RE: ER Triage Nurse MURDERS PATIENT through neglect... (Full Version)

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Aswad -> RE: ER Triage Nurse MURDERS PATIENT through neglect... (6/3/2007 6:52:57 PM)

quote:

ORIGINAL: Lordandmaster

It's horrible, of course, but it's not murder.  If there's no intent to kill, it's not murder.


Correct. It's manslaughter and criminal negligence.



Aswad -> RE: ER Triage Nurse MURDERS PATIENT through neglect... (6/3/2007 6:56:53 PM)

quote:

ORIGINAL: gothicdiva

I just can't imagine how excruciatingly painful a perforated bowel must be and the women had the symptoms for some time but somehow was misdiagnosed. What a horrible way to die!


Going by what my friend went through, and his comparative ranking of pain afterwards, I'd have to agree with "can't know", but I can clearly imagine. And I don't want to.



BlindDescent -> RE: ER Triage Nurse MURDERS PATIENT through neglect... (6/3/2007 7:34:42 PM)

Personally I  would like to see a bit more data...most ERs run a 4 to 12 hour wait to be seen after being triaged. How many were in the waiting room? How many patients were in stretchers in the hallways back in the treatment areas? How many ambulances were backed up and waiting to find an empty spot to drop off their pt.? I won't make any excuse for the behavior of the triage nurse; but 3rd visit and already evaluated that day (hopefully there was a true eval) would make it appear that she was stable. There are several patients daily who  walk across the parking lot quite fine; then as they enter the lobby suddenly fall to their knees and  present dramatically in the hopes of getting seen faster. There are numerous pain med seekers who go from ER to ER trying to cop a high. Not every one is honorable and honest in their presentation or story. Most people will try to embellish  thier symptoms to be seen faster, even at the expense of others who they can clearly see are in worse shape than themselves.
Restrospective case study always gives a  clear view of what anyone could have done better. Just remember: airway/breathing/circulation...can't breathe or symptomatic chest pain generally win. Kidney stones present dramatically and miserably but  dont trump chest pain. Stroke symptoms  win too.  It's easy to snipe at a story that is written provocatively. Try working 12 hours as a triage nurse and having responsibility for 30 to 40 patients...try not calling 911 because you vomited 2 x and your tummy hurts.  And it pisses me off even more so to hear some turd complain that the uninsured non citizens get better care than American citizens. They don't. ER s are far from perfect...you want better care...write and complain to have more money used for healthcare instead of pork barrel projects. Try being healthy, promote living wills, don't expect ERs to undo all the poor lifestyle choices you have made and fix you on the spot. Aint gonna happen. There is far more to this issue than the emotions of this story have opened up. Don;t complain...do something to change yourself or the system.



toservez -> RE: ER Triage Nurse MURDERS PATIENT through neglect... (6/3/2007 9:48:12 PM)

As a trauma/ER nurse I find the story upsetting and hope the nurse never works in the field again. You always always believe the patient until proof they are not telling the truth period.

Now sadly there is a huge gap in our healthcare system. ER’s are no longer places that can handle people basically not wanting to see their regular doctor. We are not there to do long work ups and take tons of tests. For many things like this story it is about getting them short term treated and for them to go to their regular doctor for all the bells and whistles. The gap occurs of course to all the people who do not have health insurance and therefore regular doctors and the ER becomes their regular doctor office and the truth is there just is a risk of things like this and it is not about race and income levels but how the healthcare system has just changed compared to years long gone by.




toservez -> RE: ER Triage Nurse MURDERS PATIENT through neglect... (6/3/2007 10:02:12 PM)


quote:

ORIGINAL: BlindDescent

Personally I  would like to see a bit more data...most ERs run a 4 to 12 hour wait to be seen after being triaged. How many were in the waiting room? How many patients were in stretchers in the hallways back in the treatment areas? How many ambulances were backed up and waiting to find an empty spot to drop off their pt.? I won't make any excuse for the behavior of the triage nurse; but 3rd visit and already evaluated that day (hopefully there was a true eval) would make it appear that she was stable. There are several patients daily who  walk across the parking lot quite fine; then as they enter the lobby suddenly fall to their knees and  present dramatically in the hopes of getting seen faster. There are numerous pain med seekers who go from ER to ER trying to cop a high. Not every one is honorable and honest in their presentation or story. Most people will try to embellish  thier symptoms to be seen faster, even at the expense of others who they can clearly see are in worse shape than themselves.
Restrospective case study always gives a  clear view of what anyone could have done better. Just remember: airway/breathing/circulation...can't breathe or symptomatic chest pain generally win. Kidney stones present dramatically and miserably but  dont trump chest pain. Stroke symptoms  win too.  It's easy to snipe at a story that is written provocatively. Try working 12 hours as a triage nurse and having responsibility for 30 to 40 patients...try not calling 911 because you vomited 2 x and your tummy hurts.  And it pisses me off even more so to hear some turd complain that the uninsured non citizens get better care than American citizens. They don't. ER s are far from perfect...you want better care...write and complain to have more money used for healthcare instead of pork barrel projects. Try being healthy, promote living wills, don't expect ERs to undo all the poor lifestyle choices you have made and fix you on the spot. Aint gonna happen. There is far more to this issue than the emotions of this story have opened up. Don;t complain...do something to change yourself or the system.


