Why can't people just be sick at home!? (RANT!)

Long Term Care Columnist / Guide · Dec 4, 2003

OUCH.

I'm not flaming anyone here, but I would like to ask for just a tad more understanding of the situation some of these "scumbags on total assistance" are in. You see, I once was one of them.

Yep, until about ten years ago my family and I had NO other access to health care......we made just a bit too much to qualify for Medicaid, but nowhere near enough to pay for private health insurance. We bounced on and off the welfare rolls for years before my DH and I both figured out we needed to learn some marketable skills; I'm not making excuses, just telling it the way it was. We made do on minimum-wage jobs, food stamps, and a wing and a prayer.

So what were we supposed to do when the 2-year-old developed pneumonia, as well as a fever of 105.5 degrees which caused seizures? Where else were we supposed to go when I went into status asthmaticus because we couldn't afford the steroid inhalers I was supposed to be using (at forty bucks a pop)? We hated using the ER as a primary care provider, but there was NO alternative at the time, not even a free clinic, and nobody would see us without cash up front.

This is why it still rubs me the wrong way to hear medical people sit in judgment of those who use the ER as their "doctor". I know how it feels to be looked upon like something you scraped off your shoe on the way in this morning, and I don't think ANYONE deserves that. You don't know what misfortune befell these people to bring them to this low point, any more than you know who "deserves" care and who doesn't. That's the problem with health care these days, anyway.........the rich and the middle class are seen as deserving, while the poor are not, and how dare they demand health services?

Again, I'm not flaming anyone, just asking you to consider another perspective. While my family and I are fortunate by any standard nowadays (we even have dual health insurance!), I will never forget what it was like to be among the great unwashed, and to be treated like garbage because we were poor.

Stepping down off my soapbox now.:)

LisaRN2B · Dec 4, 2003

Originally posted by mjlrn97
OUCH.

I'm not flaming anyone here, but I would like to ask for just a tad more understanding of the situation some of these "scumbags on total assistance" are in. You see, I once was one of them.

Yep, until about ten years ago my family and I had NO other access to health care......we made just a bit too much to qualify for Medicaid, but nowhere near enough to pay for private health insurance. We bounced on and off the welfare rolls for years before my DH and I both figured out we needed to learn some marketable skills; I'm not making excuses, just telling it the way it was. We made do on minimum-wage jobs, food stamps, and a wing and a prayer.

So what were we supposed to do when the 2-year-old developed pneumonia, as well as a fever of 105.5 degrees which caused seizures? Where else were we supposed to go when I went into status asthmaticus because we couldn't afford the steroid inhalers I was supposed to be using (at forty bucks a pop)? We hated using the ER as a primary care provider, but there was NO alternative at the time, not even a free clinic, and nobody would see us without cash up front.

This is why it still rubs me the wrong way to hear medical people sit in judgment of those who use the ER as their "doctor". I know how it feels to be looked upon like something you scraped off your shoe on the way in this morning, and I don't think ANYONE deserves that. You don't know what misfortune befell these people to bring them to this low point, any more than you know who "deserves" care and who doesn't. That's the problem with health care these days, anyway.........the rich and the middle class are seen as deserving, while the poor are not, and how dare they demand health services?

Again, I'm not flaming anyone, just asking you to consider another perspective. While my family and I are fortunate by any standard nowadays (we even have dual health insurance!), I will never forget what it was like to be among the great unwashed, and to be treated like garbage because we were poor.

Stepping down off my soapbox now.:)

Here, here!

Been there.

(((((((Marla))))))))

I'm pretty sick of the attitudes of those "better" than the people who have the audacity to come to the ED with what they think may be something serious.

Ya know, myself and my family have paid into the "system" for a long, long time. Please, don't tell me you have paid it all yourself and they are using YOUR money to get free health care.

My son, whose father was supposed to be paying child support and SUPPOSED to be providing health coverage and wasn't, may be dead if it weren't for the fact that we had health coverage provided by the state when he was in ICU with asthma.

The ones critical of the "welfare" system-I truly hope you never find yourself in a position where you need to lower yourself to receive state-funded care. It's no fun. But I for one thank God it was there when we needed it.

jnette, ASN, EMT-I · Dec 4, 2003

Thanx mjlrn.

It IS hard... for BOTH sides. I've been there, too.

