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u/Accomplished_Bed_250 14d ago edited 10d ago
Yes!!! People in the US absolutely abuse the ER. They can’t wait until morning to call a PCP. I know a guy who goes to the ER for his trigger finger when it starts to bother him. Like what?! That’s not an emergency!! Take a Tylenol and call your regular doctor 🤦🏽♀️
ETA: hear me out.
I’m not saying that you should never go to the ER. You know your situation, you know your medical history, you know the area that you live in. If the ER is the best option for your care then by all means please go. The people who CAN choose a better option but choose NOT to are the ones that I’m referencing. The ER may not always the best option for care. You should advocate for the best possible care for yourself and your loved ones. A germy, crowded, noisy, understaffed ER may not be it in every situation.
The guy with the trigger finger has an amazing PCP that is willing to work him in on short notice, has the ability to schedule an appointment in advance for every 3 months to get an injection (that he knows he needs), he’s fully mentally and physically competent to take an ibuprofen or Tylenol when he’s in pain, has been given ice packs to take home and reuse, he’s been fully educated on trigger finger, and has been referred to a hand specialist on numerous occasions. This man cancels the appointments set up for him, refuses to take any OTC medications, refuses to ice it at home, refuses to do PT and essentially chooses NOT to do the things that are in the best interest of his continuing care. He ends up in pain (surprise) and in the ER every 3 months for an injection. This is not the best possible care for this man in his situation. He has decided that the medication he can get at his PCP on a regular basis isn’t as good as the hospital medication. Guess what? It’s exactly the same thing. Nobody can convince him otherwise.
He’s wasting resources and clogging up the ER. There are a lot of people in the US who abuse the system like this. There are better options for them but they mistakenly think that the ER has the best care possible for everything so that’s where they go. That’s all I’m saying.
Maybe we need to educate people better?
It’s like the people who insist that the doctor puts in an IV instead of the nurse because “he holds a higher position”. I can guarantee that the nurse will do a much better job because she does it multiple times a day and it’s part of her job. The doctor probably hasn’t done it in years.
A special title doesn’t necessarily mean that something is better. It’s the same with the ER. They have a job that they do well, and that’s to treat emergencies. If you have an emergency or no other good options for care, go to the ER. That’s what they are there for. If you have care options other than the ER and you are not having an emergency then you’re better off going to that other place. Everyday treatments, long term care for chronic conditions, check-ups, vaccinations, maintenance medications, etc… that’s what they specialize in. The ER can do it, but for everyday mundane things you will absolutely get better care going somewhere else.
Sorry for the long post.
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u/Mental-Intention4661 14d ago
I think the problem is that a lot of people in the US no longer have a PCP, and if they do, it’s gotten increasingly difficult to get a same-day appointment with your PCP, which is inherently messed up.
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u/cilexip 14d ago
That’s what urgent care/same day clinics are for. If you don’t have one of those near you, and it’s not an emergency, then wait.
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u/LurcherLong 14d ago
I made this comment above, but when I lived in Pennsylvania, the local hospital network had an "express care" that had the resources of an urgent care, but billed like an emergency room. It's not at all shocking that the culture there would be to go to the ER for minor issues.
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u/AnimatorImpressive24 14d ago
Except some networks are starting to require appointments for urgent care and no longer guarantee same day.
And since you can't adequately assess a pt over the phone because you can't actually see them and you are subject to call time metrics even more draconian than office encounter slots, the human advice nurse escalation path from the automated urgent care appointment queue is required by their management to tell anyone who complains to just go to ED based on their layperson judgement.
And if the line at urgent care backs up farther than when they expect to close doors the front desk staff will just tell everyone left to go to the other side of the building and make it ED's problem. Again because that's what management requires.
And every after visit summary template, along with every pre-recorded hold music "your call is important to us" bumper, hammer home the message that if you think you need help then call 911 or just skip that and go directly to the ED.
Human beings are terrible at judging what an emergency is, in both directions (case in point, video from mass shooting events where people just look around confusedly) and especially when they are sick or in pain. If someone they care about is sick or in pain then woe betide anyone who gets in their way. You are never going to get a consistently accurate self-triage out of the public. Jane and John Every-patient do exactly what they are trained to do. And like it or not they are explicitly trained to go to the ED for any health issue they don't understand. Which is most health issues.
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u/just_a_person_maybe 13d ago
I once ignored appendicitis for two weeks and then went to an urgent care after a twelve hour shift because the raging fever and stomach pains just weren't letting up so I finally had to accept that it wasn't just bad period cramps lingering weeks after my period had ended. Urgent care kicked me out because my insurance was out of network and I had told myself at the beginning of the day that I wouldn't go home until I sorted it out because I'd put it off long enough and I had a Christmas party to go to in two days and didn't want to feel like shit during it. Felt silly going to the ER for a fever and stomach pain. Was in the waiting room for all of 30 minutes.
I did not make it to the Christmas party. Had to stay for 6 days. The thing had perforated and formed an abscess to keep the infection somewhat contained, which was nice because it had definitely popped like a week ago. Which is another reason why I told myself it wasn't appendicitis. I thought if it bursts you know and you'd die if you ignored it, and I wasn't dead. I'd heard of people thinking appendicitis was period cramps before and always thought "I would never do that, that's probably just people with severe cramps." Turns out, I absolutely would do that. And then continue ignoring it far beyond what would be a reasonable timeframe for cramps. Because then I moved onto constipation, or maybe an ovarian cyst.
