Death after two-hour ER wait ruled homicide

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.

I think the main point being made here was (in my opinion) that a new grad does not have the experience, background in critical thinking etc. to be placed in a very busy triage setting. I have been doing ER nursing for 20+ years. I did not start as a new grad, but rather had about 3 years med-surg experience and was still somewhat overwhelmed at times. However, on the flip side of that coin, I have also seen new grads that had other medical experience such as ER tech, etc. that did quite well in the ER as a new grad. I believe that each nurse is a individual case and should be treated as such. However, I will never believe that a new grad should ever be placed in the triage area until she has had adequate experience in the ER setting itself. There are far too many "ER pearls of wisdom" that only come with experience. Too many subtle signs that an in-experienced nurse may not pick up on right away. My opinion only of course.

It's not just the medicaid pts that fill our ERs...It's everyone not knowing any better, or more likely, just not wanting to wait...It's the affluent to the homeless abusing the ER...

I have to add here that some of it is due to the doctor's offices themselves. For a while I did not have "good insurance." Before that, I had very good insurance. During that time, every time I called my primary care doctor for things that could have been seen through the clinic (sore throat, sinusitis, etc.), her nurse told me "Just go to the emergency room." This drove me nuts to no end. I told her I can wait for a day or two, or three, this is not something that warrants the ED. She said, "You have insurance, just go to the ER!." I should say that this nurse (maybe she was an MA) could have used a little education about who should and shouldn't go to the ED.

For a while, Medicaid pts in my state had to obtain permission from their PCP to go to the ED (during normal business hours). If they went to the ED on their own and were not admitted to the hospital, the PTS had to foot the entire ED bill. If something happened outside of business hours, they had to use the state's "Call a Nurse" line to obtain permission to go to the ED.

I don't know if that's the case anymore. I'm wondering if it cut down on those non-emergent complaints? I imagine it would if someone got a $600 bill for a pg test or hangnail.

1. So you are making your harsh criticisms on what you heard. Not what you can see and measure with your own eyes. How come the worst criticisms are always from young military medics who are in nursing schools. and think they know everything.

My question is where was the EKG on this patient. The national standard of care is that a patient having an MI have one within 15 mins of arrival. Hence at my facility even when full up and overflowing we have one done on every patient presenting with chest pain in the triage area if need be. I would find it extremely hard to believe that this patients EKG did not have changes consistent with MI or at the very least abnormal to the point of she would not of waited in triage long enough to move some BS pt out in to the hall.

So yes something criminal did take place. As to what I will not say as I dont know that hospital system or their protocols.

With out all the informatin ie the chart specifically its hard to know what the triage nurse was presented with or saw. But since a jury determined a gross deviation from standards I would bet something pretty glaring occurred.



Rj