Posted on 11/04/2008 9:03:58 AM PST by 60Gunner
Ping to all of my very kind readers. I sincerely hope this series helps clarify things a bit. Please feel free to ask questions if you need further clarification.
God bless all of you dear friends and wonderful people. Please be careful and safe as you go out and vote today!
I hope I never live long enough to know what this is:
testicular torsion
bump to the top, through the vanity posts!
You, the patient, do not exist for us; We, the Emergency Department, exist for you.
Who pays/hires whom to perform a service?
Oh and as person that suffered with migraines for 15 years, I can tell you, there IS distress.
Bump for after the election reading.
Interesting stuff! It ties in with my wife’s ER experience last year. While carrying our daughter around, she stepped on a toy and slid down to the floor, breaking a metatarsal bone in the process. By the time we realized that this wasn’t something that just “keep an icepack on it and keep it elevated” could fix, all the local doc-in-the-box clinics were closed. The nearest ER we knew of was crosstown; and this is no underfunded two-bit hospital, it’s Duke University’s flagship teaching hospital. (Say what you will about living in Nifongville, it’s blue as hell around here, but darned if we aren’t surrounded by some of the best healthcare in the country, all within an hour’s drive.)
So leaving me at home to take care of our 18-month-old, she limped out to the car and drove off to the Duke ER. She got there at 10:30. She didn’t get home until 5:30 am. She sat in the waiting room before getting triaged, then they stuck her in a cubicle for two hours with nobody coming back to look at her, not even a pain pill for her throbbing foot. A doctor came in, poked around it for a couple minutes, then left. Another 90 minute wait before a second doctor came in, poked around it for a couple minutes, then solemnly told her that yes, she’d broken her foot. Thank you, Doctor Obvious!
She was in tears by the time she got home, and not just from the pain or the total lack of sleep. She’d gotten treated like an inconvenience, not a patient. A broken foot is not life-threatening and doesn’t require immediate emergency care, even on a slow summer Tuesday night in Durham, NC. But it wouldn’t have killed them to actually show some compassion and bedside manner, would it?
Postscript: She went back for a followup two days later with an orthopedist. He checked it, said “yep, you broke thus-and-such metatarsal, stay off it for a while.” “Well,” she said, “I’ve got a toddler, how long do I need to stay off it and what do I need to do to heal faster?” “I’ll let you be the boss of that,” he replied, and left.
}:-)4
An excellent explanation of Triage — thanks, mate!
Unfortunately, I do know what it means...
You know I saw this before and I just couldn’t bring myself to respond. I am so aggravated with nurses and triage nurses playing God. Nurses don’t assess patients anymore they just chart. I had a nurse chart pedal pulses, bowel sounds, heart sounds, lungs sounds, pupil sizes -— and the nurse had never done a thing for me except send the aid in to check my vital signs. They gave me an IV push med and never even wiped the port with alcohol swab. They(the triage nurse) told me my pain wasn’t real. She made me get out of the ambulance and EMT stetcher and sat up in a chair and wait in the waiting room when I was collapsing from fluid volume loss. Now they have the audacity to send me a bill. You can have my RN licenses I don’t want it any longer.
It doesn’t sound good...
Gents, if you inexplicably feel like you got kicked in the junk, talk to a medical professional immediately.
*assuming one is rational and a legal resident...
A patient had been wheeled directly into the trauma room by the city ambulance service having OD'd.They worked on her for a while but she expired.Before our ER's redesign all ambulance patients were wheeled in *right* past patients (and relatives) in the waiting room.Not long after the OD's arrival a woman went up to the front desk demanding to be seen right away....all the while acknowledging that she had nothing more than an ankle sprain. At this point the front desk secretary,who was brand new to Emergency medicine,told this woman "did you see that patient who was just brought in a while ago? Well,she ***died**.And she stressed the word "died".Not only the patient but everyone else in the waiting room heard this interaction.I must say that the secretary's response quieted the patient right down but I remember saying to myself at the time "oh,God...no! Please tell me that you didn't just say that".
Ah,the fun we had! (Well,not always)
Wait till they have to wait 6 months to a year for heart surgery.
Ha!!
I, personally, would like to see ERs go back to treating emergencies and turn away the petty.
I realize that not everything that seems petty IS petty, as seen by your examples above, but some ARE petty and should not be taking up the ERs time and resources.
I suppose we should tell him.
It’s when one or more of your thingies twists around on the strings they dangle down from.
Those strings are a duct (viaduct? Vy not a chicken?) and an artery and a vein.
Twisting them together is like pinching a garden hose, it cuts off the flow, strangling the blood supply to “Them”
“They” will croak without a fresh supply of oxygenated blood.
“They” will let you know they are NOT HAPPY with this prospect.
This is simply not true, especially with respect to emergency room care. The system is increasingly dominated by nonpaying patients (and that includes those with Medicare/Medicaid who have not and will not pay into the system anywhere near what they will take out of it, even if their medical needs turn out to be only average), including outright fakers seeking free narcotics and people with self-inflicted ailments for which they patently refuse to follow to medical advice to treat or mitigate. The quantity and quality of service available is what can be produced with the funds provided by the 50% or so of paying patients, and the available service is then divided evenly among the 100% of patients who show up -- often actually going disproportionately to the nonpayers, since they tend to have more serious medical problems and injuries due to irresponsible lifestyle choices.
The people who pay for the system, who are pretty much the same ones who only come to the ER with legitimate emergencies and who either don't self-inflict ailments or who follow medical advice to treat self-inflicted ailments after they've arisen, end up getting treated just the same as the fakers and my-health-is-somebody-else's-responsibility crowd. What really aggravates me is that there doesn't seem to be any sense of outrage about this among medical professionals. The career gang-banger/crack dealer/crack addict with a history of faking seizures or extreme pain in ERs in attempts to get narcotics, shouldn't go to the front of the line even if he DOES have a dissecting aortic aneurysm that night -- he should have been arrested, convicted, and tattooed/microchipped after his previous ER misdeeds, to identify him as holding "Serve Last in ER" status. The hardworking, honest, heavily-taxed father with the very mild stroke symptoms should be popped ahead of him.
There are standards that we as professionals must meet. If we do not meet those standards, then we have failed our patients and our community. Speak up! Enough people complaining about their experiences really can bring about improvement. I will pray for your rapid and full recovery. Having had two migraines in my entire life, I can honestly say that those were two too many. And I know from personal experience how horrifically painful a migraine can be. My own experience helps me to empathize, but of course,'empathy' is not a pain medication.
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