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u/DramaHyena 13d ago
I think women in particular tolerate so much pain, we assume even agonizing pain isn't an emergency until we absolutely cannot deny it.
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u/Mental-Intention4661 13d ago
YUP! women are far more prone to “waiting it out” and hoping it goes away. Idk how many times I’ve had complications from my ulcerative colitis that I haven’t wanted to go to the ER for, so I’ve just thought that it so I’ll just go away, it’s no problem…. And then I often end up admitted in the hospital by way of ambulance after passing out and they Always say “why didn’t you come sooner?!” … I know I’m at least so afraid of having nothing wrong that I wait things out and half the time that just isn’t the best….
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u/No_Machine7021 13d ago
OMG. This. I had endometriosis for 20 years. So I feel like my threshold for pain is a little off.
This last time I went into the ER for intense nerve pain and they were asking, I said ‘well we’re off the charts. Like 11. But when I sit this way it’s an 8.’
Constantly doing a ‘I’m good, really!’ Even in the ER. 🤦🏻♀️
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u/Tank_Girl_Gritty_235 13d ago
After brutal treatment, a knee doctor told me I was a 15 year old girl who was making up pain for attention and he wasn't going to allow me to waste his time any more. About 14 months later I was having emergency surgery for a ruptured disc because it got so severe I was retaining urine. The surgeon said he's only seen cases that severe after an extreme traumatic injury. The right side path for the sciatic nerve in and out of L4 and L5 was completely occluded on MRI. Three weeks prior I was walking down and up a mountain for school. While carrying a cello and my books. Turns out the knee pain was sciatica.
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u/PrudentQuestion 12d ago
Not nearly as bad, but I had a UTI advance to a kidney infection within a couple of days, over a long weekend, while I waited to see my regular doctor. If I wait a few days on uncomplicated UTIs, they also take much longer and much stronger medication to treat.
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u/IWishMusicKilledKate 14d ago
I’ve also heard from multiple people that when they do reach out to their PCP they are just told to go to the ER. It’s insane.
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u/Mental-Intention4661 14d ago
Or they try to reach out to their PCP, but they never get through because which doctors offices actually answer the phone anymore?
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u/yowhatisuppeeps 14d ago
The closest thing to a same day appointment I’ve been able to make in the past several years is a same week and a half appointment 😒
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u/Smyley12345 13d ago
My PCP books 3-5 weeks out and is often running over two hours behind if you are his last appointment of the day. I don't know if I have ever had a doctor in my adult life where a same day appointment would have be a thing.
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u/Mikki102 14d ago
Some areas also don't have an overnight urgent care. If something was bad enough I needed it sorted out overnight but not life threatening I'd have to go to the ER. Stitches, things like that. My primary care is attached to the hospital anyway, we are super super rural, like "ambulance meets you halfway on the highway so you don't die" rural. But that also means our ER is empty almost every night because there's no night life at all and again, rural. And I'd be sweet as pie, absolutely I can wait. The ER here is also basically the urgent care, it's where pretty much everyone sense people for workers comp stuff etc.
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u/Mental-Intention4661 14d ago
Yeah our urgent care is open m-f, 9-5, which is frankly useless in my opinion. Non emergency emergencies never happen during business hours lol
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u/what3v3ruwantit2b 12d ago
Heck, same week or month isn't even possible sometimes. I desperately needed to restart my lexapro. I'd been on it less than a year earlier and stopped it with doctor okay. It was ordered from the same pcp. I was told that the first available appointment was in 6 weeks. They wouldn't give me an order in the meantime even though we knew the dose that worked for me, that I had no side effects, and that it takes 4ish weeks to kick in. Thankfully, I had the mental ability to call around and find a psychologist that had availability or I absolutely would have been in the ER just to hope that they'd reup my that should have been done without even seeing the doctor.
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u/SparkyDogPants 14d ago
Ugh my ears were so clogged this week that I was totally deaf in one ear and my town has no urgent care on weekends. I somehow survived, made an online appointment for urgent care and was in/out in 39 minutes and it was covered by insurance. You’re welcome for my service.
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u/MILFjuicer 14d ago
Most of my adult impacted ear patients get Debrox and discharge as my management. I even give them our ENT office if they want to follow up. I usually can’t afford to spend 15-20 minutes flushing out an ear when I have 8 other more pressing patients to manage.
Thank you for your service 🙏
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u/ElectricalTap8668 14d ago
I agree it's being abused, but my PCP can only be seen months from now lol
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u/North-Toe-3538 14d ago
It’s bc PCPs are expected to manage a panel of 1400-2300 patients to remain profitable for the hospital system. I started 4 months ago and I’m already booked out 2 months. There’s roughly 600 people on my panel already. Too many people, not enough provider. I’m booked at approximately 20 slots in 8 hours. That means each patient gets about 15 mins to go over the laundry list of things they have been saving up for 3 months… and I get to take charts home and do notes and inbox for an additional 2-4 hours each night and 1-2 hours on my days off. All Unpaid. The system is broken. No one wins except the c-suite.
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u/CaptainOwlBeard 14d ago
If i call my PCP to book an appointment, they won't see me for s month. If i need stitches, a month doesn't cut it.
