Now THAT was an ER visit!

[underpants]

Me:"I hate coming to the ER for a hangnail but I'm at an ER for a hangnail"
Admissions nurse "Oh you're JUST the patient we were looking for!"

Extremely painful hangnail that I had to sleep with my hand hanging off the bed to kill the pain Thursday night. Woke up with a swollen hand (dissipated over time) ready for a field trip to D.C. with my daughter's school. Toughed it out but I had to get this taken care of. I knew some cutting was going to be involved and it didn't want it done at a Doc-in-a-box.

I walk in and the place is packed. I almost sat in the "flu area" until I saw the sign. Friday night 6pm.

Barely sat down and I hear my name called. The quote above followed. "Put him next door". I quickly realized I was in a storage room - okay, I didn't require an actual ER room. Within 10 minutes I'm in the room. While sitting there I hear my name called again "I've got him right here" said the nurse in the hallway. I'm in between the first door and the actual ER. I see someone walk by, open the first door, stand beside the guy who just called my name and she called my name again.

I don't know if it was the nature of my visit or the really good coverage I have but that was impressive.

The ER Doc checks out the woman in the actual exam room across the hall and then comes over to the closet I'm in. I'm sitting in a waiting room chair mind you. He looks at my finger and leaves. Here we go. I'd expected a long wait anyway. He comes back in with everything he needs. Himself. A couple of lidocaine injections on the nerves....tweezers under the fingernail, scissors, snip snip and were done. He leaves.

While the next nurse is dressing my wound I get a call from Walgreens- your prescription is ready. Wow.

All told I was there for an hour. Friday night packed house and I'm in an out like nothing.

Funny part is that when I first entered the waiting room a woman was going off about how horrible this hospital was.

[milestogo]

1. The doc probably said to the triage nurse "give me an easy one"

So you were his break.

[Farmer-Rick]

2. Wow

I was in an ER waiting room next to a guy who had cut off 2 fingers with a blade weed wacker. He sat across from us for over 2 hours.

He was in awful pain.

[Codeine]

19. That is a horrifying combination of

severing and blunt trauma. Holy Jebus.

A coworker of mine cut off three fingers and a thumb with a table saw, but with such a clean cut they got everything reattached and mostly functional. Luckily he had a little bit of skin on each digit unsevered, so he still had some feeling.

A whacker blade? That’s a whole different situation.

[Blue_true]

51. Rural ER? nt

[Farmer-Rick]

56. Yeah,

I've used those blades myself. You need it to get through tough brush. He said he had no safety switch on it. The one I have, you have to use 2 hands to run it. So, you can't just reach down and unclog it or adjust it while it's running.

The poor guy finally got seen.

[left-of-center2012]

3. Doubt it was typical

One Sunday morning I woke up with a SEVERE pain in my lower left side.
I went to the E.R. at the largest hospital in Albuquerque, University of New Mexico Medical Center.

They took my medical info (Blue Cross/Blue Shield) and vital signs,
and I sat for 12 hours without being seen.

A young couple sitting near me had come in before me and also sat all that time.

After 12 hours I got up and went home. The young couple were still waiting.
Other people had come in during that time, some had been seen, some still waited.

From news stories over the years I understand that is not unusual at this E.R.

[NCTraveler]

27. 12 hours is just foolish.

We have digital billboards around the area that state where emergency rooms are and what their current wait times are. Never anything like that.

[left-of-center2012]

44. Since that experience some years ago ...

I have gone a couple times to a different E.R ("Lovelace", downtown Albuquerque) and am taken in right away.

[Ms. Toad]

49. For cellulitis, it is extremely typical.

My daughter has had several bouts with what they expected was cellulitis - she was always the next patient called after we signed in. It can kill you very quickly if it is necrotizing fasciitis and they don't catch it right away, so they have to do an immediately evaluation.

[raven mad]

60. I am so sorry you had to go through that.

[left-of-center2012]

64. Thank you

From local news stories, it's typical of the University of New Mexico Medical Center.

[Ilsa]

4. The staff can't catch anything from your hangnail! LOL.

I'm glad it went smoothly. They probably charged your insured $100,000.

I guess you are on an antibiotic?

[underpants]

21. Yes that was the prescription

I typed that post on my iPhone without my glasses waiting for my wife's car to get inspected this morning. Did a pretty good job considering. Yearly inspection required in Va. Mostly a revenue generator for garages (doesn't affect safety much at all) $16 in and out usually.

