Stupidest reason to go to ER

[DachRN]

ER Nurses/MD's etc.

I am currently writing a "paper" on stupidest reason for someone to come to ER.

ANY input you can send me would be much appreciated. IF you'd like a copy of the FINAL draft, let me know.

THANKS in advance!

PS. My winning entry so far is:

A woman who brought 1 month old baby in at 2:30 (AM of course) because "it won't look me in the eye, It doesn't recognize me!"

Not kidding

[weezledawg]

Sore Throat x 1 day, via ambulance

Holy mother of gawd, my sister is the 911 queen of the universe. The only person I know who called 911 not once, but TWICE for an earache and was transported both times.

This is the same mother who insisted paramedics take one of her kids in for a -- no joke -- rabbit bite!!! Also the same mother who had dad bring in the younger kid via POV with a FSBG of 38.

Ow

:trout::trout::trout:

[Soon2BNurse]

Anything other than:

hemorrhage

compound fracture

stroke

severe infection

MI or severe chest pain

severe abdominal pain

labor dystocia, pp, other OB emergency

near-death from trauma or other sudden onset

sudden loss of vision or paralysis

sudden incontinence

is stupid.

What about seizures? No? Maybe etoh induced seizures? Maybe? How about a gsw? I agree with you to an extent, but I believe your list is missing some stuff.

You can't poop? Anything else?

[kmoonshine, RN]

I think I'm pregnant...

I have a tampon stuck in my lady parts...

I have asthma and my throat is closing up (this is what the patient said at triage, and once in the room they said the following)...yeah, I'm not SOB or anything; I was diagnosed with an STD last week and I didn't fill my antibiotic, and I have discharge coming from my member...

My toe has been hurting for the past year; I stubbed it and it still hurts, but only every now and then, and I only feel the pain when I'm wearing these tight shoes...

Can I get a work excuse? Cough, cough...

Toothache via ambulance...

Don't you find that those who are the least sick complain the most, while those who are the sickest hardly complain at all? (I once had an 82 year-old in the ED who never rang their call light; was just waiting in his bed for testing and lab results...each time I checked on him, he was upright and smiling - sadly, he went septic on me really fast and I still remember him smiling, saying that he felt fine and didn't need anything at the moment ).

[jojotoo, RN]

I don't really feel there are any stupid reasons, people are lonely or confused and sometimes their reasons can make us crazy, but they are trying to reach out to someone, and we are a safe haven

Then they should get a friend, get a hobby, get a job, go to church, go to school, do volunteer work - GET A LIFE!!!

But DO NOT come to the ER with your whiney, self-centered, infantile demands for attention. That is not what I signed up for and I will provide you with some very serious patient education.

[jojotoo, RN]

I don't agree with that. For people without a primary care physician, the ER can be the only way to be seen by a doctor. It's not like they are kept with the emergencies anyway, they get sent to minor treatment area of the ER.

Then get a PMD. Make use of the clinic. Use the FREE clinc if that's what you need. Not every ER has a "minor treatment area". And even if they do, those areas are pulling staff and resources away from those who truly need emergency treatment.

[jojotoo, RN]

Deleted

[malachony]

1. Not all ERs have minor treatment areas. They shouldn't either, but that's a whole 'nother thread.

I don't think that's really for you to say or not, it's what works with each individual area. Perhaps because this

2. PCPs get new patients all the time, it doesn't require an ER visit.

is not true in my area is the reason we have a minor treatment area in our ER. With the frowth in our community, no primary care physicians for adults are accepting new patients.

And this,

3. Part of being an adult, responsible for yourself, is planning for the unexpected - this includes medical care.

just sounds rude to me. Yes, there are silly reasons to go to the ER, but when you don't have a PCP and have an illness that needs medication, medical attention or something that has the potential to worsen into something serious it is not irresponsible to seek medical attention. It is taking responsibility for yourself.

[malachony]

Then get a PMD. Make use of the clinic. Use the FREE clinc if that's what you need. Not every ER has a "minor treatment area". And even if they do, those areas are pulling staff and resources away from those who truly need emergency treatment.

Like I said, not all areas have PCP accepting new patients, and not all areas have free (something is really free?) clinics. ERs with minor treatment areas are not pulling anything away from actual emergency treatment. You are treated there with the understanding that if someone with a higher priority injury comes in you will have to wait.

