Published Mar 29, 2002
Ok, so this is what just happened and I need my nurse friends to guide me on what to do next.
I go to my local corner store to buy a candy bar (need my fix for the day). The people that own/work the store are from Pakistan.
I am a friendly person and ask how he (the cashier) is doing. He says that he is ok with a bright smile on his face. As I was turning to leave his expression changed to a somber one.
I asked him if he was ok. He said, "Well, I guess." After some minor prying on my part he opened up and said that he has been having some problems with his heart. He said that a couple times a month he gets a "lightning bolt jolt that goes through his heart down his arm and then feels like someone is sitting on his chest. He was not having any symptoms when I was there, but he chose to "open up" to me.
Ok. I am only a pre-req RN student. Which really means, I know little to nothing about medicine at this point. But what I do know is that what he describes could be a serious problem with his heart.
All I could tell him was to go to the doctor. He explained that he didn't have the money or medical insurance. I told him that hospitals have to treat his condition regardless of his financial situation. This is true, right? I also encouraged him to go and when he gets the bill, pay what he could afford even if it's only $5.00/month. I told him "Your in America now and we take care of our people."
As concerned as he was about his health, I don't feel like I got through to him to go to the hospital. What should I do or say to encourage him to get this checked out?
You were wise to recommend that he follow up with a physician. Some hospitals have assistance grants supplied for medical care of the uninsured. Regardless of where funding will come from, he needs to be evaluated for coronary artery disease.
There are government regulations that come in to play when an individual presents to an emergency department, whether they have insurance or not. The Health Care Financing Administration (HCFA) has issued regulations that require patients to receive an appropriate medical screening and stabilization for an acute medical condition. Once the patient has been stabilized, he/she can then be transferred to another facility or discharged. There are specific guidelines that hospitals have to follow to prevent the patient from being "dumped" on another facility. For instance, a physician at the other facility must accept the patient, and there must be a bed available for them. The program that monitors these regulations is called the Emergency Medical Treatment and Active Labor Act (EMTALA). It was formerly known as the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. EMTALA inspectors are to hospitals what OSHA inspectors are to industy.
If your friend from the store was diagnosed with CAD, he would need to be treated at that facility or be transferred to another facility that provides a higher level of care. He could also be transferred to another facility per his request. HCFA gets kind of excited when patients are transferred soley on the basis of ability to pay.
The patient may get stuck with a bill if he chooses to stay, but he can also request a transfer if the other facility can care for him at a reduced cost. If he stayed, many hospitals try hard to work with patients and their families to work out an equitable payment plan. Some state sponsored medical facilities are able to provide care based on a sliding-scale fee system. I am not an administrator, but have been around long enough to see how things work.
Either way, he needs to seek medical care.
Couldn't agree more, Chuck.
You were exactly right to recommend seeing medical help. What your friend is experiencing could be almost nothing. It also could be a very serious, life threatening problem. Your friend should get seen. If it's nothing, the cost will be small. If it's a big deal the cost could be his life, if he doesn't get it taken care of. The sooner it it diagnosed, and treated, the lower the cost will be in the long run.
just my $ .02
Thank you so much for the information. I knew I could count on you all to educate me. Thanks for your help.
NRSKarenRN, BSN, RN
Look in the blue pages of your phone book to see if there are state or federal clinics in your area. They treat anyone without insurance--if person working, some operate on a sliding scale basis. They will even treat if an illegal alien---all ER's are required to treat and stabilize the person.
Clinics will often provide life sustaining medications for free or on sliding scale basis. All clients discharged from the hospital without insurance in PA are given a one week supply of meds until clinic appointment can be arranged.
Symptoms could be something as simple as angina to a blocked artery needing immediate surgery. Encourage him to get prompt treatment for the sake of this family.
You have the beginings of becoming a good nurse: someone opened up to you and you knew when to seek assistance. Good luck in your studies!
chuck said it too well....
can't repeat further than this.....
I am sure that in your area(as I know in my area there is a community health care that will take any patients regardless of insurance/etc) that health care should be available to him.........
sometimes all you can do is to tell someone to the best of your knowledge and then let it go.........
letting go is hard to do though.........
P_RN, ADN, RN
Proud, I'm "proud" to know you . What a wonderful person to be concerned for your friend at the store. You did exactly right. I'm also glad that you didn't try to diagnose or appease him with "it's probably notheing...etc."
I don't know about your area but here there are many mid- eastern people who are being somewhat shunned by others.
Thank you all for your support. Here is the update on our friend.
I went into the store today to "check" on him. I asked him how he was doing today. He said, "better than yesterday". I told him of the resources that you all suggested and asked if he was going to go to the dr. He said he knows it's all stress related and when he gets a chance, he will go in and get checked out.
I offered to personally drive him and make sure he gets the treatment he needs. He said, "No, don't worry, I will go."
Anyway, that is the update. Gosh, I cannot believe how concerned I am for this guy. I have heard that some nurses tend to be co-dependant, but man-o-man, I'm not even a nurse-yet!
Do you think I am sticking my nose in where it doesn't belong?
You may be saving a very precious life. Love and concern for fellow man is never none of your business. You handled this well, very professionally.
a bit off subject.....but in this area also.....middle eastern people are not in favour.....and i think this is so sad.....
there are fanatics in every part of the world, every religion, every.........
humankind and in the search for the truth.........
Peace, the undiscovered country.........
You can lead a horse to water but you can't make him drink.
As Micro has said, it is hard to 'let go' sometimes but we must!
Part of being a nurse is learning how to set appropriate boundaries and limits. You did your best, the rest is up to him.
Sorry, don't have time to read other posts in this thread, so this may be redundent. I am an E.R. nurse. We deal with language barriers all the time. I do not know how long this gentleman has been here but I believe there is plenty of help available for him through his Consulate, plus federal aide, as amatter of fact I believe that a foreigner, has much better access to health care than some of our own poor and desperate people. That is a whole different "Thread" that I may Post about when I have more time. However, if you really want to help, I would be gently insistant with him. I would encourage him by pointing out that he can't get help if he is no longer breathing I am sorry if that sounds harsh, but it is reality:o If you continue, and graduate, and begin a career in nusing, I think you will be amazed at the number of people(Americans) who can't afford health insurance. I have been a nurse for thirty years, and I am walking a tight-wire, attempting to stay one step ahead of losing my own healthcare insurance. Again a whole different thread. If you have any further questions, please feel free to PM me, or e-mail me and I will try to be of more help, if I can. Hope this helps a little:cool:
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