sending clients to ER from MH/MR facility

  1. Hello Everyone,
    I would really appreciate your input esp., ER nurses. Here's the dilema: I work in long term care facility for profoundly mentally retarded people, most of theses clinets are generally healthy. Some of them are on 02 and feeding tubes but that is the extent. Now these clients in particular are prone to aspiration,viral pneumonia, and gtube problems, etc. I work the 3rd shift with an RN. I am a new lpn. Anyone with any little change esp. in the "sicker" clients (ex. low PO2, ant temp over 100. and without waiting to see if the med helps) and this one RN believes "when in doubt send them out". Well the hospital staff I hear is getting tired of getting our clients that can other wise be observed and cared for until it is a true emergency, which I cannot blame them. I on the other hand believe unless they really need sent these clients risk picking up an infection in the hospital..and also not to mention the hospital is understaffed and the Er costs( sorry for being so practical) but what the hell do I know huh?, I am just an LPN with very little experience. So please if any Er nurses could define when a client should be sent out would be great and I hopefully help to make a difference. I will print and take these responses to work. Thanks so much.
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    Joined: Sep '01; Posts: 83; Likes: 9


  3. by   Sleepyeyes
    When I worked LTC, I sent anyone out who needed treatment or labs that we could not give in a timely manner.

    For instance, our turnaround for a stat lab draw was over 24 hours (best case scenario ). A hospital's is about 2 hours. If someone looked like they were anemic and needed blood, or had to have a sputum culture or a chest x ray asap --whatever, we sent them out.

    Some of the ER nurses might have disagreed with that decision, as a lot of our folks were DNR's, but we always called their families or POA's before we sent and asked, "Do you want this treated?" In some cases, the family would insist on sending them out. Since the ER doesn't always get the whole story, they shouldn't try to judge you like that.

    And because you are the one responsible for your patients, you shouldn't let "what the ER will think" affect your decision.