Anna Flaxis, ASN 20,808 Views
Joined Oct 15, '10.
Posts: 2,822 (67% Liked)
A headache certainly can be an emergency, although I do agree that most of the time, it is not. But this is what the triage process is for - to use the tools at our disposal to determine whether we suspect an emergency condition exists and get that patient in front of a doctor sooner, or if it is less likely that an emergency condition exists and the patient can wait.
I went to the ER last night & was diagnosed with an ear infection. Are you telling me that I should've waited until Monday to see my PCP? I think we both know that, that's a bad idea.
Migraine sufferers need help right away. It's not a life threatening emergency, but their suffering is profound.
Well I guess since I have had the throat/ear pain for awhile & was prescribed an antibiotic, the doctor felt differently.
Perhaps you would like to educate me. I would like to benefit from your insights and experience in this matter.
I will agree the ED is a unique environment but only to the point that it can, as is the case here, lead to very poor practices that do not contribute to the well being of a non-violent, willing person who is seeking help because they are contemplating ending their life. Never mind the traumatic experience, or distress, and anxiety this will leave them with.
If a person verbally agrees not to harm themselves until they get a chance to talk with a therapist, there is very little risks (assuming a good preliminary assessment is done), to allow them to remain as is. They are, after, willing. You keep an eye on them until the psychological evaluation is done. That isn't to say that a combative or overly aggressive person might not require higher safety measures. A distinction must be made. Cookie-cutter solution here is not adequate, let alone acceptable.
Yep, we use "suicide contracts", both written and verbal in my high school often.
ED RNs, do you utilize this?
I was just curious how others handled this type of situation.
^^ Ugh, Ambien comes to mind...
This is unacceptable and needs to stop now. This type of behavior undermines the primary nurse, reinforces attempts to split staff, and can result in medication errors or other mistakes because the nurse who is trying to "help" does not know the patient.
The first step is for you to talk to this nurse face to face. Tell her that you appreciate her willingness to help, but that in the future, she needs to check in with you first. If speaking with her does not result in the desired change in behavior, then take it up the food chain to the charge nurse next time it happens, at the time that it happens. If the episode is repeated again, then take it to your manager in the form of a formal, written complaint documenting each episode using objective language and leaving any emotion out of of it.
It's one thing to help one another as part of working as a team, and this is appropriate behavior. It's an entirely different thing to insert oneself into a situation without knowledge of the patient situation and without checking in with the primary nurse first to see if they even want/need assistance.
CSnyder823, a ruptured eardrum isn't an emergency. But, I can understand how a person might not know that, and think something seriously wrong is happening, and be scared, and go to the ED. I'm guessing the doctor was being kind to you and didn't want to make you feel badly or stupid. Regardless of whether a person comes to the ED for something that can wait to be handled by their PCP, there is no reason to be unkind. :-)
Having said this, ED overcrowding is a serious issue. There are all kinds of ramifications from putting a strain on resources, increasing costs, and the safety of those truly emergently ill who are stuck waiting for a bed that is being occupied by someone who is not emergently ill. The reason so many EDs have "Fast Track" areas is for the sole purpose of off-loading stable patients with minor complaints off of the main ED where you have people actually trying to die.
I have had a patient with a minor complaint that could have waited for an office visit with their family doctor come out of the room to complain about the wait, while the doctor was in another room trying to resuscitate a baby. And yet, I was still kind and professional toward the person.
But back to the original topic, again I will state that most of the time, a headache is not an emergency; however, it could be. This is why we have the triage process.
Here is a good article that I think sums up the situation from an ED staff member's point of view nicely:
ER misuse in our instant gratification society
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