My new "Urgent Care" job is like ER lite--anyone with the same experience?

pennyg1 · Apr 2, 2009

Haven't had that situation but we are fully equipped to do all that and more. The facility is highly thought of and has incredibly high standards and the staff is well trained. I wasn't expecting the volume and acuity. It's definitely getting better and my heart palpitations have stopped :) I keep reminding myself that I have to give myself more time.

beccarner · Apr 2, 2009

Very glad to hear it, thanks!

RedSox33RN · Apr 2, 2009

Our Urgent Care is attached to our main ED also, and we regularly get those that must be transferred (just a w/c ride away) to us. I wish we could do the same thing, but unfortunately, no downgrading in triage. We get a LOT of pt's that say the magic words "chest pain" and when I assess them, it's "oh, I really don't have c/p, just am nauseated and have a sore throat, and oh yeah, I need a refill on my Percocet". It makes it so difficult on triage nurses. Just this week I've had 3 pt's that came in Level 4, who are usually quickly d/c'd, that ended up being admitted for something severe, and more than twice that in Level 2 that were in and d/c'd within 20 minutes. One was almost admitted with GI bleed because of black diarrhea, guiac was negative though. It wasn't until pt told me she had taken Pepto-Bismol the night before that we called off the CT and admitting doc. That was something the pt hadn't told the triage RN, and obviously the pt was unaware the s/e of bismuth.

We hear that a lot also - that pt's went to Urgent Care or Fast Track because they didn't want to wait for the regular ED, but they really do belong in the main ED.

pennyg1 · Apr 3, 2009

Thanks for the insight. Seems like our UCC falls within the norm. It's certainly interesting and there is NEVER a dull moment.

Ruby Vee, BSN · Apr 4, 2009

my insurance has no co-pay when i go to urgent care as opposed to a $300 co-pay when i go to the er. i went to the er a couple of years ago with sudden onset of numbness in my right leg from toes to a$$. it turned out to be a herniated disc. the insurance refused to pay for the er at all, saying i should have gone to urgent care unless i was in imminent danger of loss of life or limb. (and i thought the numbness was an emergency -- silly me!) eventually i got them to pay for the visit, but it was a lot more stressful than it needed to be.

last year, i went to urgent care with chest pain and shortness of breath. (it was right next door to where i was, and the er was several miles away.) they must not have any protocols, because i didn't get oxygen, nitrates or monitored and i took my own aspirin. they didn't even do an ecg. they did, however, do a chest x-ray. finally, they called an ambulance for me and had me transported to the er. (the ambulance folks did monitor, aspirin, nitrates, start an iv and draw blood. then they told me what a poor reputation that urgent care center has among the paramedics.fortunately, i wasn't infarcting because if i had been i would have been sol.)

i guess i'm wondering if urgent care centers have mi or cva protocols, or if we should just call 911 and bypass them altogether even if we're in the same parking lot as they use when we start having our symptoms.

Displaced · Apr 4, 2009

i guess i'm wondering if urgent care centers have mi or cva protocols, or if we should just call 911 and bypass them altogether even if we're in the same parking lot as they use when we start having our symptoms.

i guess it depends on where you go. our urgent care centers have the same protocols as our er.