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Don't Leave the ER Confused

Posted Oct 23 2008 7:29pm

If your visit to the ER didn’t require an admission, that’s good news.  After being told by the ER doctor that you can go home and your doctor or nurse armed you with discharge instructions, you most likely want to high tail it out of there as fast as you can.

Wait!  Not so fast.  It’s really vital that you do not leave the ER until you are absolutely clear about the discharge instructions.  Understanding and following discharge instructions is critical for your well-being. The bad news is that complications can arise if you do not understand your diagnosis and discharge instructions.

According to the American College of Emergency Physicians (ACEP), it was reported in a recentstudy   that 78% of patients do not fully understand discharge instructions they receive in the emergency department, and sadly the majority of patients do not understand what the doctors told them.

Emergency rooms are chaotic and can be frightening and overwhelming.  In the very fast paced and frenzied ER environment understanding information can be difficult.  The communication process can be impeded in a setting that often seems confusing and unruly.  It’s critical that you first understand your discharge instructions so you can follow them.

As a registered nurse who has been on both sides of the ER, as an administrative head nurse and as a family member, here are some simple tips:

1. Always speak up and ask questions.  If you do not understand anything that is being told to you by your doctor or nurse, let them know!  By speaking up and asking questions, you’ll know what to expect when you leave the ER.  Don’t ever feel intimidated to ask questions.
2. When the discharge instructions are handed to you, make sure you review your instructions with your doctor or nurse.  Go over each and every step.  Repeat back the information.

3. If you need to write down information that will help you decipher what the doctor or nurse tells you, than do so.

4. If you are given prescriptions for medications, make sure you understand what you will be taking.  Be clear about how to take your prescription, when to take it, the dosage, and any side effects.  Also ask if it will interfere with any other medications that you may be taking.

5. If possible, it’s always a good idea to have a family member or trusted friend with you since they may be able to comprehend and understand instructions more clearly.  As a patient, you may still be feeling overwhelmed by the whole ER process. Having someone with you can help ease the overpowering environment. 

6. Be patient.  Even though you are eager to go home and you want to be discharged as quickly as possible, please be aware that you are in an ER and your doctor or nurse may suddenly need to see an incoming, critically ill patient. 

7. Despite the crazed atmosphere of the ER, the professional staff of doctors and nurses are concerned for your well-being and they are there to provide the best quality care for you.

8. If you do not feel your needs are met, you can always ask to speak to the nurse manager or during evenings, nights, weekends and holidays (depending on the hospital) you can ask to speak to an administrative head nurse or nursing supervisor.

9. Staffing issues and overcrowding are always concerns in an ER, but your care is very important.  Remember to always take charge of your health and speak up and ask questions. 

10. It’s important for you to speak up, and not only about your health, but the nation’s health. Emergency departments across the nation are in dire straits and they need you to speak up for them so you’ll be able to continue to receive the care you deserve.  ACEP makes it easy for you to make your voice heard.  Take
action now!If you find yourself in need of emergency treatment and you head to the nearest ER, remember these tips and don’t for to take “action now.”   Remember to be your own health care advocate and speak up and ask questions.   Make sure you understand   your discharge instructions.

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