I was told the other day that it is a violation for the triage nurse to tell patients waiting in the lobby what the wait time is or how many people are ahead of them.
To give a brief overview of the triage process makes people feel like their problem is not serious and they get angry.
To tell them I don't know how long the wait is but we will get you back as soon as possible despite them having already waited for four hours makes them angry.
To tell them that there are 32 other people in the lobby and that they have been waiting for up to 4 1/2 hours makes them angry.
To tell them that there are three other people in the lobby and that they will have to wait for the next bed makes them angry still.
To tell them that the emergency room is not a doctors office and that we do not see people according to time again makes the patients upset.
To tell a legitimely Ill person I have no beds available and they will have to wait adds to the frustration.
Sometimes patients will tell me they have to be to work in 3 hours and cannot wait and that I need to do something now. Even if I could most of our ER visits average 4+ hours.
How do you answer this simple question appropriately and with compassion?
Before they come to the ER, that is fine, but once they sign in, the rules change. I asked about that same thing since there are some around here that do that also.
Basically the signs and online times can help them to decide which ER to go to, but once signed in, giving times could influence them to leave.
I disagree. What do they expect you to do when they ask a direct question about how long the wait us? Lie about it?
If they leave that is a choice. I e never heard of an ER being sued because a properly triaged patient decided to leave on their own. That has nothing to do with HIPAA at all.
Not a HIPPA violation, but possibly a JCAHO issue.
We just went through this in our ER. Basically we were told that giving a wait time influences peoples decision to stay or not. Anything you do or say that can be viewed as something to encourage them to leave is a no-no, and a long wait time is something that may make them decide to leave.
It is loose-loose situation.
Yikes. Sometimes when they threaten to go to the other hospital, I offer cab fare.
There is no way you can give an accurate time estimate, because it can change in an instant. I refuse to be pinned down personally. Giving an estimate might be against policy but it has nothing to do with HIPAA.
I always tell patients "due to the nature of the ER, I can't tell you how long your wait will be. We try to get patients back as quickly as possible, but just because you got here first does not mean you will be seen first. If someone sicker than you comes in, they will be taken back before you. If an ambulance comes in with a high acuity patient, they may be given the bed that we had designated for you. This does that mean that we are not taking your emergency seriously, it just means that we have a limited number of beds and have to give them to the sickest patients first." Boom, no violations and that spiel generally shuts the non-acute folks up.
I disagree. What do they expect you to do when they ask a direct question about how long the wait us? Lie about it?
For me it has nothing to do with HIPAA or EMTALA. If I tell someone a specific time or time frame, something may come up and the wait turns out to be way longer than what I said; then I may have a much more angry patient than if I didn't give them a specific timeframe.
I tell them..."there are not rooms at present. When there is space, we will get you back." This does lead to the famous "I was here before him, but they took him back first." At that point, I will very simply reply "here in the Emergency Department, the most critical cases go first." Some people don't like hearing that they are not "critical," but that is their problem. If people want/need to use the ED as a PCP, so be it...who am I to judge. However, I have no problem if one of these individuals has to wait while a "real" emergency is taken back.
Not a HIPPA violation for sure. You guys are making me chuckle with some of your HIPPA violation examples. It is an EMTALA violation perhaps if not done well. The goal of time estimates should always be in the spirit of helping patients with their wait times. From what I understand patients and families do better if they are given time estimates so I try but ask not to be held to it since things change so quickly.
Nalon1 RN/EMT-P, BSN, RN
766 Posts
Feel better?