The emergency room can be a dangerous place, if you’re a nurse

From the LA Times:

News stories, official reports and patient anecdotes frequently highlight the perils and problems encountered by emergency room patients. Considerably fewer stories  focus on the perils and problems posed to the people working there. A new study does that.

It found that more than half of emergency nurses say they’ve been physically assaulted on the job. One in four say it’s happened more than 20 times in the last three years. Some have been hit. Others have been pushed or scratched or kicked or spit upon. And verbal abuse? Far, far more common.

Much of the violence was attributed to patients or visitors who were addled by drugs or alcohol, and to psychiatric patients. Contributing factors included crowding, lengthy wait times and a shortage of nurses.

The study’s abstract says: “Approximately 25% of respondents reported experiencing physical violence more than 20 times in the past 3 years, and almost 20% reported experiencing verbal abuse more than 200 times during the same period. Respondents who experienced frequent physical violence and/or frequent verbal abuse indicated fear of retaliation and lack of support from hospital administration and ED management as barriers to reporting workplace violence.”

Conducted by the Emergency Nurses Assn., the survey was  published in the July/August issue of the Journal of Nursing Administration.

Maine Police Eye Hospital Taser

From WBTZ:

Seeing an increase in aggressive behavior in its emergency room, a Bangor hospital wants to issue a Taser to police.

Bangor City Council is to decide Aug. 10 whether to allow police to accept a $1,000 grant to buy the Taser, which would be kept at Eastern Maine Medical Center’s emergency room for use in the event of violence.

The hospital has agreed to help police to buy the electronic stun gun, which would be kept in the emergency room 24 hours a day for use by police officers.

Hospital emergency department administrator Karen Clements told the Bangor Daily News that a scarcity of inpatient psychiatric beds and outpatient counseling are helping to drive up the number of assaults and other forms of aggressive behavior at EMMC and hospitals across the country.

Emergency Physicians Can Trust Their Judgment on Chest Pain Patients

From the Huffington Post:

Now we have evidence that emergency room physicians should trust their gut instinct when they have to make a quick decision about a potential heart patient, before lab results are even returned. Sometimes these patients could be better served by staying at the hospital and having more tests rather than being treated and released or discharged.

The findings, published in the August issue of Academic Emergency Medicine, are important in today’s health care climate. When we examine cost and efficiency of health care, I think that emergency physicians can make an impact. If we release patients who end up needing further care, costs go up.

Now it looks as if emergency physicians should counsel against discharge with other physicians when they feel strongly about a chest pain patient for whom there is no compelling data, other than our evaluation and judgment. Based on data I reviewed with colleagues, on a group of more than 10,000 patients, I believe significant advances in both optimal patient care and cost-effective patient management can result from improved and increased communication between emergency room physicians and admitting physicians.

Haggling Over Healthcare Bills

From Forbes:

Hospitals often prefer to chop a bill down in percentage terms rather than fight over individual charges. Todd Roscoe, a former executive at the hospital chain Tenet Healthcare says that a 40% discount off the inflated list price is the norm for cash-paying customers.

James Muckle, who manages a 32-unit apartment building in Sebastopol, Calif., had a similar experience. He got hit with a $6,000 bill after a four-hour visit to the er that consisted of a diagnosis of kidney stones, pain pills and instructions on how to pass the stones. He called the hospital and politely noted he was surprised by the charges. He says he was offered a 40% discount if he paid within 30 days. After an hour of back and forth, asking the clerk to explain each charge, he asked if he could pay $1,000. The hospital countered with $2,300, and he eventually paid $2,000. “Maybe I should have pressed it a little more,” he says.

ANSI approves new healthcare RFID standard

From Modern Healthcare:

The Health Industry Business Communications Council’s new set of standards for using radio-frequency identification tags to label and track medical products has received final approval from the American National Standards Institute, according to a news release.

The new standard, called ANSI/HIBC 4.0, includes guidelines for tagging healthcare products in a manner that will prevent radio frequency interference with medical devices. A June 2008 study in the Journal of the American Medical Association concluded that ultra-high frequency tagging interfered with the operation of electronic medical devices in 63% of tested cases.

HIBCC’s new standards recommend that healthcare products be tagged using 13.56 megahertz high-frequency coding. The smaller read range is less likely to interfere with medical devices, HIBCC officials said.