Comments on: Turfing patients to the ED http://www.kevinmd.com/blog/2008/08/turfing-patients-to-ed.html Tue, 14 Feb 2012 17:18:00 +0000 hourly 1 By: NH RNhttp://www.kevinmd.com/blog/2008/08/turfing-patients-to-ed.html#comment-87071 NH RN Fri, 15 Aug 2008 13:11:00 +0000 http://clients.emmense.com/kevinmd/2008/08/turfing-patients-to-the-ed.html#comment-87071 I am surprised you linked to this post, and especially featured this comment. Is there some sort of ED sympathy bias for this one, or a glee for hitting such easy targets as the nursing homes?<br/><br/>Some of the other comments might have validity in that blogger's experience. But to assume that is why nursing homes send patients to the ED takes a lot of assumptions into place. How is she going to know those reasons from the ED? There are several other plausible reasons for why imminently dying patients from nursing homes get sent to the ED: Lack of staff at the nursing home, lack of hospice involvement with that patient, believing there may be something reversible, having a transferred demanded by the family, having a doctor who does not know the patient well on call and makes an 'easy' decision to transfer to the ED rather then think through the problem, etc. etc. The ED always forgets how many patients 'could' have been sent there but were instead handled at the nursing homes. I am surprised you linked to this post, and especially featured this comment. Is there some sort of ED sympathy bias for this one, or a glee for hitting such easy targets as the nursing homes?

Some of the other comments might have validity in that blogger’s experience. But to assume that is why nursing homes send patients to the ED takes a lot of assumptions into place. How is she going to know those reasons from the ED? There are several other plausible reasons for why imminently dying patients from nursing homes get sent to the ED: Lack of staff at the nursing home, lack of hospice involvement with that patient, believing there may be something reversible, having a transferred demanded by the family, having a doctor who does not know the patient well on call and makes an ‘easy’ decision to transfer to the ED rather then think through the problem, etc. etc. The ED always forgets how many patients ‘could’ have been sent there but were instead handled at the nursing homes.

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