re: My EEEE ARE story. Asking for the MDs and ER RNs thoughts.

I use to be a paramedic and I don’t see an issue. I’ll admit I’m not very familiar with the term free standing ER. If you had pt transferred to a higher level of care, if y’all’s level of care was equal or less than ems, you did the correct thing

I theorize that these free standing emergency rooms are just being called that to justify sky high bills that an urgent care can't get away with charging. I had a respiratory issue and I went to a free standing ER because it was the only thing open besides a hospital. I had pneumonia and they couldn't even handle that. The doctor literally said "You need to go to the real ER at the hospital". They did put me in a car with family and sent me on my way but they sure as shite made me ride in a wheelchair back to the car.

I think the biggest skill lacking in healthcare is realizing when you can't help someone and you need to ask for help or refer to someone who can. It is all too common a medical professional to get in over their head and hurt their patients by not asking for help. Give me the person that will ask for help 100X out of 100 over the super confident person that can do no wrong and doesn't even consider asking for help ever.

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I theorize that these free standing emergency rooms are just being called that to justify sky high bills that an urgent care can't get away with charging.

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Exactly. That’s my only beef with this story. Why are these places calling themselves an ER if they can’t handle someone who collapses?

Are patients supposed to be able to figure this out?

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a female patient

Early 40's

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Pics?

ED RN (Management). I use you as in reference to both you + the org you work for below.

You did wrong because you admitted the ED could not handle what it is billed as. If you are charging ED bills you need to provide ED services; that includes resuscitation and stabilization. Only after stabilization (can still be critcial) should you transfer the patient. If you are providing a transfer to an unstable patient then you need to provide the resources to make it as safe as possible.

Did you ride in the back of the ambulance for transfer? Did you call for a critical care transport with an RN? If not, you lowered the level of care the patient was receiving by handing off from a physician to a paramedic.

911 services should only be used for 911 calls. An ED is expected to handle their own; they have a board certified emergency physician in house who is expected to be able to handle whatever it is that comes in the doors. If they can't then you shouldn't be charging ED bills (same price as the regular hospital).

You might have done right for the patient but the org. did wrong if they cant handle an ED patient.

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You did literally exactly what you were supposed to do.

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Agree 100%

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Your bosses are all about money

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Agree 100%

frick those suits. Half of them have only 2 skills: kissing arse and sending emails.

Should be illegal

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The sad truth is that this makes just "calling it" more appealing, and less worrisome from a job retention standpoint. Which blew my mind.

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Sadly our realities aren’t something that can be studied and data analyzed. It’s a CYA world and it’s incredibly unproductive.

I’ve worked in real freestanding ER… we’ve shocked people and ran codes, delivered babies, etc. and then transfer them once they are somewhat stable especially since there are no ventilators there. An actively coding patient has a better chance in the clinic with ER trained staff and a plethora of drugs than in an ambulance with a paramedic. Not understanding the whole context, sounds like you could have jumped the gun. I mean they aren’t rushing an unstable patient to the cath lab while doing cpr or giving epi, so what are they going to do in the “real” ER different than where you were.