While both ex-hubby and I were always employed, there were times that those jobs did not provide health insurance. We did all we could at home to care for ourselves first... but there were also times when there was no other choice... as you said, raging fevers in a child, pneumonia myself one time, exhub's diverticulitis pouch ready to rupture.... unfortunately at those times when we had no insurance and nowhere else to turn.

We just don't KNOW who is before us or what their circumstance.

I'm not saying there aren't those who could do better or differently, and I know myself, it must be emotionally trying to deal with so many who seem to be there for a "free ride"... yet we just do not know, therefore cannot... should not judge.

A country as wealthy as ours can surely come up with a better plan... something MUST turn around. If we can put ppl on the moon, and come up with all these marvelous ideas and inventions and interventions... and send billions of aid overseas... my goodness... can we not come up with something to help our own?

Long Term Care Columnist / Guide · Dec 4, 2003

Good posts, Lisa and jnette! And at this time of year, I think the words of Jesus regarding how we should treat the poor and downtrodden are especially appropriate:

"Inasmuch as you have done it to the least of these, my brethren, you have done it to me."

jnette, ASN, EMT-I · Dec 4, 2003

Originally posted by mjlrn97
"Inasmuch as you have done it to the least of these, my brethren, you have done it to me."

A wonderful feeling to be able to give back, or "pay it forward", isn't it?

It is a humbling experience to learn how to RECEIVE... and to do it gracefully.

It is exhillarating to give back... to one who least expects it... to the one who has all but lost hope.

MrsWampthang, BSN, RN · Dec 5, 2003

Where ER nurses are coming from. I have no problem with patients coming in no matter what their ability to pay is. What I and other ER nurses have a problem with is people coming in with problems that could be handled at home like mild fevers, coughs, rashes.

This does not include high fevers with seizures, status asthmaticus, acute abdominal pain, kidney stones, and other acute illness or injuries.

I also have a problem with people that come in to ER repeatedly because basically it is free; notice I said repeatedly .

It gets tiresome when people come in and demand very good service because they have had a back ache for several weeks, meanwhile down the hall, is someone that waited to come and is now having an AMI, because he ignored his symptoms for so long.

I was at a point one time when I had no insurance, and not much income. I made too much to qualify for welfare of any kind except WIC. I laid on my bathroom floor for two days with a severe headache and vomiting, never dreaming of going to ER because I couldn't afford it.

It gets tiresome when you have 10 people lined up out front waiting to come back and 5 ambulances just brought in a multicar MVA with numerous patients. Meanwhile 3 more ambulances are on the way. Try being a triage nurse and having a room full of people staring at you and wondering why you're not letting them go back. Talk about being stressed out! :eek:

Please don't judge out attitudes until you've walked a mile in our shoes! This is a forum to vent without the threat of being flamed afterall!

Just as nurses in other areas have thier stresses, ER has a whole set of our own. I can't begin to know or undertand what stresses other nurses face, so I would never chastise them for venting about work.

I love my job, and I treat all my patients to the best of my ability, but please don't look down on me when I get exasperated taking care of the umpteenth patient that could have/should have/did go to their family doctor but chose to come to ER because it was free up front and convenient.

We have a free clinic in our town, but I guess it takes weeks to get in, so we have a lot of people come in r/t that. But, we also have those patients come in that have been treated there, but aren't feeling any better.

In this day and age, it seems like no one thinks they should ever be ill, or injured and if they are, they should feel better instantly. I think that's why we see so many people come to the ER with minor or chronic ills.

Why can't people realize that ER docs don't have a magic wand that will cure all that ails you?

Thanks for letting me vent!

Pam:)

military girl · Dec 5, 2003

Hello all,

I'm new to allnurses, but love what I'm reading.

In response to the rant, I was an LPN for 5 years and all of them spent in the ER. I have been an RN for 2 years and have worked in the ER and stepdown.

It seems that it happens most often during the off tours that people come in, their doctor's offices have closed, and the state, "I have to be seen." And yes, doctors offices want you to pay them for services rendered at the time, not 2 months from now. Yes, it's really frustrating, especially when you are short staffed, and some of the staff is sick themselves.

All you can say at the end of the day-thank goodness I got through the shift and hopefully I have a few days off.

LisaRN2B · Dec 5, 2003

Pamela_g_c,

I can imagine that stressful is an understatement when it comes to working in the ER.

Your rant sounded kinda like a flame to me because it hit close to home, so to speak. I apologize if my post sounded like a flame back...I guess it really was.