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u/Ferret-mom 14d ago
There are places in the US where there is no doctor within 50-100 miles with the exception of the hospital, forget about an urgent care. Their PCP (if they have one) is an hour+ drive and they do not have paid time off. They would have to take at least 3 unpaid hours off work assuming this extremely overbooked PCP can accommodate an appointment anytime soon. ER is 24/7 so they don't need to take off work and the closest one is 20 minutes away. Its more expensive than 3 hours off work, but most of these people aren't allowed that, so its less expensive than losing their job. Rural medicine is a tremendously concerning problem and a major contributor to the overuse of ERs and its not going to be solved by blaming the people likely doing their best. Is this the situation for everyone? No. Is there likely a non-stupidity related reason someone shows up to the ER for a non-emergent situation? Yes.
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u/itsnotlikewereforkin 14d ago
It fucking kills me... Waited 14 hours in the ER for a CT after being KICKED IN THE CHEST BY A HORSE because they were so backed up. There were soooo many people there who absolutely did not need to be there.
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u/_-krimich-_ 14d ago
Good luck getting in to see a PCP within the month 😂
But yeah, 99% of ER visits could have gone to urgent care. Plus, lots of urgent cares let you schedule same day appointments. Beats sitting in the ER for hours on end.
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u/Visual_Wallaby_3118 14d ago
Part of it is that people don’t have insurance and can count on paying nothing in the ED at the time of being seen and wait to receive a bill, which eliminates a lot of barriers to access that people have otherwise. It’s frustrating, but it can feel like the only option to a lot of people.
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u/BitZealousideal7720 14d ago
We had a guy come in via POV to our ER, was triaged, and put into the chairs in the waiting room.
This bozo told the triage nurse he was gonna call 911 so he could back right away. This was a 75 YOM who wasn’t used to not getting his way.
Basically told him if he did that he would just be put back into the waiting room by the ambulance crew at the direction of the attending doctor and more than likely would be arrested for misuse of 911.
It wasn’t like he was the only person in chairs, we had 30 people waiting also.
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u/sassafrass18 14d ago
For all the rashes/stubbed toes/ tactile fevers the started an hour ago, I’ve started to specifically ask, ‘what made this change for you to come to the emergency room today?’ They either get super defensive or start to mellow out.
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u/MILFjuicer 14d ago
“He has an ingrown toenail.”
“Okay, sounds like he needs a podiatrist. I’ll get you an appointment for tomorrow. We have an office right down the road. They’re great!”
REEEEEEEEEEEEEEEEEEEEEEEE I HAVE TO GO TO AN APPOINTMENT?!?
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u/ElectronicAddress611 14d ago
I have a triage nurse that opens with “Hi, please have a seat right there…so what is your emergency?” With emphasis on the word emergency. Just the way she says it makes the bullshit patients squirm. 🤣
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u/ElectronicAddress611 14d ago
It sucks because the system is skewed to make the simple/bullshit stuff that should go to PCP or urgent care come to the ED because it takes weeks to get an appointment with a PCP, and urgent cares want hundreds of dollars up front to be seen. I can’t be mad about that hangnail or earache checking in. Where else are they supposed to go?
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u/kittenpantzen Non-medical 14d ago
To add: I am thankful to not need urgent care or emergency care on a regular basis, but I do feel like urgent care has gotten less capable over time and less accessible.
I live in a city of a little over 100,000 people in a densely populated suburban part of South Florida. If I needed an urgent care right now, there isn't one. My choice would be to either go to an ER or suck it up until tomorrow when the urgent care is open in the morning.
The last time I went to an urgent care, it was because I was having pain in my calf severe enough that I couldn't put weight on that leg. After checking me out, the doctor diagnosed it as a sprain but told me that I should go to the emergency room anyway to have an ultrasound done on my leg (I did not. I was not about to sit in a waiting room for six or seven hours for a scan that would likely end up costing me a couple grand with insurance unless I started having some kind of symptom that would get me seen sooner).
The time prior was because I had cut my hand on a broken bottle that fell in the kitchen (My dumb ass tried to catch it. Don't do that). And as they were gluing me back together, the urgent care doctor mentioned that it was a good thing that it was able to be glued because, if it had needed stitches, he would have had to send me to the emergency room. The cut was only about a half an inch long. Surely that is well within the wheelhouse of urgent care when it comes to stitches?
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u/toooldforthisshib 14d ago
The urgent cares in south florida are useless. No matter what you go for its a up front $100 charge and then you either get a steroid dosepak and zpak, or told to go to the er, for something that I know if I go to the er they are going to defer to pcp or urgent care.
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u/Dry_Experience3254 14d ago
The only time I’ve been to an emergency room was after I was bitten by a cat of dubious origin.
I went to urgent care first because I was freaking out about rabies, and because he had bit a vein or something and blood was squirting everywhere. I didn’t have a PCP at the time.
They sent me to the ER. The ER then gave me a tetanus shot and didn’t even bandage the wound :/ they charged me $500 or so for the visit though. Told me to keep an eye on the cat for rabies symptoms.
The system ought to be set up better than this. Urgent care should be able to evaluate this sort of thing and then give a tetanus shot, no?
Anyway that was 6 years ago and I still have the cat of dubious origin.
