Overnight peoples (aka. Who's up?)

[Corey]

Originally Posted by tommymac

i would love to have something like that. If I have the right people here I can move things prety quickly, but here were not a typical fast track either. We work up a lot of stuff over here due to sheer volume ( our census is about 70k a year) we actualy admit about 10 to 20 perecnt of our fast track patients as well (we work up a lot of appys, cholecystitis and other abdominal pains and gyn stuff) Plus on th eovernights I am flying solo so I get a few procedures to do and it just bogs down.

Tom

Damn. We've got a nice system in place that filters out a good amount of shit that would normally clog up the ER. If the triage nurse determines it's an urgent care situation and not an emergency, they're sent back for a further screening with a PA or a Doctor for a medical screening by a qualified medical practitioner (QMP, hence QMP process). The PA/Dr gives the final decision on whether it's an urgent care situation or if it qualifies as an emergency. If it's urgent care, the patient is given two options: pay $150 if they're uninsured (or their copay if they're insured) for treatment or go home and not get charged. I'd say 9 out of 10 times they're just happy to hear they're not dying and that they can leave with some treatment advice (take some tylenol, rest, put heat on it, put ice on it, etc) and not have to pay a dime. If they do decide to stay for treatment, and since it's already been determined that it's an urgent care situation, the treatment is typically Motrin and a script. Either way, they're outta the ER quick and not taking up a room with some phantom pain. The process cuts out people just wanting to know it's not serious, bums looking for pain meds, and retards trying to abuse the system because their tummy hurts and they want a doctors note to get outta work because they're actually just hungover.

[tommymac]

Originally Posted by Corey

Damn. We've got a nice system in place that filters out a good amount of shit that would normally clog up the ER. If the triage nurse determines it's an urgent care situation and not an emergency, they're sent back for a further screening with a PA or a Doctor for a medical screening by a qualified medical practitioner (QMP, hence QMP process). The PA/Dr gives the final decision on whether it's an urgent care situation or if it qualifies as an emergency. If it's urgent care, the patient is given two options: pay $150 if they're uninsured (or their copay if they're insured) for treatment or go home and not get charged. I'd say 9 out of 10 times they're just happy to hear they're not dying and that they can leave with some treatment advice (take some tylenol, rest, put heat on it, put ice on it, etc) and not have to pay a dime. If they do decide to stay for treatment, and since it's already been determined that it's an urgent care situation, the treatment is typically Motrin and a script. Either way, they're outta the ER quick and not taking up a room with some phantom pain. The process cuts out people just wanting to know it's not serious, bums looking for pain meds, and retards trying to abuse the system because their tummy hurts and they want a doctors note to get outta work because they're actually just hungover.

I have read about stuff like that in some of the journals, def a great idea to try to reduce wait times and move things along. I think there is a bit of a medical/legal aspect to some of it in that if one of those you send home has something bad it could bite ya in the but. I think some ER's in NY have implimented a similar system with good results. We are just so shortstaffed and underfunded here something like that wont happen for a while. Our director is handcuffed by the state so it limits what we can do. they cant even get any new PA's here because the starting salary is the same as when I started 6 years ago. back then it was kinda ok but now it prety much sucks. Were approved for 2 more PA tracks and they cant fill them for anything. Plus with the crew we have now if myself and 2 of the other PA's left they would be totally screwed since were the only ones who can actulay manage a busy room by ourselves.

Tom

[Corey]

Originally Posted by tommymac

I have read about stuff like that in some of the journals, def a great idea to try to reduce wait times and move things along. I think there is a bit of a medical/legal aspect to some of it in that if one of those you send home has something bad it could bite ya in the but. I think some ER's in NY have implimented a similar system with good results. We are just so shortstaffed and underfunded here something like that wont happen for a while. Our director is handcuffed by the state so it limits what we can do. they cant even get any new PA's here because the starting salary is the same as when I started 6 years ago. back then it was kinda ok but now it prety much sucks. Were approved for 2 more PA tracks and they cant fill them for anything. Plus with the crew we have now if myself and 2 of the other PA's left they would be totally screwed since were the only ones who can actulay manage a busy room by ourselves.

Tom

We're slightly less bound, being private instead of state and owned by HCA. I think the process has been rolled out in almost all HCA hospitals, as well as some of the other private ones. I know they've got a good list of standards that aids in eliminating as much of the legal liability as possible and the PA/Dr's have the final say and tend to err on the side of caution if something even approaches a gray area. Sucks about the staffing situation you have to deal with. I've seen it in other places as well. I can't say how the pay is in our hospital in particular, seeing as how I'm on the bottom rung of the whole deal, but there seems to be no shortage of people looking to get on staff, so I'd imagine it's decent enough. It could be another result of being privately run, but that's just a guess.

[Adeptus_Minor]

Hey Rogue.

HH, you still not sleeping?

[rogue]

Originally Posted by Adeptus_Minor

Hey Rogue.

HH, you still not sleeping?

Hey sweetie! *hugs!*