Published Jan 29, 2009
You are reading page 3 of My daughter's experience today in a Phoenix Emergency Room
SuesquatchRN, BSN, RN
If I walked into your psych unit and asked told you that I had just been shot in the arm and blood was dripping everywhere, what would you do?
Stop the bleeding and get you care.
As to "emergency rooms are for emergencies" - I live in a small town and work at the local CAH. Everyone uses the ED as the urgent care center because we don't have one, nor any doctors available evenings or weekends, and 4 MD's in the entire town. Our population doubles in the summer and activity in the ED quadruples as none of the tourists have PCP's here and stuff happens. And we KNOW how people use us and staff accordingly.
And in a small town, you may have to be flexible like that. I seriously doubt there are too many real emergencies in a town that size, anyway, so it is not necessarily taking the docs and nurses away from the emergencies like it does in most bigger ERs.
What a mish-mash of assumptions you make.
We get many traumas. And we don't have MD's. We have PA's and NP's.
I find that ERs don't always listen to teens and young adults. My son was taken to the ER by his boss one evening. His boss called me, and I got there about 15 min after they did. My son, who was 17, was complaining of chest pain. According to my son and his boss, the receptionist had chuckled and said, "Okay, yeah right!" The boy was hurting so bad that he was crying and couldn't explain. I walked over to the desk and explained to the receptionist that I was his mother, that he saw a pediatric cardiologist for a bad heart, and that he had told us to get the boy to the ER immediately if he had pain. That poor woman could not possibly have gotten out of that chair any faster. She ran to the back, hollering for a nurse and a doctor "stat". And she could not have apologized more times, nor more sincerely. But that 15 min wait could have cost the boy his life. I know that kids can be overdramatic (my daughter for instance), and I know the ER staff gets tired of non-emergencies (from people who feel miserable and can't get in to see or don't have a regular doctor), but to outright ignore a patient can be so dangerous.
I live in a rural area, and we have our fair share of emergencies. There are probably more farming accidents (you know, like their pant leg got caught in an auger and ripped their leg off), gunshot wounds from hunting, etc., rather than emergencies like a 20 car pile up....but we have our share.
First, you misread my posts. I do not work in a 'psych unit'., I work in cardiac but have worked in emergency rooms, free standing psychiatric facilities (the last one I left because they refused to give us the proper medical equipment for EMERGENCIES), as well as cardiac care.
Gun shot wounds.. check air way breathing and circulation, apply pressure and find someone to take your darn bullet out ! What else could I do?
The point all along has been 'people make assumptions and can and HAVE killed someone because of it'. In my world of nursing I believe that saying 'it's not my problem' is a disgrace. We all have a moral responsiblity to people or we do not belong in medicine.
Thank you though for your otherwise good humored remark!
Wow, I just re read your quote 'we know that intelligent creatures live in outerspace because they have not contacted us!'. I LOVE IT! Maybe they are just able to use both sides of their brains. the left for science and the right for compassion. hmmm...
I understand the need to avoid assumptions, and believe me, those who work with me know that I am one of the most caring nurses that they work around - even with frequent fliers and druggies. But that is not the point of this post.
It is about caring in giving respect for the people who present themselves for treatment, and if the staff at the ER that your daughter went to did not give respect, then shame on them.
But to say that we have a moral responsibility to treat everything is not correct. We have a moral responsibility to care about people, and caring about people often involves sending them to the appropriate channels for care. The emergency department is not the place for your daughter and her chronic conditions. If I were the nurse taking care of her, I would explain it to her, give her community resources and hold her hand, but the end outcome would be the same - she does not have an emergency and should be treated by someone who specializes in following long term or chronic conditions that are not emergencies - a PCP or orthopedic doctor. The example is a person walking into a psych unit with a gunshot wound. You would do ABC and then get them out of there where they can be properly cared for.
It sounds harsh, but it really is caring for someone to not try to do chronic care in an ER. Help the person find ways to treat the pain or discomfort, ensure that there is no medical emergency, and get them out of there where they can be properly cared for.
