ER Overload

Wow, this makes me mad. People need to learn to take better care of their bodies, and maybe how to put on a Band-Aid when they fall down. As for health care insurance...bah. The whole thing is out of hand.
Democracy and all of that would work just fine if their weren't so many idiots in America.
America...In general, the land of the idiotic and the home of the immature. (No personal offense meant to anyone here; this comment is directed towards the people who go to the ER for bruises and toothaches.)

This is one tough area for any emergency room in this country. I am a travel RN having done that for 4 years and have been in nursing for over 31 years. This system is broken and we all know needs to be fixed. I have traveled to some hospitals where the staff gets the pts. in and out quickly. These hopsitals have a fast track or something similiar to that. They have strict criteria that they the pt. must meet before they can make it to the main emergench room. I just completed a short travel assignment at a hospoital in Rosedale, MD. They saw 108,000 a year. It was an experience that I will NEVER forget. I told them before I left that in all my years in the emdical field I have never seen a emergency department that has such poor teamwork that has affected pt care. They refuse to help each other out, your team members will sit on their butts and actually watch you work, not offereing to lift a finger to help you. I went on a 15 break tmy last night there. Before I left, I gave report to a nurse to watch my pt. I received a call from an ER Dr saying I had orders on a pt. I told him that I was off the floor and to talk with (no Name will be given) since he is covering for me. When I got back to the floor, I had 4 charts ALL having orders on them and my team members just sitting. I asked him what happened athat these orders went taken care of when I left the department. No answer was given. We can not sit by and watch each other work and not help each other out. Due to this very poor team work, I have seen pt care being affected (adversely at times) due to this area of concern. If there was a heck of a lot better team work, this over crowing would not be a bad as what it is. We have to take better care of each other then what we are. Herlp each other out, don't jsut sit there. Lets think about the pt and not about each other. Forget the gossiping and who is going out with who, waht they are going to be doing on the days off. We are ALL in this business to help our pts. I do not see this in allhospitals expecially the one in Rosedale, Maryland. The type of care that some of the pts received in this ER was terrible. High incident of AMA'S also. I wonder why?!?!

I am a nurse in a very overcrowded ER, we are expanding our ER within the next 3-5yrs doubling its size. The above article is true the uninsured are not the real problem most of the time. It is a combination of the Medicaid system, the GROWING drug addict (mostly prescription drug addicts), and the sue happy people. We have a large population of medicaid recipients, but they are abusing the system coming in for pimples, pregnancy test, headaches, cuts and scratches, menstral cramps, colds and sniffles, minor coughs, bumps and bruises, heartburn and many other easily treated illness that they can go to the local drug store for. Don't tell me they don't have the money for the medication while they are talking on their cell phone and getting candy and drinks from the machine and wearing gold jewelery coming in with a McDonalds bag. They don't have to spend their own money for medications they spend mine instead. And yes there are enough Medicaid Clinics in the area to go to, But remember we have to see them and cannot refer them to a Clinic and we usually have a shorter wait time usually only 2-4 hours, pulse a cafateria, and candy and drink machines. There should be a co-pay for MEDICAID (not medicare)something small like $3-$5, this believe it or not would deter unneccesary ER visits. This co-pay should not apply to children young than 18yrs though. Another problems is the growing prescription drug addiction problem, yes it is a growing problem and it will surface its ugly head sooner or later. Yes, pain is subjective, but you don't need a narcotic for simple sutures, or the chronic backpain you have had for the past 8yrs and still bringing your x-rays from then to the ER. And yes how convenent that you regular MD that nobody has heard of is out of town when you are in the most pain you have ever experienced in you life (funny according to my records thats what you said last time). Narcotic prescribing needs to be better controlled by both the MD and the Hospital. And last MALKYNE knows. There is a lack of Primary MD's out there and they are overcrowded, but they also use the ER as a scapegoat sending Pt's that really don't need to go to the ER. And yes they and the after-hours clinic do pull the scare tactics for minor illness. If my primary MD ever pulled that I would give him a earful and my BILL from the ER. And Firemedic hits it right on the nose also. Maybe the Goverment should listen AND use healthcare workers to fix the problem.

