Perception vs. Reality

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Specializes in Emergency & Trauma/Adult ICU.

Just a quick vent ... another entry in the Perception is Everything book.

The other day an ER patient (not my patient) with chief complaint of SOB x 1 week was diagnosed with bronchitis and discharged. Not my patient, but I had the patient in the next curtained area and I was in there for quite a while, so I no choice but to hear how the other patient's ER visit played out.

Patient (young adult, no other significant PMH), had fever @ 101 F, was medicated with antipyretics and abx. CXR was clear. No respiratory distress, able to speak in complete sentences and ambulate without difficulty. Discharged with Rx for continued abx and instructions for rest, fluids and OTC Tylenol/Motrin. Also advised of worsening s/s which could indicate need for return to ER. MD and RN leave, patient is getting dressed and makes a phone call to significant other:

Patient: "Well, they say I have bronchitis and they don't want me to stay because I don't have insurance."

Significant other must have questioned this, because he repeated it twice more.

WHAT????? :trout::banghead:

I'll be the first to admit that the uninsured face enormous difficulties in getting primary care, but I wonder how common this is -- the perception that the patient is somehow being short-changed in not getting a "million dollar workup" and inpatient admission when in reality ... it's just not medically required.

Just had to vent ...

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

Very recently I had a parent with two kids in ER for scabies.

Uninsured, no Medicaid.

They were seen, she was given scripts and discharge instructions. Then, per facility protocol, she talked to a financial person to make some sort of arrangements for paying the bill (not being required to pay anything at the time, just to set up a payment plan).

Parent told the clerk that she was going to "report this hospital because you're not supposed to refuse treatment because I can't pay."

Clerk: "Ma'am, you weren't refused treatment, your children were seen and treated."

I'm not sure if she thought she was supposed to have been given the medication as well (scabies doesn't constitute an emergency as far as I know) or if she thought she wasn't supposed to be billed for the visit.

This facility, BTW, has an affiliated sliding-scale clinic which she had not attempted to access in the week the kids had had the symptoms.

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Specializes in critical care.

Young person with bronchitis, and a clear CXR. Treat em and street them. Especially, if no insurance. Now I am not saying that no insurance means short-changing care, (before people become enraged.). But what is the big deal? This person was young, without insurance, and without any other co-morbidities, right? Please save me tax dollars ED, and do not admit unecessarily. I say thank you to your ED.:specs:

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i'll never understand a person's sense of entitlement.

it has always bothered me.

only in america, are we so spoiled.

leslie

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i'll never understand a person's sense of entitlement.

it has always bothered me.

only in america, are we so spoiled.

leslie

Unfortunately that's not true.

I'm married to a Brit.

They have the same problem on an even grander scale, thanks to socialized medicine.

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Unfortunately that's not true.

I'm married to a Brit.

They have the same problem on an even grander scale, thanks to socialized medicine.

wow.

i understand if someone pays for a service, that they receive said service.

nothing more, nothing less.

and if someone is receiving charitable/govt contributions, be grateful for what you do receive.

what the heck is so difficult about that?

leslie

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Specializes in OB, M/S, HH, Medical Imaging RN.
Unfortunately that's not true.

I'm married to a Brit.

They have the same problem on an even grander scale, thanks to socialized medicine.

I am Dutch and in Holland they have socialized medicine also.

They don't complain about getting care. Doctors make house calls if necessary to babies and the elderly. Everyone who needs care can get care.

What they complain about...and why I don't want socialized medicine here is the fact that since everyone can get all the care they want their surgeons are very over booked. People have to wait up to 6 weeks for a CABG. I had a family member die week 3 of his 6 week wait. My cousin waited 3 weeks to get an abscessed tooth extracted.

We are spoiled in America. The uninsured make such comments probably because they have a guilty conscious or an inferiority complex IMHO.

I hear people with insurance complain about their care as well. ;)

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My favorites are the ones that scream that they are being "pushed out" of the hospital before they are ready, because they don't have insurance. Or because they have Medicaid, whatever. They scream that if they are "forced" to leave, that they'll sue and own the hospital.

Yep, they figure that after a week of those million-dollar workups in which NOTHING shows up except a staggering drug consumption during their stay, they are entitled to more. And if they don't get it, it's some kind of discrimination.

How about this: You're not sick enough to BE HERE!! GO HOME!!

Yeesh.

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Specializes in ICU, Med/Surg, Ortho.

I am addicted to medical blogs. A poster quoted an ED patient and my tongue about dropped to the floor. This is what the waste of air said:

"I get a goverment entitlement. That means I am entitled."

HUH?!!!!

:trout:

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Specializes in critical care.
I am addicted to medical blogs. A poster quoted an ED patient and my tongue about dropped to the floor. This is what the waste of air said:

"I get a goverment entitlement. That means I am entitled."

HUH?!!!!

:trout:

How can you read that stuff? I'd just be p***ed off all the time! I pay over $200 month for full family coverage(not bad), but I get so sick/tired of medicaid/medicare dollars being spent on futile care for a gomer, as well as money spent for the uninsured. What is the answer to this? Why can persons that are at the end of their lives continue to receive care on my tax dollars? Why do persons without medical coverage scream that they are being refused care/admission because they have no way to pay. It makes me furious!!!!!:devil::devil::devil:

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Specializes in Med-Surg.

I got a butt chewing the other day. I admitted a 45 yr old patient with pna (lung sounds clear as a bell), and she had her mid 20's daughter with her. I got her a gown, and handed it too her. Told her I was going to step to the nurses station and get my paperwork ready to bring back while she got comfortable, and told her to call if she needed assistance. I was back in the room in less than 3 minutes, and tucked her into bed.

So, She tells me DON in her "how is your service rounds" that her nurse just "put me in this room this morning, told me she hoped I could make myself comfortable because she didn't have time to fool with me". Also told her she didn't see a soul for over 3 hours.

So, I was chewed out, and told to watch how I phorificed things, and my tone. People many not percieve things how you mean them. Is it my fault she is an idiot? Also, there is a difference between 3 min and 3 hours, and a college graduate like herself should know that.

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I got a butt chewing the other day. I admitted a 45 yr old patient with pna (lung sounds clear as a bell), and she had her mid 20's daughter with her. I got her a gown, and handed it too her. Told her I was going to step to the nurses station and get my paperwork ready to bring back while she got comfortable, and told her to call if she needed assistance. I was back in the room in less than 3 minutes, and tucked her into bed.

So, She tells me DON in her "how is your service rounds" that her nurse just "put me in this room this morning, told me she hoped I could make myself comfortable because she didn't have time to fool with me". Also told her she didn't see a soul for over 3 hours.

So, I was chewed out, and told to watch how I phorificed things, and my tone. People many not percieve things how you mean them. Is it my fault she is an idiot? Also, there is a difference between 3 min and 3 hours, and a college graduate like herself should know that.

See now, let me explain this to you, it's a very common phenomonen.A time bubble, happens all the time. You stepped OUT of your patients room and then a time bubble appeared, completely enveloping the pts room and her in it. So while you felt you were only gone for a few minutes, the patient ,(within the time bubble) was alone for hours! see? Easy. Two different time zones. Happens all the time.

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