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 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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Sorry it has taken such a long time to answer your question Kendall. Our hospital has an active volunteer program for all areas of the hospital. If a volunteer wants to work in the ER, there is a couple of days of training to familiarize them with the procedures and flow of the ER, and to make sure the volunteers (usually younger people) are not violating any Federal privacy laws, etc. They stop in and talk with the patients, bring them water or food if allowed, warm blankets, and some times just keep people company. The hospital has an active pet therapy program, and the volunteers will bring in the dogs to visit with the patients. Since the ER can be a somewhat uncontrolled environment, we are careful with the pets--they only come in if there is relative peace and quiet.
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It depends on the severity of the fracture--you may not need anything, you may only need a hard soled shoe, you may need a walking boot, or you may need a cast, or even surgery. Every fracture is different and needs to be evaluated by a physician after an x ray. The physician will be able to determine the best treatment.
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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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EMT
Does your crew ever fake an emergency to slice through traffic?
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What brand do you think has the poorest quality / workmanship?
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Is Apple is still the young and hip brand or have mom and dad spoiled it?
I would love to know the answer to that question! I could write a book and never have to work again! Really, the truth is that we don't know. This is driving hospital CEOs and CFOs crazy because how can you plan for a future when you don't know what is coming. Personally I think that the workings of the ER won't change day to day. I do believe that we will be a lot busier. Our patient visits for 2013 are already up about 10% from last year. I think hospitals will have to do more with less, which means being extremely efficient with money, nurses, equipment and supplies. I already see the nurses working a lot harder for the same amount of money, the raises get smaller and smaller, and the patients are sicker and sicker. I don't know where the money is going to come from. It has to come from somewhere. The patients don't have it, the government doesn't have it, and insurance premiums don't nearly cover the cost of healthcare, so the insurance companies are going to run out of money. It is a crisis that has come to our country and I sure don't see what the answer is.
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I realized after I wrote the stuff about the blanket that I was kind of contradicting myself... Hopefully being nice doesn't slow them down! I believe that it takes no more time to be nice than to be hurried and abrupt, plus the patient will have a better experience, which is what it is all about anyway--the patient. The federal government is beginning to tie reimbursement (the payments the hospital receives) to the patient satisfaction scores that the hospital has on patient surveys. So everyone is going to have to be nice, and take care of the patient from their point of view. I'm glad that your son got good care in the ER.
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ER's are prohibited by Federal law to turn anyone away that has an "emergency medical condition." So every person has to be screened by a physician or a PA to determine that, which requires taking a medical history and performing a physical exam. By then, the docs in our ER just treat them. There is a hospital in our metro area that has a clinics attached to the ER, and they will screen non emergencies and send them to their clinic. But in our case since we have no on- site clinics, it is to risky to do that and potentially face Federal fines, or risk a patient's safety.
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