This is completely anecdotal, but I've noticed a distinct increase in GPs and urgent care clinics ordering their patients to go to the ER, and in some cases, refusing to even see them for certain conditions (e.g. chest pain). I have even heard a doctor at an after-hours clinic use scare tactics -- telling a patient that the last woman he told to go to the ER didn't follow his orders, and ended up dead. Could it be that doctors fearing malpractice lawsuits could be contributing to ER crowding?

Insurers need to take some of the blame for the wait. One major insurer told my friend who sprained her wrist that she HAD to go to the ER for treatment if she wanted to be covered, while she just wanted to go see a doctor at the doctor's office. She didn't think it was an emergency, but she was forced to go wait in the ER and take up the ER doc's time instead.

I work @ a small rural Critical Access hospital in the Northwest. As the ER CPC what I see is truelly depressing and almost sinfull. Our ED is cluttered with huge numbers of drug and alchohal related heath issues such as a racing heart from doing meth to breaking a wrist falling off a bar stool. Not only do these people really clog up our system and make it life threatning to our legitimate pts. but what really pisses me off is these jerks are usually collecting the same Medicare that my grandmother paid into her entire life. All you need to do is have a drug and/or alchohal addiction these days and you are now eligible for Medicare and or Medicaid. These are Government programs for Gods sake! Why are we tax payers paying for meth monkeys in the first place? In addition, these programs actually pay pennies on the dollar in reimbursement and the balance can not be rolled to the pt. We as a Critical Access Facility eat it. I work very hard for my living and I can not afford the insurance offered by my employer so I do not go to the ER or even my PCP as I should. However, when I do go to either, I am required to pay 100% for the services I receive.
And one more thing, while our ER MD is treating the tweekers for free, everbodies grandmother must sit in the waiting room and the MD can and often is held responsible for the condition of both. I bet if Medicare and Medicaid recipients were required to pass a drug screen every month when they pick up their check, our ER's would clear out REAL fast!

The article doesn't address the insurance/malpractice issues at all. If I see a patient in the office with dehydration due to vomiting in early pregnancy, I can't give her a round of IV hydration because I can't bill for it--she has to go to the ER. I have also seen many patients with asthma sent to the ER when 90% of them would be fine with an in-office treatment because the physician said "if something happened I could get sued--she should be seen in the ER". Yet when I was in the military, we routinely did these things because billing and malpractice insurance wasn't an issue. We need to do more than just overhaul the medical insurance issue--we need to rethink our entire so-called health care system.

From what I'm hearing everybody is blaming the "Individual Single Male" (not all of you but it does seem that as a whole in this country the Single Male is the main culprit in subjects such as this one.) But I assure yoy it is not entirely his fault, "Its Our Education System here in this Country" For instance, "The Temporary Job"
"McDonalds, he has to hurry up and get to work (he has no car, so he has to catch the bus, he will either be too early or he will be late, And You Sure Don't Want To Be Late! Ok, your clocked in at 10:00am, now its Helter Skelter time, they work you like a dog from about 11:00am to about 2:00pm at about 2:15 or 2:30 the manager grabs your arm and both of you run over to the time clock, he snatches your time card from the holder gives it to you and says, "Now its time for you to clock out now, so hurry up and clock out". You clock out, then the manager (he still has you by the arm) abd both of you run to the back door where he "Boots you out", while he's saying, "Ok, see you tomorrow at 10:00am", and then he slams the door. There is book out now, and it has been out for quite sometime now , Its Title:(which is why it didn't sell) "If You Want To Be Rich And Happy For The Rest Of Your Life, Don't Go To School" Author: Robert Kiyosaki. (I think the only book that he has written that flopped. But par for the course, this book told the "Real TRuth about our Educational System here in the United States. "IT IS HORRIFIC" Robert does a very good job in backing up his statement of the Title of that publication. The Real Problem Here? The American Public did not want to Hear The Truth. "BINGO" The TRuth in this book lies so deep that it is scary. "THE TRUTH HURTS" Whenever the Naked Truth Stares man right in the face, man will look away everytime. And then you want to argue with me and say, "Who Are You, And What Makes You An Authority figure about "THE TRUTH" And then I will have to say to you, it is not I that says these things, but it is the one who lies within that speaks of the truth. And then you say, "You speak in riddles, you are insane", and then I say, "There was a time when "THE TRUTH" walked among us, and most of us did not accept Him, but before he left us he made a mark upon all the world (the earth), he even made his mark again, upon all hearts of men (the first time was when they made man) whomever walked the face of the earth, and it will be up to that man to see if he will follow the mark of the word, or if he will follow the mark of the beast. "ECONOMICS, BIG BUSINESS, TEMPORAL THINGS, THINGS THAT LAY WASTE AND TURN TO SAND". And make no mistake, Unless This Great All Powerful, All Mighty, All Sovereign Deity changes His mind, this is the Last Century. Man hates The Truth, he cannot stand the truth, Which is the Most Pitiful, The MOST PITIFUL PART

