Doctors Sue Washington State Over ER Limits - Page 3Register Today!
- Oct 2, '11 by rn/writerSeems like the biggest things that would help the ridiculous misuse (and outright abuse) of emergency departments is, a) really good triage care, and b) tort reform so that if someone does make a bad call in good faith the family won't end up winning a 20 million dollar lawsuit.
Another option might be to have an urgent care within the ED. Patient A with the chest pain that could be cardiac goes back to ED. Patient B with a headache (and no CVA s/s) goes to urgent care.
I'd also like to see some late night or round the clock urgent care places. Seems like they'd do a booming business.
- Oct 2, '11 by AltraQuote from ToriTheTerribleYou would not be turned down by the ER in Seattle. What might potentially be turned down by the state of Washington which administers Medicaid in that state ... is payment for your treatment.BTW, I have asthma and my albuterol and advair are no longer keeping the airway as open as well as I would like. (If I am breathing heavy while chatting on the phone with you, trust me, it isn't because I am hot and bothered!) If my asthma gets really bad before my next appointment and I have difficulty in breathing (translate to can barely breathe), that would be considered non emergent. I kinda like breathing, and I hope to stay out of the ER, but if my breathing becomes so difficult before I see my NP on Wednesday, I could be turned down by the ER in Seattle. Lucky for me I don't live in Washington.
No one will be turned away. EMTALA is still the law of the land.Last edit by Altra on Oct 2, '11
- Oct 2, '11 by kcmylornThe American culture is in a large need of patient education. This abuse of medicaid and medicare has been going on for YEARS. This all came about last winter when the Director of the health and Human services laid out the new standards of health care addressing primary care as the goal for care. We have been a nation focused on acute care. But this approach to be put into action is going to be alot of upfront cost- education of the public, getting the manpower to be able to do it and the facilites put into place to serve the communities needs. Public health is going to have to get on the bandwagon and start doing some community assessments to define these needs in each community. Nursing is going to play an even greater role than it ever has before- Patient teaching/ a total re education process/ a changing of a nation's culture. The manpower of nurses that will be needed for the DHS's plan, I don't think this country is prepared for. The community clinics are not going to be manned solely by unlicensed techs and an few NP's. These techs can not do the patient education peice. I hope I am not working in nursing the day they let un educated techs do patient teaching. Techs are not allowed to legally do triage- triage is only allowed to be done by an RN by state law. I do know that first hand- I do triage in a clinic. Then there are access problems- but again that goes back to manpower- if there are not enough providers( MD's, NP's PA's) The providers can only see so many patients. That is why the wait is so long. Alot of the burden will be also shifted to the Home health nurses, more so than it is now. Maybe the solution is 24 hr clinics w/wo an urgent care in a certain radius or district and from there pt's are triaged out to a centralized ED/hospital or treated at the clinic/urgent care. Sorry to say, but maybe it would be alot easier if the govenrment ran healthcare becuase this is sure one big chaotic mess.
- Oct 2, '11 by lrobinson5I find it awful that they wouldn't cover an emergency room visit for gallstones. They are SO painful... and what do we tell them? "Yeah it hurts a lot, but you should really only come in to the ER if you turn yellow." Very sad.
- Oct 3, '11 by linearthinkerQuote from Kooky KorkyOh come on. I didn't think I needed to spell it out for nurses. The "pregnancy" (if indeed there ever was one) is already over, and she isn't going to "bleed to death," she's going to get her period. The whole scenario is ridiculous enough, hyperbole is really unnecessary, lol.I guess I'm with you as long as the miscarrier doesn't bleed to death. How would she know, though, that she won't? Please forgive me for saying it, but you have a really horrible attitude. You are a knowledgeable nurse, the patient is not. She is terrified and what the bloody H she wants is to not die and not lose her baby. What if it's 95 days into the pregnancy? Or 96? Would it be ok with you for her to show up in the ER?
I think I disliked the ER when I worked it because I worked with nurses who sounded like you. Again, my apology for being frank. I do understand your frustration.
The point is, those kind of patients waste resources. There are worse examples of course. I loved the one that followed about the 5 year old crying in her sleep. <snort> Those patients should be seen if they present and want to be seen. Everyone deserves healthcare. They just need to pay (upfront) to be seen, that's all I'm saying.
Now class, repeat after me: 'PAYMENT IS DUE WHEN SERVICES ARE RENDERED'
Again: 'PAYMENT IS DUE WHEN SERVICES ARE RENDERED'
People can, and should be accountable to plan for their health care needs and that means paying for using (abusing) premium services (ED care) when it is unwarranted by the presenting complaint (getting your period when you don't want it, i.e. spontaneous abortion, or if your 5 year old has a bad dream).
