Why FAST TRACK is wrong

speaking of fast track- I wanted to hear some input regarding your policy. we have once again started up fast track. we have assigned rooms- supposedly a PA and now a Medic. As nurses we have to give out the medications and sign the discharge papers. Some of us are unwilling to do this unless we have assessed the patient ourselves. I think it takes more time to do- instead of just assigning a nurse. we are told the paramedic cannot give out meds or sign the discharge papers. so doesnt that make us liable since we are signing the paperwork? some nurses feel comfortable letting the medic do everything and count on their documentation and sign it. some others say no- and pretty much have their assignment and take on the medics. One nurse voiced her concerns last week and refused to oversee triage- she was told if she refused- she would be sent home and considered insurbordinate. I wish we had a straight answer about this and I dont know why the PA cannot just cosign the chart with the medic since he or she is doing the assessment.

Most docs won't even prescribe medications based solely on the diagnosis of another physician, much less the patient, himself. A history of a chronic condition is frequently not the cause of "exactly the same pain." Your doctor won't accept your diagnosis because he doesn't want to miss something other than your chronic condition which may be causing the pain. If your "migraine" turns out to be a massive hemorrhage, will your family release the doc from all liability? I doubt it. So does he. So does his liability insurance underwriter

And instead the poster gets to sit in an ER in the middle of the night for hours only to be asked a few questions by the ER doc, no tests because the pt says it's her typical migraine pain, and gets medicated and sent home.

If the migraine were a bleed then pain meds would not work. What's wrong with giving the poster a script for a breakthrough pain med with instructions to go to the ER if it doesn't work? The script could be for just one or two doses so that the poster wouldn't be tempted to "take a few more doses to wait and see."