How do you explain to patients that even though they are in a room, they still have to wait for a doctor to see them to order medications. Many times patients can wait >3 hours in a room to be seen by a provider. I do every intervention I can: INT, labs, EKG, x ray, CT. I do notify the doctors of patient needs for example "Hey doc patient in room 7 has a known kidney stone and is in pain." Some providers will give orders for medicine, but many will not. The patient will yell, cry, and scream at me and I can do nothing. Of course these patients are non critical and CAN wait, but telling a patient that doesn't go too well.
Our satisfaction scores are awful. Even if I do EVERYTHING within my scope, I am still blamed.
A patient in pain from a kidney stone is an urgent patient. Waiting to see a doctor for 3 hours in an ER? Not acceptable. I get it that if the MDs are not regular ER docs and see 1 patient an hour, but this concern should go to administration. There is no reason an NP or PA cannot see many of those patients that are coming in. I've taken kids to the ER twice and did not see a doctor. Standing protocols for the nurses are a very good way to go. While the patient is waiting, the UA is being run. It takes a second to write an Rx.
We have 21 beds with plans to expand to 45 in the next 2 years. We have used a mid level provider as a PIT, but only briefly and only on days. Our problems occur between 0300-0600 when we only have one provider. Some will stop seeing new patients at 0400 and the patients have to wait for the 0600 provider to arrive. We have been told there will not be any changes to provider staffing until after the expansion. Where I live there are 3 hospitals within a small area and we are all working with these long wait times. On days there are 2 doctors and 2 mid levels. The mid levels are 0900-2100 & 1500-0300.
I'd like for your bosses to be patients in your ER. I hope they will be having severe pain - a good fracture, a huge kidney stone, anything extremely painful. You will definitely see change after that.
Ahh, so much for dreaming.
Meantime, just tell the patient the truth and don't feel badly.
I know it's hard when these accursed doctors won't give pain med to people who really need it, but it's not your fault.
And if they yell at you, just walk ou of their room.
Tell them to be sure to tell the doctor how unhappy they are with the ridiculously long wait and the untreated pain.
Why go to an ER for pain, like a kidney stone or whatever etiology, if no one will order the medication.
Skippingtowork
342 Posts
A patient in pain from a kidney stone is an urgent patient. Waiting to see a doctor for 3 hours in an ER? Not acceptable. I get it that if the MDs are not regular ER docs and see 1 patient an hour, but this concern should go to administration. There is no reason an NP or PA cannot see many of those patients that are coming in. I've taken kids to the ER twice and did not see a doctor. Standing protocols for the nurses are a very good way to go. While the patient is waiting, the UA is being run. It takes a second to write an Rx.