Did You Know?
allnurses is the largest community for nurses on the web. We now have over 388,094 members! Join today to network with other nurses, laugh, share, and much more.
| No. 100 | 
Sep 21, 2006, 11:18 AM
 Re: Death after two-hour ER wait ruled homicide
geez..........I work 12 hours tomorrow and I see by my schedule that I am the only "regular staff" person on. I will have to be charge. Do I take the triage assignment if no one else can? Do I take charge and take the "code room" assignment? Yuck. After reading about this, I don't know if I want to triage ever again. Triage is only OK if we are not busy. I actually LIKE triage if I can triage and place in bed, triage and place in bed, etc..... I HATE triage when the waits stack up and people are staring daggers at me in the waiting room (like that will help).
off the subject, we have recently been told that "diversion is out of the question". I suspect it is in relation to a news article that I recently read that states the average ER loses $1100 per hour for every hour on diversion.
I wonder how many nurses you could hire for $1100 per hour???????????
 | | Advertisement Sponsored Links | | | | No. 101 |
Sep 21, 2006, 01:53 PM
Re: Death after two-hour ER wait ruled homicide
An EKG for chest pain is mandatory within 15 minutes to our facility. I would've done one in triage if necessary. We've also got a really busy ER and I do alot of triage. I've made beds for patients in places that don't even exist for the doctors, but better safe than sorry. Now I know there are patients that know just "what to say" to get back to be seen, but that's where your critical thinking comes in. If something's not quite right about the situation, if your gut tells you something, follow it. Who cares if the doc comes out there and fusses at you? We had an interesting case a couple of weeks ago. 38 yr old hispanic male comes in around 0245 with a complaint of chest pain that was pretty much resolved by the time he was in the triage chair. Fortunately, we had a bed available, sent him straight back to a room. EKG showed NSR, IV started, labs drawn. Radiology was in his room doing a portable CXR when he grabbed his chest and slumped over. He was in Vfib, we shocked him, got back a sinus rhythm, went back into V-fib, shocked again, amiodorone given, shocked again. sinus rhythm. EKG showed massive ST elevation. Shipped him to another hospital for a cath, he had a complete LAD!!!! Oh, did I mention he had had a negative stress test that day in his cardiologist's office??? Wild!!!! It's all possible!! Whenever the hair stands up on the back of your neck in triage??? Make a bed!!
| | No. 102 |
Sep 21, 2006, 02:20 PM
Re: Death after two-hour ER wait ruled homicide
As a 12 year ED nurse, I agree with you on a couple of points. The patient should have called 911 and many patients do deny their problem. I also think there's more to this story, and we are only getting the media version. Unless I read the chart, interview the staff involved and get all the answers, I can't pass judgement on another ED. As an ED educator, I know what's right, and I know what's possible or impossible to do. In the state of CT, we have the largest increase in ED volume and my facility is expanding. There are many days when we have literally no wall space left to put anyone even in the hall. Let's not totally judge the hospital or the triage nurse unless we know all the facts involved. It's an impossible situation out there..... Negligent....perhaps. Criminal......absolutely not.
| | No. 103 |
Sep 21, 2006, 02:20 PM
Re: Death after two-hour ER wait ruled homicide
The criminal issures here are all the sore throats and belly aches that take up precious time and rooms in the ER because that's where their FREE access card covers them 100% coverage. People who come in and demand we give them Tylenol because they can't "afford" to buy it, but they can afford that $5.00 pack of cigarettes in their pockets
| | No. 104 |
Sep 21, 2006, 02:28 PM
Re: Death after two-hour ER wait ruled homicide Originally Posted by clee1 This is going to happen more and more in the coming years.... until the ptb and the medical establishment get the guts to say "No, Mr./Mrs. Whinybutt. Your sinus infection is NOT an emergency - call your PCP in the morning. Oh, you don't have a PCP? Find one.... in the morning. Good bye."
Also, the rash of Un/under-insured people using the ER as a PCP HAS to stop - like right now!
It is unconscionable that people with emergent conditions like MI, SOB, or even a serious lac requiring sutures have to wait for hours for treatment because our ER's are crammed full of the slightly sick, chronically lame, or the insufferably lazy. Oops! I almost forgot: the severe LBP x 3 months that HAS to have some IV narcs RIGHT NOW!
Gimme a break. 
