Excerpts for “ Your ER Survival Guide‘ by DocHandal
Arriving at the ER
When you arrive by ambulance, EMS will have already notified the hospital of your status. Initial treatment will be based on this report. You will be taken to an assigned area and treated. Friends and family may be asked to wait outside and to assist with registration. It’s important to allow medical personnel to do their work, especially if the person is severely ill or injured.
If the patient is critical and it is important for you to be at the bedside, let the staff know of your wishes. People do die in the ER, despite optimal and timely care. You should know how to reach clergy when death is expected.
When you are able to walk into an ER, go to the main desk and say why you are there. If you are stable, you will be directed to the triage area first. I’ll discuss triage in more detail later but understand that a Triage Nurse will speak with you in order to determine what your problem is and whether or not you need to be seen right away. This mini exam may include your vital signs—temperature, blood pressure, heart rate, respiratory rate and oxygenation level. More about this later.
If there is a long wait in triage and you’re feeling okay you will be registered while waiting. This is when you need to have your insurance card and ID information ready, as well as information on advance directives. The Registrar at the desk doesn’t need to know your health history. This person is starting a file on you that will follow you during your visit.
Your name and date of birth will be used to identify you so make sure they’re entered correctly. Even getting your middle initial wrong could put your safety at risk so be sure the Registrar got it right. Your health care team will be asking you to repeat your name and date of birth often. Don’t get annoyed. Be thankful they’re taking steps to make sure they’re treating the right person. Wrist bands with your name, date of birth, date of admission, and hospital identification number will be applied, if not already done at triage. You may be asked to verify the information by initialing it before it is put on your wrist. Again, this is done for your safety. Don’t remove it. And don’t let anyone else wear it. Once you leave the hospital, the bracelet should be cut up and destroyed like you would an old credit card.
An emergency room visit isn’t free. Expect to present a photo identification card, insurance card and information on your residence and place of work. If you don’t have insurance, understand that emergency departments have a federal directive under the Emergency Medical Treatment and Active Labor Act (EMTALA) to screen and stabilize patients to determine if the problem is a medical emergency, regardless of their ability to pay.
If you don’t have insurance and are concerned with how you’re going to pay for the visit, you can mention it now. Information on assistance may be available. But don’t expect any counseling or answers on this topic from the ER Registrar. Ask for the name of the hospital’s billing clerk who may be on site or the social worker and plan to deal with the issue later on.
Keep in mind, too, that identity theft is a problem in hospitals. People without citizenship and / or insurance may try to use yours to access health care. Be careful with your personal identification information. Share it only with people who need to know.
Speaking of need to know, you should become familiar with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). It is a federal law enacted to protect your privacy. Understand that the information put in your file about you during your hospital visit is only accessible to people who need to know it, including your health insurer. So tests, lab reports, doctor’s notes and even conversations you have with the doctors and nurses are confidential. This law also gives you the right to access your health records. If you determine incorrect information has been included in your file, there is a way to ask for corrections.
Sounds great, but there’s a flip side. When someone calls the ER to find out how you’re doing, no one can tell them you’re there or how you’re doing without your permission. You will be asked to specify who the medical staff can talk to about your status.
Remember that pen and paper I told you to carry? Start taking notes. This is for your own reference. A trip to the ER is stressful and it’s easy to miss important information so keep a log of events. Note the names of the people caring for you, what tests were run, the diagnosis, and the treatment. Remember, you have a right to understand what is being done to you and why. You will be receiving information on your rights as a patient from the hospital. The Patient’s Bill of Rights is usually posted in the ER. In general, as a patient you have the right to:
- Be treated with respect
- Information and choice
You have a right to have an explanation before you have anything go into your body or done to it. You are free to accept or refuse treatments if you are unclear or do not have satisfaction as to why you are being given a test or meds. The ordering staff member commonly the EM Doc will be told and should approach you to discuss your concerns. If they do not, I understand where you might think maybe it was not necessary-so to be sure -ask to have the ordering Doc explain why. The policy is to have a detailed explanation of what refusal of treatment means, that is be told what negative effects this may have on your health. You have the right to also refuse to participate in medical research.
Participate in all decisions about your treatment. It is your body! ”
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