Reducing misuse of Emergency Departments!

Specialties Emergency

Published

After reading much of the posts about ED Nursing, my first suggestion would be for people to stop inserting objects where they do not belong!.On a more serious note, i just read an article in the paper about a study completed which showed that 41% of parents undermedicate their children for fevers. the study examined Emergency room visits, and it determined that those visits could have been avoided had the children been dosed appropriately. What are your suggestions to reduce unecessary visits to the ER?

That's just really incredible that people think that if you are inconvenienced by waiting in the ED, that the staff is obligated to bring you a meal. Good grief! :rolleyes:

In my early 20's I had some problems that made several ED trips necessary. Before I left, I made sure that this wasn't an emergency because I KNEW that the hospital wait would be upwards of 5 hours. Not once in all those times I had to wait in ED was I offered any food. Not that I asked or even was expecting anything - even after waiting upwards of 15 hours for a room. I was sick and I figured that if I was well enough to be worried about my next meal, that I wasn't sick enough to go in.

I would have never thought of it until working in the ED on rotation. But the frequent fliers know all about it and how not to have to pay for thier stay so its just the next best thing to the "Hilton" for them.

I would have never thought of it until working in the ED on rotation. But the frequent fliers know all about it and how not to have to pay for thier stay so its just the next best thing to the "Hilton" for them.

hey...those FF are VERY smart...

they not only ask for their lunch tray before they are settled onto a cart...but they are asking for samples of meds and a cab voucher, too!!

for awhile my hospital made an arrangement with a local pharmacy to accept a voucher from the hospital. it was meant for families who were caught between no insurance and medicaid...or had fallen on unexpected bad times.i swear two weeks into it we had every ff in the county aasking us about our free meds!!

talk about networking!

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

One of my favorite FFs.

The guy that comes in, ALWAYS says "Gee i hope i don't have to stay the night", gets diagnosed with severe hypotension, and is Admitted. Did i mention that he brings a few days' worth of PJs and a shave kit in a duffle bag when he comes through the door. Hopes he doesn't have to stay the night? Yeah right.

(We think he's doubling up on his Ativan before he comes in, all labs and tests are normal, and his "hypotension" is mysteriously fine the next morning. And he's the only person i've seen who's visibly disappointed when his vitals are normal)

One of my favorite FFs.

The guy that comes in, ALWAYS says "Gee i hope i don't have to stay the night", gets diagnosed with severe hypotension, and is Admitted. Did i mention that he brings a few days' worth of PJs and a shave kit in a duffle bag when he comes through the door. Hopes he doesn't have to stay the night? Yeah right.

(We think he's doubling up on his Ativan before he comes in, all labs and tests are normal, and his "hypotension" is mysteriously fine the next morning. And he's the only person i've seen who's visibly disappointed when his vitals are normal)

Yea...

It's never good when they check in at the triage desk...suitcase in hand!!

:rotfl:

We all have good triage stories but jay levan has a point. I know I get very frustrated when the encoder goes off or I see all the people in my town check in. People need to be treated granted, I think what everyone is saying the system is abused. I also agree that our government is not doing anything to change that situation. Look at how well their dealing with the nursing shortage. On the other hand it's the PCP's that aren't doing their job. Example, we had a pt that did the right thing, he went to the after hours clinic for his c/o. They did some lab(which by the way shocked the heck out of me). The labs came back and they were totally screwed up. It read that his hemoglobin was 2. Now if this doctor had looked at the lab closely he would have realized that it was a contaminate specimen. No he sent him to the ER. We finally sent the man home after a 5 hr wait. I ask pt why they didn't they see their doctor for their complaint. Some people say "I didn't think about it" or "they told me to come here". People need to be educated! That's the big problem, because it's not happening. Just my thoughts.

Specializes in ER, ICU, L&D, OR.

when was the last time you called s MDs office

you get the answering machine saying they are closed or too busy to come to the phone and that if your really feeling bad either call back or go to the ER

I hate answering machines

:clown: i think i may have the solution for this one *says in a sarcastic voice*

every town has frequent fliers and er abusers...and every town has a walmart, or wm wishing to build in their area. wm stores sell so much already such as automotive stuff, do oil & tire changes on cars, have gas stations, groceries, and then some. how about every time wm wants to build a new store, they're required to build and staff a walmart er dept.

just think.. people could have near syncopal episodes, be taken to the side of the building to the "walmart emergency department," and they wouldn't need to worry about packing a suitcase of clothing, toiletries and other personal items, there's a food place like a mcdonalds usually, there's a pharmacy and/or otc stuff like tylenol, motrin, etc for the untreated fevers, bandaids for those papercuts, creams for rashes, and even an automated blood pressure machine. the public could become educated and have resources for items :rolleyes:

I liked the one the other night where a 6 foot 4 inch male came by ambulance after dropping the toilet seat on his external genitalia . I never asked him how he accomplished that.

I wouldn't have been able to resist asking him how he did manage such an accomplishment, but then again, I have a rather twisted sense of humor. :p

:clown: i think i may have the solution for this one *says in a sarcastic voice*

every town has frequent fliers and er abusers...and every town has a walmart, or wm wishing to build in their area. wm stores sell so much already such as automotive stuff, do oil & tire changes on cars, have gas stations, groceries, and then some. how about every time wm wants to build a new store, they're required to build and staff a walmart er dept.

just think.. people could have near syncopal episodes, be taken to the side of the building to the "walmart emergency department," and they wouldn't need to worry about packing a suitcase of clothing, toiletries and other personal items, there's a food place like a mcdonalds usually, there's a pharmacy and/or otc stuff like tylenol, motrin, etc for the untreated fevers, bandaids for those papercuts, creams for rashes, and even an automated blood pressure machine. the public could become educated and have resources for items :rolleyes:

continuing in sarcastic tone: they already have eye docs, why not ff docs? just pass out the vicodin along with your contact lens refills, and you're good to go! then you can get a soft-serve ice cream cone as a um, 'reward' for your um, ordeal!

this could be a million dollar idea for yet another doc-in-the-box! :uhoh3:

This could be a million dollar idea for yet another doc-in-the-box!

Yes and no..... the issue with "doc-in-the-box"es is they usually require payment up front.. where people can go to the ER and get services for "free":angryfire

Specializes in Emergency/Critical Care Transport.

Another nurse and I were talking the other day and decided that this might curb ED abuse.

1. Remove all creature comforts from the waiting area. No snack/soda machines. Replace with chairs with a long metal bench bolted to the floor. You know the kind you see in central booking at a police station. No TV. No AC/Heat in the waiting area. The clerks would be comfortable behind their bullet proof glass enclosures.

2 On the bare concrete walls post the following rules that would be adhered to 100%

A. This is an Emergency Medical Facility. It is not a resturant or hotel.

B. You will see a nurse or physician when we deem it is necessary for you to see one.

C. Sickest people will be taken first. We decide who is sickest. There is no appeal process.

D. You may not eat, or drink until the physician has authorized this. You will not be given food or drink unless it is medically necessary.

E. You may not make or recieve personal phone calls.

F. You may not have visitors.

G. The nursing staff will not inform every single member of your family including distant cousins of your status every five minutes.

H. What the doctor has prescribed you for pain is what you will be given, there is no negotation on this point.

I. We do not issue work/school excuses.

Thank you for choosing Suburban Hospital for all your health care needs.

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