During my time as an emergency room nurse there was always a level of frustration in regards to what patients perceived as an emergency. I always said, "One person's emergency is not another's." When our fast track area was open between 11 a.m. and 11 p.m., this was less of an issue as you could funnel less acute patients through this specially intended area. The frustration increased, however, when these less emergent patients came after the fast track areas and bogged down the care of the acutely ill. Nevertheless, we took care of everyone, because in their minds they needed to be there.
In urgent care I am seeing a complete opposite of patient perception. Just last week I sent the following two patients directly to the emergency room for further evaluation:
Case 1: 58-year-old male who was shopping at a local grocery store and told his wife he needed to go sit down in the car. The patient developed sudden onset of right lower leg redness and swelling. Has a history of a two week admission 4 years ago for severe cellulitis. When they arrived home the patients temp was 99.8 and one hour later it had spike to 102 with rigors and general feeling of unwell. The redness had increased and the lower portion of the leg now appeared greyish blue.
Case 2: 31 year old female with right lower quadrant abdominal pain that started that morning and continued increasing over the day. This was accompanied by nausea and then the inability to stand up straight. Right-sided lower abdominal rebound tenderness and guarding.
Both of these patients were admitted, case 1 for cellulitis with sepsis and case 2 for appendicitis.
Now I may have the advantage of anticipating or explaining to patients what may be done for them at the ER and I will be honest that I will use it when necessary!
I have also been afforded the opportunity to return to my ER stomping grounds as an APRN per diem. I have already completed some mini-orientation shifts and next week will work my first official 12 hour fast track shift. It feels great to return to my community, and also to work again alongside the staff that I grew to love over the last 7 years. I look forward to increasing my skill sets and fine tuning the ones that I currently have.
Time really is flying by. It still seems surreal that this is my career and this is what I get to do on a daily basis.