- My Forums
- Tiger Rant
- LSU Recruiting
- SEC Rant
- Saints Talk
- Pelicans Talk
- More Sports Board
- Fantasy Sports
- Golf Board
- Soccer Board
- O-T Lounge
- Tech Board
- Home/Garden Board
- Outdoor Board
- Health/Fitness Board
- Movie/TV Board
- Book Board
- Music Board
- Political Talk
- Money Talk
- Fark Board
- Gaming Board
- Travel Board
- Food/Drink Board
- Ticket Exchange
- TD Help Board
Customize My Forums- View All Forums
- Show Left Links
- Topic Sort Options
- Trending Topics
- Recent Topics
- Active Topics
Started By
Message
re: ER Doc says assaults against doctors and medical pros on the rise
Posted on 5/1/19 at 8:47 am to TheCaterpillar
Posted on 5/1/19 at 8:47 am to TheCaterpillar
What can be done to curb the psych patient problem? Why were the funny farms abolished?
2
Posted on 5/1/19 at 9:03 am to Bullfrog
quote:
Beds take up too much room so you can’t have as many.
This is true. Whether a bandaid or stitches, each bed requires 80SF minimum with 5ft clear between beds that results in closer to 100SF per bed. With current reno costs at $200/SF or new, ground-up costs @ $300+/SF...mental cases & people using the ER like primary care are the real problem. A lot of facilities are incorporating "fast track" areas for the band-aid tylenol crowd and mental-health ER depts (MHERs) to increase efficiency
This post was edited on 5/1/19 at 9:17 am
Posted on 5/1/19 at 9:07 am to Oilfieldbiology
quote:
What can be done to curb the psych patient problem?
Separate mental health ERs. Otherwise, the LEOs have nowhere to bring them. Chabert in Houma has one. Basically a holding area until a bed opens up in an inpatient facility somewhere. But if those beds never open up and they have calmed down, they have to be discharged by law @ 23hrs and 59 minutes...but most are held for as long as reasonably possible because there is nowhere to put them
This post was edited on 5/1/19 at 9:14 am
Posted on 5/1/19 at 9:07 am to Oilfieldbiology
Happens somewhat frequently unfortunately. I haven't been practicing long enough to say it's "on the rise".
Posted on 5/1/19 at 9:08 am to Oilfieldbiology
quote:
What can be done to curb the psych patient problem?
I really don't know how to limit the number of mental health patients, tbh. Our country is dealing with a mental health and substance abuse crisis at the moment.
quote:
Why were the funny farms abolished?
If I'm being honest, it's largely a financial thing. With current regulation, medicaid/medicare reimbursement, etc., they just don't make much money for non-state owned companies.
State wards have been shuttered as well and the private sector hasn't picked up the slack.
I know my company is investing big into it at the moment and not why you'd think. We won't make money on the psych patients themselves, but we will make money by clearing them out of the ER for other patient populations. We've learned we have to put them somewhere.
Posted on 5/1/19 at 9:10 am to Duckhammer_77
quote:
people using the ER like primary care are the real problem.
This has actually gone down quite a bit in the data I work with every day. Which covers 10+ states and 150+ hospitals.
The acuity level of ER patients that are non-psych is slightly on the rise because of the surge of Urgent Care/Minute Clinic type settings.
But the psych patients are increasing more than enough to cover that.
Companies need to create separate psych facilities, but often times due to scale and capital, it is just not a possibility.
Posted on 5/1/19 at 9:19 am to TheCaterpillar
quote:
TheCaterpillar
Looking to hire some PMHNPs?
Posted on 5/1/19 at 9:20 am to Oilfieldbiology
quote:
legal recourse
Nurses can occasionally be snarky about this. Guy is put into a medically induced coma due to an injury. He comes too, has a brief freak out and in the process kicks a nurse. No injuries to the nurse. He remembers absolutely nothing.
The next day, his sister bitches about his medical care to the same nurse. She files charges the next day.
I'm sure the case will eventually be dismissed (how do you have criminal intent when you are placed into a coma?).
Posted on 5/1/19 at 9:23 am to TheCaterpillar
I agree, I lot of places have renovated under performing areas of the hospital into fast track areas to divert the lower acuity patients and into mental-health ER-Obs units.