I would like to also point out that diagnosis are not easy. All ER’s do things on a priority basis but the fact most coming in you cannot really separate which one is more severe then another. It is literally almost impossible if you have people waiting to know exactly who truly needs to go first and that is if you just take symptoms into hand. Throw in all people are different with different pain and truth thresholds it is always a dicey situation.



popeye1250 -> RE: ER Triage Nurse MURDERS PATIENT through neglect... (6/4/2007 1:12:50 AM)

I wonder where exactly that Hospital is? L.A. County is a HUGE area!
I guess I'm just spoiled, I used the Hospitals in New England before and got great service! And the Doctors and Nurses tend to be the best in the country too. A lot of teaching Hospitals in New England.
I had two operations (both shoulders) in Portsmouth Hospital, N.H. and everything went like clockwork!
And it's absolutely spotless too!
My sister works as an x-ray tech in neighboring Exeter Hospital doing "Mams" and that Hospital is probably the most modern, high tech Hospital in the state.
In that Hospital you fill out some paperwork if you're ambulatory, see a Nurse right away and a Doctor within 15 minutes!



Vendaval -> RE: ER Triage Nurse MURDERS PATIENT through neglect... (6/4/2007 1:21:53 AM)

Exactly
 
I have heard and witnessed and experienced a wide range of attitudes and treatment at various Emergency Rooms
over the years.  A poorly staffed and under-funded hospital is not where you want to be if you are seriously ill.  But that is likely going to be your only choice if you are one of the millions of uninsured in this country.


quote:

ORIGINAL: Aswad

quote:

ORIGINAL: Lordandmaster

It's horrible, of course, but it's not murder.  If there's no intent to kill, it's not murder.


Correct. It's manslaughter and criminal negligence.




LotusSong -> RE: ER Triage Nurse MURDERS PATIENT through neglect... (6/4/2007 7:42:08 AM)

This is an account of my experience in 2001.  I'll keep it short and concise.
 
Ate supper and had intense abdominal pain.  Went to the emergency room as it was something I had NEVER experienced in that intensity.  I knew something was very wrong. Intractable pain motivates me.
 
I arrived at ER at 8PM.  Triaged in with the assurance I'd get attention immediately- have a seat.
4 hours later-  saw another nurse as she took history. She was interrupted by a gang banger who had a stab wound (non-fatal) and his girlfriend who barged in the room to ask a question.  I couldn't speak at this point due to the pain.
 
They then  transferred me to another hospital for gallbladder ultrasound.  They said "They know you are coming, so they will be taking you right in. I arrived at Midnight.
 
They had a call in for an on-call ultrasound technician.  She shows up 3 hours later.  Does my US.   The doctor gets it, éclairs that I need emergency surgery.  Another hour goes by.  By this time the realize I now have pancreatic as well as a gallstone packed gallbladder.
 
While I was under anesthesia, they had not one but TWO fire drills (DRILLS! NO FIRE) where my husband said they had to wheel me out of surgery into an elevator and back.
 
It makes no difference if you have insurance that pays 100% (like I do) or if you are on a state assistance.
 
 



fadeddreams -> RE: ER Triage Nurse MURDERS PATIENT through neglect... (6/4/2007 8:41:43 AM)

i am currently in school to be a Medical Assistant, and while i agree with the assesment that you really can't determine whose pain is worse, and who should be seen first, there is an element of human dignity and compassion that i see lacking in this story.

Quality patient care...has been drummed into my head since the first of the year.  Seeing a patient lying on the floor writhing in pain...is not acceptable...regardless of whether that patient is a "frequent flyer" or not.  What type of impression does that make on the rest of the patients in the waiting room? 

It is a terrifying commentary on the state of health care in this glorious country of ours...



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