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Calling Report to ER from Urgent Care

Nurses   (1,825 Views 30 Comments)
by misdetermined misdetermined (New Member) New Member

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Im wondering for all the ER nurses out there, what do you expect to hear know when getting report from an urgent care center when referring a patient. Sometimes i get put on hold for extended periods of time or the nurse seems too busy to receive report or i get drilled for a whole health history when I only just met a patient a few minutes ago. I know you ER nurse are busy, but when I call to give a heads up, I am doing this as a courtesy or at least I think I am. My facility does not have a mandatory policy to call the ER when providers are referring patients over to ER. When I call I usually provide:

Name

DOB

Complaint

Pertinent history

Results of abnormal labs

Any meds given

Mode of travel

This takes about 2 mins tops. What else should I add? Just want to make sure that Im giving the best and most efficient report. TIA :)

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74 Likes; 4,821 Visitors; 370 Posts

Ideally our charge nurses take report on any patient being sent to us, I don't decide who is going to take a patient until I get the call from EMS or they arrive, the ED is far too dynamic for me to routinely mark off a room for an unknown amount of time for a transfer. That being said any of our nurses who are allowed to take EMS radio/phone reports can get a sending facility report. There is no reason to be on hold for an extended period of time.

As far as what I want to know varies just like any other ED patient. Report for a amputation should only take 30 seconds or so; a critical or complex patient will require a much more detailed report (similar to what a ICU/PICU nurse will be expecting from me).

If you have an established nursing relationship with a patient you are required to give a nurse to nurse report on a transfer, it is not a courtesy.

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1,123 Likes; 7 Followers; 21,287 Visitors; 2,691 Posts

Your report looks good - with the understanding that "pertinent history" could vary widely depending on the case. Don't worry about others' bad attitudes. If you're being drilled, state "I'm sorry but this is all the information I have" or "we didn't address that" or "the visit didn't get into that information at all." If you're put on hold for much more than the time it takes for someone else to pick up the call, hang up, call back and state you can't wait on hold but would like to leave a call-back number.

Agree w/ Peak re courtesy. I hope you are treated with courtesy, but courtesy (or an employer's policy) itself isn't the reason we are doing any of this. We're all ideally giving and receiving reports because that is what's in the patient's best interest.

:)

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blondy2061h has 9 years experience as a MSN, RN and works as a Nurse, duh!.

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I would add what, if any, IV access was established to your list along with what specifically prompted the ER transfer if it is not immediately evident from the presenting complaint

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114 Likes; 16,508 Visitors; 1,489 Posts

All I "need" is the info that might affect my decision making. What room, etc....

I used quotes because if they are coming on their own, they are not critical. If they are coming by EMS, they will call.

Your report looks fine. If somebody wants detailed and irrelevant history, they don't know what they are doing.

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psu_213 has 6 years experience.

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If you have an established nursing relationship with a patient you are required to give a nurse to nurse report on a transfer, it is not a courtesy.

As far as I know, there is no legal requirement for an UC to give an ED report on a pt they are sending over. I know I have gotten plenty of pt's from an UC without report (of they call after the pt has been in the ED for over an hour).

To the OP, your report sounds good. Make it short and sweet--I just want a heads up, not a full change-of-shift ICU report.

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114 Likes; 16,508 Visitors; 1,489 Posts

Ideally our charge nurses take report on any patient being sent to us, I don't decide who is going to take a patient until I get the call from EMS or they arrive, the ED is far too dynamic for me to routinely mark off a room for an unknown amount of time for a transfer. That being said any of our nurses who are allowed to take EMS radio/phone reports can get a sending facility report. There is no reason to be on hold for an extended period of time.

As far as what I want to know varies just like any other ED patient. Report for a amputation should only take 30 seconds or so; a critical or complex patient will require a much more detailed report (similar to what a ICU/PICU nurse will be expecting from me).

If you have an established nursing relationship with a patient you are required to give a nurse to nurse report on a transfer, it is not a courtesy.

A patient being referred to an ER may, or may not be a transfer.

But, even if it is a transfer, are you sure that nurse to nurse is a requirement? Maybe a facility rule, but is it required by EMTALA?

