woman dies in ER waiting room (article) - page 2

the first few paragraphs, click link for rest of story (too long to cut/paste) interesting. says she was in for abd pain 3x in 3 days,but never what they did for her test wise, or what they... Read More

  1. by   EmerNurse
    Quote from Myxel67
    How could anyone let a woman lie on the floor in pain like that. ER nurses can do it because they are extremely judgmental and they think they know it all and are always right.
    Umm.. scuse me?
  2. by   Soup Turtle
    Quote from Myxel67

    T. Soup--how can you lay the blame for this at the feet of ER patients. This woman needed care, and apparently never got any kind of diagnostic workup. They gave the woman instructions to come back if pain worsened. She did, and they totally ignored her. Not even so much as a temp or BP check.
    I don't blame the ER patients, but I don't think the staff takes things as seriously as they should at times because there are so many "fakers" out there.

    My husband was an emergency room patient for a similar reason and waited, writhing in pain, for over 7 hours before he decided to leave to "die at home". I don't know how he managed to get up and get to the car and I really thought he was dying. His colon had ruptured, but luckily somehow fused with his urinary bladder. He was very lucky.

    Anyway, we had no insurance and were at a county hospital. There were several people lying on the floor, moaning and putting on what might or might not have been a good "show". I also saw several people get loud and demanding although their emergencies didn't seem too serious.

    So no, I don't blame the patients, but I can see how this could happen. I'm not saying I think it should have happened, though...
  3. by   MrChicagoRN
    Quote from multicollinarity
    I'd like to see equal attention given to the police officers who were arresting a woman who couldn't even sit in a wheel chair and was screaming in pain. She died while the cops were trying to get her into their car. Can you imagine dying that way?
    LEOs are not doctors.

    They frequently see citizens who are agitated & histrionic.

    The police normally wouldn't remove an apparently distressed patient from the ER unless someone on the staff indicated she was ok to go & they weren't going to treat her.
  4. by   Multicollinearity
    Quote from MrChicagoRN
    LEOs are not doctors.

    They frequently see citizens who are agitated & histrionic.

    The police normally wouldn't remove an apparently distressed patient from the ER unless someone on the staff indicated she was ok to go & they weren't going to treat her.
    Well, I disagree about the cops' actions.
  5. by   Soup Turtle
    Quote from MrChicagoRN
    LEOs are not doctors.

    They frequently see citizens who are agitated & histrionic.

    The police normally wouldn't remove an apparently distressed patient from the ER unless someone on the staff indicated she was ok to go & they weren't going to treat her.
    I agree. The cops can't be held responsible, IMO.
  6. by   Myxel67
    i realize the "c.r.a.p. score" is "satire" and is an attempt at humor. people often reveal their true feelings through humor such as this, however.

    the c.r.a.p. score
    permalink
    a fellow nurse brought this in the ed where i work and i thought it was cute.

    the c.r.a.p. score by d. slow p., md

    crap=(ops+af)(sc)(ec)

    ops=old pain score
    af=adjustment factor
    sc=story credibility
    ec=exam credibility

    situation: we are supposed to documents our patients' pain on a 10 point scale in order to objectify if and make sure we address it and provide timely and appropriate analgesia

    observation: there sure seems to be a lot a variability in the way people measure their pain. it's enough to make you want to throw the whole pain scale away. we all know it's true. some people not only verbalize their pain more effectively, they also seem to experience it more effectively. these patients may come to the er once a month with "10 out of 10 pain". they also seem to require more work notes. it seems that what was meant to be an objective scale, couldn't be more subjective.

    assessment: if the pain scale is to survive-and i'm by no means suggesting that it should-but if it is, i'm sorry to say we may have to find a way to adapt it to each individual patient. we used to think that "mild, moderate, or severe" was adequate, but now we know better, a ten point scale is quite superior. but, is it good enough? if you want to practice cutting edge medicine, get ready for yet one more complexity.

    plan: i propose that a formula be developed to enhance the functioning of the current pain scale so that each patient can be treated as an individual. the canadian relativity adjusted pain, or crap for short, will be calculated as noted above.

    the key value here is the adjustment factor. for "lpt" patients (low pain threshold" this will be calculated as follows: for every point over 10, which the patient reports, subtract one. if they say their pain is a "12" then subtract 2 points and start with an 8. for every visit the patient has had to your er in the past 12 months for a painful condition that was either chronic or went undiagnosed, subtract 1 point. if you push on a non-painful or uninjured area of the patient's body, the shin for example, and they say "ouch", subtract 1 point. for every allergy to a non-narcotic medication that could be effective for their condition, subtract 1 point. if they are wearing sunglasses, subtract 1 points. if they still have tape or ekg lead residue on their body from a prior hospital visit, subtract 2 points. for "hpt" patients (high pain threshold" you will be adding numbers to their pain score. if a spouse fo family member forced them to come in, add 1 point. if you check their records, and every time they've come to your er for a painful condition something was torn, broken, ischemic, or perforated, add 2 points. if they have no allergies add 1 point. if they are tachycardic or hypertensive and 1 point.

