ER visits

That Guy, BSN, RN, EMT-B · Oct 11, 2017

Welcome to the wonderful world of the primary care...er I mean Emergency Room.

I think you nailed it with the medicaid, urgent care costs money. Coming there is free.

Ruby Vee, BSN · Oct 11, 2017

Right now I am in school for nursing and I am doing my preceptorship in an Emergency Department. I've noticed that lots of people come in for non emergent things, like a stubbed toe or vomiting one time, things like this. I'm wondering why these people aren't going to quick care, is this coming from being uninformed about what is an emergent situation or is insurance covering these trips? Maybe it has something to do with medicaid? I'm curious why the ER is the first place people are thinking to come for these things. I've had one ER visit in my whole life and a nurse told me that she knows someone who has had at least 70 ER visits in 6 months! That is crazy to me!

Many years ago, I noticed that there were a lot of ER visits at 2am on a Friday or Saturday night for non-emergent problems. Back pain that had been unchanged for a year, a child's single episode of vomiting after ingesting seven corn dogs, etc. My very wise friend told me that the bars close at 2 am (in that city) and home was probably an unsafe place for a woman to be when her abusive mate came home drunk and in a foul temper. There aren't many SAFE places to go when you need to be out of your home at 2am, hence the ER visits.

In colder climates, the homeless folk are looking for a warm, safe place to be.

And yes, insurance issues. And drama is another reason. A relative heads off to the ER claiming chest pain whenever she isn't getting the attention she thinks she deserves from the family.

Guest219794 · Oct 11, 2017

Right now I am in school for nursing and I am doing my preceptorship in an Emergency Department. I've noticed that lots of people come in for non emergent things, like a stubbed toe or vomiting one time, things like this. I'm wondering why these people aren't going to quick care, is this coming from being uninformed about what is an emergent situation or is insurance covering these trips? Maybe it has something to do with medicaid? I'm curious why the ER is the first place people are thinking to come for these things. I've had one ER visit in my whole life and a nurse told me that she knows someone who has had at least 70 ER visits in 6 months! That is crazy to me!

2 issues:

For the most part, decision making is very similar to how you might make a decision. Given a range of choices, you would pick the least expensive and the most convenient. For most of the folks you are talking about, the ER is free. Whether it is from their insurance, or the fact that they simply don't pay, they get world class care for free.

As far as convenience- well hard to beat our hours.

Perfectly reasonable decision from that perspective.

The next question is why people seek help of any kind for certain issues. For example- my son crashed his bicycle, and I just wanted him checked out. The kid has a few scrapes, all his limbs move. This type of assessment used to be a part of parenting. But, a certain number of folks are unable to deal with things that you or I might find simple. And, it's free.

adventure_rn, MSN, NP · Oct 18, 2017

Ironically, those patients often end up feeling even more miserable because they have to sit in the waiting room for hours on end (since they're lowest acuity) and then there's literally nothing that can be done for them. If I had back pain, the last thing I'd want is to sit in a waiting room for 4 hours, then lay on an uncomfortable gurney under bright lights for another several hours just to be told that I should take some asprin. Unfortunately, you can't actually tell patients that because of EMTALA laws (the federal regulations which ensure that all people coming into the ED receive treatment regardless of insurance or ability to pay). There's definitely room for improvement in the system.

KelRN215, BSN, RN · Oct 18, 2017

The root of the problem is that many primary care offices don't accept Medicaid.

Someone I went to high school with who, no doubt in my mind, is on Medicaid used to regularly post on facebook about being in the ER for things like a toothache.