Monday, March 7, 2011

Please, Just Read the Sign!

Worked with Cripes last night, always a treat. Stuff gets done, people are seen quickly, and he's a hoot to work with. But still, it was busy not only in the ER, but for all of the outpatient crap as well.

Because of a call-out we only had one secretary to register the boat-load of both out-patients and ER patients. None of which had any actual emergent condition:
Flu-like symptoms, seen yesterday by PCP; not magically better
Sore throat, seen yesterday by PCP; not magically better.
Dental pain
Dental pain
Chronic abdominal pain, nausea and vomiting, "I have a bowel obstruction"; 3 visits in last week, one hospital admission, abusing laxatives and enemas, taking oxy's.
And, same guy:
NO evidence of bowel obstruction and refuses CT scan.
On Medicare which won't pay for Zofran which is what he comes in for.
Does NOT want pain meds.
Wants surgery and "can't find" a surgeon.
Talks continuously about surgery and insists, insists, insists it is the last thing he wants. Suspect Munchausen, which we won't be fixing this in the ER.

The sign-in list is for out-patients, not ER patients. Nobody ever reads the signs. At least once (maybe 5 or 6 times if we are really busy and people are inordinately stupid) a day someone signs in when they should be an ER patient.

Mary, trying to be helpful, waded into the mass of humanity in the waiting room to ask if anyone had any xray orders.

She discovered that an ER patient with some completely non-emergent problem (that had now missed their pediatrician's appointment, haha) had been waiting an hour for registration. Mary got right on her high horse, adamant that the signage was not clear.

Me: "Mary, the signs are crystal clear; the douchtards just don't take the time to read them".
Mary: "My daughter signed in and waited and she needed to be seen in the ER"
Me: "Mary, your daughter is an engineer; clearly she didn't read the sign".
Mary: "Yes she did, she thought she was an outpatient".
Me: " It VERY CLEARLY states what comprises outpatient status, lab, x-ray, mammo, etc".
Mary: "Well, it says those things in small letters written beside it"
Me: "This is a pointless argument; I am going to draw circles on this paper and ignore you until you go away".

I wrote up another sign.

If nothing else, it will keep people busy. I don't see any loopholes or inconsistancies, do you?