abdominal pain as chest pain, eye injuries, or anything else that threatens loss of life, sight, or limbs is a true emergency. I know ER can be hectic, but it seems the triage person was taking a lot on her shoulders when she let this one by. I would hate to be in his/her shoes.

[TazziRN]

What that triage nurse did was assume that because the pt had already been discharged, that there was nothing wrong with her. That was her big mistake. All pts returning with worsening symptoms have to be categorized as a fresh pt, and that didn't happen.

[chuck1234]

Originally Posted by cardiacRN2006

Uhh, chuck, you have a whole whopping 8 months more experience than me in nursing. Not to mention I was a PCT for 10 years prior (mostly in ICUs and ERs) and actually worked in EMS prior to that.




Yep, I actually did read all the posts. It's nice of you to assume that I didn't, but whatever. And what does "so-called ER nurses" mean? Now they aren't even ER nurses??? So, not mentioning the pt's kids somehow makes the ED nurses who responded self-centered? That's quite a naive, simplistic and ignorant view.

Her death was horrible..so why did the Dr's miss it? Do they need any punishment?

I guess, until you become a triage nurse (no thanks, for all the reasons listed in the thread, invluding having your fellow nurses throw you to the wolves) then you really can't critize what you do not know...

Where is the critical thinking skill?
Read carefully, including their profiles...I only address this problem to those ER nurses...anyone of them has any feeling for those kids....
ER doctors did do something wrong...as a nurse, when you discharged a patient...if you see anything wrong...or after you discharged a patient, and that patient is having a problem..don't you think, as a human being, that you should bring this patient back to square one, rather than "rushing" her out. If you don't address the problem to the doctors, how would they know. Don't forget, we have to learn to speak for the patients when doctors are not doing thing right. As a result of that, Ms. Rodriquez died.

[chuck1234]

Originally Posted by TazziRN

What that triage nurse did was assume that because the pt had already been discharged, that there was nothing wrong with her. That was her big mistake. All pts returning with worsening symptoms have to be categorized as a fresh pt, and that didn't happen.

This is really my first time to agree with you...and based on your statement, I already know that you are a nurse with common sense...a nurse with common sense is a good nurse....
Good luck with your job interview....

[chuck1234]

Originally Posted by passinthru

Is it not still true that abdominal pain is always triaged as a top priority? No matter how often the same patient presents with the same problem...abdominal pain as chest pain, eye injuries, or anything else that threatens loss of life, sight, or limbs is a true emergency. I know ER can be hectic, but it seems the triage person was taking a lot on her shoulders when she let this one by. I would hate to be in his/her shoes.

It is true that abd pain might not be a priority.
But when the patient came in and c/o the pain in the abdominal area, you takes notice...at this point, you should have a clear picture or baseline about this patient's mental status....when the patient's mental status has changed, then you should address the problem to the ER doctor.
Abdominal pain is one thing, but when the abdominal pain persists and mental status has changed....in the case of Ms. Rodriquez, she was laying down on the floor...this is a Big Red Flag!!!! The nurse taking care of Ms. Rodriquez has missed a big one....a human life.

[CritterLover]

Originally Posted by passinthru

Is it not still true that abdominal pain is always triaged as a top priority? No matter how often the same patient presents with the same problem...abdominal pain as chest pain, eye injuries, or anything else that threatens loss of life, sight, or limbs is a true emergency. I know ER can be hectic, but it seems the triage person was taking a lot on her shoulders when she let this one by. I would hate to be in his/her shoes.

No, it isn't true that abd pain is always triaged as "top priority." At best, it is going to be a level 2 (on a 5 level triage scale). I usually traige it as a 3, sometimes I give it a 2. But then, I frequently give chest pain a 3, as well.

Why???? Well, for one, on any given night, chest pain and abd pain make up anywhere from 50%-75% of the patients in the waiting room. Rating them all an ESI of 2 kind of defeats the purpose of having a triage system in the first place (and the purpose of triage is to sort who should go where and when).

Also, most causes of abd pain (and chest pain, where I work) are not emergent -- bladder infections, constipation, STDs. (For chest pain, our most commen dx is bronchitis or atypical chest pain, Atypical chest pain moslty just means that the cardiac workup is negative, no cause of the chest pain was found). These patients can get bumped up to a level 2 or even a level 1 based on assessment findings (abnormal vs, abnormal assessment findings, abnormal labs, abnormal EKG -- and we do start labs/ekg in triage where I work). That is where assessment skills come in.

Thinking that everyone that c/o abd pain gets moved right to a stretcher in the back is very idealistic. It really is a nice thought, and it would really cut down on my headaches if it happened. Reality, however is the following: You have 36 people in the waiting room. 12 c/o chest pain, 12 c/o abd pain, (and the other 12 probably have a "spider bite" ). You have 16 rooms in the back, and can stretch it to 24 in a pinch (hall beds), which you have done tonight. Things are moving slow, because you are only staffed for 16 beds, even though you have an additional eight patients in the back. You can't get extra staff in to help move things along because no one will answer their phone. So, if everyone that c/o chest or abd pain should be brought straight to the back, where on earth do you put them, and who is going to take care of them?

Once again, I'm not trying to make excuses for the triage nurse. What I am trying to do, however, is to point out that it isn't so simple. It really surprises me how so many other nurses her are condeming the nurse that worked triage that night.

There wasn't all that much information in the articles that I have read, and the information that is there did not come from medical professionals. Much of the information came from her family, and they have a very unique perspective on the situation. Please, try to remember that there are at least two sides to every story. We have no idea how full the waiting room was, if the nurse was caught up in triage or had many people in front of her. We don't know what the patient load was like in the back, or how many ambulanes were rolling in. We don't know what kind of medical work-up had been done in previous visits. We don't even know what the patient told the nurse she spoke with. And actually, we don't even know that she spoke to a nurse.

As I've said before, I know that hospital has a horrid reputation. I've read many stories about its troubles that spacenurse has posted here. I wouldn't be all that surprised if everyone is right about the triage nurse being negligent and irresponsible. However, there are an awful lot of facts missing to pass that kind of judgement right now, and that bothers me.

[TazziRN]

The only thing I condemn her for is not re-triaging the pt but telling her to go home. BIG EMTALA violation!!! When you present to triage again, even if it's only been 5 minutes since discharge, you get another medical screening exam.