[Ilsa]

26. Ours range from $15-25.

New cars can skip the first year. Can't imagine why 2nd, 3rd can't skip.

Get well fast!

[moriah]

5. My last ER visit was referral from doc-in-box, and was admitted.

Got back pretty much instantaneously, they didn't send me back into the waiting room from triage. But pneumonia in an already scarred lung and asthma exacerbation, and terrible O2 sats, will do that.

I generally only go to ERs if broken or unable to breathe. I don't mind the sitting for broken when at least I know where I show up needing 4L of oxygen to get above 92 satted and shut off the alarms that I will get seen appropriately.

[Dennis Donovan]

6. Behind the scenes...

...the ER gets your CCD from the HIE which, as long as your GP kept your records up, has your HX including PMH, Family and Social HX. By the time the ER Dr came in, he knows more about you than anyone except you.

Modern EMR is a great thing. I know because I design and implement it.

[3catwoman3]

8. Interesting. What system? I'm a nurse practitioner...

...in a private pediatric practice, and we converted to EMR 5 years ago. I absolutely HATE it. We have Epic, which I am told is one of the better ones, but it's the only one I know, so I have no standards of comparison. It is very "click heavy" and feels like it has a million parts.

Our office visits are only 20 minutes long, and it typically takes me every second of that 20 minutes to get the patient care done in a safe and thorough manner. Even a simple encounter takes me about 10 minutes to document. I have designed my own templates, and have created all manner of dot phrase short cuts, but it is still extremely time consuming. I can't take 10 minutes to close a chart at the end of a visit, or I'll be ten minutes late for the next patient and be hopelessly behind in no time. No way my practice will spring for scribes, sad to say. I understand they make all the difference.

Part of the time crunch is my own weakness in keyboard skills - I never took typing in high school (way back in the 1960s), so I have to look at the keyboard while typing. Even if I didn't have to, I think it is rude for a clinician to be focusing on the keyboard and not looking the patient/parent in the eye while they are telling you what is going on. In peds, we often have weeping moms, and I need to give those women my full attention - computer be damned.

I end up doing my morning records during what used to be my lunch break, and taking home 2-3 hours of work to complete on my own time at night.

I have read that in an average 11.4 hour work day, the typical primary care clinician spends 5.9 hours of it on the computer. That sucks. I often feel more like a data entry clerk than a clinician. Thank gawd I only work 2 days a week.

[Aristus]

13. Interesting.

You and I have perfectly opposing views of EHR. I use AllScripts, which is also 'click-heavy', and I actually like that. One could ostensibly complete an entire billable chart note without doing any keyboarding. But I tend to do a lot of that anyway.

Being able to click a chart entry enables me to chart very quickly. We also have an auto-text feature like Epic, and I must have a hundred or so templates on there with which I can enter entire paragraphs of free text with just a few keystrokes.

I respect your desire to keep off the computer when in the exam room, and focus on your patient. When you're looking them in the eye, they know you're listening to them and to their complaint. What I do is look over the MA intake briefly before going into the exam room, memorize the chief complaint and the vital signs, so I'm prepared to start forming a differential once I start the visit.

I put my laptop on the counter and forget about it. I listen to the patient and memorize the details that I can record later. As a patient myself, I've known providers who keep their heads buried in the computer the whole time, and just respond "Uh-huh, uh-huh, uh-huh" the whole time. I know they actually are listening to me, but that's not the impression most patients would get from that behavior.

If a visit requires medication Rx's or refills, labs, imaging, or referrals, I explain the plan in its entirety to the patient, which also reinforces my memory for putting it all down on the chart note later.

I try to chart the complete visit right after finishing up with the patient in the exam room. I have to do it while it's fresh in my mind, or things can get missed. That's why I love the 'point-and-click' format so much, because I can get a lot done in a short period of time.

Sometimes, finishing a chart note for the previous patient means keeping the next patient waiting a few minutes longer. But most of my patients are fine with that, since I tend to be very thorough in evaluating their issues. But the upshot is, I rarely have to finish up more than one or two charts at home. I get them closed out quickly and sent off to billing. This generates a lot of revenue for the clinic. I don't care about revenue, but the people who sign my paychecks do. And they like to keep me happy as a result.