I would never presume that I know everything there is to know about working in the ER, heck I don't know anything about being a nurse at all...I am a student. I DO know about being a patient, though, and I have children who have had more than one trip to the ER in their lives. For the most part our ER adventures (shall we say) have been very positive. Great care and compassion.

There have been times I have been sent to the ER by my family Dr. only to be questioned when I got there why the heck I thought I needed to be there. Well *I* didn't, but trusted my doc (and still do).

I know that it must be overwhelming to have the flood of people walk through the door and all hell breaking loose with ambulances bringing more sick or injured people in. And also adding to that stress, the ones who really don't need to be there. For what it's worth, I do give you my compassion about that, and thank you for being there when we, the sick and injured, need you most. :kiss

JaHazle · Dec 5, 2003

Of course there are 2 sides to everything and nothing is ever black and white. I have been on both sides of this story. I was as are many a recipient of medicaid...and also did clinicals in the ER. There were times that with that medical card, I couldn't even get a family physician. So, I guess I was one of those one labeled a "frequent flyer". However, for the most part I was treated with respect and dignity. Being divorced with three children to care for, there were many trips to the ER. Yes, sometimes over coughs, rashes, earaches...and such. Because, whether I had medicaid or not...when my children got sick, I got worried. As a nursing student we all know that abscence is not tolerated just because you have a sick child. So, after 4-5 days of the same cough just getting worse, yes, if needed they went to the ER. BUT...hats off to all of you ER nurses...now I am a self supporting nurse, with the ability to pay for health care and have a reliable physician who can see myself and my children. You ER nurses are the heart of the ER...usually the first and last people seen in a visit..and I thank you! :kiss

stressednurse · Dec 5, 2003

Mjlrn, I hear ya. But maybe a please and a thank you occasionally instead of "get me this" and "get me that" "Cuz its my right" might create a better environment.

Nurses don't immediately dislike patients or their problems, its the presentation and the reaction and the "this is a service industry now... so jump when I say... attitude" that gets us a bit testy.

Treat the nurses in the same manner as you expect to be treated...It really does work. If you are dying or might die soon you will be seen immediately. If you are destitute as you were and need to use the ER as a PCP, then please be patient with your doctors office visits. someone will see you in 4 to 6 hours. That is the expected wait time in most ERs for non-emergent patients. That is the wait time in the clinics that you don't quite qualify for either.

Oh yeh, when you finally make some cash and can have a PCP, the wait time for an appointment is 1 to 2 weeks. Geeze, what happened to the better health care with insurance, shit. LOL

Marie_LPN, RN, LPN, RN · Dec 5, 2003

"I especially love the scum bags that come in and are on total assistance and state that they are "considering becoming a nurse"

The ER was my only option 2 1/2 years ago before i entered school, if i got sick. I mean 103 temp, dry heaving, dizzy, the runs, etc. Because they send the bill in the mail and i can make payments on it. And i got treated like SH*T for not having an insurance provider. Sonn as i said "no insurance" the nice routine dropped. Kinda sucked when i spent half the time APOLOGIZING for being an inconveniece! I just reminded myself that the attitude the employees expressed to the 'scum' would not be the way i'd treat or talk about my patients because that's NOT the nurse i wanted to be, and that's NOT the way i'd want to be treated. That would make it seem like i thought that i was better than everyone else. I'll also keep in mind that i was once on total assistance myself a long time ago, and i was still a human being as i am now.

V. Nightingale · Dec 5, 2003

I don't think anyone is belittleing those private pay folks who come in with legitimate emergent problems -- if your child is having a seizure, or you're in status asthmaticus, the ER is where you need to be and never mind whether you have insurance. It does get frustrating, though, when people abuse the system to get pregnancy tests and the like. The hospital where I work is less than a ten minute drive from the county hospital, which receives governmment funding to care for the uninsured ; we don't. Yet private pay patients continue to clog our facility with nonemergent problems, and we have to treat them, knowing the hospital will probably never see a dime of the money we're owed. Their reasoning? If they go to the other facility they'll have to wait to be seen. It drives up costs for those with insurance, drives down profit for the hospital resulting in budget and staffing cuts. . . I don't know what the solution is, but it's a helluva convoluted problem for sure.

And for what it's worth, I think most of us ER folks realize that for some people, there just aren't a lot of health care options available. But the ones who blatantly abuse the system stick in our minds, and we end up coloring everyone with the same brush without really meaning to.

P.S. hope you're feeling better, Pam!