This can't be right...

Maybe the doctor was telling you what was going on based on Hipaa. As nurses we don't do medical diagnosis.

Why do we flame each other so?

OP, I just recently took TNCC, I'll admit I'm no expert, so I will probably be flamed too.

My take on the situation-that's a time to call 911 immediately. Support c-spine, with possible head injuries you should always assume spine injuries as well. Good job clearing her airway. Judging by the age of the child and that she was clearly upset, those vitals wouldn't have been too terrible. The falling asleep between screams and nausea would have concerned me also. As nurses though, we do have to collaberate with the doctors and do as they say. There are ways of asking Doctors to do more test, ect. It involves playing the nurse/doctor game. "Doctor, this patient was unconscious after falling and now she is falling asleep between screams and complaining of nausea, gosh, do you think we should see if she has a head injury?" "No" "I guess I still have alot to learn could you please help me understand this?" Always protect their egos, you get more that way.

The child was okay, so...maybe the doc didn't have time to explain everything to you, but possibly what he saw from his ER years might explain why he didn't do all the tests he could have done. You could have maybe asked the nurse to explain. Now, they did observe the child for an hour, so possibly with no changes, there were no interventions needed.

Keep asking questions, good luck with nursing school.

I am thrifty, by all means. But if I had to "rack up a hefty ER bill" to be sure my child was safe, then so be it.

As far as the bolded statement, it means nothing to me. I have met some of the stupidest, most incompetent MDs in my lifetime.

I could say the same thing for a few nurses I know. Every profession has some idiot that is flying by the seat of his pants. Generally speaking though, doctors know what they're doing.

Not a flame but i'm just putting it out there.

If you had to pay for it out of your own pocket opposed to having it billed to your insurance would you feel the same? A lot of people don't care about racking up hefty medical bills because it's one thing to have an insurance company pay $2,000 for an ER bill than it is to have to pull $2,000 out of a bank account or charge it on your personal CC. Now lets imagine if the doc said the child is fine but if you want a CAT scan then go to the cashier and pay her in advance for this unnecessary test.

This is the problem with health care today...people feel that money is no object as long as the bill is going to the insurance company or the govt.

Just my:twocents: and I humbly apologize if you meant that you would have no problem spending your hard earned money to pay for a test that has been deemed unnecessary.

I am thrifty, by all means. But if I had to "rack up a hefty ER bill" to be sure my child was safe, then so be it.

As far as the bolded statement, it means nothing to me. I have met some of the stupidest, most incompetent MDs in my lifetime.

if it was my child losing consciousness, a ct scan would've definitely been done especially since they're going to charge you a ton of money anyway. furthermore, doctors may be taught assessment skills. however, many doctors don't even use them and instead ask the nurse about the physical assessment of the patient. there are incompetent doctors just like there are incompetent nurses.

I don't believe in overtesting or putting all my eggs in the lab basket, but clearly the staff didn't do so hot on communication. A couple of minutes might have aleviated a lot of concerns/fear. I firmly believe teaching is always part of the job even if you only have 30 seconds.

Thank you for your replies. I can see both sides better now.

LTC RN JC: Thank you for your post. Its true that when questioning anybody, especially a Doctor the way you phrase your question means a lot. I wish the ED Dr. had explained like you had! That would have helped a lot!

For my child yes I would spend tons of money on a test that might not be necessary. If it means the childs life or quality of life. There are already going to charge you a few hundred just for saying hello to you, might as well cover all your bases. Besides assuming that there is inusrance your not paying it anyways. I don't see a problem with sending large bills to insurance companys. Thats what their there for, paying the bills. And if there is no insurance well that sucks but the kids life is more important.

Well, as far as communication, the doc didn't explain things to the OP who is apparently of no relation to this child, just a random person doing missionary work, so why would he?

The doc did an assessment. The doc made a diagnosis. The kid is fine. If the kid wasn't fine, you'd take them back to the ER. But the kid was fine.

The doc also didn't do a full skeletal survey. The doc didn't do a VCUG. Why not a liver biopsy and a full septic workup with 3 days in the hospital on IV antibiotics until the cultures all come back negative? There's a lot of things the doc didn't do because they didn't need to be done. The kid was FINE.

To the OP, when you're in these impoverished countries in the future, you won't have a CT machine available. You're going to have to trust the assessment skills of the people around you.

It's not about money. It's about unneccesary radiation. What is a CT's radiation? Something like 2 years worth of radiation? Not to mention, unless she was showing severe signs of mental status change, a CT in most cases isn't even going to show something.

Just because a test is available, doesn't mean it needs to be done. Procedures are limited to bare minimum for kids. If they don't need an IV, they don't start an IV. BECAUSE IT MAKES THE KID MORE AGITATED. Agitation leads to increased heart rate/respiratory rate, if the kid DID have a brain bleed going on, that would make things worse. Stick a kid in a giant piece of metal on an uncomfortable metal table. WILL MAKE THINGS WORSE and like I said, a CT isn't going to show things at that point anyway unless they were bad enough to be creating more extreme mental status changes.

Geez o peezo. Can't a student ask some experienced nurses some questions without being critiqued on paragraph and sentence structure? This is the mentality of some nurses that I wish would just go away. I am a new nurse of one yr myself and remember being hypervigilant about certain pt's I was assigned to as a student; just seemed to come with the clinical territory and "by the book" thing going on. Why is it important to respond to OP's with condesending remarks, dissing them for help with a homework question, or feel certain that the OP is troll. To the OP, you had some decent skills going on in that circumstance, and now simply questioned if enough was done for the little girl. I've seen youngsters topple off their bicycle, split their lip and see stars and a few other symptoms similar to the OP's scenario. Parent takes them into ED and a stitch or two and they're good to go. Two days later they are back in with a subdural hematoma. Give these baby nurses a break. Just sayin.

Give these baby nurses a break.

You're more likely to be given a break if you don't come in looking for verification that the big bad ER doc was wrong and doesn't even know as much as a nursing student. If you want to learn, you don't come on and say, "I saved her life and then the doc didn't even run enough tests! And I've known lots of stupid docs!" You say, "This happened, and I would think they'd have done a CT, why didn't they?"

newtrees: THANK YOU!!!!!!!!!!!!!!!!!!!!:)

I have met some of the stupidest, most incompetent MDs in my lifetime.

I'm not trying to sound snarky, but every MD I've met on a professional level has had a basic level of competency. There were a lot I didn't like personally, and some I thought were better than others, but they were all at least miminally proficient. And in my year long stint in the ER, I met the some of the smartest docs. I honestly feel it was a privelege and an honor to work with them.