ER visit -- part vent, should I complain? Long, as usual

dragonlady wrote in message

But I developed one hell of an appreciation for why so many poor
families end up using ER as their first stop -- it is increasingly hard
to get medical care if you can't pay up front.

meh

This is why I really hesitated to mention the other cases in my OP. I
do have a great sympathy for people who have no other options. And I
know some people who seriously misuse the ER, in my opinion, but at
times I can't say I blame them.

I think though, if someone's got a non serious injury, and they
haven't explored other options, or don't have any, they're in the same
boat as all of us -- sickest/most serious first. It would really be
awful to sit there all day with a kid with a fever, or a cough, but
when others are there with broken bones and suspected poisonings, it
has to be that way. Which is another added issue -- lost wages,
waiting for medical care that you hope you can then pay for somehow.
I am certainly sympathetic, and hope I don't/didn't sound otherwise.
I know that I'm very lucky in that we have insurance, and it's good,
and believe me, with all of my family's medical issues, I am thankful
for this every day. There are many times when I possibly wouldn't
have had cash on me, but our family are around. I don't know what I'd
do if they weren't.

Knocking wood, being thankful -- as all of us who are reading and
posting here are, I'm sure.

Tina.

dragonlady wrote in message

I've gone in by ambulance once, DH once, and, between my 3 kids, have
had 3 trips by ambulance. In each case, it was legitimately ambulance
business (in two cases, we were unable to get up or be moved without
paramedic help, in one the fire fighters called the ambulance, and I
don't even want to THINK about the other two -- but someone else called
for an ambulance both times.) And when my kids have gone in by
ambulance, they have been receiving treatment before I could get there
to fill out anything or sign anything, which was a Good Thing.

It's hard to know how quickly we would have been seen if we'd been able
to get in without the ambulance, since we've never used an ambulance
except for cases where it was necessary. But knowing how quickly we
each got seen, I can understand that mother's approach -- even as I
resent it.

meh

I understand the approach, and if it works where you are, I guess it's
one tactic. But as far as I can tell, at ours, it's strictly by
triage. Sounds to me like your cases were all very severe, and that's
why you were seen so rapidly.

I mentioned earlier that my husband basically waited overnight to see
a Dr., following an ambulance trip. Solana was rushed in without even
being officially triaged when she had her asthma attack, and we'd come
by car (we were reprimanded for not using an ambulance). And Sage was
seen immediately once for croup, even though by that time, everything
was OK -- the ER was just pretty empty, and the Dr.s kids had croup
that week, too, so she wanted to talk to us. And the ambulanced baby
this week waited. In my experience, if you call the ambulance for a
non emergent case, it will be treated that way at the ER as well.

Tina.

"Tina" wrote in message
om...
It is not the fault of parents that the ER
is their only option in these situations, and given that the limitations
for
off-hours care are well-known, it seems to be that the ERs ought to be
staffed appropriately to handle the load (though, of course, I realize
that
is easier said than done given the shortage of qualified nurses and
doctors
willing to do ER duty).
--

Is it considered not good to work in the ER? Seems to me that'd be a
good place to work! Maybe I'm just so familiar with it ...

I wouldn't think so considering the hours.

toypup wrote in message ...

"Tina" wrote in message
. com...
It is not the fault of parents that the ER
is their only option in these situations, and given that the
limitations
for
off-hours care are well-known, it seems to be that the ERs ought to be
staffed appropriately to handle the load (though, of course, I realize
that
is easier said than done given the shortage of qualified nurses and
doctors
willing to do ER duty).
--

Is it considered not good to work in the ER? Seems to me that'd be a
good place to work! Maybe I'm just so familiar with it ...

I wouldn't think so considering the hours.

The hours don't matter; it's the same hours no matter where you work in the
hospital. In fact, our ER has the most flexible hours of any other floor in
the hospital because they're so desperate for help.

