Veroniche
Western Region, US
Female, 54
I’ve been an ER nurse manager since 2009. Previously, I spent 24 yrs as an ER nurse. My hospital, a Level III trauma center, sees 70,000+ ER patients/yr. My responsibilities include billing, federal/state regulation oversight, metrics reporting, software education of e-records, and hiring/termination/disciplinary actions. The ER is one of the key impacted areas of healthcare reform. It’s a scary and exciting time for us, not just in the care of patients, but what the future holds for healthcare.
I love the administrative and business end of the job! A nurse geek! I worried that I wouldn't be taking care of patients, but I’m in the ER a lot of the time assisting during busy times and talking to patients and families when they have concerns. It is just the right balance for me. When I was involved in direct patient care, I was taking my work home with me (emotionally). I continually wondered if I had given the best care or had made mistakes. Now, if I miss a spreadsheet deadline or am late for a meeting, it is not affecting the patient at that moment.
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I have never seen that in the ERs that I have worked. However,the staff get hit on by a lot of patients, especially if the patients are intoxicated. Where I am working right now, a patient has been stalking a nurse, showing up at the ER saying he has a date with her and getting really upset if they don't let him in (the ER is a locked unit). She has called the local police but they have said unless he threatens her there is nothing she can do. So she walks out to her car with security and keeps a close eye out. I have seen a lot of involvement between staff, affairs between married employees, sex in a closed office between employees, stuff like that. Two of the staff were having an affair, and one of the spouses would come to the ER trying to find the other spouse, lots of Jerry Springer drama. That is so frustrating as a manager. Be professional, people! I don't want to know who you are sleeping with, especially when it is another employee.
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I actually don't remember the first patient that died while I was caring for them. The first one that affected me the most emotionally was the sudden death of a 12-year-old. We were trying to resuscitate him, and we brought the parents into the room with us as we were doing CPR and trying to save him. As a parent myself, it was the most difficult thing to see this mom and dad with their dying child. This was years ago and I still remember the little details like it was yesterday. I guess it still affects me emotionally because I started to tear up while writing this.
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I have not seen this in my current ER. In a previous ER in the early 90's I remember a patient who was diagnosed with this. She was seen on camera (while she was a patient in the hospital) injecting fecal material under her skin, mostly on her legs. We saw her in the ER for repeated infections. I don't know what eventually happened to her. Moms who make their kids sick is called Munchausen by Proxy. I have only heard about this, and have not personally seen it. So sad
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Border Patrol Agent
When you catch an illegal alien crossing the border, is he deported immediately?
Movie Theater Employee
Why is movie theater food so overpriced?
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How much do promo girls at convention booths get paid?
That is not an easy question to answer. There are many factors that determine the cost of an ER visit. Each ER has a system to calculate the charge (called the facility level charge). This method of billing comes from the government. A level 1 charge could be something as easy as a medication refill, or stitches being removed, up to a level 5, which is usually a complex medical condition with or without admission. There is also a level of charging called critical care, above a level 5 charge. So for a simple ER visit such as a sore throat, ear ache or cold, which would just require an exam, possiblly a prescription and then discharge, that generally would be a level 2. In our facility, a level 2 charge is about $500. That does not include the bill you would receive from the physician, which could be another $150. If you are uninsured, the hospital will give you a discount of about 40%, bringing the level charge down to about $300. If your chief complaint (why you came to the ER) is more complicated, and you have tests such as lab or x ray done, the level charge will increase according to those factors. Alevel 5 charge in our ER is over $2500 and that does not include the costs of medications, lab or radiology testing that is done. Of course, every hospital has different charges for different levels, so you may be charged more in a different city or state. The government does not set prices. Just an aside, we have patients who come into the ER and they exaggerate why they are coming just in order to bump the line. For example, most folks know that people with heart attack symptoms will be seen faster than those with an ear ache. However, once you say that you are having chest pain (even if you are making that up in order to see a doctor faster), the physician is obligated to make sure that you are not having a life threatening emergency such as a heart attack or a blood clot in the lung, or pneumonia, etc. You will be charged for the complexity of your care and how much it takes for the physician to determine whether you have an emergency medical condition or not. Be honest, tell the physician all of your symptoms and your concerns. If you minimize your symptoms in order to save money, you run the risk of the physician missing something important. If you exaggerate with the express purpose of getting in faster, you will pay with your pocketbook, and might impede the care of someone who is truly ill.
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I would like for our hospital and ER to not have to worry about where the money to care for the public is going to come from. There is not enough money to sustain the health care system as it is. The only way the government will get more money is to either tax the citizens more, or cut down on the healthcare that they pay for. And the insurance companies will have to charge more for their premiums. There is a lot of negative press given to corporations and pharmaceutical companies. But they are the ones that develop the state of the art treatments for cancer, heart disease, etc. Who pays for the development of technology? It is truly between a rock and a hard place. Will the US become like so many other nations who have to ration health care in order to afford it?
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Sure, I would be happy to help, I will email you
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