To Take or not to Take?

mcdonl said:
Your killing me slim!! :P

You know what I was saying, we are all people and none of us are any better then the next guy just have a different Scope of Service.

But... ok... maybe a few of the residents!

While we are on the subject, why do they not teach the operation of buckles are in med school. They clearly taught the use of trauma shears, and I am almost certain they are told specifically to CUT all straps securing a patient to a backboard. :)
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I think I deleted my answer before I sent it. Anyway, we used to do a one day orientation for incoming EM residents covering back boarding, scoop stretchers, and even traction splints. I don't know if we still do it, because it was taken over by our training staff and it was probably too much like work.
 
CAOX3 said:
Its called professional courtesy, if they're slammed I dont have a problem getting a BP for them. I am under the impression that its my patient anyway until a report is given then again we dont have the "us vs them" mentality more like we're in this mess together.
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The patient is theirs once you hit the door. Actually, the patient is theirs once you are on their campus or within 250 yards of it. You'll have to look up the CMS "250 yard rule" on your own.

Remember they know where the donuts are. :)
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Inside their bellies, as a rule. Although in many cases they seem to have migrated a bit, um, lower.
 
Too Old To Work said:
Inside their bellies, as a rule. Although in many cases they seem to have migrated a bit, um, lower.
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GetInMyBelly.jpg
 
mcdonl said:
Good stuff!

http://www.acep.org/PrintFriendly.aspx?id=40440
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Thanks!

What does this mean for emergency physicians? Any patient or the patient's representative, such as a paramedic, babysitter, or friend, who comes to an emergency department requesting "examination or treatment for a medical condition" must be provided with "an appropriate medical screening examination" to determine if an "emergency medical condition" exists, regardless of an individual's ability to pay.
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Although the ACEP extract is geared towards physicians, it effects nurses as well.
 
Too Old To Work said:
Although the ACEP extract is geared towards physicians, it effects nurses as well.
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Unless the triage nurse is playing funny with categorizing patients due to insurance or the nurse is providing the medical screening exam (which triage is not), I'd be interested to know how.
 
Usually once we offload pt care is done by the hospital staff.

However, often are hospitals are so full (free :P) that we have to wait in the hallway of the hospital with the pt until they can free up a bed. Sometimes we have to wait with pt inside ambulance (practice called ramping). In these cases we are still responsible for pt care.

It very bad that this happens. The other night i spent 1 hr waiting in the hall with one pt and 2 hours with another. One was a triage category 3, the other a 4. (scale 1 worst to 5). This really sucks because while we are stuck in hospital, less ambulances to respond in the streets. Our bigger stations have 2 night crews and others 1. If we have 6 Ambulances held up at hospitals, that leaves a huge hole in coverage at night.
 
Well...

Transport times in my area are ridiculously quick.

Emergent transport will get the PT to the hospital in <10 minutes. Non emergent will get them there in ~15-20.

So we only get to do one or two sets of vitals. For non-emergent patients and occasionally emergent transported patients we will hold them in the unit for an extra 60 to get one last set before handing them off.
 
Um, no. Although with my pt.'s that are hooked up to the LP12 I will cycle a fresh set as we are arriving at the dock/wheeling towards the room. If they want it I will be more than happy to tell them what it is.
 
Fox800 said:
Um, no. Although with my pt.'s that are hooked up to the LP12 I will cycle a fresh set as we are arriving at the dock/wheeling towards the room. If they want it I will be more than happy to tell them what it is.
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Why "Um, no."?

You can get a full set of vitals in <30-45 sec...

It takes that long for the driver to get out to the back and open the hatch doors to assist with the stretcher legs......
 
Jeez, if it takes the driver THAT long to walk 15 feet and pull one latch....




We've already gone over the why of "um no"... it's not our job. We're happy to assist, but don't "demand" it of us when you're standing right there able to do it yourself.


(Generic "you")
 
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medicman90 said:
Why "Um, no."?

You can get a full set of vitals in <30-45 sec...

It takes that long for the driver to get out to the back and open the hatch doors to assist with the stretcher legs......
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The hospital staff are paid to do just that. The RN/LVN/tech/whoever has the responsibility of taking initial vital signs. Do it over and over again and they expect you to do it for them, and will get pissy if you don't.
 
Fox800 said:
The hospital staff are paid to do just that. The RN/LVN/tech/whoever has the responsibility of taking initial vital signs. Do it over and over again and they expect you to do it for them, and will get pissy if you don't.
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I'm a volunteer...not a career worker.

I like throwing in the little extras. Seriously...whenever you can...just do it?

Wouldn't you want the medics taking care of your grandma or kid or dad to do that?

Stop being lazy.
 
medicman90 said:
I'm a volunteer...not a career worker.

I like throwing in the little extras. Seriously...whenever you can...just do it?

Wouldn't you want the medics taking care of your grandma or kid or dad to do that?

Stop being lazy.
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I wouldn't care, as long as it gets done.

So we're lazy by not doing the hospital staff's job. OK, bucko. :rolleyes:
 
Fox800 said:
I wouldn't care, as long as it gets done.

So we're lazy by not doing the hospital staff's job. OK, bucko. :rolleyes:
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No, but taking an extra set to hand over with the PT sometimes yields interesting results...

and it helps with trending?

I don't know, it's just something my preceptor taught me to do.

It's not like taking vitals is difficult or anything...
 
medicman90 said:
No, but taking an extra set to hand over with the PT sometimes yields interesting results...

and it helps with trending?

I don't know, it's just something my preceptor taught me to do.

It's not like taking vitals is difficult or anything...
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No, it's just laziness and complacency on the part of the ER staff.
 
So, medic, where's the anger at the hospital staff that doesn't help lift the patient or take some vitals for YOU before you take a patient away?



I refuse to do extra work that is someone else's job because they are lazy, so long as it doesn't put the patient at risk...
 
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Linuss said:
So, medic, where's the anger at the hospital staff that doesn't help lift the patient or take some vitals for YOU before you take a patient away?



I refuse to do extra work that is someone else's job because they are lazy, so long as it doesn't put the patient at risk...
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I just do the work. What's wrong with a little sense of pride in what you're doing?

Also...why don't they help lift?

If you need help. Ask. It will come.
 
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