Seriously?!?!

NICUmiiki, DNP, NP · Mar 3, 2013

That's amazing

My ER does this too.

Psychcns · Mar 3, 2013

Why are some ER's smart about this??

Is it having docs that are willing to make the tough calls?

Is it having residents wanting to do million dollar

Workups because they can?

Is it having smart ER policies?

Using the ER as a walkin clinic is expensive.

sandyfeet · Mar 5, 2013

On the board as chief: "Heart racing after Zofran (HR 84)".

moriahcat · Mar 7, 2013

Even for those who really don't want to waste health care dollars, being uninsured leaves the ER being one of the few places that a person can go. (BTW, I used to have an account here when I was attempting nursing school, decided to try nursing computers, they don't complain as much. So no, not a people nurse, and maybe if I'd stuck with it I wouldn't be uninsured right now, between jobs ATM.)

I read up on here after this week's experience. I thought I had the flu last week. Did standard home treatment for the flu, but after a week and the fever staying up over 100... my respiratory accessory muscles hurt so badly and my breathing was not good (I have a fairly complicated asthma history and one previous admit for an exac). My roommate put his foot down when he got home from work, and took me in to the ER. So my chief complaint was one I felt really guilty about -- "still sick". (If I have to put "still" in front of whatever the issue is and I'm showing up at an ER.... I know I screwed up somewhere along the way.)

There's no question I was sick. I ended up admitted for two nights, RML and RLL pneumonia, and was upstairs in less than two hours so didn't take up a bed long down there. Yes, I needed medical attention. But what I really needed was medical attention long before I was in the ER, so I could have avoided the ER *and* the admission. I wasn't coming in for a hangnail or stabbing myself in the gut (really? yes, *those* gems are the reasons we non-ER people can't help put read the threads here, even if we're not even attempting nursing anymore), but it still doesn't mean my visit was the best utilization of resources either.

moriahcat · Mar 7, 2013

(BTW: My vitals when I hit triage were 110/80/p100+, o2 sat hovering between 89 and 90, and within 10 minutes of my roommate opening the car door at the hospital, I was on oxygen and getting an updraft. I feel terrible that I had to have an ER fix me up when it really shouldn't have gotten to that point, but there's no question that when you *are* sick -- even if the ER really isn't where you should have ended up -- ER nurses kick tail, and do it fast!)

erinRNphillips · Mar 8, 2013

That's amazing

Omg!!! That's great why doesn't every ER do that ?

ERksome · Mar 8, 2013

In my head I wonder about insurance- esp when mom brings in her 7 yo son at 0300.

cc? Leg pain.

Well, at dinner, son sat on his legs, felt numb and tingly, then hurt ( ummm they fell asleep?!?) So 10 hrs later, he's in my ER, playing a video game, watching cartoons, happy as a clam, and in NO PAIN when asked.

Mom brought him in, just because. So yeah, in my head I'm thinking a) what kind of parent drags their perfectly fine kid to the ER in the middle of the night b) damn you must have great insurance!

CharleeFoxtrot, BSN, RN · Mar 10, 2013

One of my favorite things to witness in the e.r. is when I discharge someone and ask them where their ride is they say "im calling an ambulance to take me to another hospital" I used to argue and try to reason with these people but I finally gave up and stick them in the waiting room and say "good luck with that." You just can't fix stupid!

I was a paramedic and an ERtech in an urban setting before I went though nursing school. My personal best was a frequent flyer who managed to hit all 3 ERs in the county during the course of a 24 hour shift-and while he didn't call 911 from the parking lots he did walk out of one ER and flagged down my rig in the bay to take him to the "other hospital that has better turkey sammiches" LOL.

Too many stories to have a favorite, but I remember one where we got a call at 0430 for an 18 year old female with ABD pain-my mind starts churning about ectopics and/or miscarriage enrt. We had run all night, the roads were icy and listening to the radio chatter I knew the ER was backed up with a couple of shootings and some bad MVAs. We get there, and after I assessed her I called in this report:

Me: BigCity ER, BigCity ER, this is Alpha123 inbound (Biiig dramatic pause) Priority 4.

Radio Triage Nurse: Go ahead Alpha 123

Me: Apha123 is inbound 18 year old female, CC of ABD pain x1 day. A/Ox4, BP 120/80 HR 70 Resp@20. Pt states she has lower quad pain approx every 21 days. LMP 21 days ago.

Before I can continue my priority radio traffic the ER radio cuts in...

Radio Triage Nurse: (SNARLS) TRIAGE HER Alpha123 (meaning drop her off at the front entrance to triage rather than bring here to the back)

Ayup, we got called for a female who had her monthlies and wanted something done about it. The radio triage nurse was laughing when we got there :)

opossum · Mar 10, 2013

flagged down my rig in the bay to take him to the "other hospital that has better turkey sammiches" LOL.

I think I know this guy... :yes:

UseYourNoodle · Mar 11, 2013

love to ask pt's "what is your emergency today?" during triage just to see their puzzled face when they realize they really don't actually have an emergency

PMFB-RN, RN · Mar 12, 2013

Once had a young woman who came to ER with a very swollen and infected foot after stepping on a nail 3 days ago. We gave her IV ABX, tetnus and a Rx for PO ABX & vocodin. After discharged her we got a call from a pharmacy questionsing her Rx. Apperently we were the 4th ER she had hit that day (used a different name at each) with her infected foot. She had recived 4 doses of IV ABX and 4 tetnus immunizations and all just to get a 5-10 pills of vicodin Rx. She ended up back on another hospital with acute renal failure.

Racer15, BSN, RN · Mar 15, 2013

"Leg pain x2 years, not currently hurting". And it was a night when we were absolutely SLAMMED.