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What happened to the "Emergency" in "Emergency Room?"

Emergency   (13,630 Views 80 Comments)
by Emergency.RN Emergency.RN (New Member) New Member

Emergency.RN specializes in Emergency.

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You are reading page 3 of What happened to the "Emergency" in "Emergency Room?". If you want to start from the beginning Go to First Page.

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I personally don't mind the non emergency people who show up however I can understand your frustration. My only issue is when people who come in with very minor issues that they could go to their Family Doc or WIC Complain how long they have to wait, especially in my ER where we only have 1 or 2 doctors working at a time.

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cupcakeluver specializes in Ortho.

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I think a big issue is that a lot of people don't realize that an ER is for an "emergency". I never realized it myself until I got into nursing school and was exposed to the other side of the health care equation. Am I stupid? Probably. I always just assumed if you were in terrible pain or feeling really sick, then the ER was an option. Especially if it's the weekend and no other offices are open. I live in a poor, rural community and most people don't understand a thing about the healthcare system. At all. It's shocking how much people don't know about healthcare and the issues included.

I never really thought about taking space from someone else. I always thought that was what triage was for. The sickest person is seen first. I'm not trying to make excuses. I'm just trying to point out that some people truly do not understand that the ER is for potential life-and-death situations only. I think a lot of it comes down to misinformation and a lack of education.

I know I've learned a lot from this thread.

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JBudd has 38 years experience as a MSN and specializes in trauma, teaching.

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I never really thought about taking space from someone else. I always thought that was what triage was for. The sickest person is seen first. I'm not trying to make excuses. I'm just trying to point out that some people truly do not understand that the ER is for potential life-and-death situations only. I think a lot of it comes down to misinformation and a lack of education.

I know I've learned a lot from this thread.

But that's just it, ERs aren't just for Life&Death anymore, we are totally set up for everything else and make money off it..... The middling ones, the appys, the dehydrated gastroenteritis, the rule out chest pains, the orthos that wouldn't die but are in a lot of pain.... all need the ER. Most of the admissions in any hospital come through the ER.

You hit the nail on the head with "that was what triage" is for... but getting someone in pain to understand that in today's me-first society isn't likely to happen, educating the public or not.

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ArrowRN has 3 years experience as a BSN, RN and specializes in Med Surg, Vascular, E.N.T.

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They make money off it but its just one of the few things that are running up health care costs and when people like me who may go in for legit reason our wait times suffer.like last time I was in the ER having early signs of stoke it took them 3 hours before I got a bed. Why can't hosptials open and run urgent care centers 24 hours a day instead of just during business hours? Well some open till 8pm. The other problem is with people with no health insurance it dont matter if its a bruised toe, they go to the ER cause noone else will take them and the rest if us pays their bills

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Momma1RN has 4 years experience as a BSN, RN.

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But that's just it, ERs aren't just for Life&Death anymore, we are totally set up for everything else and make money off it..... The middling ones, the appys, the dehydrated gastroenteritis, the rule out chest pains, the orthos that wouldn't die but are in a lot of pain.... all need the ER. Most of the admissions in any hospital come through the ER.

You hit the nail on the head with "that was what triage" is for... but getting someone in pain to understand that in today's me-first society isn't likely to happen, educating the public or not.

Especially true when our reimbursements are partially based off of surveys. If the majority of people coming to an ER is non-emergent and ESI class 4-5, and wait 4+ hours to be seen, they're going to be upset. And upset patients ALWAYS fill out the surveys.