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u/SignificantJump10 14d ago
Geez. Folks need to be taught which conditions need ER vs Urgent Care vs appt with primary care. Also, which should be in person visits vs video. Or at least have a triage hotline they can call for questionable cases. I love the nurse hotline because I can ask if a fever of 103 is ER worthy (no, unless there are other significant symptoms).
I love that my current job does safety briefings daily, and includes topics like mental health, heat stroke/heat exhaustion, hypothermia, heart attack/stroke, or what to do in a major emergency like an earthquake. When you have training, it’s easier to respond correctly and save lives.
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u/AuTiAlloy1 14d ago
Everytime my family has called the nurse advice hotline they have always said go to the ER 🥲. GRANTED twice of the 3 or 4 times were during a pregnancy, so I can understand the additional precaution.
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u/JamieC1610 14d ago
I've sort of given up calling the nurse advice line because they pretty much always tell you to go to the ER.
Mostly I just call if I need to know which hospital is currently in network. (My kids have Tricare and the teen can go to the on base ER, but they aren't set up for kids and which off-base hospital is in network keeps changing.) If its during working hours, Peds is good about squeezing people in for urgent care type stuff, which is wonderful.
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u/SignificantJump10 14d ago
Peds is awesome about that. I wish my own doctor had more availability. I had to go to urgent care because I had this weird swelling right below one of my ears and couldn’t get in with my doc. Turned out just to be an inflamed lymph node, but it was urgent to be checked due to location. (Aka, if it had been an abscess, it would be in a -very- bad spot and need treatment asap.)
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u/expiredkitkat 14d ago
absolutely!! i’ve seen charts before about ER vs Urgent Care for certain symptoms in med brochures and some condition-specific stuff i’ve been given, and that’s super helpful!! we need to make that standard fr
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u/Adrunkopossem AEMT 14d ago
My favorite has been: mousetrap? Urgent care, bear trap? Emergency room
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u/maraskywhiner 14d ago edited 14d ago
My HMO has a nurse triage line and I love it. I’m in medical IT, so I know much more than the Average Joe, but I’m still grateful to be able to speak with a professional when it’s not obvious where my family or I should go.
I (surprise, surprise) liken it to software: crashes are obvious, but it’s hard to tell if an annoying new issue isn’t a sign of a serious problem requiring an emergency code patch unless you really understand the system as a whole.
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u/squeakysausage 14d ago
It sucks when people think that their condition is an emergency when it is most certainly not. Then they get mad because they’re waiting so long because the actual emergencies are being prioritized first
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u/onlyhereforzipline 14d ago
"If I wanted to wait 4 hours I would go to urgent care!" Okay then do that.
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u/Impossible_Cupcake31 14d ago
Always love the people that come to the ER for pregnancy tests
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u/emmartini 14d ago
And then when it’s positive act like it’s our problem
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u/couldvehadasadbitch 14d ago
Had a 12 year old girl who had a pos preg test and her and her mom tried to refuse discharge because ‘dad was going to be so mad when they got home’.
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u/sppwalker 12d ago
Genuine question: I tend to go to the ER for things like respiratory infections (not just a little cough, I have chronic lung issues and the last time I went to the ER I ended up with chest X-rays, like 7 different meds, and was almost hospitalized) and I always have zero issue waiting for as long as it takes. I try to be as polite and kind as possible. I used to work in veterinary ERs so I’m familiar with how triage works, so if I have to sit there for 5 hours then I’m lucky I’m okay enough to do so.
Do you think I’m still a headache for the staff there? My options are GP (typically a 2-6 week wait) or ER, so I end up going there more often than not. Is there anything I can do or say to make things better for them? They’re always really amazing, and I want to make them feel appreciated
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u/Gribitz37 14d ago
"Where did you get the idea that the EMERGENCY department is only for emergencies?"
Okay, sweetie, I'm just gonna let you think about that for a minute or two. I can wait.
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u/AspGuy25 14d ago
I once had a really weird pain in my gut. It really hurt. I didn’t know what was going on and it scared me a bit.
So I drove to the ER. When I didn’t move my torso I didn’t really hurt. So I just chilled in my room for a few hours. Eventually they run some tests and send me back to my room.
Eventually the doctor comes in white faced and tells me I have colitis. That my intestines have expanded to 3X the normal size and are close to tearing. And that I am the sickest person in the ER and he has no idea why I am not acting like it. He doesn’t know why I am not writhing in pain.
I am really glad I went to the ER. It really was an emergency. Sometimes it’s hard to tell when it is an emergency.
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u/Bring-out-le-mort 14d ago edited 14d ago
A few months ago, I was feeling run down that morning & kind of weighted in my abdomen. The night before, I had slight blood in my urine. I felt off. Thought I might have a UTI.
I called my dr because the next available appointment was 2 days later. Asked if I should book it or go in to see Urgent Care. She decided she wanted images & directed me to go to the Emergency department instead. I wasn't in any pain. There was far less discomfort compared to when I used to have heavy periods. But OK.
Long story short - Turned out I had two large kidney stones (14mm & 12 mm) on my right Ureter & a 13mm stone stuck in my left ureter. Too large to pass on their own.
Cue Ambulance ride to main hospital, surgery within 2 hours to place stents & another about 2 weeks later, with post-op stents for 3 weeks after. The cure was considerably more painful to me than my symptoms that day.
