Most common non-emergency visits

2011NursingStudent · Jul 26, 2008

your sig says it all: future nurse. these er nurses are venting. someday, when you're a nurse, you'll get it. but right now you don't. you haven't walked a mile in their shoes, and therefore have no right to criticize.

no, you are right, i definitely didn't mean to criticize. reading the crap people go to the er for, i do understand all the venting. it's too bad those people go to the er at all, because if they didn't, nurses would probably be a lot more patient with the people freaking out about a uti/back pain like me

:heartbeat

sissiesmama, ASN, RN · Jul 26, 2008

No, you are right, I definitely didn't mean to criticize. Reading the crap people go to the ER for, I do understand all the venting. It's too bad those people go to the ER at all, because if they didn't, nurses would probably be a lot more patient with the people freaking out about a UTI/back pain like me
:heartbeat

Nursesuey --It's not that the posters are being mean or anything. If you start in the ER, you will understand more about the need to vent even after a bad shift, whether in the ER, or on one of the floors. And, one of the things that is hard to see is the patient that comes in with a c/o tooth pain that has been going on for 4 or 5 days - not one an actue pain but one that has been ongoing and could have been handled by the dentist.

And I refer to dental pain, if I had one and it was after hours and I was miserable, believe me, I would be in the ER too if it was too severe. But one of those patients that come in and don't understand why a pt. from an MVC or chest pain or the likes "gets to go before me" is something that is hard to explain over and over. Some patients don't understand, no matter how you explain it. When you are "knee deep" in a trauma code or AAA or a resp. pt. that has to be tubed, some of these patients that are waiting get the picture, and some of them either don't understand that the nurses are trying to save the patient, and that means someone else will have to wait. I know when you are in pain or sick, it is a different ballgame completely, and I know when I am sick, I do want to be seen ASAP, but I do understand I will probably have to wait.

Anne, RNC

chicagobsn · Jul 26, 2008

Ive only been in the ER ...goin on 3 months now...and Ive seen:

"just want to get checked out cus I have the day off and thought Id come to the ER"

something green is oozing out of my member

I have a headache, and dont have any tylenol at home

my neb machine broke this am, and dont want to be seen by a doc, or a nurse, refuse to change into a gown, and states "just want a breathing tx" then got mad and left

CP..then get them to the room and slap monitors on them, iv, labs, ekg ...and ooops..theyre here cus they have the flu and thought faking cp would get them in sooner

my third day in the ER, we had a major..MAJOR issue..man came in with a hang nail

the ever so fun psych pt who wants ativan

the drunk guy who comes every single day to eat food, smell the whole ER up to where pts complain, sleep and leave AMA

"I think I might be pregnant"

"my 27 yr old son has the flu"

oh my favorite...drunk girl who was vomiting "a lot" so she came in to see if she was dying

and yes .. the since Im in the ER...everyone in my family should be seen too..and were all hungry and thirsty because we havent had anything to eat all day

daisybaby, LPN · Jul 26, 2008

I'm an L&D RN, not ER, but I have always wondered why insurance companies and Medicaid continue to pay for these non-emergent visits that gum up the ER..... people won't stop using the ER for all-hours primary care until they are held responsible for it (although, plenty of people are just fine with ignoring those bills)....

My mom, who is an ER nurse, once told me that if her ER started charging everyone a pack of smokes and a beer to get in the door, they'd be out of business. I'm inclined to think she's right.

kmoonshine, RN · Jul 26, 2008

For everyone who is trying to understand what ED nurses deal with on a daily basis (and literally, this IS what I deal with):

http://www.myfoxmilwaukee.com/myfox/pages/Home/Detail;jsessionid=165EDD3AC6C74B22982DB227A0D717B1?contentId=5646040&version=1&locale=EN-US&layoutCode=VSTY&pageId=1.1.1&sflg=1

I think that government-paid health care should allow one free "oops" each year for emergency care (ie sore throat, earache). Any other "oops" must be approved by your PCP within one week following your ED visit in order to get it covered without penalty. Children under 18 should be exempt from this, because some parents wouldn't seek care even if it truly was an emergency because they don't want to pay anything.

The only problem: these patients are the least likely to pay their hospital bill, so the hospital would probably never see a dime from a majority of these patients. So would it be in the hospital's best interest to put up and shut up, because fifty-cents on the dollar from the government is better reimbursement than nothing? Or, would the threat of accountability cause people to seek care at more appropriate places (such as planned parenthood, PCP, etc)?