People don't want to work in the ER because it's so damn nuts. At least
where I've worked and work now, it can just be crazy. I, for example, like
the excitement and the traumas and heart attacks and such, but can't stand
the drunks and the mental patients (I don't mean to sound insensitive, it's
just not my cup of tea). But you have to take all those things together,
and most people don't want to deal with that. Also, you're on your feet A
LOT, you are in nursing anyway, but in the ER you are even more. It's
harder to find a "home" to sit and chart, and you always feel like your work
is half undone. Then, the floor nurses harrass you for not doing this and
that when you bring up a patient to be admitted (often rightly so, often
not).

laurie
mommy to Jessica, 2.5 years
and Christopher, 5 months

*This email address is now valid*

SNIP
Does anyone know, if she
had been bleeding inside her head, would that amount of waiting made
things worse -- or is there anything that could have been done in that
time to lessen an injury if there was one? Or is it like some things
where if it's going to happen it's going to happen, and there's no
stopping it? In which case, why do they send us for catscans?!?


My father, who suffered a very large head injury with bleeding, did not die,
atributed to the rapid response. Minutes more and he would have been dead.
Beyond a doubt, rapid response to head bleeding is critical to a good
outcome. I would be absolutely furious if I were you. You seem to be a very
nice person. I would not have been son nice in the ER, with my child at risk
of such a thing. I feel the steam positively blowing out my ears at your
treatment. Please give me the name of Nurse Cratchet so I can go give her a
piece of my mind!

Anyway, it sounds like things worked out OK anyway. Thank GOD (certainly
don't thank the freakin' hospital!)

S

Thanks for reading, and any opinions/advice,

Tina.
(and the still sleepy, kind of grumpy but OK Solana, and Sage, who
loved school and almost didn't notice that I'd just tossed her in
there and run back out)

"dragonlady" wrote in message
...
In article ,
Jenn wrote:

In article rWkab.40989$n94.40634@fed1read04,
"Circe" wrote:

"Tina" wrote in message
om...
Does anyone else think it's exceptionally slow to wait three and a
half hours after a head injury with symptoms (sleeping, uneven gait,
pain moving around her head) in a child with a bleeding disorder to
get a catscan? I'm still angry (obviously), but I don't know how
angry to get, if I complain. That nurse definitely lied, I know that
for sure.

I agree with everyone that 3.5 hours seems like far too long to have
to wait
to be seen after an incident like this, particularly if the child has
a
known clotting disorder. OTOH, I have to say that my experience
suggests
it's not at all uncommon and might even be normal.

When Julian cut his finger open with a pair of scissors on a Sunday,
we too
him to the ER. It was very busy, and we eventually ended up going to
an
urgent care center because the wait was 6+ hours. However, it was an
hour
(and maybe 1.5 hours) before we were even triaged. And during that
hour, we
met a couple with a son a little over than Solana who'd had a garden
tool
fall on his head at a local home improvement warehouse. He had a
significant
laceration on the top of his head and had been exhibiting other
potential
symptoms of concussion/brain-bleed like Solana (sleepiness, nausea).
They
had been there at 3 hours by the time we met them and they had still
not
been seen by the doctor when we left, so they must have waited a good
4
hours before they were seen!

one of the reasons for this is that people take kids with cut fingers to
the ER -- it is this great surge of trivial problems that clog things up

part of the reason is that ERs are used as primary care by those without
insurance, and pediatricians who routinely worked with patients with
minor problems e.g. broken arms, cut fingers etc in the past, now don't
work after hours and send people to ERs and part of it is the judgment
of people who think it appropriate to use an ER for a trivial problem.

Where is it you think I'm supposed to go if I need stitches or have a
broken bone? My "regular" doctor doesn't take walk-ins, and if I call
I'm told to go to either urgent care or the ER -- and not all places
even have an urgent care or acute care center, it's either the ER or
nothing. The urgent care center is also not open 24-7, so it isn't
always an option. And $$ is sometimes an issue: at the urgent care
center, if you can't give them $$ when you get there, you don't get
seen. My co-pay for the urgent care center is now the same as my co-pay
for the emergency room (dumb!) but I know the ER will treat me whether I
have the $75 in my hand or not.

If possible, I make an appointment with our regular doctor; that's what
we did Tues. when my 17 yo had symptoms of an infection, and he got in
in about 5 hours. If they aren't open, I try urgent care -- but there
they do absolutely NO triage, and *I* have to guess whether it's more
important than the potential wait. I'm not a doctor or nurse, and I may
guess incorrectly. However, if there's a lot of blood, you can bet I'll
opt for the ER.

