RN79

Being that it is a very small facility and there is limited nursing staff (1-2 nurses in the ED) and that the patients actually present at the registration desk initially to be registered because the ER is behind the registration desk there is no way for nurses to know a patient is there until they are notified by admission staff so being seen by a nurse when they initially walk up is not an option. Again not sure how they expect us to prioritize care

Oh and let's not forget my all time favorite... Medic calls report to charge nurse pt in vtach 180ish charge nurse puts medic on phone with md who gives orders. Pt arrives to ED lidocaine gtt hanging medic states pt slowed down but hasnt converted while pt is being moved over and being put on ED monitor as medic shows md monitor strip from field md states "that's not vtach, that's afib with rvr" I'm like WOW! Still! And that was a few years ago. Lol

Walking and/or standing "seizures", a pt who attempted to flop like a fish over a siderail while "seizing" then when finished sat up and asked if that was a seizure, when told no attempted to get a description of what a seizure looks like. A guy (not diabetic) who took 3 cc's (not units) of insulin in attempt to kill himself because his girlfriend broke up with him, almost did the job.

I am a nurse (specifically ED nurse) at a small rural facility. Recently the registration staff has been told by their management (which I assume trickled down the line from administration) that they are NOT allowed to ask a patient his/her complaint when they present to the ED because it is a Hipaa violation. Now, that being said, they were told they were allowed to let us know if there is a chest pain/sob at the window so that we can meet core measures. I was not aware of any changes in Hipaa laws that don't allow a presenting complaint to be taken at the time of presentation. I find this to be very much an issue in that #1 if registration cannot ask a complaint then how are they going to let me know if there is a chest pain or sob so that core measures CAN be met, #2 if several patients present during a very close time (and this did happen on a recent shift) how am I to prioritize care if I don't know what a patient complaint is. Point is... even if i know about chest pains and/or sob pts what about the others? I mean a kidney stone or ams would definately come before the toothache or earache that frequents the ED, regardless of who presented first. I have worked at other facilities (relatively large and small) in the distant and recent past and have never had issues such as this. Have there been changes in Hipaa regulations? Sorry, just needed to vent!