Educating patients on ER use

[anh06005]

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.

[jadelpn, LPN, EMT-B]

My insurance it is a $25 co-pay for urgent care, $100 for the ER.....but then you get into if you need labs/x-rays and the like it falls under one's deductible, much like an MD visit. So people do go to the ER knowing that for that $100 it is all inclusive.

People who have had outpatient MRI's or CT scans already scheduled will come to the ER--as then it is one's co-pay and not out of pocket expenses. (which can be as high as 1500-2000 or more).

Then there's the Friday night/Sat am crowd who suddenly happen to have a UTI/strep throat/need stitches whatever--and the Urgent Care is closed crowd...or RX refills, a dose of their RX.....and pharmacies are closed.

Most policies in most hospitals are such that if anyone for any reason presents to the ED, they need to be seen. Period.

[brillohead, ADN, RN]

Most policies in most hospitals are such that if anyone for any reason presents to the ED, they need to be seen. Period.

Or rather, it's the LAW in ALL hospitals that accept Medicare (which is all but a very select few in the country) -- see EMTALA.

[h=1]Emergency Medical Treatment & Labor Act (EMTALA)[/h]

In 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay. Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented.

[bradons]

I give up educating patients on proper Er use. No point in wasting my breath.

I do however get stern and quiet "pissed" off when we have an actual emergency and the abusers of the department keep asking how long the wait is.

[AtLeastMyDogLovesMe]

As long as what defines "Emergency" is up to the individual to determine, the ED will see everything and anything that is so very clearly NOT an emergency. But just try explaining THAT to the person who has no Tylenol at home and has a headache NOW. But it's a REALLY REALLY BAD headache. Like maybe a brain tumor. That's an emergency, isn't it? A possible brain tumor?? OF COURSE he has to go to the ED, are you MAD, ignoring a potentially life-threatening illness?!

Sigh.

I know this is an old post but your point is something I bang my head about at work every day. People think "emergency" is subjective to their situation and don't understand that its our job to determine who needs help first, if at all. "My pain is more important than that guys" is the mentality.

I once had a guy of seemingly sound mind tell me that he just went down playing soccer with his daughter without ANY contact. He came in with a knee brace and crutches from prior injury. He told me that he bypassed ortho and came straight to the ER so he could get X-Rays and MRI's all in one shot. I told him he did it backwards and that if he had an orthopedist willing to see him without a referral that is the route he should have went because ordering MRIs in the ER isn't a standard practice unless the situation is emergent. He replied, "I can't walk. How is this not an emergency?" It was very hard for me to not say, "Bro your leg ain't gonna fall off. That would be an emergency."

[applesxoranges, BSN, RN]

My general policy is to say something along the lines of "I cannot guarantee a treatment. A provider will assess you and determine a treatment plan in the ER." If they ask for MRIs I say that I have very rarely seen an MRI ordered and that I cannot guarantee that they will get an MRI today.

[db2xs]

It was very hard for me to not say, "Bro your leg ain't gonna fall off. That would be an emergency."

I would have said something to that effect but not so bluntly. I would have told him about how triage works and how priority is given to people who are having breathing issues, heart issues, bleeding issues, and anything else that involves imminent death and permanent damage. People need to be educated on these things.

[brillohead, ADN, RN]