That said, the only time I've taken a child in for a head injury, she
was totally asymptomatic when we arrived, and there wasn't a mark on
her; the nurse at the triage desk started to take some of her clothes
off to get a better look (it was winter) and my baby started vomiting.
We got right in. (And she had a skull fracture and we stayed in the
hosp. for about 36 hours.)

I know I've had some real problems getting attention when I thought we
needed it; on one occassion, I think my brother damned near assaulted
someone -- it was the third time in 3 days he'd taken Dad in, they kept
saying he just had a stomach bug, and it was obvious to my brother that
it was worse; they finally looked more closely, and in less than an
hour he was in emergency surgery to have a VERY close to bursting
appendix removed (apparently not something they look for in an older
person, but in the two previous visits they hadn't even done a white
blood count!)


This reminds me. My sister-in-law's mother was very obese. She went into the
ER with CLASSIC heart attack symptoms. She died in the ER because they
thought she had gas. Obese = gas. DUH.

S

In article ,
"Laurie" wrote:

Jenn wrote in message ...
In article ,
(Mary Gordon) wrote:

Yeah, I'd complain, and in writing to .

I'm kind of dumbfounded at the way the ER treated you. My middle kid
has no medical conditions that make high risk like your child. He's a
pretty healthy kid. When he was in Grade 1 he got wonked twice on the
head in the school yard and got a concussion - and I should mention,
he never lost consciousness, but he did throw up and was dizzy, drowsy
and very pale (he looked really awful). We took him to Sick Kids
hospital here in Toronto, where there usually is really long wait in
the ER (if what's wrong is not immediately life threatening, you can
be there for a loooooong time, even with broken bones). Because it was
a head injury and poor Con was looking so green-grey, they took him in
immediately - we jumped the queue, they examined him immediately and
sent us off for a scan right away.

In the case of your child, who has a known medical problem that makes
this kind of injury particularly dangerous AND a specialist called
ahead, whoever did the triage when you came in should be fired. Just
plain inexcusable.

Mary G.



you might also want to refer to this condition as 'hemophilia' next time
-- VW is a mild form of this illness and people might respond more
quickly to something they recognize

Except this could backfire, as typical "hemophilia" is only associated with
boys, so the ER nurse may think she's mistaken. While VW is a deficiency
of factor 8, as is hemophilia (A), they have different characteristics and
treatment results.

perhaps -- creative lying is often necessary to deal with inept front
line ER types though

I have a niece with serious asthma -- she becomes seriously nauseated
and vomits with the most typical ER drug used for serious asthma attacks
-- there are others that work without this effect -- my SIL finally gave
up trying to tell the ER people not to give her the drug because it made
her violently ill -- they always ignored her and the kid always ended up
heaving her guts out -- now she just says 'she is allergic' and they
give her the alternate medication

"Circe" wrote in message news:Cllab.41002$n94.38489@fed1read04...
"Jenn" wrote in message
...

This was NOT a trivial cut and it makes me see red that you assume it was.
It was a SERIOUS cut. It was literally gushing blood and we were not
entirely sure at first whether he had severed the bone. He needed 6 g*ddamn
stitches and no one in the ER thought it was trivial--simply that he wasn't
in danger of dying or losing the finger if he had to wait a few hours to be
seen. (The only reason we were able to take him to the urgent care center
for the stitches was because a second pass by the triage nurse determined
that the cut didn't quite make it all the way to bone.)

Don't patronize me. I know the difference between a minor injury and a
serious one, and this was serious. It was not *life-threatening*, I agree,
but it needed attention *that* day (and it was a Sunday, so where exactly
should I have taken him other than the ER, especially since I didn't know
the urgent care center even existed until after we got to the ER?).

Which brings up a question that has puzzled me. Are urgent care
centers/walk-in clinics just not that common in California? They are
everywhere around here. (We have 3 or 4 of them in our medium sized
city.)
When we were visiting California last fall, I needed to get some meds
for Shaina's asthma. (Her peak-flow readings were pretty low, though
she wasn't in any particular distress.) My BIL (a pediatrician)
thought we needed to get her on a course of prednisone. He too was
visiting from out of state, or he would have just written her the
scrip. Anyway.... I was trying to get a hold of her pediatrician here
at home (and eventually succeeded), but we figured that, if we
couldn't, we could just take her to a walk-in clinic -- but a search
through the local yellow-pages didn't turn-up any at all! And yeah, I
hated the thought of having to take her to the ER for something like
that.

