Being Safe At The Emergency Room

I spent part of the other night with a client and his wife at the local ER.  His primary care doctor had sent him there after hours.  My client’s wife and caregiver had thought she could handle it herself but on the follow up call, she was in distress.  My client was having a difficult time understanding what was happening to him.  She was at her wits end, feeling alone and becoming unhinged.  I told her, I was on my way.

I arrived at the ER and had no trouble being sent to the room.  I immediately assessed the situation.  I took a few minutes to speak with the my client’s wife and then headed to the nurses station.  I introduced myself as a patient advocate and nurse practitioner and requested an update.  As usual, it takes a few seconds and blank looks for the nurse or doctor to engage in conversation.

I think it surprises most of the staff that I ask very pointed questions in regards to potential diagnosis, actions taken and whether there will  be an admission or discharge.  I make it clear that I am not there to make decisions but to get all the information.

It makes a difference for my clients.  The staff can explain medical details to me and I know how to ask the questions.  I can help a family evaluate options and move things along.  I can also work with the ER staff to include discharge services like visiting nurse, physical therapy, new medication or medical devise management.  I also make sure the staff maintains the best possible safety measures like washing hands.

The problem with most ERs is communication.  Doctors and nurses move from room to room without much information.  Often it is because there isn’t any new information like lab results.  But it is scary, isolating and cold.  The lights are bright and it is noisey.  It can be disorienting for the patient and the family.

Here are some tips to making an ER visit smoother and being the best advocate for your loved one.   I advise having this information in a notebook, or electronic devise like the iPad.                                                                                                                                                              1. List of medications, dosage and prescribing physicians.                                                                                                                                      2. List of current diagnosis.                                                                                                                        3. Brief past medical history.                                                                                                                       4. Insurance cards.                                                                                                                                         5. Health Care Proxy, Power of Attorney and Advanced Directives.                                                6. Pen and paper to write down what doctors and nurses say.                                                     7. Snacks, light blanket and something to read.  It can be many hours in the ER.

I think everyone should have an advocate when in the ER.  Colleagues of mine in Connecticut ,started a service called Health Champions @ The ER Advocacy Services.  http://www.healthchampion.net/eldercare-support.services.asp                           Boston area requests are referred to Healthcare Whisperer, Inc.