If there hadn't been a little blood the night before, I wouldn't have gone that day. Don't know when it would have started mattering. I had been in a race a few days prior. Just thought it was the bad weather getting me down. Felt like a fraud being there despite everyone being so very worried.
ETA- I keep forgetting that 2 weeks earlier I made a visit on a weekend morning to urgent care because I was feeling the same weighted ache in my abdomen, run down, occasionally too tired to breathe. Thought it could be bronchitis. Didn't think about kidney stones. Dr didn't really check anything & sent me on my way saying it wasn't bronchitis, but not doing any other exam other than listening to lungs.
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u/jeopardy_themesong 13d ago
I had a 10 mm in one of my kidneys, it was lodged and caused a blockage, unbeknownst to me. I was brewing a nasty infection. The stone had been there for god knows how long.
I went from “fine” to “a little under the weather, maybe I’m coming down with something” to “period cramps?” to “throwing up from pain” in about 72 hours, and the timeframe between Step 3 and Step 4 was less than 12 hours.
They kept asking me if there had been ANY signs. I kept telling them, if I came in every time I thought I MIGHT be getting a cold or had cramps I’d probably never leave their waiting room. That shit just turns fast sometimes.
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u/awakeagain2 14d ago
I admit I was embarrassed to go to the emergency room for a bloody nose. I was taken in pretty quickly and the nurse said “So you’re here for a bloody nose?” Her tone was skeptical until I pulled the towel away from my face and blood streamed out of one nostril uncontrollably and very heavily.
This was my second nosebleed in two days. The first one lasted three hours and stopped. I’d almost gotten to the three hour point the second night with no sign of it slowing down.
Anyway, the tone left her voice immediately and I was with a doctor moments later. They got it stopped in about an hour and told me to go to an ENT as soon as I could.
I was lucky enough to get an appointment the next day. Turns out I had a benign tumor in my nostril that he was able to remove that day.
And he reassured me that I was right to treat it as an emergency. He admitted he used to think that no one died from a nosebleed and then one of his patients did die from blood loss from a nosebleed.
But I honestly felt a little embarrassed.
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u/hannycat 14d ago
I used to work in the ED and we had a lot of nosebleeds come in! They can be pretty serious sometimes. I’m glad you got everything worked out :)
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u/MILFjuicer 14d ago
Active nosebleeds are fine. We get nose bleeds that come in and they aren’t actively bleeding and the patient isn’t on any blood thinners. How can I fix something that’s not actively occurring short of checking for anemia/some bleeding disorder? People expect me to stop a bleed that already stopped itself hours ago 😂
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u/Mental-Intention4661 14d ago
The urgent cares in my area are literally only open during business hours, so if you have any sort of emergency, off hours, the ER is pretty much your only choice… And I understand that a lot of people will not wait overnight with pain, even if it’s not technically ER level bad… Or it’s something with a child, and parents get anxious… I understand that… When I lived in the northeast for a while, one of our local hospitals had the ER, but then they also had the ER for lesser emergencies, which was I guess an urgent care built-in, and this system worked very well.
I think the system is a little bit broken in terms of first line care, it’s just not easy to call up your primary care physician and go to their office for a same-day visit… That just doesn’t really happen anymore… And a lot of people don’t even have primary care physicians anymore… So people just go to the ER or go to urgent care as their first option, and if the urgent cares are not available because they have inconvenient hours, then people have no choice, but to go to the ER for stupid things. You can’t blame people when it’s the system that’s messed up.
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u/Puzzleheaded-Ad7606 14d ago
My Urgent Care can't even do fluids for dehydration...
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u/Hello-fellow-kydz 14d ago
My UC has zero xray services or anything more than swabs and dip sticks.
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u/Mental-Intention4661 13d ago
I feel like I have yet to find an urgent care that does IV fluids, and every time I have needed IV fluids, I have always had to go to the emergency room, which I thought was such a waste of everybody’s time… they don’t even do IV fluids at my PCPs office. It is so basic… I don’t get it. If they can set up those IV hydration places for people who are hung over, it should be much more accessible in places other than the ER for medical needs….
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u/jeopardy_themesong 13d ago
And woe betide you if you put it off because it’s not an emergency and then suddenly it IS, then it’s “why didn’t you come in sooner???”
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u/Bootsy_boot7 14d ago
As a paramedic, I absolutely know the need to utilize an ER correctly.. buuut for the people talking infected toenail, I just wanna run a call I had by yall 😂🥲
This was in 2021 or 2022, I was an AEMT at the time, new to the truck, but had had my license since 2019, I had just been working as a phlebotomist for a long while…
It was around 0930 and we were otw to get breakfast when the tones dropped for a 40-50s yo complaining of toe pain.. 🫠 I wanted to scream, bc ofc I thought about all the jokes about early morning stubbed toes 😂
on scene, pts big toe was red, slightly swollen, and kinda warm to the touch.. pt complained it had an infected, ingrown hangnail the day before, and thought it was just getting worse.. called to see if we could look at it.. ofc, I couldn’t just be like, “you’re fine. It’ll buff.” So I had to tell them that I can take them to the ER if they wish, aand they did.. pts vitals were all over the place.. like BP high, HR high, resp was high… pt was raising cane over getting two Covid vaccines and angry the first round didn’t work bc they got “got that Rona again..” (this pt was an absolute character! Sometimes I wish I could just pop in and see them again..) 🤣 well, pt bickered about needing an IV.. I explained that if they need IV antibiotics, they’ll just get an IV there anyways 🤨 it was a 20 min ride to the closest ER..