I am so with you and could add another 1000 lame excuses for misuse of the ED....but EMTALA says we turn no one away. If we had the ability to tell the obvious they're not an emergency problem and sent people away to take responsibility for themselves, our chest pains wouldn't have to sit for 2 minutes!! God forbid anyone takes care of themselves these days..run to the ED!!!!!!
| | No. 105 |
Sep 21, 2006, 02:30 PM
Re: Death after two-hour ER wait ruled homicide Originally Posted by ERTRAVELER The criminal issures here are all the sore throats and belly aches that take up precious time and rooms in the ER because that's where their FREE access card covers them 100% coverage. People who come in and demand we give them Tylenol because they can't "afford" to buy it, but they can afford that $5.00 pack of cigarettes in their pockets
ABSOLUTELY RIGHT!!!!!!!!!
| | No. 107 |
Sep 22, 2006, 05:48 AM
Re: Death after two-hour ER wait ruled homicide Originally Posted by lizz Last semester our teacher really hammered on this point during our ER lecture ... that people need to go to doctor's offices, urgent care, etc. instead for minor ailments.
Nevertheless, while I'm doing my ER rotation ... there's one of our nursing students bringing her kid into the ER for a minor ear infection. I was stunned ... did she listen to the lecture at all?
She's a nursing student ... and she should know better. It just goes to show how bad it is. People will continue to abuse the ER as long as you let them. 
I don't know all the circumstances of your story but an ear infection can be quite painful. Also primary md offices are overloaded as well. I agree ED is for emergencies but if you can't get treatment for an ear infection what are you going to do? I had a cyst on my back, became huge size of a tennis ball, hurt so much and was draining but needed to be cut out, cultured and stitched up. I went to PMD, got my hmo referal to the dermatologist, took week see dermatologist only to be scheduled it for removal in THREE WEEKS after that!!!!!!!! I almost started crying infront of the receptionist when she told me. I couldn't sleep on my back, stained bunch sheets and clothes despite continually putting on bandages to my back. Had to WORK like that. But I did it b/c that's how I thought it should go. NO it should not take that long. We only have one dermatologist in our entire area. Now I'm working in the ER and I'm like wow should've just came here probably fixed faster. So some cases have to come just based on the failure of other systems ex other pmd and specialty offices. And what about Ortho coverage for ED. Been a big joke, ortho refusing to do it. It is such a mess. Now I'm sure people just come to Ed without considering pmd and that should not be but the way the health system is right now sometimes you do have to go to the ED to take care of things. Now, those people then should definitely wait for less emergent cases. We have a huge issue b/c some mds like to cram in minor cases to increase number meanwhile more critical maybe not cp but definitely more critical are waiting longer. So our management wants to implement if there are more critical waiting then minor emergenices to select 1/2 the minor section for the fast track cases and then the other for those acute make it a subacute to get them in. Now some mds don't like this then there's staff issues. But that is what should be done but with staff and equipment dynamics mixed with overload pts it's just so difficult.
| | No. 108 |
Sep 22, 2006, 05:53 AM
Updated
Sep 22, 2006 at 05:57 AM by Sheri257
Re: Death after two-hour ER wait ruled homicide Originally Posted by mysticalwaters1 I don't know all the circumstances of your story but an ear infection can be quite painful. Also primary md offices are overloaded as well. I agree ED is for emergencies but if you can't get treatment for an ear infection what are you going to do?
First, I saw the kid ... and he was fine. He wasn't crying in pain or anything like that. Second, there are at least three urgent care facilities she could have gone to. I've personally been to them and you can get seen right away, especially if you show up first thing in the morning.
I can assure you that she didn't need to take her kid to the ER. | | No. 109 |
Sep 22, 2006, 05:58 AM
Re: Death after two-hour ER wait ruled homicide Originally Posted by ERTRAVELER The criminal issures here are all the sore throats and belly aches that take up precious time and rooms in the ER because that's where their FREE access card covers them 100% coverage. People who come in and demand we give them Tylenol because they can't "afford" to buy it, but they can afford that $5.00 pack of cigarettes in their pockets
They also seem to have plenty of money for booze as well ...  |
| 366 members
2,835 guests 3,201
| 1 | | | 11 | | | 2 | | | 9 | | | 17 | | | 11 | | | 14 | | | 16 | | | 37 | | | 14 | | | 20 | | | 23 | | | 19 | | | 24 | | | 10 | |
|
Nursing News