Saturday, December 22, 2012

patient satisfaction sweepstakes

The patient satisfaction thing has officially gone off the rails.

I read that an emergency room in Massachusetts is starting a policy in which nurses can order pain medication on their own. Due to medicare reimbursement being linked to patient satisfaction scores, a policy has been developed in which nurses can order anything from tylenol to vicodin to morphine to dilaudid after using some kind of pain assessment scale. The goal is to treat pain within 30 minutes of arrival.

Isn't this outside the scope of nursing practice?  Isn't this practicing medicine without a license? Doesn't this open nurses, hospitals, the doctor up to a whole lot of liability?

With the increasingly common use of NPs and PAs in the ER, along with stuff like this, why do we even need ER docs?

Your thoughts?


Nurse K said...

They tried to do this when I was in management, and I was just like "you're joking, right?" The medical director gave an example of nurses ordering Percocet 1 tab for earaches and sore throats.

"Okay, want the entire neighborhood to get triaged, get a fix after describing a subjective complaint of earache, and then leave without being seen? Isn't that called drug dealing?"

I'm not THAT OLD, but when I was a new nurse, you couldn't even get Percocet post-op for things like spinal fusions.

Moral of the story is that I basically said that no nurse in my ER would be ordering a Percocet or Vicodin for a patient in the lobby, and if they wanted patients medicated for pain more quickly, they could go out to the lobby and assess them there and take responsibility for their own orders.

That being said, there are times where I'd love to just give out a Vicodin or two...People with deformed wrists and ankles after a fall who are waiting and waiting is my main example, but it's not that hard to ask for an order.

Beth said...

That's insane! Totally agree with Nurse K on this one.

On top of it, I can just imagine some asshole frequent flyers getting a hold of that info and being like "IT'S BEEN 30 MINUTES WHERE THE HELL IS MY DILAUDID>!!!?!??"


Anonymous said...

Oh. Hell. No.

Sara said...

No way, no how, no where. That's asking for a whole toilet full of trouble!!!!

Nicky, BSN said...

Don't let the addicts hear about this - they are already honed in their skills for obtaining the max dose with manipulation and minimal effort - better stock up if this policy is implemented.

Anonymous said...

Ugh, hate the idea.

But, we order anti pyretics for children in the waiting room. Same concept... practicing medicine without a license.