[3catwoman3]

34. You and I have discussed EMR before. I wish I liked ours.

I don't, and neither do most of my physician colleagues. I know the point-and-click templates can be efficient, but what I don't like about most of them is the descriptions created by whoever designed them doesn't sound at all like the way I usually word things. I'm something of a writer/wordsmith at heart, and when I read ER records or notes from most other providers, they are stultifyingly the same - very rote/ rubber stamp. I want my work to sound like my work.

The point and click ROS is OK, altho some of the sxs it includes aren't at all pediatric appropriate - how many children have claudication - LOL! I also care about spelling in the narrative portions so I correct typos. Many docs don't. I prefer to have relatively short paragraphs in the narrative that are easy on the eyes because it's pain in the ass to read thru a run-on paragraph looking for the most important information, so I make sure spacing is reader-friendly. If I think something is particularly noteworthy, I bold it so it stands out for others to see.

Maybe I care too much, if that is possible, about the quality of my documentation. I've read lots of notes from others and the quality of the charting is often pretty inferior. One of my colleagues has lots of auto correct short cuts - "c" for constipation and "v" for vomiting - you type the first letter, and the whole word pops up. Efficient, but sometimes hilarious inaccuracies. I know he never reads over his notes because when I was following up a couple of his patients, one record talked about the kid having "constipation difficile," and another high school kid played "vomiting ball." If he read his stuff, he see that.

What is the time interval for your visits? 20 minutes? I which I could spend part of a day with you, and see how your system works.

I enjoy sharing stories with you.

[Aristus]

39. I learn a lot from you, and I respect you.

I agree with you about wanting your chart notes to reflect your style of writing. I'm the same way. I love writing, and even in a clinical, scientific profession such as ours, I want my writing to be distinctive as well as accurate. That's why I do so much free-texting. I imagine that I'm writing for an unseen audience (which I actually am; whoever it is who is auditing my charts...) instead of just scratching out notes for my own review.

If another provider has to take over care of one of my patients, I like to think that my quality of writing will give them all they need to know to give good proper care for my patient.

[3catwoman3]

40. Why, thank you!

Another thing that I am always mindful of is not wanting anyone to ever feel that they have gotten short shrift because they "only" saw the nurse practitioner, not the doctor. It's been my observation over the years that is someone has what they perceive to be a less than 100% satisfactory experience with an NP, they decide we all suck and they don't ever want to see another one. Does that happen with PAs also?

There are also parents who refuse to have their kids seen by me without ever even meeting me. I don't have the proper initial after my name.

If I see a child very early in the course of an illness that has not yet "settled" anywhere definitive, and the child is sicker 2-3 days later, the frequent assumption is that something must have been missed because the child was not seen by the doctor. Some parents come in with sxs that have only been present for a few hours, so it's not unusual for there to be no definite findings that early on. I once examined a kid who'd had a sore throat for 30 minutes.

[Aristus]

45. I think there have only been three or four incidents in my eight years of practice

where someone has played the "You're only a PA! I want to talk to a doctor!" card.

More often than not, when I introduce myself to a new patient and tell them I'm a Physician Assistant, they say "Oh, I love PA's! I'm never visiting with a doctor again, I can tell you!"

It's gratifying, but I try to stick up for my colleagues who are MD's.

'Panicky Parent Syndrome' is one of the cardinal reasons why I don't like visiting with pedes patients. As you pointed out, the illness hasn't settled into something definitive, but the parent, who rushed the child into the clinic for something that is obviously not life-threatening, still wants you to sort the whole thing out without enough evidence to go on.

[3catwoman3]

46. My practice has had the odd approach of booking time slots...

...but not specific providers for same day sick visits, unless someone has made a request for a certain person when they made the appointment. Only place I have ever worked that does that. There are typically 2 of us in the office, and we'd just go from room to room and get it done. The problem with that is, for those who prefer MDs only, I sometimes don't know that until I get in the exam room and get greeted by what I call the "Oh, shit, it's not the doctor" facial expression, and I get asked to leave. A combination of embarrassing and infuriating as hell. Being told I'm not acceptable is always preceded or followed by, "No offense, but...". I don't mind not going in a room. It bugs the hell out of me to be sent out. How can one NOT be offended by that?

Hasn't happened in a while. The last time it did, the father involved was rather rude and arrogant, and when he pulled the "no offense" bit, I informed, him politely, that it was difficult not to feel offended when told you are regarded as inferior. Not an exact quote. Turned on my heel and left.