- Oct 3, '11 by JDougRNI find it amazing that people don't make the connection- So for all of the people thinking this is a bad idea, let me fill you in on the "behind the scenes stuff." Medicaid patients abuse the system more than ANY segment of the population. Why? Because they CAN, without any consequence. Most people are smart enough to differentiate between a real emergency vs fluff. I pay into my insurance, and I have a co-pay to come to the ED. If I need to see my Doc, I make an appointment- but because I have to monetarily contribute (plus I have some common sense...) I use it with discretion. ONLY Medicaid patients show up (brought in via ambulance, BTW) for tooth ache, prescription refill, or stupid things like "My child woke up and threw up once, so I called 911." Now I ask you....If your child wakes up in the middle of the night and vomits....ONCE...with no abd. tenderness, no fever, no other sx. What are YOU going to do? Give them some gingerale and watch them. I just triaged a 10 yo who had too much b-day cake. The parents called 911. So our taxes just went to pay for a 1000.00 ambulance ride, and we just spent time/effort/energy/money on a kid who was just bloody FINE by the time they got to the ED.Plus, we get to pay for the cab ride home as well. Or how bout the guy who's CC was "I been doing crack for three days, and now I feel funny." Dude, if you can afford 3 days worth of crack, I shouldn't have to pay for your health care. Same with the ETOH patients- HOW is it that ya have money for booze and cigs, but I have to pay for your ride home. Or the chronic "back pain" issues, or the "I lost my Hydrocodone bottle....so I need another script." Honestly, I understand that it is difficult for these patients to find a Primary care MD....but isn't it their own fault? By that, I mean the multitude who have used the system for silly things, causing billions OF DOLLARS IN WASTE. iF THEY USED IT WITH SOME DISCRETION, OR COMMON SENSE, There would be more $. More $ available means better componsation for the MD= MORE MDs willing to take Medicaid pt's....WHAT A CONCEPT! Don't forget the ETOH/homeless people who KNOW if they call 911 c/o CP, EMS HAS to bring them to us, and we HAVE to treat them. OK, I believe healthcare should be available to everybody.But why aren't there any safeguards? We had one guy who fit this, went through HUNDREDS of thousands of dollars- would be here for 12 hours, get discharged, go buy 3 40 oz cans, drink them, and come back via EMS 2 hours later for some more CHEST PAIN. Really? I feel bad for those who are really unable to care for themselves, who need the help of society- that is just fine- I have a problem with those who CHOOSE not to support themselves, because we are stupid enough to do it for them. They are usually the ones who come in with the "I had a 3 minute nose bleed that stopped on it's own, but I still felt the need to call 911, even though I'm only 25, with no medical hx, and I'm JUST FINE now..." This is the type of garbage that runs up costs, and needs to stop. Chest pain should be evaluated. Gaul stones should be treated. An earache that you have had for the last 3 weeks is NOT an emergency.Whew......I feel better now
- Oct 3, '11 by pumpkinseedsQuote from woohHow bad is the ED abuse in Canada and England? Perhaps instead of calling single payer healthcare "socialism" we should learn from other countries...
From what I heard from my Candadian ER coworker, ER patients can and are routinely turned away, told that "you can see your PCP for this problem." That being said, I found a source (cbc.ca) that said wait times in one area of Quebec was about twenty hours long.
I dunno. Part of my dissatisfaction with working in the ER was dealing with these non-emergent patients I'd thought the ER was for, you know, emergencies.
- Oct 3, '11 by TrekfanQuote from rn/writerthat is a grate ideaseems like the biggest things that would help the ridiculous misuse (and outright abuse) of emergency departments is, a) really good triage care, and b) tort reform so that if someone does make a bad call in good faith the family won't end up winning a 20 million dollar lawsuit.
another option might be to have an urgent care within the ed. patient a with the chest pain that could be cardiac goes back to ed. patient b with a headache (and no cva s/s) goes to urgent care.
i'd also like to see some late night or round the clock urgent care places. seems like they'd do a booming business.
- Oct 3, '11 by TrekfanQuote from linearthinkeroh come on. i didn't think i needed to spell it out for nurses. the "pregnancy" (if indeed there ever was one) is already over, and she isn't going to "bleed to death," she's going to get her period. the whole scenario is ridiculous enough, hyperbole is really unnecessary, lol.
the point is, those kind of patients waste resources. there are worse examples of course. i loved the one that followed about the 5 year old crying in her sleep. <snort> those patients should be seen if they present and want to be seen. everyone deserves healthcare. they just need to pay (upfront) to be seen, that's all i'm saying.
now class, repeat after me: 'payment is due when services are rendered'
again: 'payment is due when services are rendered'
people can, and should be accountable to plan for their health care needs and that means paying for using (abusing) premium services (ed care) when it is unwarranted by the presenting complaint (getting your period when you don't want it, i.e. spontaneous abortion, or if your 5 year old has a bad dream).
sorry but i must jump in here yes people do use the system and i hate it as much as the rest of you ! my driver is the queen of using the system and trust me it @@@ me off because its my money too. but not evey one can pay upfront and yes i am using myself again as an example my paycheck on friday was $100.00 because of a lot of things i do plan ahead for healthcare
i a 2nd insurance plan . but i have had to go the er for meds a lot recently and each time i walk out with an rx that $25 or more and i then have to pay for a $45.00 cab ride home sometimes also a $45.00 cab ride there . there is no money left for a upfront $150 copay for er or an upfront $75.00 copay for urgent care . and remember i have 2 insurebces ..