Healthcare Traveler - September 2008 - (Page 22)

West/Southwest: National issues on a local level Whether practicing in his Illinois hometown, an Arizona snowbird community, or a Colorado mountain suburb, Fernando “Rey” Guerra, RN, PALS, TNCC, ACLS, has served a wide variety of patients. He’s witnessed his share of interesting circumstances, and, at the same time, Rey has watched the growing phenomenon of emergency department crowding resulting from individuals using the ED as a substitute primary care provider. He observes, “I think that is a general scenario taking place in so many cities across the country.” A traveler with American Mobile Healthcare, a staffing agency based in San Diego, California, Rey has devoted all 7 years of his nursing career to the ED. “I like to get people feeling better and on their way. And, I always liked the adrenaline rush.” His 4-year mobile career has taken him to Arizona, California, Michigan, Illinois, and to his current assignment at Centennial Medical Center in Centennial, Colorado, where he works the night shift. What is unique about this contract compared with others is the relative quietness of the ED. Rey explains, “Of course, we see the typical earaches, sore throats, bowel and chest pains, and the occasional drug overdose. What took some getting used to is that we average about 40 patients a day. I was not accustomed to that easy of a pace before coming here.” Rey cites the fact that the hospital is in a rather affluent area as a possible reason for its low census and short wait times. “This part of Colorado is developing and has not suffered as much as other areas from the subprime housing crisis or the economic downturn. But, wherever I travel, I have seen more people using the ED for non-emergent complaints.” It was an assignment in Arizona, however, that really made an impression upon this traveler. Because the state is a seasonal home to thousands of older people during the winter months, the types of conditions nurses encounter in the ED switch toward those commonly associated with geriatrics. For example, Rey remembers one woman who had fallen while out shopping. “Because she was a senior citizen and she had a bump on her head, I evaluated her differently than I might have examined someone younger. At first, she checked out okay clinically, Circle Career Card No. 621 22 Healthcare Traveler September 2008 http://www.hrnservices.com http://www.hrnservices.com

Table of Contents Feed for the Digital Edition of Healthcare Traveler - September 2008

Healthcare Traveler - September 2008 Editor's Desk Contents In a Flash Paws for Thought Field Notes Regional Differences in the ED Joining Together Drug Update Clinical Tips Cityscape Advertiser's Index Name It Travel Tips Big Deals Tax Facts Dot.com Contest Rules Allied Corner Going the Distance Classifieds Tales from the Road

Healthcare Traveler - September 2008

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