Earlier in my career, I used to apologize for not being the doctor. Now, I simply say, 'I'll leave immediately. The doctor is already in with someone, and has a couple of requests booked, so you may be waiting for a while."

Finally, early this year, after 20 years of putting up with this, I was able to convince the managing partner that we should try a dedicated schedule for me. Sometimes, my physician colleague of the day has so many requests that, for them, it is effectively a dedicated schedule even if not called that. The front desk ladies now tell someone, "You are booked with the nurse practitioner at 10:20, " or whenever. It seems to be working pretty well (no reason it shouldn't) and I certainly like it better.

It's always puzzling to me that parents would think that a medical practice would hire someone the physicians didn't consider qualified. No doc worth his or her salt would risk their reputations by doing that.

[Aristus]

47. The most recent incident I had was back in December.

I walked in to the room to visit with a new patient, and introduced myself, as always, as a Physician Assistant.

The patient smirked at me and said: "Oh, so you went to some community college somewhere for three months, and now you think you're a doctor?"

I turned around and walked out. I went to the scheduler and had her put him on my supervising physician's schedule. He was on vacation and wouldn't be back for a week or so. So the patient kind of screwed himself there.

The funny thing is, back when the PA profession got started, the training program really was only three months long. But the students were all military combat medics who had just spent a year in Vietnam performing combat medicine in the field under the most stressful conditions, and had a literal baptism of fire that prepared them very well for a career as medical providers.

So the patient would have had a point, if his information hadn't been fifty years out of date...

[3catwoman3]

52. I have been a PNP since 1976. Back then, most NP programs...

...were continuing education programs that were 4-6 months in length. That is the type I attended. I spent about 18 months as a bedside nurse after graduation, and it was a real disappointment. In my BSN program, we had learned a lot of pathophysiology and other in-depth, sophisticated information, which never seemed to be needed in the working world.

If I worked the day shift, the most important thing was how many beds and baths could I get done before the breakfast trays arrived. WTH? One time, while caring for a patient who's had a craniopharyngioma resected and had lots of fluid and electrolyte problems. I remember asking one of the interns to refresh my memory on inappropriate ADH, and he looked at me with disdain,and said, "Where did you ever learn about IADH?" I wanted to smack him. Arrogant SOB.

I worked on a very busy peds unit, and it was organizationally challenging, but not intellectually. The interns and residents made all the decisions, and the nurses carried them out.

I was becoming fairly sure I'd made the wrong career choice. I'd learned about the new NP career while still an undergrad. It had just started in 1965, and this would have been 1972. Graduated in 1973. I decided I'd give it a try. The potential independence and decision making on my own appealed to me. A former professor tried to talk me out of the CE path, and urged me to get a master's degree. Knowing that I wasn't sure I was going to stay in nursing, I told her I didn't want to spend 2 years getting a master's in something I wasn't sure I was going to like.

I went to a 4 month program at the University of Buffalo, starting in January or 1975, and it was superb. I still use things they taught me every day. I then spent 4 years in the Air Force nurse corp - 2 years in San Antonio at Lackland AFB, and 2 years in Japan. Worked my ass off and learned a lot. Didn't want to stay in, but after the 4 years I knew for sure I liked the role and was good at it, so I used my GI Bill benefits to get my master's at the U of Colorado, where the PNP role had originated.

Been at it ever since, in one capacity or another.

I took the very first certification exam ever offered, in 1977. About 830 people took it, and 780 passed the first time around - I was one of them. In the whole US, there are now only 92 PNPs who still maintain certification from that year.

I know you were in the Army. How long, and did they cover your PA education?

[Blue_true]

53. One of the most difficult medical situations that I have ever had was solved by a Nurse Practioner.

My medicine was not removing inflammation. The Nurse Practioner put me through a series of checks then concluded that my dosage was wrong, she made the adjustments, gave me new instructions and bingo, after a few days, things were better and after a few weeks, the problem was gone.

[3catwoman3]

54. What a gratifying story. Most of us are very good at what we do.

One of the most frequently voiced concerns it NPs is, "Do they know what they don't know?" Emphatically, YES!

I tell people who express that fear that anyone who preforms any sort of service for you needs to know what they don't know - your lawyer, your plumber, your dentist, your car repair technician, your surgeon, your lawn care person, your veterianarian, your roofer, etc, etc, etc.