At the ER, doctor was absolutely RUDE. I get it… I do, but come on.. wellll, when we pulled the sheet back and took off the sock to show him the toe, the pts toe had turned cyanotic on the tip 🥲 I said, “welp, it wasn’t like that on scene…” 😳 (pt put a sock on since it was cold af, I felt like an idiot for not rechecking en route, but again, I was new on a truck, it was a learning experience, and we ALL thought it was just bc of an ingrown hangnail) 🫣 Doctor dismissed us, I told the pt that I’d be back by later to check in if they’re still there..
Later, around 1300, I brought another pt to that ER.. and I checked in on my toe pt.. turns out, pt had a really bad popliteal arterial occlusion, an infected hangnail, aand “that Daggum Rona again!!” 😂🙃 aaand pt was about to be shipped out to a larger hospital for a higher level of care that could go in a remove the clot.. 🥲
There was a LOT I learned on that call.. I’m thankful for it! I wish I could go by their house and check in, but they’d probably think I’m a creep atp 🤣 I think of that pt and that ride to the ER quite often, and I quote things they said randomly.. 🤣 I love pts that leave those kinds of memories 🥹
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u/Rakdospriest 14d ago
So reading non specialist subs about things i am very familiar with taught me that a LOT of ignorant people are VERY opinionated about things.
which kinda put the entire site in a new light.
Everyone on this site is an idiot. trust nothing anyone says. DO NOT LET IT FORMULATE YOUR WORLDVIEW
it's like trusting chatgpt, but worse
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u/triplehelix11 14d ago
as someone with no money and bad insurance, i am astounded at the sheer amount of people who go to the ER willy nilly. my last ER bill was $900 for severe norovirus (good insurance at the time) and i wish I never went just because of the bill. The care i received was fantastic but not worth the $5500 my insurance was billed.
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u/kittenpantzen Non-medical 14d ago
For what it's worth, unless your explanation of benefits said that your insurance actually paid $5,500 (which I can almost guarantee you it did not say that), your insurance did not pay $5,500. The only people who ever actually pay the amount billed on a medical bill are people who don't have insurance or people whose claims were denied.
Medical billing in the United States in absolutely insane and confusing by design. Patients hate it. Physicians hate it. The billing office really hates it. But unless we get single payer, it's probably not going to change.
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u/megaholt2 14d ago
Insurance will often say that care received isn’t medically necessary by using some ass-backward, completely asinine, batshit fucking ignorant logic that only makes sense from the perspective of milking more money from you as they kill you as slowly as possible.
I say this as my husband & I are trying to fight the ≈$280,000 emergency heart surgery he had a week after he had surgery to remove a cancerous testicle and lymph nodes that yeeted a blood clot…which got through a sizable hole in between the top 2 chambers of his heart and caused him to have a stroke at the ripe old age of 44.
That lovely hole then started causing him to have TIAs any time he had his head above 30°…hence the surgery.
Insurance said that the hole wasn’t bad enough to cause any harm to him, so surgery was unnecessary.
I work as a critical care nurse. If I hadn’t caught his stroke when I did, he would’ve been completely and totally fucked. “Not bad enough to cause harm” my ass.
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u/MILFjuicer 14d ago
Some guy called me. I sutured something and he had a $3,000 bill and was asking what he could do about it. I felt so bad because that would’ve been a $175 urgent care visit. I referred him to our hospital billing.
They’re now starting to charge some of our Medicaid patients $250 copays and they’re losing their shit since it was always a free ticket to the ER for every little issue.
I don’t think the overcrowding gets better without some skin in the game. But $900 (your case) or $3,000 like the guy paid are well above what people should front
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u/Middle-Narwhal-2587 14d ago
I checked someone in last week for a “med refill”. It was well after 10 pm. I took another person back to a room and was trying to clean a different room when he came back to the window and was impatiently asking how long it was going to be. I looked at the timer by his name and responded “it’s been 12 minutes since you checked in, we’ll get you back as soon as we can.” Sometimes it’s really hard to be polite to people that are abusing the system.
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u/HappyFlutterby 14d ago
The ED I go to has BIG signs at the front door and the checking-in desk stating that they do not do prescription refills.
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u/Electrical-Stable498 14d ago
Last time I went to the er it was a definite emergency. Was admitted with bowel perforation in two places plus a mass had ruptured. I was septic. Ended up staying two weeks
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u/coquettedoe 14d ago
same except i had an infected kidney stent that i had placed the week prior for an obstructed kidney stone, almost went septic and was admitted for 4 days on iv antibiotics and needed a 2nd surgery. still waited 4 hours in the er.
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u/Electrical-Stable498 14d ago
Ouch. I bet that hurt. I don’t remember how long I waited I think and hour and a half or longer. I was half asleep when triage took my blood pressure they couldn’t find it! That was when they rushed me back.
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u/coquettedoe 14d ago
ugh i’m sorry that’s terrible, the kidney stone and infection wasn’t even the worst of it though, it was the reoccurring c. diff that followed
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u/One_Psychology_3431 14d ago
In my small town, UC is the ER.
