Comes to ER, told to follow up, doesn't, comes back, gets angry

Specialties Emergency

Published

Some patients come to ER for an ongoing problem, for example, abdominal/ bowel problems. They get a workup. In this example, the patient is told to follow up with GI. A colonoscopy would be the next step.

Months later they return to the ER with the same problem, having failed to follow up as instructed. Do they expect an emergency colonoscopy?

The doctor runs some basic tests, then instructs the patient that they must follow up, that a colonoscopy is the next step.

Pts gets mad and is going to file a complaint against the doctor, storms out of room.

I feel that the health classes in school need to educate our young on how to navigate the medical system.

Specializes in Med-Surg/Neuro/Oncology floor nursing..

Due to an array of health issues I've suffered over the years(both acute and chronic) I've been to the ED many times. From the patient point of view when you are told to follow up with your GI or primary or whoever doctor it can be frustrating because you are hurting NOW and having to wait until you get an appointment with the respective doctor could mean days of waiting in pain(or dealing with whatever symptom that was bothersome enough to warrant a trip to the ED).

Add to the problem many people not fortunate enough to have insurance and that's that..they aren't going to make a follow up appointment they simply can't afford it.

I am not saying using the ED for every little problem is ideal but what is the alternative? Patient comes in and they aren't sick enough for an admission to the hospital for these tests(my hospital does perform GI tests to inpatients where the case is emergent enough I actually had an upper endoscopy done because I was throwing up blood) but they don't have the resources to follow up with a specialist on an outpatient basis so the patient is in a kind of medical purgatory not knowing what else to do..so what do they do? Its a sad state of affairs and I don't have a good solution or answer for those patients that can't and don't follow up.

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I'd say, at least once a shift (often multiple times), I have a patient that did not follow up and comes back because they are not better. I have had patients actually not fill their prescribed antibiotic and come back 2 days later because they are not better and "something needs to be done." It is a problem, but I do not have an answer. We live in a different world now. Sometimes the problem is access to healthcare, but many times it is not. In my area there are many places for the uninsured or low income to go to for PHC. There are free and reduced meds. We give the information. We teach/educate. I discuss options to expensive meds such as meds on a $4/month med list or smoking cessation to free up money and most times it falls on deaf ears. I discuss diet and exercise as a potential way to not need that htn med that they can't afford. Again..deaf ears. I truly care...and want to help, but you can't change people. We live in a society of "not my fault" and "it's your job" mentalities that only seem to be getting worse. I will continue to try to educate and care for those that do not even attempt to help themselves. However, when I clock out...I have to leave that behind. "I did my best" will have to be my peace!!!

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