A Clinical Observation Question

[nursenat1]

I was observing a few weeks ago in the ER and began to wonder if all ER's are the same. Keep in mind this was during the middle of the day (not really a busy time). I noticed that when the patients were attimited to the ER they would stay for maybe an hour, long enough to have a CT, MRI, X-ray, or whatever test(s) they needed done given some pain meds and then discharged. I thought this was kind of pointless. The nurses were only concerned with the problem the patient was attimited for, they did not assess the patient to see if another problem was present. I was just wondering if all hospital ER's are this way or this is an unusal occurence.

Thanks

[APinkston]

Hi! I am a second year nursing student and I had an opportunity to observe in the ER last semester. Because the hospital was fairly small and another hospital was located near it, the ER was not busy at all. So, patients would come in for infections (esp. UTIs), and proper care for cuts from accidents. In these cases, the nurses did the same thing you described, and the patients were sent home. However, I did get to observe nursing care for diabetic patients who were hyperglycemic, which was a little more exciting. I don't think that every ER is like what you and I experienced. It probably depends on where the hospital is located for the degree of trauma seen, and the type of conditions that the patients have (a common infection, or something more serious like signs of an MI) for the degree of assessment, diagnostic tests, and treatment. I plan on getting to observe the ER in another hospital this semester so maybe it will be a better experience for me.

[BrandyBSN]

That is actually one of the reasons that I like the ER so much!

Im a fourth year nursing student, graduating in May, and I plan to go straight into the ER.

ER is just for Chief Complaints, and emergent care. if a patient needs a full workup past their Chief Problem, they should go to their doctor, not the ER. Patients misusing the ER for routine illness is one of the main factors that attributes to high healthcare costs. Tests and procedures cost more in the ER than any other department because managment can not always schedule and predict what a patient will need, requiring a wider variety of professionals, and more people on call. If I am assessing a broken foot, I am not focusing on their bowel and bladder habits, just on their chief problem, being the foot. In the ER, you must be very problem oriented. Things are fast paced, and just because things may be slow now, you cant assume that they will be that way 5 minutes from now. ER is supposed to be used for problems that can not wait until tomorrow to be assessed, not for a whole body physical. Its just not time, or cost effective.

It must be more problem oriented. If further evaluation is warranted, then it does happen :)