[Dennis Donovan]

35. Epic is a competitor of ours...

I work for another EMR/PM. We were voted #1 EMR by Medical Economics mag a few yrs ago.

http://medicaleconomics.modernmedicine.com/medical-economics/news/ehr-report-card

[3catwoman3]

38. I think the main reason we have Epic is an...

...affiliation with Chicago Children's Hospital (now Lurie Children's, in honor of major benefactors.) I believe we got some sort of "deal" on the cost of the system by doing going in with them. We are a relatively large private practice, with 9 pediatricians and one nurse practitioner (me), and 3 locations.

We are also part of a 9 practice consortium, and all the practices use Epic. The smallest practice has 3 docs. One other practice is as big as ours, and has 6 docs and 4 NPs. 6 of the practices do not employ NPs. There are a total of 46 docs in the consortium, 3 of whom are DOs.

[Dennis Donovan]

42. I run into that alot

Large hospitals use Epic, so satellite offices use it. But we interface seemlessly with it.

[3catwoman3]

43. I think Epic might be somewhat better suited for in-patient...

...documentation. There is a whole bunch of stuff in it that I never use, but have to navigate around, which wastes time.

Before we "went live," there were auto-tutorials we all had to do. Mostly worthless. My sample patient was a fictitious 59 year old man with high cholesterol, and one of the things the tutorial wanted me to do/learn was order a year's worth of sequential labs to monitor the effectiveness of his Lipitor. Something I will never, ever do.

I remember thinking, "Damn it all, if i have to learn a new and overwhelmingly confusing system, can't I at least have a pretend 5 yr old with an ear infection, so that something feels familiar?"

[underpants]

22. TY Mr. Acronym

I think I understood that.

[Dennis Donovan]

36. Hahaha!! I meant to add a glossary...

...but I took a nap.

CCD - Continuity of Care Document
HIE - Health Information Exchange
GP - General Practitioner
HX - History
PMH - Past Medical History
EMR - Electronic Medical Records

[raven mad]

57. IIRC, Fairbanks (AK) Memorial is using your system.

Don't know for sure but I do know their triage is awesome. Having had cause to visit a few times over the past 15 or so years, I can swear they are top of the line.

[Siwsan]

7. Wow - my visits to the ER with my mom and aunt averaged around 10 hours

I was at the ER a whole lot with them, and never got out of there in less than 8 hours. The worst was 14. And these visits all started either in the morning or afternoon. They were in their 80's - 90's so when 'we'll be right back' turned into a 2 hour wait, I figured they just weren't a priority. After that 14 hour ordeal, I am shocked that my rather explosive, obscenity filled display of displeasure didn't get me barred from that hospital. Unfortunately for the community, I don't think it was something they hadn't heard before - repeatedly.

The Saturday night ER visit with my brother, who is in his 50's, saw us in and out in less than 2 hours, reinforcing my suspicion.

[Frustratedlady]

9. Our ER is the same way. In and out quickly, unless you need serious care done.

They've been that way for years and you rarely hear anyone complaining.

It can be done.

Enjoy your field trip.

[3catwoman3]

10. It sounds as if you were well cared for. Great!

Last edited Sat Apr 14, 2018, 05:27 PM - Edit history (1)

During flu season, I would much rather sit in a supply closet that a waiting room full of people coughing all over everything.

At the pediatric office where I work, we often get parents wanting to get their kids examined 2-3 days before going on vacation - "just in case." I make it clear to people that my findings on exam at any given moment are valid ONLY RIGHT THEN - no 10 day warranty.

If you are about to travel, the very last thing you should do is bring a healthy child who has no symptoms of anything at all into a waiting room of sick people. Getting them examined has no preventive powers, and more than likely guarantee they will pick up something that will manifest itself during the vacation. If your child is not sick, STAY HOME before going on vacation!

[UnhelpfulYoda]

11. Ah, good to see you are taking advantage of Bush-Era Free Medical Care.

Via the emergency rooms around the country.

It's a proud legacy, we here in the United States are quite proud of. Anyone can walk into an ER and get their free healthcare.


