sevans

One problem with this type of situation is that the person who decides whether or not an emergency exists is looking at it from THEIR experience - not the patient's. Our hospital does not have any kind of urgent care or clinic option - the nearest place for treatment after 5pm is an hour away. Now for myself, I will take a chance and wait until morning when I can call a doctor - but I won't take a risk when it is my son's health at stake. Last year he was injured during football practice - he was 12, the high school trainer was called over to the middle school - told the coach to call me and have me take him up to the emergency room - that his finger was broken, and needed to be checked out. Now if it was me, I would have buddy-splinted it and waited until the next day. But it was his right hand, it had swelled and discolored immediately, and the finger was crooked - I was not going to take a chance that something was going on in there that could have permanently affected the mobility in his dominant hand. After a 3 hour wait to be seen, I immediately got attitude from the staff when we were taken back - "it's just a finger!" "we'll send you back to xray as soon as we can, but we have some REAL injuries to take care of first" etc. Now I understand that in the major scheme of things, a broken finger is not a life-threatening emergency. But as a mother, I am not going to make my child lay around in pain for 16 hours from an obviously broken bone, waiting for the doctor's office to open at 9am. The emergency room just needs to accept the fact that as long as they are the only medical care available after 5pm, and as long as they have the only xray machine available, they are going to get things like this. Especially when it comes to children - most mother's will err on the side of caution when it comes to their kids - this is a fact of life, not a desire to mis-use the emergency room. The same goes for the new deductibles that insurance companies have started to charge for "non-emergency" emergency room visits. They need to make sure that they are basing their decisions and attitudes on whether or not it is reasonable from the patient's or parent's point of view - not the point of view of a doctor or nurse that is comparing it to a heart attack or MVA.

About 11 years ago my 3 year old had what his pediatrician called an allergic reaction to Septra. He would be fine in the morning, acting normal, no fever (I would take his temp to be sure). I would give him the dose of Septra, and then drop him off at day care. Within an hour they would call for us to pick him up - his entire face would be bright red, and he would be running a fever between 101 and 102. By the time my husband would pick him up and get him home, within an hour he would be fine - no fever, no red face. After the second day, I called the Dr. and he said it was an allergic reaction, and to list it as such whenever forms ask for drug allergies. Usually when I put it down, someone asks how he reacts - when I describe it, some count it as an allergy, and some don't.

Leaving a dressing in place as long as possible does not necessarily mean someone is not doing their job. This is one of the rationales behind many of the newer dressings that are designed to stay in place 3-7 days. While they are not suitable for all wounds, many times the orders for dressings that require daily dressing changes are due to tradition, rather than necessity.