But more urgent care clinics would likely cut down on the crush in the
local emergency rooms. I've only had the opportunity to visit my ER a
couple of times, but it's never very busy -- perhaps BECAUSE we have
several walk-in clinics to handle the more routine stuff.

Naomi


part of the reason is that ERs are used as primary care by those without
insurance, and pediatricians who routinely worked with patients with
minor problems e.g. broken arms,

And another one. When Julian broke his arm, I was *told* by my pediatrician
to take him to the ER because it needed to be set and she couldn't do it due
to the way the bones were broken. If he hadn't broken both the ulna and the
radius, she probably *would* have set it herself, but under the
circumstances, she didn't feel she could. (For a host of reasons, this
turned out to be a mistake, but I was taking the advice of my PHYSICIAN when
I took him to ER that time. You think perhaps the *pediatrician* can't tell
the difference between a problem she can treat and a problem she can't?)

cut fingers etc in the past, now don't
work after hours and send people to ERs and part of it is the judgment
of people who think it appropriate to use an ER for a trivial problem.

Well, I agree, there are plenty of "trivial" problems in the ER. (There was
the lady my husband ran into in the ER when I was in cardiac arrest who was
there because she'd taken too many diet pills and felt funny. Well, stop
taking too many diet pills!) Notwithstanding, there are times when the ER is
the *only* option--weekends, nights, etc.--and a condition is emergent
enough to require treatment before the regular pediatrician's office and/or
the urgent care center is open. It is not the fault of parents that the ER
is their only option in these situations, and given that the limitations for
off-hours care are well-known, it seems to be that the ERs ought to be
staffed appropriately to handle the load (though, of course, I realize that
is easier said than done given the shortage of qualified nurses and doctors
willing to do ER duty).
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [18mo] mom)
See us at http://photos.yahoo.com/guavaln

This week's special at the English Language Butcher Shop:
"No parking passed this sign" -- hotel parking lot sign

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

"Stephanie Stowe" wrote in message ...

My father, who suffered a very large head injury with bleeding, did not die,
atributed to the rapid response. Minutes more and he would have been dead.
Beyond a doubt, rapid response to head bleeding is critical to a good
outcome. I would be absolutely furious if I were you. You seem to be a very
nice person. I would not have been son nice in the ER, with my child at risk
of such a thing. I feel the steam positively blowing out my ears at your
treatment. Please give me the name of Nurse Cratchet so I can go give her a
piece of my mind!

Anyway, it sounds like things worked out OK anyway. Thank GOD (certainly
don't thank the freakin' hospital!)


We are very thankful that things worked out so well. Lana's still a
little loopy even today -- two full days later. Nothing horrible, but
you can tell she was hurt.

I guess I'm also lucky that I didn't really know what could have been
happening due to the lack of rapid treatment. Now that I do, it's
unlikely anyone there will think I'm nice at all if this happens
again! (Not that they thought I was nice anyway, but at least you do!)

Thanks for the info!

Tina.



S

Thanks for reading, and any opinions/advice,

Tina.
(and the still sleepy, kind of grumpy but OK Solana, and Sage, who
loved school and almost didn't notice that I'd just tossed her in
there and run back out)

"Laurie" wrote in message
...

toypup wrote in message ...

"Tina" wrote in message
. com...
It is not the fault of parents that the ER
is their only option in these situations, and given that the
limitations
for
off-hours care are well-known, it seems to be that the ERs ought to
be
staffed appropriately to handle the load (though, of course, I
realize
that
is easier said than done given the shortage of qualified nurses and
doctors
willing to do ER duty).
--

Is it considered not good to work in the ER? Seems to me that'd be a
good place to work! Maybe I'm just so familiar with it ...

I wouldn't think so considering the hours.

The hours don't matter; it's the same hours no matter where you work in
the
hospital. In fact, our ER has the most flexible hours of any other floor
in
the hospital because they're so desperate for help.

I was thinking ER vs. clinic.