Death after two-hour ER wait ruled homicide - page 7

Death after two-hour ER wait ruled homicide "WAUKEGAN, Illinois (AP) -- A coroner's jury has declared the death of a heart attack victim who spent almost two hours in a hospital waiting room to be... Read More

  1. by   weirdRN
    Quote from tferdaise
    Ouch.... everybody has the RIGHT to use the ED when they are sick. Tony
    I respectfully disagree.

    The EMERGENCY room/department is supposed to be for Emergencies.

    Emergency to me means that if you are not seen and treated you will die.

    It does not mean that you are just sick or think you might be pregnant. You might consider reading a very informative thread by the ED Nurses that was posted here a while back. "rules for the ER' or something like that.
  2. by   MikeyBSN
    First of all, this was NOT a homicide; gross negligence at best. Although the situtation is disturbing, I work in a busy ER and I can see how it could happen. The triage nurse should have done a STAT portable EKG to monitor for ST elevations and T wave changes, and worked with the charge nurse to get the patient in the back. Sometimes, there really is nowhere to put people. When you have thirty people in the waiting room and fifty in the back with colds and no insurance, who you are legally obligated to see, you still can't just "kick" them out without screening and treating them.
  3. by   Bikechicky
    For those of you that have never done triage in a busy ED you have no idea how hard it is. I once worked in an ED that I could always make a place for a CP. I now work in an ED that is frequently overwhelmed with patients. 6 hour waits are not uncommon, 2 hour waits are common. Yes those include pts with classic CP sx. Yes I can get EKG's at triage, but even that takes time when you have 6 or 8 pts and family lined up waiting to check in, bleeding and in pain. A waiting room full of pts! I just explain to every pt checking in that there will be a wait, and tell them how long people have already been waiting (it is nice to see the whiners leave then!)

    Anyway this is truly a case of ...."there but for the grace of God goes I"

    I am a compassionate, caring and skilled nurse, Triage kills me, and after 6 hours of it I have no compassion left.
    This is a crisis in health care, I hope it helps make a change in our systems.
  4. by   Back2School@40
    Why do ED's hire new grads, with NO medical background? While working the ED I saw a couple of new grads being hired, and none has previous medical experience, the ED is not a place to get your feet wet when you are a true leve one, it can be a very overwhelming place. These new grads made mistakes which I thought they shouldn't have made.


    First of all I find this statement to be a huge generalization and mildly insulting. I started in the ER as a new grad. Every new grad has "some" medical background, obviously, as they went to nursing school and attended clinical rotations. I believe the ER is a fabulous place to get your feet wet, providing they have an exemplary new grad training program. I believe that the weak or unqualified get weeded out before they ever hit the floor on their own. At least this is the case in the hospital where I work.

    Secondly, mistakes should never be made. I believe this is why we call them "mistakes". But we all make them. It does not matter where in the hospital you work. Not a single one of us is perfect.

    In the case up for discussion, our hospital would have done a lobby EKG immediately. We would have moved someone to a wall bed to create a monitored space for this patient within minutes. In the two hours she sat in the waiting room at the offending ER, she would have been through our cath lab and already resting quietly in the CCU. It's a shame that hospitals are only portrayed in the news when something negative happens, and never for all of the lives they save everyday.

    Definitely a sad sad situation that never should have happened.
  5. by   MikeyBSN
    Quote from Bikechicky
    For those of you that have never done triage in a busy ED you have no idea how hard it is. I once worked in an ED that I could always make a place for a CP. I now work in an ED that is frequently overwhelmed with patients. 6 hour waits are not uncommon, 2 hour waits are common. Yes those include pts with classic CP sx. Yes I can get EKG's at triage, but even that takes time when you have 6 or 8 pts and family lined up waiting to check in, bleeding and in pain. A waiting room full of pts! I just explain to every pt checking in that there will be a wait, and tell them how long people have already been waiting (it is nice to see the whiners leave then!)

    Anyway this is truly a case of ...."there but for the grace of God goes I"

    I am a compassionate, caring and skilled nurse, Triage kills me, and after 6 hours of it I have no compassion left.
    This is a crisis in health care, I hope it helps make a change in our systems.
    The condition of ER's in the country is a true crisis. Instead of making government legislation that forces an ER to screen and treat a misquito bite (litterally and I've seen it) they need to allot some money for community health centers for the indigent.
  6. by   MikeyBSN
    Quote from Back2School@40


    First of all I find this statement to be a huge generalization and mildly insulting. I started in the ER as a new grad. Every new grad has "some" medical background, obviously, as they went to nursing school and attended clinical rotations. I believe the ER is a fabulous place to get your feet wet, providing they have an exemplary new grad training program. I believe that the weak or unqualified get weeded out before they ever hit the floor on their own. At least this is the case in the hospital where I work.

    Secondly, mistakes should never be made. I believe this is why we call them "mistakes". But we all make them. It does not matter where in the hospital you work. Not a single one of us is perfect.

    In the case up for discussion, our hospital would have done a lobby EKG immediately. We would have moved someone to a wall bed to create a monitored space for this patient within minutes. In the two hours she sat in the waiting room at the offending ER, she would have been through our cath lab and already resting quietly in the CCU. It's a shame that hospitals are only portrayed in the news when something negative happens, and never for all of the lives they save everyday.

