Title says most of it, but here is some more detail:
I work in the urgent care department of an outpatient facility. We make up the rapid response team of the building, but sometimes clinics will call our department and tell us they're sending a patient rather than paging an overhead RRT.
Here's the question:
Is it appropriate and within scope of practice for us to tell another healthcare provider (such as LPN, physical therapy, occupational therapy, clinic RN, etc) to call 911?
I have done so before for patients I've seen as being in their best interest to skip the urgent care experience and go directly to an ER (for example, chest pain with SOB, BGLs >600, syncopal patients, etc). We were just told it's outside of our scope of practice to do so and all such calls should be referred to one of our physicians to decide if 911 should be called or if they should be brought to our department.
I checked my state's scope of practice and it mentions helping outside of course or place of work, such as accident scenes, but nothing about this kind of situation specifically.
Also, clinics can and are encouraged to call 911 in addition to RRTs. So there isn't a rule about clinics not calling 911.
For what it's worth, all of the nurses in our department are ACLS certified and start IVs, do EKGs, give meds, etc. as well. We transfer people to local ERs daily.
Specializes in Outpatient Cardiology, CVRU, Intermediate.
As PP have said, this sounds more like a "capture all the patients for $$" situation to me. This "policy" sounds very unsafe. If the RN who "didn't call 911," when it clearly was indicated for a non-UC-appropriate situation, was linked to a poor outcome, I could see this rolling downhill to a terrible outcome for both the patient and that RN.
I'd work to get things streamlined and policies changed, or start looking for a safer environment to work in.
bitter_betsy, BSN
456 Posts
Is it an EMTALA thing where the doc has to see the pt before they leave in an ambulance or risk EMTALA fines?