I wonder if the problem would get better if each patient who gets gov-funded health care was automatically assigned to a PCP. In order to keep receiving these benefits, the patient must get a yearly physical. Personally, I think that if you qualify for free health care then you should show that you want it by establishing primary care ("use it, or lose it"). However, not a lot of PCP's are eager to take gov-based health care patients because the reimbursement puts them in the red. Therefore, a bottle-neck is created, and those "overflowing" patients splash into the ED. Its a safety net for our health care system, and the net is breaking...

cursenurse · Jul 27, 2008

What I do not understand are the people that have not tried to relieve their pain with tylenol, motrin, asa. You ask what did you take at home for this 10/10 pain, they say "nothing." It makes you have a newfound appreciation for the guy that tries a few shots of Mr Daniels at home for relief of his pain. I'm like, who raised you to not even try to take care of your minor pain at home?

sissiesmama, ASN, RN · Jul 27, 2008

What I do not understand are the people that have not tried to relieve their pain with tylenol, motrin, asa. You ask what did you take at home for this 10/10 pain, they say "nothing." It makes you have a newfound appreciation for the guy that tries a few shots of Mr Daniels at home for relief of his pain. I'm like, who raised you to not even try to take care of your minor pain at home?

cursenurse - Oh man, you are so right!!!!! We always get the screaming baby at some ungodly hour with a temp. And of course, the baby has a temp of 102 or so and the triage nurse asks, "When was he/she given any Tylenol/Motrin..." Then we always get the answer that just curls your hair..."Oh, I didn't give him anything, cause I knew you guys would't think he/she was sick if he did't have a fever."

Then, there's the parent that doesn't own a thermometer, and brought him in, "I just figured you people could just check it for me."

Anne, RNC

SuesquatchRN, BSN, RN · Jul 27, 2008

I'm in a small CAH, in a rural area with limited medical access. Our ER is quite realistic about the fact that we are largely the local urgent-care center.

Of course, all that stops if he get an actual emergency, which are largely MVI's.

AandE angel · Jul 27, 2008

Yep cursenurse, that gets me too, they could get an oscar for their portrail of 10/10 pain score but wouldnt dream of self medicating analgesia!! the other one is parents with kids with minor injury or a temp who dont give Calpol (not sure what the US equivelent is) or brufen before coming to ED!

Larry77, RN · Jul 29, 2008

Of course, all that stops if he get an actual emergency, which are largely MVI's.

Um...whats an MVI? Is that like MVC/MVA or MI? Just curious...

samantha11 · Aug 4, 2008

Constipation by bowel obsessed lonely grandpa's

mva's with no injury cause "the police told me to get checked out"

bunions

tinea and assorted dermatology problems, not allergic reactions

the lacerations you have to say "point it out for me" and the patient says "it's right there!"

vomiting x1

loose stool x1

fever 99.9

med refills

seekers: our system connects multiple er's together and it shows previous visits and what they were seen for when you log in for a patient. We see where they were and when, we even have dictated charts and can see prescriptions. Foolish people. no vicodin for you!

I also get irritated when they had a surgical procedure at another hospital and come into ours. just complicates things, not that they are coming in for stupid reasons but it's stupid not to go to where they had the surgery. They don't understand their discharge instructions????

10MG-IV · Oct 20, 2008

However, its those patients that flat-out lie who really bother me: "I can't breathe!--->(now in a room, RN at bedside)--->yeah, I was dx with an STD last week and still have discharge, and no I didn't fill my abx; and I never said I had SOB." I'm amazed how frequent people c/o "chest pain" when they see that there is a wait...it makes me hard to do my job, because I treat chest pain as an emergency. But when I see a 16 year old talking on her cell phone, eating chips but is complaining of "chest pain" - I'm sorry dear, but you'll have to wait.
Those are the ones I like to run to the back cut the shirt off for the stat ekg, slap on the leads and BP q5 min. get a 18 or 16G int in the hand or a/c. Draw 8 vials of blood, bloody blood. NTG q5 min x3 giving them a bounding Headache... oh. that was a unit meeting fantasy,,,,,,
What we really want to know is when are the Insurance companies going to catch on to the fakers on c/p