7. What is an appropriate transfer?

An "appropriate transfer" (a transfer before stabilization which is legal under EMTALA) is one in which all of the following occur:

  • The patient has been treated at the transferring hospital, and stabilized as far as possible within the limits of its capabilities;
  • The patient needs treatment at the receiving facility, and the medical risks of transferring him are outweighed by the medical benefits of the transfer;
  • the weighing process as described above is certified in writing by a physician;
  • the receiving hospital has been contacted and agrees to accept the transfer, and has the facilities to provide the necessary treatment to him; No mention of nurse to nurse.
  • the patient is accompanied by copies of his medical records from the transferring hospital;
  • the transfer is effected with the use of qualified personnel and transportation equipment, as required by the circumstances, including the use of necessary and medically appropriate life support measures during the transfer.

While I agree it is best practice, I don't think it is a law or regulation.

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52 Likes; 3,470 Visitors; 232 Posts

When I worked in SAR we were supposed to call and give report to the ER whenever we had to send a patient out. After the like 20th time of feeling like the nurse on the other end of the line wasn't even listening and was just "uh huh" "okay" "mmhmm" while doodling on paper, I stopped bothering. Half the time when I called to follow up on my patient the nurse would be "Oh, well, we did C, D, E and G" as I am going "Umm, but I sent them there for A and B! what happen to A and B!?". It became more of a hassle than it was worth. I started just asking the EMTs if they were gonna call in and give report or if they would like me to. About nine out of ten times they would, so I let them.

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That Guy has 6 years experience and works as a RN.

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Why they came to you, why are they coming to me, anything you guys did. Other than that I will ask it all myself anyways. Keep it short, sweet and simple.

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1,123 Likes; 7 Followers; 21,287 Visitors; 2,691 Posts

A patient being referred to an ER may, or may not be a transfer.

But, even if it is a transfer, are you sure that nurse to nurse is a requirement? Maybe a facility rule, but is it required by EMTALA?

7. What is an appropriate transfer?

An "appropriate transfer" (a transfer before stabilization which is legal under EMTALA) is one in which all of the following occur:

  • The patient has been treated at the transferring hospital, and stabilized as far as possible within the limits of its capabilities;
  • The patient needs treatment at the receiving facility, and the medical risks of transferring him are outweighed by the medical benefits of the transfer;
  • the weighing process as described above is certified in writing by a physician;
  • the receiving hospital has been contacted and agrees to accept the transfer, and has the facilities to provide the necessary treatment to him; No mention of nurse to nurse.
  • the patient is accompanied by copies of his medical records from the transferring hospital;
  • the transfer is effected with the use of qualified personnel and transportation equipment, as required by the circumstances, including the use of necessary and medically appropriate life support measures during the transfer.

While I agree it is best practice, I don't think it is a law or regulation.

The sending facility may not be obligated by EMTALA at all.

But there's a court case from within the past couple of years where it was ruled that hospital-owned UCs do have some EMTALA obligations.

Edited by JKL33

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MunoRN has 10 years experience and works as a Critical Care.

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While they go by various names in their marketing, walk-in clinics / freestanding ERs / urgent care are all just considered clinics in terms of regulation. Freestanding ER's that are part of an acute care facility but off-site are regulated as ERs, and EMTALA would apply as ongoing acute care is established by that ER, but many if not most places that describe themselves as "free-standing ERs" are just outpatient clinics as far as regulations are concerned. Outpatient clinics don't initiate ongoing acute care that would trigger the rules of patient transfer and transfer-of-care requirements that would necessitate a nurse-to-nurse (or other receiving-licensed-staff handoff).

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DowntheRiver has 5 years experience and works as a Registered Nurse.

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I worked for a huge Urgent Care that was not affiliated with any hospital and I encountered this A LOT. Literally there was a hospital across the street but people did not want to go to it. We would have chest pain, head injuries, digit amputations, and all the like come to us when they should have been across the street. Our policy was to call 911, give report to the medic, and then call the report to the ER because it was my Urgent Care's policy. I would always call report to the ER and ask to speak to the charge, however you could tell they did not care or have the time for it. I would be met with "uhh huhh, yep, mmhmm." I would just get a name and document who I spoke to in the chart. I always gave a thorough report to the medic with a face sheet that included SBAR, allergies, and medicines.

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