Emergencies in Retail Healthcare
Most retail clinics are located in host establishments; some are owned by the host and others are renting space from the host. One issue that continues to arise is responding to medical emergencies that occur in the host facility. A medical emergency is defined as an injury or illness that poses an immediate threat to a person's health or life, which requires help from a doctor or hospital. The main concern for practitioners is balancing their nursing ethics and host relationship with their clinic obligations. I think there would be 100% consensus that if a person is experiencing a life threatening emergency that the practitioner would drop everything and respond to that emergency. However, the emergency line is blurred when the host asks for response from the retail clinic practitioner. The debate that continues to surface is this: should the retail practitioner respond to emergencies in the host facilities?
One example that comes to mind happened on a day that I was in my office seeing a client when a host staff member knocked on the door and said that someone hurt them self in the store. I asked if the person was bleeding or not breathing, the response was no. I explained to that person that I could not respond because I was with a patient. The host staff member was a little upset with this reply. I finish taking care of my patient and then followed up in regard to the emergency. A child bumped his head on the shelf when bending down, there was no blood, no open wound, and as far as I am concerned, no emergency. This type of injury did not meet the requirement of a medical emergency.
Another example that comes to mind is that the host store has an employee that has medical issues that occur frequently. Sometimes the complaints may appear legitimate and other times the person appears to be faking. I have also noticed that if an employee states that he or she is sick the host staff will come and get the practitioner to assess the employee. However, neither of these persons wants to pay to be treated in the clinic. Should the retail clinic respond or attend to the host employees? These examples are truly not life-threatening events.
Now, I have responded to several real emergencies such as a man who was on blood thinner and cut his leg, bleeding heavily in the isles. I responded and controlled the bleeding until EMS arrived. On another occasion, a woman slumped over in the store and appeared to have experienced a TIA or stroke. I responded to these emergencies without any hesitation. However, I am still cloudy in regard to responding if I had a patient in my office. Would it be appropriate to refuse or should I leave my paying customer to attend to the host store emergency?
I have had several conversations with my colleagues regarding this matter and our opinions differ slightly. Nevertheless, we all agree that what constitutes an emergency for the host facility may not be considered a medical emergency by the retail practitioner's definition. Handling these issues is a delicate task because retail practitioners want to maintain a positive relationship with the host without inconveniencing their clients for unnecessary reasons. Prior to the retail clinic present in these facilities, the host facilities were trained to handle and respond to their own emergencies. Should the host rely on the retail clinic now for support or should they be required to continue as if the clinic is not present? This question continues to plague the retail practitioner. What are your opinions on this situation?