Death after two-hour ER wait ruled homicide

Should this nurse be charged and found guilty of murder, you can bet this ER RN will no longer do triage. Here's the realty folks! We have to see everyone that presents to the ER, regardless of ability to pay, regardless of the complaint and even if that person is not an emergency. IT IS NOT!, the nurses fault that a patient died of natural causes (An MI is a natural cause). Also, the patient was only 49 yo. Besides hereditary causes, I'll bet you her life style wasn't the most conducive for good health!! Granted a reasonable and prudent nurse would have obtained an ECG w/i 15 minutes of that pt's arrival. Now, comes the good part, an ER I use to work in had an average daily census of 300+ pt's in 24 hrs...now they are over 400+/day. So, naturally I can see how these types of errors occur. I had to have active CVA pt wait out at triage because, we would of had to treat her on the floor. 47% of the ER's in the USA are on the verge of finanacial collapse, due to the fact ppl think health care is free. That nurse's doctor's ancillary staff don't need to get paid so they can live. 97% of ppl that don't pay their medical bills, simply don't want to. 3% are actual chairty. The hospital I discussed earlier, use to waive $3,000,000/month in charity. That was in 2000, God know's what it is now. There is actaully a nursing shortage occuring, and we have to do more with less. What was this nurse's training? Was the ER manager reasonable and prudent in hiring this nurse? Was the nurse fresh out of school? You get my point, there are so many factors that play into the fact that ppl die in ER waiting rooms...sorry but since the government, insurance companies, and drug companies, have totally ruined our healthcare system we will have to endure. OH and lets not forget, it's time for ppl/pt's to be responsible for their own health, when they are given d/c instructions, they need to follow up with the referred MD, take their meds as Rx, change lifestyle habits towards preventative medicine/good health. This could set a precedent, where if ANYONE!!! makes a mistake they could be held accountable, arrested and sued. Also, I think if this person is convicted, one will see a mass exodus of ER nurses....then what?

triage should be manned per pa/np who can sort through and give certain meds.
You said the above - but the fact is that no one even a PA/NP can give a med (except aspirin / Ntg / tylenol) etc until the pt is assessed and esp a possible MI; EKG and cardiac enzymes are done. And in the Ed where I work we just don't have enough beds to bring people back to a room, when our waiting area is overwhelmed: No matter who is working in triage. We are lucky to have Part-time PA/NP's to help the overwhelmed MD in the ER much less have one in triage!!! Our ER does have nursing standing orders for RN's to start IV's and get labs and x-rays - and that does get things moving and ready for the pt - but we still are limited on what we can do.

There is no way that many hospitals could function if triage had to be staffed with PAs/NPs, particularly in rural areas.

That is a horrible thing to happen but what are you going to do when you have 150 waiting to see the doctor and 3 doctors. You can only stack so many people in the hallway. If people would quit using the ER as there primary caregiver or for drug seeking the waiting time wouldn't be 2-8 hrs for real emergancies. I'm sure we all know people who visit the ER multiply times a year for crap...Maybe this should be a crime. The triage nurse made an assessment, she didn't feed this women cheeseburgers and cigarettes. She shouldn't be (or even be threatened) with a murder charge.

The thing that I find really wrong in all this is that they decided it was homicide. Homicide is implicitly a willful act of murder. This coroner's jury has decided that the ER staff made a conscious decision to murder this woman and I can just about guarantee you that it's not the case. Malpractice and negligence I could see. Murder I find ridiculous, even idiotic. What happened to this woman is tragic, but inevitable. It had to happen eventually and it will happen again.

We have a system that has too many opposing imperatives to function as it was designed. What's surprising is that it doesn't happen more often. Events like these become lightning rods for righteous indignation based on ignorance of what really goes on in an emergency department. I feel very sorry for everyone involved in this case because they have a long and hard row to hoe. I'm also very grateful that I wasn't involved in it. There's nothing like having your professional practice disected under a microscope by people who have no real idea what you go through every day.

Just my two cents,
Joe

so, where were the daughters then if they were so concerned?

ER Triage Nurse to Walmart Greeter....how unfortunate

First the "disclaimer"...
I've been a nurse for 29 yrs. and have worked everywhere except OR/OB. Only been pulled to those areas. Worked ER for some time and now am ICU charge. I'm licensed in several states and traveled for a time. Also did a stent in supervision.

Now the comment....
With the presenting s/s this pt. shouldn't have been sent back to the waiting room. What info, if any, did the daughter give the staff when she went back to them to ask how much longer til her mother could be seen? Was Mom deteriorating....SOB, sweating, increased pain, related pain/numbness, etc.? This info could have made a difference, but lay people just don't always know this. All too often they are just clueless. Many of you have voiced very vallid c/o's & concerns about ER nursing and nursing in many areas, but I've also heard criticisms of the pt's. life style with no knowledge of same. I have a friend who leads a relatively healthy lifestyle, no smoking, rarely drinks and has had two heart attacks before the age of 55. She's also never had an abnormal EKG at the time of her attacks. Apparently she inherited her father's lousy heart genes instead of her mother's lousy kidney genes. It's not unheard of to move a "junk" pt. out of a room (and temporarily back to the waiting room) to put a sick one in the bed.
IMHO, with the limited knowledge I have, the staff is negligent. Many localities have a charge of negligent homicide. No, the homicide wasn't intentional, but it happened because of someone's negligence. This is truely a sad event for all involved and I'm sure really scary for the staff. I would be terrified. The fact is none of us know enough details to make an informed decision. It will be interesting to follow this.
I think there shouldn't be the first jury allowed to convene for malpractice cases or something like this without a staff peer on the jury. The "experts" are great and do a good job, but all to often in my opinion, are way too removed from the daily functioning of nursing areas.
Mick

There should be a way to educate the general public, a series of news articles or something in every area, that teaches aspects of health care. One of the things that could be taught is the real use of the ER and what things should be seen at nonurgent care facilities.

Education of the public is needed that is for sure. One reader was right in that non medical people really do not know what is an emergency and what is not. It had to be a horrid experience for the patient's daughter and the one's working ER that day. We have almost all looked back on situations and wondered if we missed something or could have done something differently.

I was floating to a "sister" hospital. The charge nurse asked me to, "Get to ER STAT, I'll be responsible for your patients!"
There were two bad accidents with several trauma patients ages pediatric to geriatric. Not being a trauma nurse I assisted with an intubation, started IVs ("Only an 18"), took and recorded vitals and such tasks. The triage nurse came in and I was asked to, "Go to the front and triage."
I had to refuse because I'm not competent. This was so recent I'd been following this thread. An ER nurse who just graduated last summer did triage for about an hour and a half. She is neither trained nor experienced for triage. Thankfully I don't think there was any harm that night.
I wrote an incident report and letter to the manager. ER staffing was less than usual to start.