The dreaded pregnancy test

Specialties Emergency

Published

So a few days ago...pt checks in during the middle of a very busy day... Her CC: "Need pregnancy test"

The MD (a non-nonsense doc) goes in to see the pt. Conversation as follows:

Doc: Do you smoke?

Pt: Yes

Doc: Do you have cigarettes now?

Pt: Yes

Doc: Then you have the money to go to the dollar store and get a pregnancy test. I'll get your discharge papers ready.

Love it! :yeah:

Specializes in NICU, Post-partum.
So a few days ago...pt checks in during the middle of a very busy day... Her CC: "Need pregnancy test"

The MD (a non-nonsense doc) goes in to see the pt. Conversation as follows:

Doc: Do you smoke?

Pt: Yes

Doc: Do you have cigarettes now?

Pt: Yes

Doc: Then you have the money to go to the dollar store and get a pregnancy test. I'll get your discharge papers ready.

Love it! :yeah:

I want to come work for him!!!!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
So a few days ago...pt checks in during the middle of a very busy day... Her CC: "Need pregnancy test"

The MD (a non-nonsense doc) goes in to see the pt. Conversation as follows:

Doc: Do you smoke?

Pt: Yes

Doc: Do you have cigarettes now?

Pt: Yes

Doc: Then you have the money to go to the dollar store and get a pregnancy test. I'll get your discharge papers ready.

Love it! :yeah:

:hhmth::hhmth::hhmth::hhmth:......PRICELESS!!!!!!!

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How did this person get past triage? And why does this constitute an emergency?

Who puts an IUD in a virgin??? Just curious!!!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
OK here what i do not get the last time I was in the ER they walk in and told me they where going to do a pregnancy test, I told them there was no way in #### I that I could be pregnet , WHY because I cannot have kids , have an IUD to try to stop my bleeding , and Oh I am a virgin !!!!! and I did not want one and and did not want to pay $150 .00 for one I did not need .

At this point they first froze in place because of the virgin thing and then I was told it did not matter that it was mandatory !!!

As a long standing ED RN........and I do not mean to imply you or the truth of your statement........but I have delivered MANY babies from women that were from sworn virgins on their peroids.......as the baby is crowning.

I had a freind who delivered very healthy twin girls......along with her IUD.....:o

We the ED have a hard time believing anyone tells the truth:yawn:..............So in our book you are guilty until proven innocent.:smokin:

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
How did this person get past triage? And why does this constitute an emergency?

Who puts an IUD in a virgin??? Just curious!!!

I don't know who would put an IUD in a virgin....they seem mutually exclusive:confused:......but you can't turn them away at triage. Triage is not a you get registered you don't so leave. Triage determines how long you wait the waiting area and who gets seen first.

SO..........At triage.......I just let them know you are going to have a looooooong wait for that pregnancy test...........hopefully they'll get P.O. and leave without being seen......:smokin:

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Specializes in ER.

I had a similar thing happen to me!!

The doc walked in the room and said,"Now, this is an emergency room, and there isn't anything emergent about you being pregnant. So I can't do a pregnancy test on you."

Pt says,"well, what if I'm having abd pain?"

Doc,"Well, yes, we would do one then."

Pt,"Well, I'm having abd pain right here" (Points to left lower quad)

Doc,"Oh, well, tell me about this abd pain! We can treat abd pain. We'll have to do some lab work, x rays, probably a CT scan. You'll probably be here for a while because it takes at least an hour to get CT reports back.."

Pt,"Um, well, I guess it's not hurting too bad... I can just go get a test..."

Seriously... I was in the room. Serious kudos to the doc.

Btw, even in triage, we can't turn ANYBODY away who wants to see the doc, no matter how silly the complaint. We cant even hint they shouldnt be there, or hint they should be seem somewhere else (Like, our hosp doesn't do L&D, the one 5 mins down the road does.. but we CANT turn away pregnant people, even though we aren't the best place for them.)

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Specializes in Emergency, Telemetry, Transplant.
I don't know about anyone else, but I'm really curious to know the patient's reaction! Would you please tell us?

I think the pt was a little suprised by how the doctor approached the situation. Didn't really repond to the doc. Took her DC papers and left.

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Who puts an IUD in a virgin??? Just curious!!!

