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 have not seen that particular series. When I was younger I was hooked on St Elsewhere (shows you how old I am!), and then began watching ER a couple of seasons in, then quit watching. I will watch old reruns of "Trauma--Life in the ER",--which I have found to be the most accurate, however after a while I have said--I do this everyday, why do I want to watch it in my free time. I get frustrated watching medical shows on TV, especially shows such as ER, Chicago Hope, Grey's Anatomy, House, etc. They are all just soap operas set in hospitals. I wonder if law enforcement employees get tired of all of the cop shows on TV?
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We have a wonderful relationship with the ED physicians. They are a contracted group of ED board certified physicians, we have had the contract with them for over 20 years. The relationships in the department are very collegial and we work well together. The docs and the RNs are in constant communication about the care of the patients. Since the department is so geographically large, everyone carries cell phones so it is easy to contact each other. We also have the ability to communicate with each other electronically on our computer tracking boards.
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I would not go to the ED for a rapid HIV test, although you could. This type of testing should be done through your PCP or clinic to ensure adequate followup. If a person has concerns they have been exposed, one negative test only tells you that you are negative right then. The conversion to a positive result may take months, so you may need further testing. An ED is not the place to create an ongoing doctor-patient relationship. As far as treating with the medication, the physician would talk to you about the risks of immediate treatment with these medications. The meds are not without risks or significant side effects, so that would have to be balanced with the chance of developing a positive HIV test. If you know for certain that the other party was HIV positive, that could sway the decision. It also depends on how much exposure you had--long term continuous exposure vs. a one time thing. There are a lot of factors.
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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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Basketball Referee
Ever get into a physical altercation with a crazed parent?
Antiques Dealer
What's the most profit you've ever made from a single item?
Bartender
What's the best way to get a bartender's attention?
You want to get on the phone with billing start talking to them right away. Generally if you are uninsured, the bill can be lowered to approximately the same contract rate insurer's pay, you can get from 40-60% off. Ask for the patient rep, ask to talk with financial services and don't wait. You can also ask for a payment plan for the negotiated balance. Don't forget to go over your bill for any errors, just that could save you some $. Don't ignore the bill though, start talking to them right away. It's when you ignore it that it starts down that collection road. good luck, and start looking for the insurance exchanges to get coverage for yourself.
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Wow! I don't have any expertise in that at all! I think that is a question for a police officer or security company.
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The Emergency physician is a board certified specialist who enters a 3-4 year program after medical school. They are specifically trained in Emergency Medicine--they need to know how to treat any kind of health issue, including trauma, and medical emergencies for adults and children. They are unlike primary care or family physicians, who treat and have established relationships with their patients. ER physicians generally do not have private practices, they only work in ERs or Urgent care centers. In 2011, about 7% of graduating medical school seniors entered an Emergency Medicine residency program in the US--there are about 100 programs in the US. It is a fairly new specialty, just over 20 years, so it is very popular and can be difficult to enter. A physician who is not board certified in Emergency Medicine can still work in an ER, however, I would want a board certified physician treating me if I had an emergency. In the hospital where I work, all of the physicians are board certified, and you will see that in most ERs. ER physicians are not generally on call--they work their shift and go home, so it can be an attractive area for that reason. The malpractice insurance is higher than some other specialties, but not the highest. You can't really compare ER docs to other specialists, whether one is "better" than the other, it is like comparing apples to oranges. I would want an ER doc to treat me if I had an emergency, and I would want an OB/Gyn doc to take care of me if I was having a baby.
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