Monday, June 1, 2009

U.S. vs Canada?

I had a patient the other day who came in with pleuritic Lt sided chest pain, with a coughx2 weeks. We were able to get her into the department within a half hour of her arrival, and did all the chest paineur type things like bloodwork, ECG, ASA for the slightest chance that this cough-induced pain could actually be a heart attack.

Her ECG looked great (confirmed by MD), Troponins were negative, and although she was still in pain on deep inspiration/expiration and cough, she was doing just fine.

We were having an incredibly busy night with people needing internal pacing, intubation, ICU-bound-type patients. Thus the doc's were behind on seeing the urgents and less urgents. They were getting to them, and we were letting people know there would be a wait, this particular patient was infuriated.

"Why haven't you done anything yet?" she states, 'Where is the doctor?" This is, of course, after we have placed an IV, drawn blood, did O2 therapy, gotten an ECG, and given her ASA. The only thing we haven't done is done a chest xray (which nurses can't order on their own through the medical directive). After explaining that the doctors were tied up with very sick patients, the lady then states these words: "If we were still in the States we wouldn't be waiting." When I explained the severity of the sick people in the department, and that people DO have to wait for a doctor in the States, she stated "If you have insurance, you do not wait".

I kept my mouth shut, knowing full well that even people with insurance in the States, especially at a busy Emerg, would be waiting just as long as she was. She left AMA, which was fine with me... If she wanted to complain about the 'service' here, she can go back where she came from.

1 comment:

Ellen said...

Yes, Elaine, you are correct she would be waiting in a US ED also. I can assure her "wallet taps" (or a check on someone's insurance) are not done AND here we have EMTALA AND we take people in order of severity. As an American who loves her country and has traveled extensively in Canada and elsewhere, I must tell you how much I dislike Ugly Americans...in any form.
PS I'm an ER nurse in Arizona who also teaches a Clinical Nursing class.