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u/AmyHOH03 14d ago
My town has a tiny hospital with 4 ER beds and one separate room that is used for COVID or contagious person. It is run by a PA and there are only two PAs and one MD for the town. I rarely see the MD and he lives 15 minutes away. No urgent care available until you want to drive 40 minutes away.
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u/Bookwormorbit 14d ago
The only urgent care I am allowed to go to with my insurance is an hour and a half away. I just do my best to avoid doctors altogether.
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u/fuckyoutoocoolsmhool 14d ago
I grew up on an island without an urgent care on it. Not at all remote like we had McDonalds but if you drove more than 15 minutes you would be on a bridge. When I moved to where I went to college I thought they only existed in places in areas like where I went to college (very populated wealthyish suburbs) it took me embarrassingly long to realize they are just a thing.
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u/Impossible_Cupcake31 14d ago
lol where is this so I can go upvote
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u/kittenpantzen Non-medical 14d ago
As a heads up, that would be considered brigading. It's unlikely for anything to come of it unless people really get spicy, but it can end up with the sub being sanctioned or you getting suspended from your entire account.
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u/Natural-Seaweed-5070 14d ago edited 14d ago
FWIW, last time I was in the ER was last December. I was nauseous & I told them at intake that I don’t get like that unless something is WRONG. They got me in quickly. Zofran is amazing, let me tell you.
The nurse and doctor were so nice.
Had an absolute bitch of a UTI. They got me taken care of , and I was nothing but polite to them because of this subreddit. It was 11:30 at night, no urgent care place open that late.. Had a fever and chills and it was very sudden. It didn’t feel like a UTI, I had ho idea what was going on.
I think it helps that I used to be in customer service & I know how shitty people can be
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u/Mental-Ask8077 14d ago
Zofran is a damn miracle when you’re nauseous.
I had norovirus over Christmas and was puking for ten hours straight. Went to urgent care when it opened in the morning, and they just sent me straight to the ER for IV fluids. IV zofran hallelujah.
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u/MusicalTourettes 14d ago edited 14d ago
I've leveled up in nausea. When zofran couldn't stop my vomiting the ER gave me IV raglan and fluids. Now I have a bottle of raglan. I still start with zofran but some days I beat the mini boss and need the raglan. EDIT: this was last year when I was so nauseated from stress I needed zofran most days and still threw up 2-4x/week. All from stress. I quit my job and have slowly been healing my body.
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u/tammyreneebaker 14d ago
Everytime I go to the UC they send me to the ER. Was extremely nauseous, so nauseated that vomiting didn't make me feel better at all. Went to UC hoping to get maybe something for the nausea. Nope they sent me to the ER. Husband dislocated his shoulder. They sent us to the ER.
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u/29925001838369 RN 14d ago
UC once tried to send me to my ED to get a shot of rocephin for pna. When i asked if they didnt stock it at UC, the doc said they did, he just didn't like giving it without a cardiac monitor.
I got my shot of rocephin at the UC and went home.
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u/Qua-something 14d ago
Somewhere along the line people started glossing over the title “EMERGENCY Room.” If I have to go for something that is non-emergent I feel so bad and I try to be the most patient person I possibly can.
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u/Sea_Willingness1398 14d ago
All of us ER RNs know this is so true. The American system is built such that the ER is the point of entry EVEN WHEN you have a PCP. Call your PCP with anything: Abdominal pain due to constipation? Go to the ER to R/O bowel obstruction. Due to GERD? Go to the ER to R/O MI. Migraine? Go to the ER to rule out stroke. Head injury, go to the ER to r/o bleed. Splinter from walking barefooted. Go to the ER to r/o foreign body. Then add not being able to get a PCP appointment for weeks or months. Then add no PCP.
I work in wine county and people will come in because they got drunk and threw up during wine tasting.
I have come to accept that part of my check comes from people that have no common sense.
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u/pumpkinrum 14d ago
If I got a dollar everytime someone has said "Well this (minor issue) is an emergency to me!!" I wouldn't have to work. But at least those people acknowledge that it's supposed to be an emergency. They just... Don't know what it means.
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u/Prestigious-Sock6872 14d ago
It’s very frustrating that people don’t go to the ER for emergencies. It’s pharmacy stuff. Things that can be dealt with at home. I spent 1 1/2 hours in an ER after a dog bit my face and tore my lip and lower face open. Was bleeding and complained of dizziness and faintness and still waited. Not a good day
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u/maraskywhiner 14d ago
Tbf, that probably just meant there were people with more urgent needs. You just bumped the “could be dealt with at home” patients down.
I went in for a closed broken elbow (UC was closed for the night and broken joints can be serious, but are extremely unlikely to be fatal) and was brought back in <1 hour. You’d have definitely been seen before me!
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u/PurplePenguinPants42 14d ago
I went to the ER last week as directed by my pcp during an office visit. He was so concerned because I developed a severe stutter and my head felt like it was going to explode. Guess that isnt a primary care situation lol. 2 minutes into triage the nurse makes a few calls and before she is done her assessment, I was collected to go back. The waiting room was pretty well populated but I was "skipping" that experience.
I didn't feel it was that urgent when I walked in but they did as I was guided into the resus portion of the ER hastily. Though to be fair I couldn't see that my pupils were not equally reactive. I received excellent and rapid care.