    here is an example. a young man presents to your er for his 7th visit this year for a migraine headache and reports his pain as "12" on a 10 point scale. he is allergic to reglan, imitrex, toradol, prednisone and tylenol. he also has been to the er 5 other times in the past year for back pain or abdominal pain, all times sent home with normal studies. when you enter the room he is yelling at someone on his cell phone and eathing cheetos, but tells you, "this is a bad one doc." on exam his vs are normal and his abdomen and back are both tender. "i didn't even notice they were hurting," he says. his crap score sould be (10-6-2-5-5-1)(0.5)(1) which would be negative 4.5, but since his number is negative, you decide to leave out the credibility conversion for a score of negative 9. you tell him that pain medications are not indicated for his headache because his crap score in negative 9 and he can go home whenever he is ready.
    hollysunshine
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    04-23-2007, 02:45 pm #2 user profile scizzerin vbmenu_register("postmenu_2171576", true);
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    re: the c.r.a.p. score
    permalink
    te he he!!!!
    if only......

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    04-23-2007, 04:28 pm #3 user profile ivanna_nurse vbmenu_register("postmenu_2171700", true);
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    re: the c.r.a.p. score
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    ooooohhhh.. this is goood!!
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    04-23-2007, 06:23 pm #4 user profile ann rn vbmenu_register("postmenu_2171890", true);
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    re: the c.r.a.p. score
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    oh, yeah!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!


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    04-23-2007, 06:37 pm #5 user profile chip193 vbmenu_register("postmenu_2171923", true);
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    re: the c.r.a.p. score
    permalink
    this is really, really good.

    i wonder how long it will be until someone comes on here and tells us that the patient’s pain is always real, no one would ever seek drug, and that we’re just burned out. then, as punishment for even reading this from the op (because we should have know just by the title, don’t you know!) we should immediately turn in our nursing licenses, be prepared to be struck down by god herself – florence nightingale, and be forever thrust into the wilderness (like ems!) forever.

    ready to be shot with that lightening!

    chip

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    04-23-2007, 06:43 pm
  7. by   chuck1234
    Rest in peace Ms. Edith Isabel Rodriquez, you were not the first to encounter this; and certainly will not be the last one. I hope God is taking good care of you right now.
    I am so sorry that you have to go through this. I am also sorry that your kids have to go through this.
    Last edit by chuck1234 on May 21, '07
  8. by   brycenemmy
    Wow. That is awful. Its too bad.
  9. by   MistiroseRN
    I pray I will never become hardened to a patients pain. I have had it drilled into my head pain it what the patient says it is. I hope to always remember this.
  10. by   brycenemmy
    Quote from mistirose
    I pray I will never become hardened to a patients pain. I have had it drilled into my head pain it what the patient says it is. I hope to always remember this.

    You are absolutely right! and I hope that I dont harden to a patients pain either.
  11. by   canoehead
    Here's a link to the ER thread.

    https://allnurses.com/forums/f18/sac...se-224869.html

    I want to point out that my posts may offend many, but I wrote them in all honesty. Let's talk to each other, and avoid a flamefest.
  12. by   pepperann35
    Quote from reesern63
    Since you weren't there and were not privy to all the facts, you should not be passing judgement
    Well, I certainly don't see how they could just let her lay there in front of all the other patients, rolling around on the floor....no, not right, whether they believed her or not, how could that happen?:angryfire And. yes. the ER nurses at our hospital often have this attitude and once yelled at me when I was trying to give report on a patient we were sending them from our LTC facility. She was having extreme abdominal pain and had a history of panceatitis. She said, "Well, it's 1:30 in the morning! How long has she been in pain!!!!!" Well, excuse me, I thought, I will try to schedule my patients pain at a more convenient time for you! She arrived at the ER with her husband and they would not even let them in saying they were on by-pass right at that very moment. The hospital is accross the street from us. She went to another hospital and was admittted right away with acute pancreatitis.
  13. by   angel337
    there is too much missing information in this article. where i work we will triage a frequent flier 20x's if we have to. its the law and it's also an EMTALA violation if everything they say happened is correct. i have worked in substandard treatment hospitals before as agency and i won't go back because the morale is so low and you feel like your license is on the line everyday. this will be a huge lawsuit. if i were the ED nurse working in that triage, i would prepare for a career change.

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