Educating patients on ER use

Nurses Education

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Parents might need to think twice before bringing their child to the E.R.

A hospital in my state is the topic of this article about using the ER and when it might not be the best option. There are family members points of view in the article and many comments as well that make me realize some people just don't get it (true reasons for an ER visit).

How can we do a better job at educating patients and families on emergency vs non emergency?

Does your doctor have a paging system for after hours? Do many know about it?

Just wondering what some of you more experienced people have to say. I'm not meaning to start any arguments but ideas on how I can help my patients understand.

Specializes in Transitional Nursing.

I think what would stop all this craziness is some kind of protection for Doctors where they can't be sued for the simplest of things......

They tell Patients to go to the ER if it gets worse, because if they don't, and the 1 patient who has acute appendicitis and doesn't go to the ER (because they're an idiot) can come back and sue because no one told him to go...... That'd be a good start.

Ok, I'm sorry, i'm all fired up for some reason.

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But you're making an excellent point.

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Specializes in OR, Nursing Professional Development.

This is part of the problem with our inefficient health care system combined with the desire for instant gratification. People expect their health care issues to be resolved this instant with some sort of magic pill at the least amount of cost (to them- they don't care about the system). So, instead of using urgent care centers (where available) or waiting for an available appointment with their PCP (if they even bother to have one), they clog up the emergency system. It's wrong in that the ERs cover their butts by running every test imaginable, people get away with not paying their bills, and people with true emergencies potentially suffer because the resources dedicated to emergency services are tied up with non emergencies. The system needs to be fixed.

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Specializes in Transitional Nursing.

I would so fully support a system where non-emergencies could be turned away. I"m talking hangnail, cold sore, pregnancy test etc. It is absolutely insane that these people get seen and take up time, energy and resources that could be spent on someone who really needs them.

Here's a nail file/blistex/ept. Have a nice day!

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PCPs are part of the problem. Too many send any patient with the slightest hint of illness to the ER, even if you call during office hours. As nurses, we have a good idea of what is truly an emergency. For most nonmedical people, if their doctor tells them to go to the ER, they go.

I agree. The times I've had to go to an ED, I was sent there by either an urgent care or PCP, and each time it was a CYA type of deal. I definitely could have been treated outside a hospital.

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Specializes in Transitional Nursing.

I shouldn't be so, so rash though because I do LOVE my ER, they take me seriously and helped get my hubby on the road to recovery....

We had a PCP who didn't take my husbands stomach pain seriously enough, and we wound up in the ER because he had blood in his stool. (Paranoid freak of a Wife......yes hi, thats Me)

After an abdominal CT W/WO and several hours of anxiety, we figured out it was colitis of some kind.

Took him over 4 years to get a dx, and if it weren't for that fabulous ER doc who was willing to do the testing, we may have waited even longer......They still don't know for sure if its Crohns or UC.

Had he been referred to a GI to begin with, we never would have been there.

Had I known then what I know now, I'd have made the appointment myself.

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Specializes in Med/Surg, Academics.
I work in an ER. A lot of times we will ask patients why didn't you go see your PCP and more often than not their response is "my PCP told me just to come here". The second most popular response is "they told me they couldn't get me in for 2-3 weeks!" So we end up with a lot of minor sniffles. Our ED does have a more Urgent care type area but that area and the main ED become blurred when we are really busy. The major hospital system in our area promises "same day appts" but that doesn't mean with your PCP or even in your community. I tried this system once when I didn't have a PCP and the only appt they could offer was 45+ minutes away! For those who rely on public transportation that's not going to help them, so they end up in the ED. This week we were super busy and a 2-3 hour wait all of a sudden made people decide maybe they really didn't need to see the doc :)

Part of the problem is no triage at the PCPs office. I had a UTI, and I wanted to go to the doctor's office, but they couldn't get me in for 2-3 weeks. My UTI was already getting worse (advanced from frequent urination to pelvic pressure), and I knew it needed to be treated before those little buggers climbed to my kidneys. They told me to go to the ER, and I went reluctantly. (These days, I would have gone to a minute clinic and paid out of pocket because I have the means, and I am loathe to contribute to unnecessary healthcare costs.) PCPs should be held accountable for triaging their patients for non-emergency ED visits.

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Specializes in Med/Surg, Academics.
Our insurance charges a $125 co-pay if we're not admitted. If we are, they pay 100%.

My co-pay for my UTI ED visit was $200. My office co-pay is $25 for me, $50 for the kids at the peds. I'm with an HMO, so if they want to waste money on their capitation, I don't know how to convince them otherwise.

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Specializes in Mental Health, Gerontology, Palliative.
I think every hospital with an emergency department should have an urgent care area and an emergency area, and patients triaged into one or the other. I don't know why more don't do that. Urgent care need not be a separate facility, I think.

Thats standard in all public hospitals here.

We also have Urgent care after hours clinics which can be pricey which is why people end up in ED

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Specializes in Mental Health, Gerontology, Palliative.
Our insurance charges a $125 co-pay if we're not admitted. If we are, they pay 100%.

I was admitted recently via ED via urgent care with septicemia and a L axilliary access. After a 6 day stay which included TDS IV ABs and surgery, it cost me a grand total of $14.00 for the discharge script for antibiotics. There may possibly be an additional $85 for the ambulance however wont pay more than $100 for the entire six day stay.

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Specializes in Transitional Nursing.
I was admitted recently via ED via urgent care with septicemia and a L axilliary access. After a 6 day stay which included TDS IV ABs and surgery, it cost me a grand total of $14.00 for the discharge script for antibiotics. There may possibly be an additional $85 for the ambulance however wont pay more than $100 for the entire six day stay.

What a rip off!

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Specializes in critical care, ER,ICU, CVSURG, CCU.

my ins, charges $300.00 copay, if not admitted.......otherwise pays 80-100% re admission.....

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