Discount No Patient
Next week I
will start my new job in the ER. Along with reading my Tintinalli Emergency
Medicine Manual, I have spent a little time at the PA
Forum. If you have
not been over there, they have a little something for everyone (pre-PA, PA-S,
PA-C).
Their
emergency medicine section is packed with pearls of dos and do nots, odd case
presentations and tips of the trade. Essentially, it's like sitting down with a
veteran ER PA who is giving me all the down and dirty before I start. Something
in particular stuck out.
The
emergency department I will be working in has multiple divisions of care; among
those, a fast track. Fast Track ERs are meant for "minor" emergencies. But who
is the one determining what is minor? Yes, there are trained triage nurses, but
PAs/docs/NPs cannot rely upon triage fully.
When a patient is labeled as having a minor emergency, the sense of
urgency lessens. However, what if the apparent "minor" injury turns out to be
life-threatening? That is where the provider must be keenly aware of the
patient and not swayed by the "minor" label.
When you
hear, "It's probably nothing" from one of the triage staffers, stay tuned. Don't
discount the patient. I'm sure it's easier said than done. I'm eager to get
started so that I can develop my own pearls. Can't wait to share what I learn!