Also, the current FGI design/licensing codes for ERs are being rewritten to allow for rapid non-acute care areas in smaller recliner bays rather than a full bed space.
Also, the current FGI design/licensing codes for ERs are being rewritten to allow for rapid non-acute care areas in smaller recliner bays rather than a full bed space.
Posted on 5/1/19 at 9:26 am to Oilfieldbiology
quote:well with Obamacare, every po hoodlum be commin in da ERa wit a headache and be gettin pissed when da docta be like, you havta wait cause you not an emergency.
How the hell is this allowed and why isn’t discipline and legal recourse uses more often here?
Posted on 5/1/19 at 9:27 am to TheCaterpillar
I was working in a smaller market a few years back when the DEA shut down the two biggest pain docs. One had an active patient roll north of 3500, the other 5000+. Within two months, they had robbed a hospital pharmacy in broad daylight with numerous LEO within 200 feet. I was talking with one officer just after the robbery, asking his thoughts. He told me heroin and gang activity would explode within six months. He was right. As for mental health, many markets simply do not have the facilities. I looked for two months, unsuccessfully, by request of one my GPs to find a place for a young man, 6’5” 300+ lbs, who was experiencing homicidal delusions/fantasies. Not suicidal, homicidal. He was sleeping in a closet of the practice because it was the only place he felt safe. Without him breaking the law or hurting someone, I was told repeatedly there’s no place for him. Nobody wants the Titicut Follies again, but states need some form of non criminal mental health facilities.
Now both hospitals in town have armed security that rivals govt research facilities. Scary.
Now both hospitals in town have armed security that rivals govt research facilities. Scary.
This post was edited on 5/1/19 at 9:28 am
Posted on 5/1/19 at 9:31 am to lsunurse
quote:This push by medical bureaucrats in the late 1990s was a disaster. Has lead, in part, to the opiate issues.
Pain levels are still treated like the 5th vital sign
Posted on 5/1/19 at 9:35 am to CarRamrod
quote:
well with Obamacare, every po hoodlum be commin in da ERa wit a headache and be gettin pissed when da docta be like, you havta wait cause you not an emergency.
This has very little, if anything, to do with Obamacare.
I'm opposed to ACA, but you can't blame this issue on it.
Posted on 5/1/19 at 9:47 am to TheCaterpillar
The Oregon Medicaid expansion research, prior to ACA, somewhat disagrees with you on that point. It showed that not only did ER numbers not go down, they actually increased in most hospitals.
Posted on 5/1/19 at 9:58 am to 3lsu3
quote:
The Oregon Medicaid expansion research, prior to ACA, somewhat disagrees with you on that point. It showed that not only did ER numbers not go down, they actually increased in most hospitals.
I would bet it is mostly psych and not low-acuity, non-emergent stuff.
Just so happened that a surge in mental health issues and substance abuse happened around the same time.
At least that is what our hospital data suggests.
Posted on 5/1/19 at 10:01 am to TheCaterpillar
I guess I look at it like sales, the more numbers you have coming through the door, the more likely you are to have problems. I definitely agree with you, those issues exacerbate the problem.
Posted on 5/1/19 at 11:04 am to Jizzy08
quote:So that makes it ok for the hospital to rape them in the butt?
Well this sounds like an injury that didn’t require someone to use EMERGENCY services now does it?
Posted on 5/1/19 at 12:18 pm to Oilfieldbiology
I’m an ER nurse and unfortunately this is a huge problem. When a psych patient acts up and assaults one of us we are basically told there’s no point in pressing charges because “it won’t hold up in court” because they are psych. Another huge issue is police dumping off their psychs and drunks when they can’t handle them.
Posted on 5/1/19 at 12:36 pm to Oilfieldbiology
quote:
How the hell is this allowed and why isn’t discipline and legal recourse uses more often here?
Because of administration. So much has changed since the Affordable Care Act was initiated.
Administration sees everyone as a customer and not a patient, and employees are no longer of value to them or their medical setting.
Posted on 5/1/19 at 12:42 pm to Oilfieldbiology
quote:
Any ER professionals care to comment?
Not any ER doctor but "assaults" on doctors, nurses, medical students, etc was not uncommon during my time in the ER during my clinical training.
Page 3 of 4
Back to top
Follow TigerDroppings for LSU Football News