By what I am reading here is that people are putting the blame on people who either cannot afford insurance,
or they work at a "McDonalds" where they want you to hurry up and come in to work(clock in), once there they work you like a dog, then when its time for you to clock out (you have to clock out by a certain time for if you don't, "McDonald's" will have to start paying you insurance benefits), So you've got to hurry up and clock out. Bingo!!! No Medical Insurance. This country is loaded with these type of temporary jobs. But to be honest and truthful about this subject Americans have go to look at themselves, The one's who do have good jobs, as well as the one's who do not have good jobs. "Its Our Education System" To get a real understanding about this very important subject I invite everyone to read the one book that was a "Total Flop" at the book stores, and I'm not sure about this but it may be the only book that this Multi-Billionaire Teacher of Entrepreneurs had no success with. The Author: Robert Kiyosaki, the book, "If You Want To Be Rich and Happy, Don't Go To School", this book was a total flop, you know why? Because of its "Title" Even though Robert backed up this statement in his book to point out the real truth regarding our education system here in the United States, "The American Public didn't want to Hear It", even though it was and still is the truth, so guys, do yourselves a big favor and purchase this book that told the truth, yet no one wanted to listen then nor do they want to listen now. It was the same problem that JESUS CHRIST had when HE walked the face of the earth. THE TRUTH WAS HERE, Yet No One Wanted To Hear The Truth. So Sad So Sad So Sad!!!

I just got home from working a 10 hour shift inthe ER. I am a Tech and a paramedic. These are ALL reasons the system is back logged. I've taken patients in because they didn't have a ride for the sore foot for a week, and they never even called their doctor. had a patient sit for 6 hours on a very high aquity nights, for a hang nail. Yes, you read corectly, a hang nail. And this person had the audasity to complain. We also have quite a bit of my Dr sent me here because my labs results are off and he wants me admitted. If that's the case, then why isn't the Dr calling for a direct admission. Or the Immediate care, that sends the patient to the ER for vomiting for 3 days, but not today, but lets the chest pain patient, with a questionable EKG drive himself over. It is so many things that are casing the ER backlog, not just one. I don't see it getting better, before it gets worse. I think the type of patient you get, IE: medicaid, illegal, etc, also depends on your local demographics, but either way, it's going to be a while before there is an answer. In the mean time, if you have a fever, take an aspirin/tylenol. (Or motrin/tylenol) If you have a cold, treat it with something over the counter. Talk the pharmacist. Use common sense. Emergency is for EMERGENT. Not he I put it off for the weekend, and now I need a note for Monday, when I call in. Not the well my Doctor can't see me today, so I'll just run to the ER and be in & out. If you an afford smokes, and drink, you can afford over the counter remedies. Better yet, go the the library, and look into old fashioned remedies. It's amazing the resources that are out there.

Would someone PLEASE forward these comments to McCain and Obama??? In our ED, we call it "MasterCard...I mean Medicaid". We also refer to it as the "cabulance". We're in between 2 reservations, so the grand majority of our Medicaid card holders are young, more-than-able-bodied, non-working adults.