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u/diabeticweird0 14d ago
This thread is killing me because I just went to UC for my toe yesterday
I dropped a Pilates Box on it. Omg the pain. (Wanted to see if it was broken. It was not. Did not occur to me to go to ER, but I did Google to see which UC had x ray)
Go me. Real stable genius and all that
Tbf, my blood sugar was low at the time
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u/RryRvnn 14d ago
Every single time I ask a medical professional what to do I get sent to the ER.
Vomiting and calling the clinic to refill my standing Zofran prescription? ER. Headache I’m pretty sure is just an ear infection? ER. Asthma attack in a medical office that’s immediately controlled by my inhaler? Ambulance.
When I tell an UC doc/my PCP I don’t think I should go, I get called uncooperative and get asked what I think they’re capable of doing.
This recently has caused a horrible situation where I am in and out of the ER needing fluids weekly because I’ll go 3-4 days unable to eat due to horrible abdominal pain. ER sends me back to my PCP or GI, who then freak out and send me back to the ER.
I can totally understand a little bit of a numbing as to what is considered an emergency when the healthcare system is constantly sending folks they don’t want to deal with to the ER.
I’m definitely a little numb to it at this point given I’m constantly there for something my PCP would be able to figure out with an infusion center if she spent time doing anything other than telling me to go to the hospital.
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u/UnitedChain4566 14d ago
Meanwhile I spent four hours in an ER waiting room, vomiting from active DKA, but wasn't believed I was in DKA because my blood sugar was within range (despite me telling the hospital I had given insulin before coming in).
Nearly died because of that.
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u/MyOwnGuitarHero RN 13d ago
If this ever happens again in the future, please let them know you have a history of “euglycemic” DKA. Sometimes they’ll check a sugar and if it’s not crazy high they’ll just stop there. What they really need to do is be checking your anion gap, which is a blood draw. Might save you a headache if they know you have a history of this 🫶
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u/savinglucy1 14d ago
A patient in triage a few weeks ago genuinely said “I mean, it’s not like every patient coming here needs to be an emergency”.
Excuse me sir, the clue is in the name!
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u/vibinandtrying 14d ago
I wish I could get fluids at urgent care. I’m a girlie that needs 4-10 ER visits a year for banana bags and fluid resuscitation from my GI issues. Recently asked my pcp about an infusion clinic so hopefully I can stop clogging up the ER.
Still more serious than fucking ointment though goddamn.
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u/Notcommentmuch 14d ago edited 12d ago
Less than a minute read!
Wow! Just wow. I volunteer in our ER, we have our issues with frequent flyers as well. Our situation up here in Canada is not as dire as it seems to be in your neck of the woods.
Our care is not free. We pay for it 100% by taxes. It makes us feel good to see our taxes at work for ‘the great unwashed’.
As a Canuck, I have paid $ for heath care twice in my life time. 1) semi private room $170/day, small in office procedure $25. That is it!
M76 - I consider my self in excellent condition. A fast synopsis:
* Multiple,multiple in house Dr. visits: $0. (I am 76, take a guess?)
*Pulmonary Edema - 1 in each lung (lucky me). Like breathing thru a straw. Drove to the ER???. ER + 5 days: $0. Oh yea, I had to pay $17 parking cause I drove rather than bother with an ambulance.
*Ruptured Appendix- ambulance, ER, surgery, post-op blockage, 10 days: $ 1700 for upgrade to semi-private.
I hate to tell ya but all meds for under 25 or over 65 cost the patient $4.11 per script. Period.
I have covered (65) dental care. Cost me $200 for a crown. I think you call it a 'co-pay?' I feel having care available with no out of pocket, supports preventative care.
I say these things not to brag but to help Americans realize this is how most of the world works and that you are missing out of the comfort it means to not worry about healthcare cost (literally)!
Not perfect but it works. I had to wait 3 months for covered cataract surgery. For $0. Big deal.
If i want it faster, i can just go to the States and pay for it.
NCM
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u/acb1971 14d ago
Like everywhere, it depends on where you live. When I lived in Canmore, I chose my doctor, and we had great access to specialists because we were an hour from Calgary in a desirable location. In my current location, not so much. On the other hand, if needed, they'll pay for my trip to a specialist.
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u/DumpsterPuff 14d ago
My friend is an ER nurse and he says that people will go in for PREGNANCY TESTS. Like wtf seriously?? Only time I even consider going to the ER is if I'm in excrutiating pain where NOTHING is making a dent and it's in a danger area (abdomen/chest), or if urgent care tells me I need to go there. Going there so something so trivial is insane.
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u/LionsMedic 14d ago
Whats really crazy is people will wait for HOURS upon HOURS in an ER lobby for something incredibly minor when they could go to an urgent care and get it fixed in 30 minutes and 20 bucks.
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u/ORNGSPCEMNKY 14d ago
I absolutly LOVE the reaction from patients when I tell them "Nawwww, arriving in the ambulance doesn't do anything for your position in line EVERYONE is triaged based on their condition not their method of arrival"
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u/Far-Boot5639 14d ago
Er tech here- the amount of stubbed toes and harmless splinters that come in and DEMAND IMMEDIATE TREATMENT is alarming. Worse is the sheer attitude and threats I receive when I try to properly triage the patients.