Parade article about ER danger - page 2

This totally had me fuming. I think Parade will be hearing form a multitude of health care professionals. How about a article with information such as 1.) having a primary doctor. 2.) knowing the... Read More

  1. by   ortess1971
    Quote from BSNtobe2009
    This is probably going to be a very politically incorrect post, but when I go to the ER, I refuse to be seen by NP's or PA's.

    I made this decision years ago, when I accidently slashed my hand at home, and had to have 14 stitches. What I thought was the doctor, came in, took a look, and returned to sew me up.

    When I got the confirmation from the insurance company that paid, it was a female's name. (yeah, I know they both work under the supervision of a doctor)

    That is when I discovered you get charged the same for both. I figure if my insurance is paying for a doctor, I want to be seen by a doctor. A doctor shouldn't be able to collect the same fee for never walking into the room.

    I just want to note, it's not that I don't think that PA's or NP's are not qualified, that isn't even the reason, it's just that I just want to get what my insurance pays for. (or did, before I started back to school).
    Even worse, my hospital tried to have ER techs discharge people. So much for patient teaching about meds, conditions etc. I put my foot down and asked for a nurse and later complained to administration..That changed very quickly.
  2. by   rgroyer1RNBSN
    Quote from caroladybelle
    Has the lame brain that wrote this EVER worked in health care and do they even remotely have a clue as to what "attending physician" means?

    The vast majority of us may see the "attending physician" once a day if at all.

    "Attendings" in teaching facilities make rounds once per day, maybe twice. They are generally not in the hospital for most of the day (either home/asleep/clinic/office/teaching/research). The rest of the time your MD is an intern/resident/fellow. This is one of the perks of being an attending.

    In nonteaching facilities, your "attending" is generally your PCP, and 95% of the time, you are in the ER because you neglected to make an appt w/your "attending"/did not follow his or her instructions/ he or she fouled up or you need care beyond your "attendings" capacity. Rarily is your "attending" even at the ER nor are they likely to be come in for most of what presents there. Heck, they shouldn't even be woken up for most cases. And if you are in the ER in dire need, what you want is a specialist probably not your "attending".

    Not to mention, if you are healthy enough in the ER to ask for an attending, you are probably low on the priority list to be seen, period.


    Let them come to my er and do that Ill send in the intern, and no ems will not get you in faster because we triage ems pts. hahaha!:angryfire
  3. by   medsurgnurse
    Quote from ruby vee

    thanks for posting the link.

    there was a previous thread about this article, but it didn't post a link. from the notes in that thread, i was expecting something awful, but this article really wasn't that bad overall.

    i doubt that arriving by ambulance will get you seen faster, but it's better for someone to travel by ambulance if they're having a heart attack, stroke, or serious injury anyway. as i've pointed out to my parents many times, you can't do cpr and drive at the same time. call an ambulance. and it's not bad advice to ask the person in the white coat who they are -- but the reality of the situation is that you're rarely going to see an attending physician, and the article should have pointed that out.

    1) it's good advice to have a primary doctor, and know their name, how to spell it, and how to contact them. this information should be on a card in your wallet or in your address book in your purse.

    2) also on a card in your wallet: a list of your allergies and what type of reaction they cause. ("lasix makes me pee too much" or "benadryl makes me sleepy" are not allergies, and one should know the difference.) i make my husband carry a list of my allergies in his wallet, and i have a list of his.

    3) know your medications including correct spelling, dose, frequency, and why you're getting that med. it's not enough to tell me that you're taking viagra (wink, wink and sly grin to young female nurse.) don't let us assume that you're taking it to enhance your sexual function when you're really taking it for your end stage pulmonary disease. again, this should be on a card in your wallet. on another card, you're spouse's meds.

    4) know -- and communicate -- your medical history. some of this will be obvious from your list of medications, but if it's not, or your caregivers are inexperienced, it's helpful to spell it out. i need to know you had an mi in 1999 and a cabg in 2000. if you had a surgery, tell us. tell us what surgery you had, why you had it, when you had it, and where you had it. (i don't need to know that your cousin's husband's best friend drove you to the er, or that all 67 of your lodge buddies visited you after your surgery. save that sort of thing for when your kids visit.)

    5) and please tell us all of your symptoms. when my husband took me back to the er after my back surgery a few weeks ago, he told them i had a headache. he had forgotten to mention the discectomy i'd had a few hours ago (outpatient surgery), the projectile vomiting, or the fact that the headache was the reason i'd taken the percocet prescribed for post-op pain. the post op pain was nothing compared to the headache! it made the difference between a migraine work-up and lying flat for a week due to a dural tear. my husband should have known better, but he was frightened and upset.

    so while the article wasn't bad overall, i would have emphasized what you can do to improve your care -- and demanding to see an attending "if you're not comfortable" wasn't even on my list!
    ruby vee, that's entirely my point. why doesn't media print an article just like your reply. the tone of the article was condensending to healthcare professionals. it made it sound like you very life is in danger unless you stay on top of those darn healthcare people and make sure they do their job right. sounds like the pa may misdiagnose you. a lot of misdiagnosis can be attirbuted to inaccurate describtion of symptoms. anyone who has worked in er knows that the nurse asks very thorough questions regarding symptoms, onset, duration, specifics. doctor goes in and the symptoms have magically morphed into something completely different.
    the article did describe that er are overwhelmed. but it did not point why ers are overwhelmed, because they all full of people with non-emergent conditions. i want to see an article with "how to manage you health." with suggestions for healthy lifestyle and then suggestion about primary md know you history and meds just like ruby vee described. also, commom sense info about calling for an ambulance. you know they are a barrage of public service announcements about getting tested for hiv. how about of public service announcement about tkaing care of you health. know your: doctor, meds, history, allergies.
  4. by   medsurgnurse
    double posted??? don't know why.
    Last edit by medsurgnurse on Oct 30, '06
  5. by   medsurgnurse
    Quote from TazziRN
    Yeah, but in the next sentence it says to time your visits because mornings are quieter.

