A Headache is not an emergency

OrganizedChaos, LVN · Jun 19, 2016

I use to think that way but now that I have Medicaid & the walk in clinic in my town doesn't take it, what am I suppose to do? Drive 2 hours out of my way to a walk in clinic that takes Medicaid?

I went to the ER last night & was diagnosed with an ear infection. Are you telling me that I should've waited until Monday to see my PCP? I think we both know that, that's a bad idea. I don't have the money to pay out of pocket if I went to the walk in clinic.

I hope now you have a better understanding as to why some people use the ER that way. By the way, there was no one in the waiting room & it took me all of 30 minutes from waiting room to discharge.

Emergent, RN · Jun 19, 2016

Migraine sufferers need help right away. It's not a life threatening emergency, but their suffering is profound.

If a simple headache sufferer gets you this irrate, maybe another type of nursing would be more up your alley? You get a lot of clinic stuff in ERs. Either people are poor planners or they can't get appointments with PCPs. It is what it is, better not to let it bug you.

steffimiesha, ADN, RN · Jun 19, 2016

I've went to the er a handful of times for a migraine. It was the worse pain I've ever experienced in my life. My cousin went to er for a migraine. Turns out it was a brain aneurysm, so to you it may be a simple headache, but you don't know what that person is experiencing or feeling or that "headache" is actually something else.

lifelearningrn, BSN, RN · Jun 19, 2016

I think if it's "the worst headache of your life", or a severe migraine that OTC isn't touching, it is an emergency. If it's your average, Tylenol worthy headache, and you're just looking for free Tylenol, well, I would have to agree that's really not an emergency.

I feel bad for people who can't afford the urgent care co-pays, but the ER really isn't supposed to be primary care or walk-in care. I've personally always been one to wait out a cold or fever until I can get in to see my doctor.. but that's just me.

emtb2rn, BSN, RN, EMT-B · Jun 19, 2016

Me thinks troll. 1st post, kvetching about something er nurses know not to be the case. Meh.

Anna Flaxis, BSN, RN · Jun 19, 2016

A headache certainly can be an emergency, although I do agree that most of the time, it is not. But this is what the triage process is for - to use the tools at our disposal to determine whether we suspect an emergency condition exists and get that patient in front of a doctor sooner, or if it is less likely that an emergency condition exists and the patient can wait.

I went to the ER last night & was diagnosed with an ear infection. Are you telling me that I should've waited until Monday to see my PCP? I think we both know that, that's a bad idea.

Yes, assuming that you are not immune suppressed, you could have waited until Monday to see your PCP. Treating uncomplicated ear infections with antibiotics right away is no longer the standard of care, and a wait and see approach is reasonable. If, after 48 hours, there is no improvement or there is a worsening of symptoms, it would be reasonable to call your family doctor.

Migraine sufferers need help right away. It's not a life threatening emergency, but their suffering is profound.

As a person who suffers migraines and as an ED nurse, my opinion is that a person with chronic migraines should be under the care of a primary doctor who can prescribe medication for their condition, and they should try this before seeking further treatment. An Urgent Care clinic is capable of providing effective treatment for a migraine headache. While it's understandable that there may be issues with insurance or hours of operation that drive people who have migraine headaches to the ED, the ED should be the last resort. Unfortunately, many use it as a first resort, before they've explored other reasonable alternatives. I think, for some of us, that is where the frustration lies. It's like the person who has a PCP, who vomits one time and comes to the ED without even calling their doctor's office - calling your PCP and trying simple home care measures for the first 24-48 hours is appropriate for most simple and non-life threatening illnesses.

OrganizedChaos, LVN · Jun 19, 2016

Yes, assuming that you are not immune suppressed, you could have waited until Monday to see your PCP. Treating uncomplicated ear infections with antibiotics right away is no longer the standard of care, and a wait and see approach is reasonable. If, after 48 hours, there is no improvement or there is a worsening of symptoms, it would be reasonable to call your family doctor.

Then wait how long until I finally get seen? There aren't multiple doctors at my PCP. There is 1 NP or PA there so the next opening isn't for a little while. So no, I wouldn't be able to see my PCP on Monday.

Sorry not sorry I go to the ER because the walk in clinic doesn't take my insurance, I can't get to see a doctor or practitioner in a timely fashion & I don't want my issues to go unresolved until I can get seen.

mindofmidwifery, ADN · Jun 19, 2016

Then wait how long until I finally get seen? There aren't multiple doctors at my PCP. There is 1 NP or PA there so the next opening isn't for a little while. So no, I wouldn't be able to see my PCP on Monday.
Sorry not sorry I go to the ER because the walk in clinic doesn't take my insurance, I can't get to see a doctor or practitioner in a timely fashion & I don't want my issues to go unresolved until I can get seen.

Stating: "Are you telling me I should have waited until Monday to see my PCP?" Sounded as if you'd be able to see your PCP on Monday.

mindofmidwifery, ADN · Jun 19, 2016

In some cases, a headache ends up revealing a more serious, underlying issue. In many cases, it is someone who doesn't drink enough water or someone who suffers chronic headaches and should be seeing a specialist or working something out with their PCP. I suffer with occasional migraines, knowing myself and knowing that once I eat something, drink something, sleep and/or take a couple Ibuprofen, it will go away. A simple headache is one example something that can be frustrating to a healthcare worker as patients continue to check in to the ER and as higher acuity patients continue to wait for 4+ hours before they can be seen.

LadyFree28, BSN, LPN, RN · Jun 19, 2016

As a person who suffers migraines and as an ED nurse, my opinion is that a person with chronic migraines should be under the care of a primary doctor who can prescribe medication for their condition, and they should try this before seeking further treatment. An Urgent Care clinic is capable of providing effective treatment for a migraine headache. While it's understandable that there may be issues with insurance or hours of operation that drive people who have migraine headaches to the ED, the ED should be the last resort. Unfortunately, many use it as a first resort, before they've explored other reasonable alternatives. I think, for some of us, that is where the frustration lies. It's like the person who has a PCP, who vomits one time and comes to the ED without even calling their doctor's office - calling your PCP and trying simple home care measures for the first 24-48 hours is appropriate for most simple and non-life threatening illnesses.

As a complex migraine sufferer, the ED IS a last resort due to intractable vomiting; I go to a Neurologist that specializes in pain management because other neurologists and my PCP (changed her too) was NOT effective in giving me medications that were effective, and I had migraines since the age of 8...nothing on the market was doing the work needed up until the age of 32, around the time where urgent cares started popping up in my area-hard area to break in when there were TONS of hospitals, especially where PCPs are capitated to and if one needed to be admitted, the physician would be able to continue to be reimbursed for their services.

I know when a migraine occurs, will take my migraine meds with 400 mg Mortrin, 50 of Benadryl, Rantinidine, and make or buy Gatorade; if it doesn't work, I'm going to the ED and will meet my Neurologist there.

OrganizedChaos, LVN · Jun 19, 2016

Stating: "Are you telling me I should have waited until Monday to see my PCP?" Sounded as if you'd be able to see your PCP on Monday.

Sorry, bad wording on my part. That's what you get when you type after taking your medication.