9 page essay on EMTALA law
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BReflectivepaper-Someworkidid.docxI WROTE SOME OF THIS OUT FROM INFORMATION ON THE INTERNET AND FROM MY HEAD. I NEED THINGS ADDED SUCH AS SOURCES AND GOOD CITING, ETC…
You can use this information if this will help.
Introduction
The enactment of The Emergency Medical Treatment and Active Labor Act (EMTALA) has been influential in patient care and nursing practice. This act was created to provide certain enforceable standards of care within the emergency department. The EMTALA law requires emergency departments to medically screen, stabilize and treat patients regardless of their ability to pay. EMTALA defines “stabilize” as such “medical treatment of the condition as may be necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to result from or occur during the transfer of the individual from a facility.” EMTALA has impacted cost, technology, aging, diversity, disease and treatment. These factors have also led to further impact on nursing and nurse leaders.
Cost
The EMTALA law has caused a tremendous burden on hospital emergency departments. Although hospitals are covered under the EMTALA law, they are left to deal with the bills that are accumulated from non-emergency care. The increase in volume has placed tremendous burdens on emergency departments with the high fixed costs. Uninsured patients make up a significant portion of emergency department visits leading to higher amounts of unpaid care. The EMTALA law restricts any hospital’s attempts at transferring or “dumping” uninsured patients in attempts to save money. Patients from all socioeconomics are now able to receive care without fear of being turned away. ERs cannot turn away illegal immigrants or uninsured. Undocumented workers who become ill or get injured while in the United States are left with few options for medical care. With that being said, undocumented immigrants will obtain healthcare from hospital emergency departments. With large number of citizens who are uninsured or underinsured, the nation’s emergency departments are experiencing more overcrowding. They are using the emergency department for non-medical emergency conditions or as their primary care.
Diversity of population and the Workforce
With the increase in diverse and undocumented patients using the emergency room for their care, hospitals are now required to have a translator or phone translator offered to all patients. This means hiring more nurses who are bilingual in the emergency room.
Technology
EMTALA has increased ER visits putting severe strain on hospitals forcing them to become equipped with advanced technology in response to the EMTALA Act. The increased volume of patients requires hospitals to have updated technology to cater to the increased number of visits. In order to keep up with the increased volume, emergency rooms need to have an efficient health record systems to provide continuity of care. Such as having immediate access to patient history, diagnostic imaging and lab results. In order for patients to be stabilized, some may need appropriate diagnostic images or further tests to deem them as “stable.” If hospitals are not equipped with the appropriate technology or equipment to stabilize patients, they may need to be transferred to another hospital with higher level of care.
Aging Population
APA RESEARCH PAPER 6.28.18 9:13:36 PM
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APA RESEARCH PAPER 6.28.18 9:13:36 PM
Changing Disease Patterns and Treatment
EMTALA has brought on primary care usage and return visits to the emergency room knowing that they are legally required to be seen. This obligation to see patients impacts how their chronic disease and illness. Patients who require a specialist or a primary care doctor may not follow up they are required to make a payment up front at their office. Physicians and specialists are no longer under the rubric of EMTALA at their office. These patients are then right back in the ER. This repeat cycle of visits causes no continuity of care, increased cost for the patient and hospital, disability of condition or worsening of symptoms. Almost all hospitals have an on-call policy for specialists if the ER physician determines that a patient needs further evaluation. Specialists are evaluating patients, but finding reasons that a particular case may be out of their area of expertise, or not appropriate for their care, or not in need of surgery immediately.
My Thoughts and Reflection
The EMTALA Act has impacted emergency rooms across the country causing long waiting hours. The ER is seeing an increased number of patients with minor illnesses. Such as sore throats, cold symptoms minor cuts and bruises. The challenges with the long waits in the ER can impact quality of care that patients receive. There is also an increased number of patients with disabilities due to not following up with a specialist. There is no continuity of care for patients who have chronic illnesses. I recently had an undocumented immigrant who came to the ER for cholecystitis. Patient was treated with antibiotics, pain medications and IV fluids. Surgeon was called, but was told to tell the patient to follow up with him in his office. Pt was then discharged and told to follow up with a surgeon. However, the patient returned to the ER 3 days later with the same symptoms.
Nurses and Nurse Leaderships
With the uncertainty of healthcare, nurse leaders must try to create new ideas in this chaotic new system. As nurse leaders, we must collaborate and be more effective in times of chaos for better patient outcomes and safety. Today’s healthcare landscape has created an environment poised for transformation, and as nurse leaders we must turn it into an opportunity to improve access and continuity of care. Patients have always expected high quality, more affordable care. However, the difference now is their desire to access care more affordable and conveniently. As nurse leaders, we need to focus on continuity of care which includes addressing patient flow into the healthcare system, access to primary care and specialists, wait times for procedures and admission, and post discharge follow ups for all patients.
Globalization
As we look to the future, we see new regulatory changes, advances in science and new expectations for how those we serve will access and receive care. Healthcare is being reinvented in many ways, and as nurse leaders and change agents we must both adapt to meet changing needs and continue to lead transformation.
Transformation of Self and Practice
The RN to BSN program has helped me become a stronger voice and leader in my department. TAlso using evidenced based practice … DON’T KNOW WHAT TO SAY HERE.
References
Rosenbaum, S., & Kamoie, B. (2003). Finding a way through the hospital door: the role of EMTALA in public health emergencies. Journal of Law, Medicine & Ethics, 31, 590-601.
