Tuesday, January 17, 2012

Conversations in Triage

After triaging a 14 year old patient with a 102 fever:
Hood Nurse: Okay, well everything looks good but that cough and fever you're having, so I'll go ahead and give you some Ibuprofen while you're waiting to see the doctor. It should help with those chills and make your throat feel better, too.
Patient's mom, rolling her eyes: Really? All you're gonna do is give him some Ibuprofen? I have that in my medicine cabinet, I could have done that at home.
Hood Nurse: Um. Well...

After I suppressed the urge to tell that between her and her teenage son, one of them probably should have figured out that antipyretics work for fevers, she then got mad because I tried to give him pills instead of a liquid. I'm just saying, this stuff might be why I come across like a cranky B at times.


  1. "Patient's mom, rolling her eyes: Really? All you're gonna do is give him some Ibuprofen? I have that in my medicine cabinet, I could have done that at home."

    So why didn't she? Whose gut reaction to a cold is run to the ER?

    1. And let's not forget those that say, "Well, I didn't want to give my kid anything to help with the fever so ya'll could see just how sick he really was."


    2. Well, I assume that you either:

      1. Have to actually pay to go to the ER. I know an ER visit costs me at least 50 bucks (assuming I've met my deductable already)


      2. If you do have medicaid, you are either unemployed/underemployed such that time does not equal money (ie you have nothing better to do than spend several hours in the ER).

      The worst are the patients that come in wanting a script for ibuprofen or naprozen (in the state where I was scripts cost $1 to fill on medicaid) as it was a couple bucks cheaper than buying ibuprofen (or naproxen) off the shelf. While these people didn't have a lot of money (obviously unemployed as they had the time to do this) they usually smoked 1/2 to a full pack a day so they clearly had some disposable income.

    3. er did that wrong *aren't* unemployed/underemployed

  2. I can't tell you how many patients of mine that I have told this to...."why not take ibu at home....THEN your MD will know you have tried everything you could at home and won't just hand off something you could have given yourself" AT HOME. AND - if the ibu works...it saves you a trip in!!! Some of them see the light, some go anyway. I have also had them say the same as ANON @08:08...and I tell them we don't NEED to see "how sick" they are. If Ibu doesn't work - they will probably still look sick....

  3. And may I ask did these fine people have insurance or was the (apparently) totally unnecessary visit subsidized by honest workers and taxpayers like us? How much money would be SAVED if people were penalized for "idiot visits"? Yeah, I know I know it's probably something that can't ever be done b/c of the risk of NOT treating someone who really needed it...but how satisfying would it be to send the next drug seeker to wash dishes in the cafeteria for a few hours to make up just a tiny bit for the unnecessary visit?? I bet making a few of these people do SOMETHING as a consequence to an unnecessary visit would cut down on them... (yes I know I'm dreaming, but...)