We all complain about ER abuse, frequent flyers, drug seekers, etc.
We have this idea that the ER is for emergencies. Get over it. The problem is with the name. ER evokes images of life saving, ameliorating pain, and all that good stuff. It really should be called "free and convenient medical clinic that is more likely to give you what you want then your own doctor, and is also set up to deal with the occasional emergency". It's not a cool name, and kind of a mouthful, but it's a hell of a lot mor accurate than ER.
While we may be right to complain, we are complaining about the wrong people- it is silly to expect the users of the system to change when we constantly re-enforce their behavior. This is a population not especially renowned for responsible use of their own money. Any reason to think they would be any more responsible with your money?
We are open 24/7.
Even a long wait n the ER is a hell of a lot shorter than the time it takes to get an appointment.
We are more likely to give what you believe is necessary than follow any evidence based guidelines.
We are more likely to:
Give narcs for a headache than any neurologist.
Give antibiotics for mildy symptomatic OM than any pediatrician.
Give antibiotics for a viral uri than any family practice doc.
The list goes on, but the bottom line is we frequently give people what they want, rather than what medical research indicates.
We do all our tests on the spot, and do a lot more of them than a PCP would. Does your doc have a CT machine? By the time you get an outpatient appointment, your problem might have resolved on its own. We can get a pt in to a specialist a hell of a lot faster than their own doc can.
In addition to the superior service we provide, we advertise, soliciting the business we complain about. The focus of ER advertising is convenience. Billboards on the side of the road boasting short waiting times. Ever see an ER advertisement that explained acuity based priorities?
And don't forget- It's free. Obviously it's actually expensive, but the ER users we complain about don't pay anything. While many have government insurance that prohibits non emergent use of the ER, this is not enforced.
So- we solicit the business, and reward the behavior. Kind of numb for us to complain about it. The ER you dreamed about doesn't exist. Get over it. With very few exceptions, if you want to do any emergency nursing, you are going to have to wade through a bunch of crap to do it.
The people we complain about aren't the problem, they are the symptom. The problem is the system. I bet half the complainers on this forum don't even vote. While venting is healthy, it doesn't change anything- except how you feel after work. Change the system.