Diabetic, wheelchair-bound patient dumped at DTLA homeless shelter | abc7.com
http://abc7.com/health/diabetic-patient-dumped-at-dtla-homeless-shelter/3321202/


Video shows patient left at cold bus stop at night, wearing only a hospital gown - CNN
https://www.cnn.com/2018/01/11/health/baltimore-hospital-patient-video-bus-stop-trnd/index.html


Mother of Patient Left Outside Baltimore Hospital in Gown Says She Was Denied Care - NBC4 Washington https://www.nbcwashington.com/news/local/Woman-Left-in-Cold-in-Hospital-Gown-Was-Denied-Car-Mother-Says-470088423.html


California nursing home accused of dumping patient at homeless shelter - CBS News
https://www.cbsnews.com/news/ronald-anderson-avalon-villa-care-center-patient-dumping-skid-row/

[marble falls]

31. A little over the top there, yoda. She didn't get her treatment free.

[Aristus]

50. I think that UnhelpfulYoda was alluding to George W. Bush's belief

that medical care obtained in the emergency rooms is free.

Just one of many idiocies Bush spouted from the depths of his privileged upbringing, and with no knowledge of the challenges that most citizens face in life.

[marble falls]

55. I think you may give Yoda a bit more credit than called for.

[UnhelpfulYoda]

67. lulz, while in general, this could very well be the case...

Last edited Sun Apr 15, 2018, 11:40 AM - Edit history (1)

...and, while, I know that I'm new here and it's bad form to start off by imposing my idiosyncrasies on everyone else.

I kinda have this thing where, if I have to place a ' /s ' after a sarcastic statement meant to be funny, then it's no longer sarcastic, or funny.

[Fla Dem]

68. Here's the thing, while you may think you're being subtly sarcastic and comedic

most readers aren't going to take the time to analyze the methods behind your postings. We generally take a person's posting at face value. You'll probably find yourself on the wrong side of s jury decision.

Welcome to DU.

BTW, if you enjoy humor there's oodles of it in the DU Lounge and Offbeat forums.

[UnhelpfulYoda]

66. I think you are both giving Bush way too much and way too little credit.

Objectively, we know that Bush was of below average intelligence, and would never have stepped foot on the Yale campus had he not had Daddy's money and clout, HOWEVER, he's not mentally challenged, and he knew and knows that ER visits, are not only not free, but are not a substitute for proper medical care.

....for a wide variety of obvious reasons, anyone, even the 'poors' can reason out on their own.

He said it because he doesn't give shit about people not born into wealth and/or who might be less fortunate. So, I get it, you are blaming his comments on his disconnection from the reality many face, but I would be careful giving him this, and assuming he had no malevolent intent in pushing the policies he did.

[Sampan]

12. Part of the reason for long ER waits is that some people use the ER inappropriately.

[George II]

16. We used to get people showing up in the middle of the night because they were lonely.

[sarah FAILIN]

37. Agreed

Our insurance jumped 20% due to us being a self insured company full of people making poor choices with our Healthcare dollars. I sent a message to our plant manager telling him that part of the problem is inappropriate use of ER service. People don't want to take off work to go to a general practitioner, so they go to the ER after they get off. Also, some parents rush to the ER with their babies or young children at the first sign of a fever. We have Children's Hospital that specializes in kids and some people think they have to go there every time their kid spits up.
Our HR department set up a training of sorts to go over what kind of doctor is most appropriate for different situations. You would think they would know, but they seemed to think it was free unlimited medical care if you pay your premiums. A 20% increase woke them up.

[Tipperary]

63. As evidenced by this op.

The er for a hangnail? Smh.

[elleng]

14. WOW! Very cool!

LUCKY!

Which hospital??? Inquiring minds want to know!

[underpants]

25. St. Mary's (Bon Secours) Richmond Va

That's our go to hospital even though it's not the closest. I actually drove by another hospital to take my daughter there when she had a concussion. Our daughter was born there.

[George II]

15. You're lucky, especially for a Friday night, but it was still early.

Many years ago while in college I worked Fri/Sat nights in a NYC emergency room (midnight - 8 AM), it can be a madhouse. Some nights are so quiet that my "dinner break" (during which I napped) stretched to three hours, other nights couldn't get a break at all.

They may have assessed your problem as relatively minor (not to you, of course!) and figured they'd get you in and out to make room for a more serious case. That, and some of the others may have already been evaluated and were waiting for a specialty resident to get down there.

[Hortensis]

61. Makes sense, rooming can-be-treated-quick

patients along with others who are going to require various waits.