    Definitely a sad sad situation that never should have happened.
    Thank you, I'm a new grad in the ER and sure it's hard but I don't think that I don't deserve to be there. Some of the people I came in with never made it off orientation. It's a good place to learn because you see so much of so many different things. Sure it's overwhelming at times, but not impossible.
  7. by   tferdaise
    Quote from WhimsieRN
    I respectfully disagree.

    The EMERGENCY room/department is supposed to be for Emergencies.

    Emergency to me means that if you are not seen and treated you will die.

    It does not mean that you are just sick or think you might be pregnant. You might consider reading a very informative thread by the ED Nurses that was posted here a while back. "rules for the ER' or something like that.
    Ok its 3pm on a thrusday, and you ( you aren't a medical professional) feel like crap, you are running a fever (low grade 100.8) and are flush looking. What are you going to do... Yup, call your Dr. the girl on the other end of the phone says, "I'm sorry, we aren't taking any more appointments today, but I"ll get you in tomorrow, or if you feel like you need to be seen, go to the closes ED to be seen."

    I do NOT know how many time I was told at the Triage window from people who called t hier Dr's office and was told to go to the ED. The Family Practice Dr's are working twice as hard as they did 15 yrs ago since the insurance comanies and as well as Medicare reembustments are less and less, so they have to see more pt to make the same amount of money..

    The real problem is the Healthcare system..

    Granted you get the people who go to the ED because they are plain uninformed (I was going to say stupid) I worked the ED for 5 yrs and saw a lot of things first hand on how people who are on government assisstant would use the ED as thier personel Dr, not follow up at the clinic like they were told to do, when I DC'd them the last time, but since they have free healthcare they well abuse the system because they can... There is a law called EMTALA which is good and bad the bad out weights the good....

    Tony
  8. by   mercyteapot
    Quote from MikeyBSN
    First of all, this was NOT a homicide; gross negligence at best. Although the situtation is disturbing, I work in a busy ER and I can see how it could happen. The triage nurse should have done a STAT portable EKG to monitor for ST elevations and T wave changes, and worked with the charge nurse to get the patient in the back. Sometimes, there really is nowhere to put people. When you have thirty people in the waiting room and fifty in the back with colds and no insurance, who you are legally obligated to see, you still can't just "kick" them out without screening and treating them.
    In the first place, gross negligence is what caused the negligent homicide. They're aren't mutually exclusive terms. As far as being legally obligated to see people with colds and no insurance (don't understand what the insurance status has to do with it), those people just have to wait. There's no legally mandated time limit in which they need to be seen. That's what EDs have triage systems in the first place.
  9. by   tferdaise
    Quote from MikeyBSN
    First of all, this was NOT a homicide; gross negligence at best. Although the situtation is disturbing, I work in a busy ER and I can see how it could happen. The triage nurse should have done a STAT portable EKG to monitor for ST elevations and T wave changes, and worked with the charge nurse to get the patient in the back. Sometimes, there really is nowhere to put people. When you have thirty people in the waiting room and fifty in the back with colds and no insurance, who you are legally obligated to see, you still can't just "kick" them out without screening and treating them.
    Mike, your comment,about 'who you are legally obligated to see' hit the exact chored in which EMTALA was written. But people don't seem to really understand EMTALA. The law says, basically you can not turn people away regardless if they can pay or not...

    You as a RN, in triage in a busy ED well triage these people. YOU are the one who is the gate keeper in who goes in the back first or 15th.

    So you if you have people who presents to you with symptons of a cold or flu and they are young and healthy (no other major underlying health issues) then make then wait in the waiting room. You send the people in the back who are sicker... My comment to people was this, THAT person might be having a Heart attack, you sir have a cold. that usally piss's them off enough and they leave.. YOU haven't broken ANY laws since they make the choice to leave...

    Tony
  10. by   mercyteapot
    Quote from Pat_Pat
    If someone is in this country ILLEGALLY they don't have a RIGHT to ANYTHING.
    (Perhaps we have a MORAL responsibility

    Pat
    Undocumented immigrants qualify for emergency Medicaid and EDs are legally compelled to treat them. That certainly sounds like it means they do have the right to be there.
  11. by   MikeyBSN
    Quote from mercyteapot
    In the first place, gross negligence is what caused the negligent homicide. They're aren't mutually exclusive terms. As far as being legally obligated to see people with colds and no insurance (don't understand what the insurance status has to do with it), those people just have to wait. There's no legally mandated time limit in which they need to be seen. That's what EDs have triage systems in the first place.
    Negligent homicide usually involves criminal negligence, not civil tort. The insurance issue is relavant because people without insurance usually can't find a PMD so they use the ER as an alternative.
  12. by   LilPeanut
    Wow. some of the comments here are downright hateful.

    Illegals absolutely do have rights. Many of the people who post here, their parents, grandparents or greatgrandparents were probably illegals at one point.

    People have the rights and protections of the US Constitution, even when they are not citizens. That's part of what sets us apart from other totalitarian and fascist regimes.
  13. by   mercyteapot
    Quote from MikeyBSN
    Negligent homicide usually involves criminal negligence, not civil tort. The insurance issue is relavant because people without insurance usually can't find a PMD so they use the ER as an alternative.
    But the real problem is people with colds going to the ER, period, whether they have or don't have insurance. Lots of people on Medicaid go to the ER for things that aren't emergencies, too. Yes, negligent homicide would be criminal homicide. What made it criminal is that is was gross negligence... mere negligence would have been a civil matter.

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