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ER stands for EMERGENCY room. Emergency is defined as "a serious, unexpected, and often dangerous situation requiring immediate action". 75% of the patients that come in are absolutely not an emergency and do not require immediate attention. If you do chose to check in at the ER, please know that there is a potential for a very long wait. I do become exhausted after hearing patients state "can't I just go to fast track" or " I see people that are going back when I was here first". I feel that it should be complete common sense that an ER is not like a restaurant where its first come first serve. The problem is that there are so many people that have this sense of entitlement. It is extremely frustrating! One particular situation still upsets me to this day. A daughter of an elderly patient (who still lived alone and adequately took care of himself) with a dislocated hip asked if her dad could have something for pain. I asked him if he would like something for pain and he stated he was ok right now. I should include that the patient DID NOT have dementia or Alzheimer's, which could absolutely cause difficulty in verbally expressing pain. I still told the daughter who was persistent on pain meds that I would inform the doctor. Fast forward literally 3 minutes, code blue room 97 eta 2 minutes. The doctor who was caring for the elderly individual with the dislocated hip, was also caring for the patient that would be coming into bed 97. The code ended up being a 27 year old male. The doctor was in that room trying to save that individual. Trying everything he could. Meanwhile, I am called back into the room by the daughter. She states " my dad is still waiting for pain medication". I very nicely explained that the doctor is with an extremely critical patient and will absolutely order pain medications when he can. The daughter had the very nerve to say "well my dad is critical and that is no excuse". She then replied "is the doctor with the code blue I heard overhead?". I softly stated yes he is. The grand daughter in the room who had just started nursing school says " I just finished ACLS and there only needs to be 3-4 people helping in a code". I am doing everything to control myself at this point. People need to understand the heartless individuals that we interact with in the ER on a daily basis. Oh did I mention the daughter in the story was a retired nurse? That situation sticks with me to this day. Also, establishing a PCP is not an easy thing to do absolutely. However, once someone obtains insurance or Medicaid they need to do their research and find a PCP. At that time they need to schedule an appointment to establish themselves. It is easier to schedule an appointment with a doctor, in the future, after you have already seen them. So, I'm sorry, I don't appreciate the individuals that come in once a week on Medicaid with no PCP. It's an insult to what we do in the ER.

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JBudd has 38 years experience as a MSN and specializes in trauma, teaching.

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The grand daughter in the room who had just started nursing school says " I just finished ACLS and there only needs to be 3-4 people helping in a code".

Answer: "Yes, and one should be the DOCTOR!"

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sharkbacon has 6 years experience.

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I work in a rural hospital ER (2 RN's, 1 doctor, and me-- registration LPN). Since I'm the one registering, and I can see all this information, I would go as far as to say that 98% of our patients are Medicaid. Illinois Medicaid ER copay is $3.90, but very rarely will anyone pay it, and the hospital doesn't bill for anything under $10, because of the cost of printing it up, sending it out, etc. (I guess, that's what I'm told). And on top of that, Illinois just isn't paying hospitals these days the money they're owed for Medicaid patients. So it's quite a pickle.

But that's off topic.

Mostly, the reason I see is that the hospital won't bill them, whereas the clinic will require payment up front before being seen. So, basically, they can get out of paying for it entirely by coming to the ER.

But, to be fair, we have only one after hours clinic, three days a week, and no urgent care. But I still think all twenty sore throats/runny noses (not exaggerating) I checked in on Saturday could have waited until Monday morning.

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brillohead has 5 years experience as a ADN, RN and specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

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When I start peeing blood at 11pm on a Friday, I most certainly am NOT waiting until Monday morning for my PCP's office to open.... I'm heading to an ER (there were no Urgent Care Centers in my area).

While the UTI may not be a life-threatening emergency, it's close enough in my book!

My insurance company originally denied the claim, saying that a UTI wasn't cause for going to the ER, and I should have gone to my doctor's office. Upon hearing the "peeing blood at 11pm on a Friday" (which was easily confirmed by checking the date and time on the claim), they changed their tune and processed the claim.... justified!

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I will not go to the ER unless I am bleeding out. I cannot afford the high co-payment. About 80 percent of the people who go to our ER do not have insurance and come in several times per month for the same things.

This one guy got admitted. He is young, addicted to meth, opioids, has copd, non compliant. Got mad and wanted to leave ama because the doctor wouldn't give him any more pain medication. He said he can get more on the street. He had been to the ER 36 times for free in 6 months! It's frustrating because the doctors will admit these people for bs reasons ( this guy's "exacerbation" wasn't even bad, and he still went out to smoke) If they come in enough times. Our facility has no money, gives no raises but continues to allow this with no one ever paying their bill. I was late paying a bill to my facility (labs) and they threatened to turn me into collection.

There has to be a better way!

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