Re: daily migraines

[Guest guest]

Kathy, Millie.

Firstly, when a patient shows up in an ER for a headache I would say 90 percent

of the time the primary care doc is NOT called.  Even if he/she is called and

states give the patient this, that doctor is not the physician of record, and is

not responsible for the care of the patient. THEREFORE IS NOT required to order

anything that your private doctor wants.  

As a nursing administrator I dealt with this problem over and over again, and it

was always with Migraineurs.  For anyone who has ever had a migraine I liken one

to: you are scared you are going to die, and on the other hand, you are scared

you are not going to.

There are 2 ways around this.  Firstly, if during the day, the private doc can

call in orders for the patient to receive whatever meds/iv fluids etc. the

patient is to get in the Same Day Surgery Department.  The other way around it

is for your private to make you a 23 hour observation admission with the orders

called directly to the hospital.

The last 2 ways your physician is in charge.

Because you are dealing with a professional who is qualified by training and

education to formulate treatment plans on his/her own they often do not consult

private docs. When the ER's do have to get in touch with private docs, any time

the patient is to be admitted. They must call the " on call " doc for that

specialty.

If a specialty problem or an internal medicine doc to admit. this is because the

responsibility is passed from the ER physician to the accepting/admitting

physician) there were problems with return phone calls taking hours, not being

able to facilitate discharges from the ER/admissions to the hospital and then

bam the ER has to close to ambulances etc because they don't have any beds

available.

Debra

>Millie wrote:

>Kathy,

>Have you talked to the medical Director of the hospital that you go to? Maybe

talking to him directly or writing a letter about what happens every time that

you go to their ER will get the ball rolling and he could make sure that

everyone is on the same page.

[Guest guest]

Kathy wrote:

> I have good Drs. and several meds. to choose from and orders on file at the ER

if I have to go. The problem is they (at ER) still treat me so awful every time

I go there that I swear I'll never go back. I even called a patient liaison who

assured me it wouldn't happen again.

>

> They take a part of the instructions on file and make up their own cocktail of

meds which rarely works. How can I get these people to follow the orders on

file?

Kathy,

If you have worked with the Patient Liasion, get her home and cell phone number

and have it to call when you go to the ER and they do not follow the

instructions on file, keep a copy of the prescriptions that work for your in

your pocket for the ER doctor to have, and explain why you have it as the others

do not work.

You know, I do not have migranes except when my allergies get full blown, when I

found that out, we get my allergies treated IM, then the migrane meds, and it

has been a God send for me. Jan and Sept are my problem months.

Always keep in touch with your patient liaision representative but also the

quality assurance officer has to write it up and follow it up until it is

resolved so you can call the front desk and as for the qm, quality assurance

officer, it will usually be a RN and they will write it up and follow it until

it is resolved and it will be

counted against the hosptial until it is cleared. Bennie