re: Emergencies in Retail Healthcare

K Bass — Wed, 05 Aug 2009 19:17:05 GMT

One of the problems is that in the retail setting you may have multiple NPs or PAs covering the clinic during the week. One NP may feel comfortable triaging non-emergent incidents in the store or among employees. This makes it very difficult for the rest of us because we're looked upon as being unfriendly and unsupportive. Of course, emergencies are different. But it is not an emergency when an employee asks for routine services that are not within the guidelines of your particular setting. If you volunteer your services (BP assessment, asthma management etc) in ways that are not covered by your clinic you may be operating outside of your boundaries and may not be covered for these voluntary "off the record" services. Example: You volunteer to check a store employee's BP everyday and your clinic does not offer BP screens. What is your liability if the patient's blood pressure escalates and without your knowledge the patient has stopped BP meds (due to cost, covenience, side effects)? What happens if this patient strokes and the pt's wife lists you as the sole provider "managing" their BP for the past 6 months. Your employers liability coverage may not protect you. We have to be careful and set boundaries early. It's not being cruel or unfriendly. It's acting in the best interest of the consumer, our employer and ourselves. If employees and customers want to be seen it's best to practice within your guidelines and either see them as a paying customer or refer them out. %0d%0a

re: Emergencies in Retail Healthcare

Kathy — Wed, 08 Jul 2009 15:40:10 GMT

I am lucky to work in a host store where this isn't a problem. Our policies are clear: no workers' compensation cases whatsoever. I have been in the middle of the work comp arena in a previous job, and I don't want to be in the middle of that kind of relationship between a company and an employee.

Regarding store "emergencies," I think that our management here is pretty independent, and 9-1-1 response is very rapid in case of a true emergency. Sorry, the child that bumps her head on the shelving and starts screaming is not an emergency in my book, ESPECIALLY when I am in with a patient. There is a line that needs to be drawn, and coming from a former ED nurse, they can wait even if they don't like it. Regarding liability, the "reasonable and prudent layperson" clause kicks in. If said layperson thinks that a person should be seen, then have them go to the ED or urgent care. I think that if this is a problem in the store in which you work, then it would require a heart to heart with your store manager or higher up about the situation.