Does your LTC get mad when you send patients do the ER? - page 2

At the nursing meetings, we are told to always try to keep the skilled care medicare patient at the LTC by suggesting to the doctor that he order lab work, antibiotics etc etc etc instead of sending... Read More

  1. by   BrandonLPN
    Right, I didn't mean emergencies.
  2. by   chrisrn24
    I would see nothing wrong with suggesting to a doc "well you know we can XYZ here" such as "you know dr. we can do IV antibiotics here if that is what you want." But if you're doing it out of pure financial motive that is terrible.
  3. by   al586
    I have experienced this unfortunate situation all too often in my short time as a nurse in LTC. Docs appear to believe that LTC facilities have the same resources as a hospital...on-site labs and pharmacies, access to necessary equipment, etc. Unfortunately, that is not reality. "Stat" labs can take hours, and essential equipment can be impossible to procure. With this in mind, I will transfer a patient to the ER in a heartbeat if I believe they will receive better care there than I am able to provide at my facility. Reimbursement worries are the problem of administration, patient worries are mine. I may get in trouble, but if the patient receives what they need, that is what matters.
  4. by   dream'n
    Company money situations should not figure into the nursing care we provide for our patients. I would and have in the past while working LTC, let these types of management edicts go in one ear and out the other. Do not be bullied by administrators. They are looking at the financial bottom line, you are looking at the patient. Provide the most appropriate, competent care to your patients. Think of it this way; if something happens do you want to say to the DON or the BON you did the best you could in your judgement for a patient by sending them to the hospital, or would you rather say that you were trying to save the facility some money by keeping a patient in-house against your clinical judgement?
    It is not unethical though to suggest to the Dr. that the patient be treated at your facility IF the patient's clinical status warrants AND the Dr. is informed about how long it may take for Xray, labs, etc.

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