How To Maximize A Visit To An Emergency Room
If you have a specialist or primary care doctor who is associated with the hospital, call and let him or her know you are in the ER. Perhaps he or she can meet you there. It will be beneficial to have someone there who has knowledge of your medical history and a direct concern for your health. If your doctor can't meet you, ask that he or she at least call the ER to let the ER know he or she is concerned and would like a call with the results. It is beneficial if the ER knows that another doctor is looking out for you.
If you have a managed care plan, ask that you only be treated by in-network doctors if possible. If an in-network doctor is not available, you can argue with the insurance company later that you had no choice but to use the doctor(s) who helped.
Speak up about your symptoms. Don't underplay your symptoms. Emergency rooms function on the triage system-which means that patients with the most immediate medical needs or those with life-threatening situations are always given top priority. If you underplay your symptoms, or don't let the personnel know if the symptoms get worse, you won't be moved forward as quickly as you should.
Express your needs.
- Be firm in making your needs known but try to stay nice. You can safely assume that every ER staff is over-worked.
- Request comfort items such as water and a blanket. If you're hungry or thirsty, ask for liquid or a food tray. You will receive help from the ER staff until you receive a room assignment.
- If you are hungry, ask for food. There may be machines available. It may even be possible to call a local restaurant for delivery.
- If you will be admitted to the hospital, make your needs known before you are assigned a room. Up to the point of being assigned a room, you should be able to get attention from the staff. After that point, you may be in for a long wait without attention.
If possible, bring a family member or friend with you, or have them meet you at the emergency room. This person can act as your patient advocate and advocate on your behalf. Your advocate can help to ensure that your needs are met during a time when you may not be up to the task. You can learn more about choosing an advocate in Entering the Hospital On An Elective Basis. If you don't have someone with you, be prepared to advocate for yourself.
If you know a big shot at the hospital, it can't hurt to drop his or her name in the ER. It may get you on a fast track to a room or more attention while in the ER.
If the wait is long, try to speak to the head nurse of the ER. The head nurse generally has the authority to change standard procedure. Let him or her know how long you've been waiting - and why you need to see a doctor as soon as possible. A polite approach generally works better than an aggressive, combative approach.
Before you are discharged from the ER, be clear about:
- The diagnosis of the problem(s) discovered.
- The tests you took.
- The treatments which you were given.
- Instructions about what to do after leaving the hospital, including an understanding of what drugs you are to take, why, and for how long.
An easy way to be sure you're clear about these subjects is to describe them to the doctor.
If you are admitted to the hospital ask if you will be on "observation status."
- Sometimes a patient is admitted to a hospital on an "observation status." While on "observation status" you stay in the hospital, and receive hospital services. However, you are not considered to be a patient.
- "Observation status" is meaningful when it comes to your bill. Medicare and some private insurance charge patients a 20 percent co-payment. There is also no coverage for the cost of post-hospital nursing care or rehabiltation which require a minimum stay as a patient in a hospital before coverage takes effect.
- In theory, observation status should not last more than a day or two. However, hospitals are sometimes using it for longer stays to avoid Medicare penalties in case there is a readmission soon after discharge.
- If you are admitted on observation status, insist that you be changed to "patient" status as soon as possible.
Herbert Spiers, Ph.D.
New York, NY