[Soon2BNurse]

I thought most places with doctors offices and walk in clinics weren't open 24 hours where-as the ER usually is, so the ER is more convenient I'd imagine for some to go to at odd hours of the day/night? :imbar

[CritterLover, BSN, RN]

ers with minor treatment areas are not pulling anything away from actual emergency treatment. you are treated there with the understanding that if someone with a higher priority injury comes in you will have to wait.

uhm, not quite the case.

minor treatment areas do pull resources from other "emergency" patients. while nursing and mid-levels may increase their staffing, radiology and lab don't always.

where i work, radiology often gets completly flooded with silly xray requests from the minor treatment area. if someone presents with a pain somewhere, i can almost guarantee you that they will get an xray -- even if they have already had that body part xray'd, even if they have had the pain for the past 2 years.

even if radiology could increase the number of xray techs shooting films, the department is still limited by the amount of xray equipment.

same with lab. even though the er personnel usually draw their own blood, the sheer number of bladder infections/stds/etc that are treated on a daily basis (and require some type of lab involvement) can certainly adversly affect on the turn-around time for tests on other patients.

and don't forget the financial resources that er minor treatment areas suck up. remember, these are er visits, and they are billed as such. so the bladder infection that could be treated for say $150 cost to the insurance company (office visit, ua, abx, less copays), is going to cost many times that in the er, even if the patient is seen in the minor treatment area.

as far as the minor treatment patients understanding that they may have to wait longer for treatment if something of a higher priority comes in -- don't i wish. please. the patients that go to the minor treatment areas are usually the most demanding when it comes to being dischaged quickly. i often hear things along the lines of:

"i need to be seen now. i've got to get to work."

"i've been here for four hours for a sore throat."

"i waited six hours in the waiting room, and the doctor didn't even spend five minutes with me." (this is one of my favorite press-gainey complaints, because it shows how little that person really "got it.")

the fact is, people often come to the er for "minor" complaints for a very simple reason: the ers can't turn them away, and they don't have to pay up front. when you go to urgent care, you have to pay before you are seen. the over all cost for treatment at an urgent care is much, much, much less; however, that doesn't matter if you don't plan on paying anyway.

i do realize that some areas don't have many urgent cares, and i truely believe that is something they need to work on. it certainly isn't ideal, but it is a much better use of financial resources. (one problem is that most don't have contracts with medicaid, which is very unfortunate. medicaid would save quite a bit of money if it would let its participants use urgent care clinics instead of ers when appropriate).

but in my area, and the other two cities i've worked in, that isn't the case. all three cities (and we're talking about three very different parts of the country) have had urgent care clinics that were very accessible -- not to the 24hrs/7days point, but at least 12 hrs/day, 7days/wk.

[mom2michael, MSN, RN, NP]

Here was this week's

I've missed my period x2 months no other c/o. We when asked for LMP, we were told June 31st. We when told her that she couldn't have feasbily missed her period for 2 months when her LMP was the end of June and we are now in just the month of August (and just barely), she screamed at us for 10 mins. and told us how stuipd we were for not being able to calculate properly. Wasn't she the one that thought June had 31 days in it???????

I need a tenatus shot. No lacs, no wounds, nothing. Just time for the ol' booster shot because it's been 7 or 8 years. And by the way ----- hurry up because I have an appointment at 5p.m. tonight (it's 4:45).

And yes, those are the people that drain us ol' inconsiderate ER nurses.

[mom2michael, MSN, RN, NP]

It's not like they are kept with the emergencies anyway, they get sent to minor treatment area of the ER.

We don't have a minor care in either ER I work in so yes, people who use the ER as a PCP drain us all the way around. They drain the ER nurses, the ER doctors, the lab, the X-ray department and most of all they take away from people who really need that bed for true emergency visits.

And they tend to be the most demanding and the ones to file the 1st complaints against us as the staff. Take for example last week....rash on my butt for 10 days made a complaint against us because we were intubating and flying a 16 year old kid out in the next room and she had to wait and missed her grandson's baseball game. We each had our butts handed to us by upper management for that complaint because even though we only have 2 RN's and 1 tech and 1 doc and we were freaking busy with the dying 16 year old...we should've found the time to attend to her.

So yes, they do drain and tax our ER to sometimes un-speakable levels. All because they didn't take their c/o to a PCP.

And yes, in both towns I work in - finding a PCP is hard and difficult and at my 1 facility that area has seen such a huge growth in population, there are only 1 or 2 docs even taking new patients. But guess what....if a person has lived with the problem for weeks, months or years....they can wait an extra few days to get in to see a regular doc. Or they can go to urgent care to be seen. There are options instead of taking the ER way out of things.

Both of our facilities are implementing some pretty heafty new guidelines on treating long term illness that are not in an acute stage when they present to the ER. Both have already started policies on only giving out 48 hours worth of meds (except antibiotics) and a referral to a PCP. And most docs are simply saying....need to find yourself a PCP and follow up if they present in the ER and they are not acute when they get there. This is trying to deter patients from using the ER as a PCP.

I find myself having to ask "why is this an emergency TODAY" more and more during triage.