Tackling the Crisis in Emergency Care

[herring_RN, ASN, BSN]

september 05, 2008

tackling the crisis in emergency care

las vegas sun story about a man who suffered a heart attack and went to the nearest er for help:

"but even as linda scheinbaum-morton's wife of 24 years-was screaming [in the emergency room] for medical attention to save his life, the mountainview hospital nurse was insisting on getting his social security number, emergency contact and insurance information....

...begin with the seeming villain of this tale, the pigheaded nurse who forced paperwork on the scheinbaums in a time of crisis. blogger annie has some issues with the sun's less-than-probing characterization: "is the 'nurse' cited an unlicensed admission clerk?" asks annie. "a secretary?...or a licensed registered nurse who is obligated to perform triage and intervention to conform to state regulations and to the hospital's accreditation agency standards?"

this is important--if the nurse in question is a registered triage nurse, then it's her job to prioritize patients based on the severity of her conditions. this would make her failure to recognize morton's condition all the more scandalous. though the sun isn't specific on the matter, the nurse probably wasn't a triage nurse, since linda was screaming that her husband needed to see a triage nurse and got no response. ...

...as i argued in my earlier post, america's nursing shortage can be solved by encouraging: innovative partnership programs across nursing schools, providing higher pay for nursing faculty and clinical nurses who work in high-stress situations, and--perhaps most importantly--improving working conditions for nurses through better benefits and greater voice in hospital decisions. ...

http://www.healthbeatblog.org/2008/09/tackling-the-cr.html

[Kyrshamarks, BSN, RN]

I have worked ER's all over the country and I have NEVER seen a "nurse" demand the ssn or contact info. That is always done by an unlicensed person. These types of stories are scare tactics that do not help the nursing situation. I do not know any nurse that even cares about that info being given, we just treat we do not care about ssn's.

[Thornbird]

Hospitals I have worked in or dealt with triage BEFORE patient sees admission clerk. That seems the best way to do it.

And, not to make anyone mad, it requires having qualifed triage nurses who know how to properly assess. I have seen a pt. arrest in the waiting room due to some moron's decision to put a "float" RN on triage who apparently did not know how to triage properly. Another reason RN's should not be floated to sprcialty areas unless they are specifically qualified in that area.

In the article cited, NO WAY was that a nurse. I can't imagine any nurse acting that way. We put the patieent FIRST, hat's what makes us nurses.

[clairebearrn]

I'm my ER we have a registration clerk...The patients see the triage nurse and if are not a 'rush' patient they see the clerk or else they just go straight onto the ER and get registered there. I agree this story has it wrong. It wasn't a nurse asking for the SSN, that os not our job.

[jayne109, RN]

I agree with ClairBearRN: we have a registration clerk that puts the information in the computer. I can do it as well but I only do it if the clerk is busy. I definately do not do it on a rush patient. If someone says chest pain, and they are at the age or have a cardiac history, family can give the info, I take the pt straight back. I am a dedicated triage nurse, only a few people float up to triage if there are not one of the 5 of us dedicated nurses there.

This is the way it was with both the Level I ER I left and the Level III Er that I am in now.

The other thing is, I tell my pts that #1 I don't need their insurance at the time of registration and #2 I am not allowed to see it. SO when they digging for this info, I wave them off.

We may need a SSN but it is not required to find the person in the computer. and it is not necessary if a pt is in distress or, heaven forbid, arrest.

hope this helps.

M

[Blee O'Myacin, BSN, RN]

An arresting patient can be put into the system after the fact. That's why we write on the sheet or whatever else is handy. To people in distress, anyone in scrubs is a "nurse" unless they are wearing a white coat. Then they are a "doctor".