#nursblr

the charting system at work now has an AI option to write your notes for you.

to write your notes for you.

to write your notes for you.

you know, the notes you make about PATIENT CARE.

Her parent is having their legs wrapped in Coban compression dressings twice a week, which I have explained maybe a dozen times to her is not something home care is able to do long-term. Our policy is that once a client’s lower leg edema has been reduced to a sufficient degree, we have to transition them into graduated compression stockings. Daughter is upset because when her parent was recently transitioned over to GCS, they developed a leg wound. Her solution is that we keep the client in Coban indefinitely. I said I would contact the primary care provider for further guidance, which I did — this communication included details about home care policy and rationale for compression therapy. She also contacted the doctor to say, “tell home care they need to keep using the Coban.”

Well, when I read out the doctor’s response, which was along the lines of, “We will need to do some further investigation of the edema; med changes to be made pending lab results. Please keep in Coban until wound heals, then transition to higher level of compression with GCS,” the daughter went deadly silent, because that’s not what SHE told the doctor to say.

Like, ma’am…I’m sorry you weren’t aware that doctors are not gods, and that they can’t just order the home care program around. If their recommendation is not in line with our policy, we have the right to say no. Our specialist team that assesses the appropriateness of medical therapies for clients probably knows more than the average citizen — you, for example — about what is and isn’t best practice for the management of chronic conditions. I can appreciate that you want to advocate for your parent to receive appropriate care, but your opinions and preferences do not supersede program policy.

I would like to share an edited version of my response to this person here because perhaps it will help others to understand why they had a similar experience at an ER.

This is not me trying to discount the very real issue of having too few primary care providers or the many problems our healthcare systems are experiencing, it’s simply an explanation of why the emergency room staff said “sorry, can’t help you,” after you just spent 17 hours in their waiting room to see a doctor.

~ ~ ~ ~ ~

As frustrating as it is to be sent away with what seems like no help, an ER’s job is to make sure you are not dying right now.

If you are not dying right this very moment, you will likely be sent home to follow up with a long-term death prevention professional — a family doctor, physical assistant, or nurse practitioner — to ensure that beds and resources are available for those people who ARE dying right now.

People walk around and live their everyday lives with high blood pressure, and while it’s not healthy in the long-term, unless you are in a hypertensive crisis putting you at risk of imminent death or severe permanent injury RIGHT NOW, the emergency room can’t do much for you.

This goes for other issues that feel urgent because they are negatively impacting your quality of life, but are ultimately not causing you to die right now.

Testing company Visby Medical launched its three-in-one test for women last year, following FDA approval in March. The urine-based test includes a vaginal testing swab and a small electronic device that develops the results and sends them to an online app for review. The test, which costs $150, also includes a telehealth consultation with a medical provider who can discuss the results and prescribe antibiotics or other medication, if needed. The entire process — from buying the test to getting a prescription — can take as little as six hours, compared with several days under the traditional testing model, says Dr. Gary Schoolnik, Visby’s chief medical officer.