    I got ticked enough to write. The unfortunate incident involving the shunted child sounds misleading to me, it doesn't sound like the problem was with the ER, but with the on call surgeon.
    If you can plan your visit to the ER you night be a non-urgent.

    Gee, I'm sick I think I'll go to ER in the morning, but wait tomorrow is Monday morning its too busy I'll have to wait too long. I'll go Tuesday morning. Yeah that's what I'll do.

    Then you are not sick enough to go to the ER at all!
  6. by   CoeliaPhineas
    I am not sure if anyone noticed and wrote about this but
    the front cover of Parade pictured OR personnel. Not to mention
    the big ominous light with the staff peering down in a Halloweenish sort
    of fashion.

    :uhoh21:
    Coelia
    Just my two cents.
  7. by   BSNtobe2009
    Quote from ortess1971
    Even worse, my hospital tried to have ER techs discharge people. So much for patient teaching about meds, conditions etc. I put my foot down and asked for a nurse and later complained to administration..That changed very quickly.
    Oh jeez, how terrible! I have only been taken to the hospital once in my lifetime my ambulance. I collapsed at work due to exhaustion (after just a horrifying fully week of no sleep)...and I'll never forget the nurse walking in and keep in mind, my cognitive abilities had shut down and I could barely speak. She came in with a gown and said, "You don't need any help getting this on, right?" She barely waited for a response before she just rushed out of the room.

    I was like, ok, let's review, I wasn't well enough to come by car, I can't lift my arms and can barely speak, do ya THINK I might need some assistance?

    I just laid there until the doctor came. That really $%%#$ me off.
  8. by   mysticalwaters1
    Quote from BSNtobe2009
    This is probably going to be a very politically incorrect post, but when I go to the ER, I refuse to be seen by NP's or PA's.

    I made this decision years ago, when I accidently slashed my hand at home, and had to have 14 stitches. What I thought was the doctor, came in, took a look, and returned to sew me up.

    When I got the confirmation from the insurance company that paid, it was a female's name. (yeah, I know they both work under the supervision of a doctor)

    That is when I discovered you get charged the same for both. I figure if my insurance is paying for a doctor, I want to be seen by a doctor. A doctor shouldn't be able to collect the same fee for never walking into the room.

    I just want to note, it's not that I don't think that PA's or NP's are not qualified, that isn't even the reason, it's just that I just want to get what my insurance pays for. (or did, before I started back to school).
    Wow I didn't realize that! I wonder if that happens a lot. That's not fair. you can argue as you stated the primary md works over the others but if you are seen by NP and PA the insurance should cover it. I can't stand insurance and drug coverage garbage. It used to be cheaper to get generic forms of drugs. I remember not even liking that and NOW my pharmacy coverage has a list of in and out meds and equivilents of unapproved meds. Not a generic form another drug. I mean works similar but it is a different drug. I can't stand that. I was on birth control pills for cramping. Put on estrostep and yes newer and more expensive but man did this stuff work but an equivilent was trivora. Now estrostep $50/mth, trivora $5/mth and supposedly very similar. Of course for price I moved to trivora now my cramping came back not as much, heavier bleeding, skin breaking out. What the heck not fair. And my only other medicine is restatsis for dry eye after trying multitude of abx, gtts, ointment, patanol, warm compresses, punctal plug and this was the last resort. There's no equivelent for this med. It's not approved. I only have to pay 50% which is better than 100% but it's $132/mth so I pay a little over $50. I didn't have laser eye surgery, it's a chronic condition not going away. Maybe it's due to some people it works and some it doesn't. It's suppose to increase tear production but maybe i thought I read not definite. But what a pain :angryfire
  9. by   BSNtobe2009
    Quote from mysticalwaters1
    Wow I didn't realize that! I wonder if that happens a lot. That's not fair. you can argue as you stated the primary md works over the others but if you are seen by NP and PA the insurance should cover it. I can't stand insurance and drug coverage garbage. It used to be cheaper to get generic forms of drugs. I remember not even liking that and NOW my pharmacy coverage has a list of in and out meds and equivilents of unapproved meds. Not a generic form another drug. I mean works similar but it is a different drug. I can't stand that. I was on birth control pills for cramping. Put on estrostep and yes newer and more expensive but man did this stuff work but an equivilent was trivora. Now estrostep $50/mth, trivora $5/mth and supposedly very similar. Of course for price I moved to trivora now my cramping came back not as much, heavier bleeding, skin breaking out. What the heck not fair. And my only other medicine is restatsis for dry eye after trying multitude of abx, gtts, ointment, patanol, warm compresses, punctal plug and this was the last resort. There's no equivelent for this med. It's not approved. I only have to pay 50% which is better than 100% but it's $132/mth so I pay a little over $50. I didn't have laser eye surgery, it's a chronic condition not going away. Maybe it's due to some people it works and some it doesn't. It's suppose to increase tear production but maybe i thought I read not definite. But what a pain :angryfire
    I never remember the name of who treats me, it doesn't matter to me so I don't put it to memory. But if the insurance bill had come with a man's name on it, I never would have questioned it. I just assumed the guy who sewed up up was a doctor.

    In the end? Does it matter? Nope, but I just think a supervising ED, at minimum, should have to come into the room and examine the wound..I don't care if it was a paper cut, if they want to get paid on it.

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