A couple years ago triage for a crowded ER sent my husband straight back to a room when he walked in by himself, even though they had 7 people waiting for one to become available, and he was seen immediately by a physician.

He'd had his first-ever anaphylactic reaction, from an insect, passing out and foaming at the mouth from what turned out to be a blood pressure crash while I was driving him in to check out his weird first-ever hives. He insisted he felt back to normal and so I let him walk in alone to the desk right inside while I ditched the car, but the triage nurse wasn't fooled into thinking he was okay.

[yallerdawg]

17. This might be the key: "The really good coverage I have."

Depending on the location and the mandatory requirements of the ER, it's quite possible you could be the only paying customer in the facility.

[underpants]

24. I threw that in from another example many moons ago

First night in a new house I missed the last step (coming downstairs from studying to get some water) glass shatters in my hand. Need stitches. I go to the downtown teaching hospital MCV - now VCU. Saturday night. It looked like a pan shot from a movie - native/Mexican with paint IN HIS EYE, Black woman who got stabbed in the forehead, old drunk near his end, party boy with a split head, ......other's.....me - white older college student with contained bleeding. I got called first.

I asked the intern how I leap frogged that crowd. "You're a VCU student. We know you have coverage"

1995.

[BigOleDummy]

18. Gotta give ....

.... the V.A. Healthcare another shoutout after reading some of the comments here. I get 100% of my Healthcare needs from the V.A. and have had to use the E.R. three times now. One of those I had to wait maybe a half hour and the others far less. Last visit I was in an exam room before I caught my breath from walking in from the parking lot. Don't listen to the slammers, V.A. Healthcare is top notch, at least the Hospital's of theirs I've used. (4 , in 3 different States) It boils my blood to think of how so many of the repuglican "leaders" want to privatize the V.A. . Why screw with something that works so well? Yes, I know it's "Big Government" and it WORKS so they seem to want to tear it up just so it WON'T work anymore.

[underpants]

23. Though I served I don't qualify for the VA

Of course I know someone in my family who really didn't qualify but someone else in the family knew that of applied in a certain county of a certain state he'd get in. He did.

I've never been to a VA but I'm sure the stories (considering the sources) are exaggerated. Well there are some problems.

[Glorfindel]

28. I qualify for V.A., too, but I don't utilize it. I made one visit to a V.A. hospital and realized

that every minute a doctor or nurse spent with me would be a minute taken from a veteran who needed them much more than I did. Fortunately, I have had good insurance in the past and now have Medicare and a supplement, but I won't use V.A. unless there is absolutely no other choice.

[raven mad]

58. Fairbanks Memorial here in town IS the only VA hospital in the Interior.

Basset Army Hospital used to be - all military, retired, etc. got good care there; now everyone qualifying for VA either goes to the local provider (FMH) or has to go to Anchorage. 360 miles, one way, 2-lane mostly mountain road; or the train which doesn't run most days in winter; or fly.

[The River]

62. Well Said

I've used 2, one on either coast. Much better than most public hospitals.
The VA is proactive about your health care. They catch things early and fix whatever it is before it's get way worse. Age appropriate scans and tests, shots, etc.

[Stonepounder]

20. We have been extremely well cared for in the ERs we've been to (only two)

Northern KY - passed out in garage on a Saturday night. Ambulance to ER, straight to examining room/bed. Mrs. Stonepounder does the admit paperwork while a battery of docs and nurses run tests. Am admitted. Sun AM angiogram. Monday morning surgery, triple by-pass open-heart surgery.

Kansas City - cut finger that would not stop bleeding. Went to Urgent Care who said get thee to the ER. Proceeded to ER. Didn't even get to sit down. Straight to a bed, Doctor 2 minutes later, several stitches later check out and head for home. Total time, less than 45 min from arrival to departure.

Chest pains. Straight to ER. Two days in hospital. Docs can't find anything wrong. (Found out a couple of years later it was gall stones.)

Northern KY - The Mrs. wakes up with BP over the moon. Call Doc's office, they say get thee to the ER (which is only about a 10 min drive from house). I am still with intake nurse when triage nurse comes out with wheelchair and whisks the Mrs. away. Meds and observation for a couple of hours until BP goes down. Go home.

Another BP episode. We know the drill, head to ER. Again Mrs. is whisked away while I am still doing paperwork. This time she is admitted. Whole battery of tests, new regimen of meds. Haven't been back since.


