legal issues in the ER

[nyangel]

What are possible legal implications related to emergency care? I'm a nursing student and I spent the day in the emergency room. The nurses there told me mainly that they were -- no discrimination (everyone is treated regardless if homeless or whatever), if it's a DNR pt (not to code), and that the hospital gets sued alot for IVs (causing phlebitis). I have to hand in a focus sheet and this is one of the questions. I was wondering if there was anything else. ------------Thank you

[l.rae]

well that is a loaded question...my take is that one of the more vulnerable legal aspects of emergency care is centered around the initial triage. This is where the determination is made of how emergent the situation is for the patient...situations can be very deceiving and require quick accurate decisions....sometimes several pts demanding treatment or even requiring treatment emergently....split second decisions have to be made sometimes......does that help?........LR

[pointhope]

You might also look at you hospital policy for its copy of the laws governing EMTALA. This is the governments way of making sure that people are "screened" and treated appropriately without being refused or inappropriately transfered to another hospital. On most violations of this policy the initial fine to the hospital making the error are no less than $50 thousand. Big legal mess and the hospital usually distances itself (fires) from the nurses involved in the case. (BIG SURPRISE) Another issue from a lisensure stand point would be keeping the doctor informed of your patients status even when he is running around crazy seeing other patients. DOCUMENT, DOCUMENT, DOCUMENT. There are other issues of course, like watch how many meds are given on verbal orders even when the ER has a policy to prevent this situation except in the event of a code. It happens in every ER. What if the doctor says later "I didn't say that", guess who is reported to the BNE with a med error. Patient privacy is another big issue. Most ERs have hall beds. No one can tell me that a patient in a hall bed has any privacy. There is another governing body JCAHO (that we all hate) that governs things like privacy and pain control (the big issues this year) This organization gives accreditation to hospitals. Medicare/Medicade unofficially use this accreditation to decide to pay hospitals. Oh well, I could go on forever.

[teeituptom, BSN, RN]

Everything in the ER has possible legal pitfalls, just document your ass off.

doo wah ditty