Again, if the staff was rude to your daughter, then shame on them, but it sounds to me, just based on what you are saying, that they looked into her condition and treated her accordingly. It isn't that her symptoms can't cause problems - it is that they are not emergencies, and in trying to get care in the ER, she is getting care from doctors who do not have the expertise or infrastructure needed to properly follow her conditions.
I know that there are plenty of specialists around who will work with those who do not have insurance to try to find ways to reduce rates and get workarounds for expensive treatments. I used to work as an LPN at a pulmonologist's office and we would regularly give large discounts to uninsured who paid with cash. Call around and find out who is willing to work on similar deals with your daughter.
It sounds like she is having symptomatic stress reactions, and if that is the case, perhaps it would be better for her to come home for a little while to get herself back on her feet and sort her life out a little and then try again. It's not a failure to do that, in fact it is showing strength to accept that sometimes you need a little support. Earlier you asked what good it would do for her when she is trying to learn to be on her own.
She needs to have a soul search to determine which is more important: feeling like she can do it herself when it sounds like, at this moment at least, she can't, and in so doing endangering her mental and physical well-being, or returning home to get things sorted out, and in so doing suffering some short-term disappointment.
When all is said and done, however, the ER really is not the place for her, and the more it becomes so, the less available it will be for its true calling: emergencies.
The first words out of the doctor's mouth was, "you can get a pregnancy test at the dollar store'.
Yes, they treated her like a dog. My case in point. Yes, ER 's are for urgent matters; however, we have a moral obligation to treat people with respect and dignity. The kid couldn't walk!
But thank you for your input.
Yes, it is a tragedy to move away from home, get mugged, get hurt and have reoccurring issues and not enough resources to address them.
However, she didnt need a pregnancy test.
Given that information, it sounds like she was very poorly treated. I still think that the ER is not the place to get the treatment that she needs, but courtesy should not be a foreign language to healthcare providers.
I hope that you will understand my defensiveness given the number of times I have seen people get the exact treatment that they need and then proceed to complain about being mistreated when I know for a fact that they were not mistreated at all.
I so do understand. It happens to me once a week.
I still try to treat everyone with dignity and respect.
Working cardiac, I often encounter people that are angry from how they 'perceived' their treatment in the ER.
I get the brunt of it!
Again, I understand the function of ERs; however, not everyone is there to abuse the system :)
Emergency rooms are for EMERGENCIES!!!! Knee pain for an injury that happened 2 mths ago is not an emergency, esp. if she able to ambulate. As far as her PCP not being able to see her til she has a well visit means she needs to call her health plan Mercy and let them know she has an acute condition that her PCP won't see her for. They will intervene and get her the much needed appointment as Mercy doesn't want her in the ER either. If for some reason Mercy feels this trip was not an emergency but something that could have been handled in a PCP office they may refuse to pay it. And she can't self refer to an ortho--she has a form of Medicaid. Nausea without severe vomiting is not a medical emergency. If she has chronic ear fungus then she should get an extra RX antibiotic from her PCP to treat it to prevent ER trips, esp if it happens this fast.But it does sound like she needed a mental health referral to help her cope with the stresses of life. Maybe moving back home for a while til she regroups her finances might be in order too. She may need a little more time to grow up to help face lifes challenges.I hope her the best...it is difficult, at best to try and make it in the world in todays economy.But the ER is for emergencies!
And she can't self refer to an ortho--she has a form of Medicaid.
Nausea without severe vomiting is not a medical emergency. If she has chronic ear fungus then she should get an extra RX antibiotic from her PCP to treat it to prevent ER trips, esp if it happens this fast.
But it does sound like she needed a mental health referral to help her cope with the stresses of life. Maybe moving back home for a while til she regroups her finances might be in order too. She may need a little more time to grow up to help face lifes challenges.
I hope her the best...it is difficult, at best to try and make it in the world in todays economy.
But the ER is for emergencies!
She was in severe pain. That is an emergency.
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