Non emergent ER visits

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A favorite topic around here. Just thought I'd share a personal experience.

In the 10 years I have been with my wife, she has been to the ER twice- Once because I insisted that a corneal abrasion get immediate care- Friday night, scratched while hiking earlier in the day- and a more recent visit.

She had a cough for just under a month, unable to sleep through the night. It seemed to start with a post nasal drip, and get worse. Tried every OTC, and several prescription meds, with no symptomatic relief. She started looking sick, and I finally talked her into going to a local clinic. I am a travel nurse-(ER) no local PCP.

While I don't have particular faith in walk in clinics, we don't go to ER's for non emergencies. Once in the clinic, we found out it was out of network, meaning expensive to us. The ER was a block away, and in network. We opted to pay at the clinic, because we don't go to ER's for non emergencies.

The doc gave her Avelox, assuming that it was a bacterial sinusitis that had migrated south.

Later that evening, she had a very brief, but complete, inability to inspire. I saw it, and it scared me. I dragged her to the ER. She did not want to go.

The ER doc was diplomatic about her opinion on the ABX for what she figured was viral in origin. Neb tx, and prescribed po steroids and inhaler. A highly competent MD, RN, and RT all provided good care.

Bottom line is we paid a lot for marginal medical care, and were well covered for the excellent care we received in the ER. I don't work in that ER, but I know it is a great work environment, and as a result, they can be very selective about staff.

It really should be no surprise to us that people use the ER for non emercencies. Great care, and no financial dis-incentive. (In our case, $150 worth of incentive)

hherrn

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Specializes in Emergency Dept, ICU.

Glad you had a good experience.

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Specializes in ER and Home Health.

That is the thing. Everyone gets the best care in the ER.It is also done quickly and efficiently and all is done within a few hours. All your labs, ekg, ct, radiology, sono, mri. It all gets done. well maybe mri takes a while.They can be difficult there. But if you see you good old doctor. Labs take 24 to 48 hours, xrays depending on how fast you can get there take a day or so before you get results etc. Got to the ER get it done quickly, and better. You have a Doctor, your own Nurse and techs available. Oh yes did I forget all the good drugs they can give you to make you happy.They will also feed you and your family.Case worker are there, some people in the ER I havent yet to figure out who they are and what their purpose is yet.Whatever can be better than the ER.

Moral of the story is. If you want it done, Go to the ER

That is what makes it a challenge in the ER.

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Specializes in Psych ICU, addictions.

I've had to use the ER for non-emergent issues a couple of times, but that was not my choice--I was forced to by my medical insurance. The plan I had at the time would not allow me to go to urgent care clinics for treatment, so if my doctor's office was closed I either had to wait until they reopened (if it's a Friday night that's a heck of a wait if you're in pain) or go to the ER :/

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Specializes in MSP, Informatics.

Moral of the story is. If you want it done, Go to the ER

That is what makes it a challenge in the ER.

but if everyone went to the ER...it wouldn't be as fast. There are days that you wait hours and hours to be seen. It is not first come first serve. we get all sorts of people in our ER that just didn't want to wait and get an appointment with the Doc for something that has been going on for months.

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Specializes in ED, ICU, PSYCH, PP, CEN.

There have been several instances lately where patients have gone to the urgent care for simple lacerations and the urgent care wouldn't take care of them and sent them to the ER.

There is obviously a glaring health care crisis and I don't know what we are all going to do about it.

I'm glad that your wife is okay, and obviously you wouldn't use an ER unless it was a true emergency.

It is a great time to be an ER nurse because as more and more people come to the ER for the many of the reasons you and I have posted our job security is only going to get better.

Many nurses I know have had their hours cut due to the recession, but the ERs are going to be brimming.

Thank God I have a portable skill

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Was this not an emergency??: my dad brought my mom into an er complaining of shortness of breath, a cough with sputum, change in mental status and lacerations to her forehead as she had fallen the day before. The only thing the e-room staff did was a CT scan of my mother’s head. They drew no labs, did no chest x-ray. I question whether they even listened to her lungs or did a full set of vital signs. My father was told the head CT was negative for any bleed.

My mother was discharged home by a physician's assistant with a recommendation for triple antibiotic for the lacs and to follow up with a family doctor. My father questioned about my mother’s shortness of breath and the need for a chest x-ray and was told my mother has COPD and this is something they do not address in an emergency room, and only 20% of her lungs are functioning and that she is going to die from this. My father took this as she would die very soon. He has been distraught over that statement since. How does the PA know only 20% of her lungs are functioning when they did NO diagnostics or other work ups on her at all?

The next day we took my mom to another ER where she received all the work-ups. Her Pulse ox was in the 60's, her ABG showed arterial O2 in the 20's! and chest CT showed a PE!! the second ER admitted her into ICU. I am very stressed.

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Specializes in ER, MICU, Med/Surg, Neuro.

WOW. I am so sorry, Colleen- that is awful. I never thought an ER would treat someone the way the first one did for your mother. I hope she recovers soon!

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Specializes in ER.

I agree with CathyLew. It is ok to come to ER for non-emergencies, but don't complain when you have to wait hours to be seen because we prioritize ABCs first. I see more and more people coming to the ER as a clinic which is ok depending on their complaint. But things people can take care of through OTC drugs, home remedy or a visit to a nearby clinic shouldn't really come through the ER.

For example, a lady c/o her knee pain in triage box, then she mentions burning on urination on assessment. After we collect urine sample, she suddenly wants her cholesterol level done and wants prescription for lipitor along with percocet b/c she knows her cholesterol is bad and she has chronic back pain. Then we have people coming in because they want refill on methadone and fentanyl or psych med. I mean... it's called EMERGENCY room for a reason. Emergency = life and death situations. Some people really abuse EMTLA and charity care... :p

I can't stand people who c/o back pain for 3 months and expect to see the doctor right away so they screaming at the nurses. What were they doing all this time?! Why can't they wait 2 more hours if they were waiting on it for 3 months???

SOB and Altered mental status is a big red flag and should've been triaged as emergent. I don't know why they brushed it off. I would be really upset too!

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Specializes in Trauma, Teaching.

We had a family bring in a young woman with chronic abdominal pain, had had many workups and surgery advised, which they refused. They wanted the ER to fix her with out all that, and were sure if we'd just give her a "high colonic" she'd be fine.

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Specializes in ER.

As an ER nurse, I also had such an experience where I gained perspective on why people...even the insured, are coming to us instead of an urgent care clinic.

Couldn't get myself and son into the doc on a Friday for a step infection...went to urgent care clinic, told me Oh, yeah, yeah we take your insurance" (no reason to doubt them). 420 bucks later, after simply receiving an rx for abx ,found out that, gee, the place is in no way covered by my insurance, after all.

Would have been cheaper to visit our ER where it would have been FREE ( since I work there) or 50 dollar co-pay if I didn't.

Answered my own question about why no one seems to be using that clinic for minor medical issues.

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Specializes in ER.

Also, recently read research regarding the fact that it is getting to a point where there is little difference in the actual numbers of insured versus uninsured using the ER for non-emergent complaints nowadays due to an increase in patients viewing it as "one-stop shopping" so to speak.

It is easier to go to the ER than make an appointment for, lets say, your belly that has been hurting for three weeks and just get everything done there, rather than go to the family doctor, possibly be referred to a GI doc, who then orders a scan/Ultra sound which needs a separate appointment, which then takes a few days for results... then go back in to doc to get the results...etc. etc.

This ties in to Whykiki's example of the lady who wanted all her various complaints that were completely unrelated treated in the ER. The fix me now...I don't want to wait mentality that is becoming very prevalent.

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