The majority of doctors in the US don't want to insert an IUD unless the woman has already had a baby. However, being nulliparous or even being a virgin isn't a contraindication. And it's much easier to find a doctor who will insert an IUD for a NP woman if you leave the US to have it done. Medical tourism is a big business in some places, you give them cash in dollars and you get your IUD, NP, virgin, or whatever!

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Btw, even in triage, we can't turn ANYBODY away who wants to see the doc, no matter how silly the complaint. We cant even hint they shouldnt be there, or hint they should be seem somewhere else (Like, our hosp doesn't do L&D, the one 5 mins down the road does.. but we CANT turn away pregnant people, even though we aren't the best place for them.)

Off subject but I have a quick story (rant) about this. My sister who was pregnant and out of state went to a hospital for pregnancy complications. The hospital she went too had no L&D but she had no way of knowing that....she just googled the nearest hospital and went there. So, she sees the triage nurse waits about 10 min to be seen and is promptly told they can do nothing for her but transfer her to the hospital about 3 blocks away. My sister (very upset at this point for having to wait to be seen at a hospital who could do nothing for her but transfer her) throws a royal fit that no one informed her she was at a facility that could not handle this type of emergency and that she wasted precious time waiting (in the time it took for her to register, and see the triage nurse she could have walked to the other hospital) to be told that nothing could be done for her there. Then about a month later when she got the bill another fit ensued. I can't say I blame her why couldn't the triage nurse have told her that there was no L&D there? After many angry phone calls and threat of legal action my sister got out of paying the bill....I have never worked in the ED and I am from a very small town so my understanding of this is pretty limited but the whole ordeal just seemed so nonsensical to me.

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Specializes in Emergency & Trauma/Adult ICU.
Off subject but I have a quick story (rant) about this. My sister who was pregnant and out of state went to a hospital for pregnancy complications. The hospital she went too had no L&D but she had no way of knowing that....she just googled the nearest hospital and went there. So, she sees the triage nurse waits about 10 min to be seen and is promptly told they can do nothing for her but transfer her to the hospital about 3 blocks away. My sister (very upset at this point for having to wait to be seen at a hospital who could do nothing for her but transfer her) throws a royal fit that no one informed her she was at a facility that could not handle this type of emergency and that she wasted precious time waiting (in the time it took for her to register, and see the triage nurse she could have walked to the other hospital) to be told that nothing could be done for her there. Then about a month later when she got the bill another fit ensued. I can't say I blame her why couldn't the triage nurse have told her that there was no L&D there? After many angry phone calls and threat of legal action my sister got out of paying the bill....I have never worked in the ED and I am from a very small town so my understanding of this is pretty limited but the whole ordeal just seemed so nonsensical to me.

There is a simple answer to your questions: EMTALA.

http://www.cms.gov/EMTALA/

In short, this federal law in effect since 1986 states that anyone experiencing a medical emergency (and the definition of "experiencing an emergency" includes having simply shown up in the ER requesting to be seen) MUST be offered a screening exam, stabilized if necessary (with explicit documentation of the patient's stable condition), and transferred if appropriate or necessary to continue care (or voluminous documentation of the patient's refusal of transfer).

It might seem to an outsider that it would be far more efficient to point out to an alert, ambulatory patient that she would be better served by walking/driving an additional 3 blocks ... but such an action would be a huge EMTALA violation with a resulting six-figure fine for the hospital. Yes, really.

BTW -- a "royal fit" over a 10-minute wait? Hmm.

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Thank you for your answer....I will pass it along to my sister. As a nurse the best I could offer to her as an explanation was "you can't refuse medical services to the ER patient" but that still didn't explain why no one mentioned they couldn't help her there so she could make the decision to stay or to go somewhere else.

She felt deceived and like they were just after her money.

Yes royal fit because she was pregnant and having bleeding and very worried about her unborn child.....I don't think anyone has ever accused a scared pregnant mamma of being rational lol.......

Seems sad to me that in a situation like that legislation trumps common sense

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Specializes in Emergency, Telemetry, Transplant.
It might seem to an outsider that it would be far more efficient to point out to an alert, ambulatory patient that she would be better served by walking/driving an additional 3 blocks ... but such an action would be a huge EMTALA violation with a resulting six-figure fine for the hospital. Yes, really.

BTW -- a "royal fit" over a 10-minute wait? Hmm.

And the EMTALA you-know-what would hit the fan if something happened to the pt during their 3 block trip.

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