Of course the Northern KY stuff is one of the reasons we moved where we did when I retired. We have GREAT hospitals, ER's, and Docs around here.

[Hugin]

29. This is what pocket knives are for...

Ya big baby!

Seriously, tho. I've been pretty lucky with my ER visits. There have been a few over the years.

I'm glad your experience was good.

[c-rational]

30. Wait till you get the bill Last year on the day of the Women's March I had wax in one ear

and could not hear. I could not get to the Urgent Care clinic (I live in NYC near the start of the march) and walked to the Emergency Room. I also was taken care of quickly...a little peroxide and water flush, and out in a jiffy. Mind you I asked if this would be stupidly expensive and got a non-committal response. Well several weeks later I got the bill from the insurance carrier - over $5,000 in charges. Thank the stars I ha good insurance and only had to pay a little over $600. I am now registered with my local Urgent Care clinic. Hope I have not burst your bubble of good feelings.

[underpants]

65. Scrip was $4.33. Marking to update you on the bill.

I think an ER visit is $45 to be prohibitive.

Our premium is less than $300 a month (family of 3)
$500 or less deductible
$3K out of pocket max a year

There's a reason I beat out 295 applicants for my job

[underpants]

69. Just got my bill ........ $40

Yep $40.

[mnhtnbb]

32. Lucky you!

I went to the doc in a box for a wound infection on my finger in March. Felt like an idiot. I had gotten a tiny little splinter in my finger from the old decking wood at the beach house where I was staying--but it was hot, hard, full of pus. Didn't want to mess with it. I have two joint replacements that the ortho tells me I should always take an antibiotic prior to dental treatment just to be sure I don't get any infection that could settle in the joints.

The doc had to go look for a magnifying glass so he could dig it out. Drained it. Gave me a script for an antibiotic. I was still apologizing for coming in for such a nothing injury. Then he told me it was a good thing I had, because he knew there was MRSA in some of the old wood at the beach!

It is ALWAYS better to take care of something that seems like nothing before it becomes something serious!

[cwydro]

33. You say you have really good coverage...

Why in hell go to an ER instead of your primary care doctor?

[pnwmom]

41. Good you got it taken care of, but you shouldn't have delayed. I know someone who almost lost an arm

because of a hangnail. She wound up being treated for flesh-eating bacteria.

If you finger was swollen and you couldn't sleep normally with it, that would have been a sign you needed treatment.

[Ms. Toad]

48. Cellulitis puts you at the front of the line.

By and large, flu isn't going to kill you (or require an amputation) if you have to wait an hour or so.

Cellulitis (what you had), can, depending on the bacteria. It kills 1 in 4 people who have it, as quickly as 12-24 hours. They can't tell until they evaluate it.

Every hear of flesh-eating bacteria (necrotizing fasciitis)?

One nurse's story about NF starting from a hangnail: http://www.kctv5.com/story/36725198/nurse-on-mission-to-inform-others-after-battling-flesh-eating-bacteria

http://www.kare11.com/article/news/minnesota-man-loses-leg-from-flesh-eating-bacterial-infection/422657157

[raven mad]

59. Underpants, you have a good medical community!! Really good!

I love our local hospital; ER staff & clerks, staff docs, consulting docs, PA's, and nurses (RN, LPN, trainees), right on up to the janitorial and "pink lady" folks. Super caring, and everyone providing care (if you don't think of the janitorial and volunteer staff as doing so, just imagine a stay without them)!

My last ER was an "on the fly" from my primary care (ortho) doc - I was in extreme pain and my beautiful, incredible PA at the doctor's office sent me literally across the street! Because it was chilly out (about 28 below), they wrapped me up (over parka, etc.) with warmed blankets and called ahead. Ready? Hell yeah, so fast my head spun - the part of it that could still sorta reason.

Saying I'm proud of our small medical community would be understatement. I had to be re-admitted, and the admissions clerk (after they situated me in a room) - I swear - had SNL training, she was so funny. I'd only been released 10 days before, on the same thing (fractured pelvis), and some of the one-liners............. well, you can guess!

If you get hurt or sick up here, don't discount the helicopter landing pad! With so much outlying, not-on-road-system communities, and time of the essence, they do one hell of a great job.

For every single Shrub-based hospital or so-called health care system, either too big, not enough or indifferent, I wish ALL of you an FMH if you have to have one! Sorry for the brag and rant, but this place deserves the praise and photos.