What exactly is 24 hour emergency care in RR?

With continuous physician staffing in place the Rainy River Healthcare Centre can now insure 24 hr Emergency Service is available to the communities serviced by our hospital. But just what is 24 hour Emergency service and how does it operate? With approximately 2500 Emergency Room incidents per year at the Rainy River Health Centre, it is evident our little Centre provides a very valuable service for our communities. This is a team effort involving hospital staff, physicians, ambulance, and perhaps as well fire department, and law enforcement staff.
But that does not mean there is always a physician on site at the Emergency Room, only that there is one on call and available on very short notice when needed. With three emergency stretchers, and if available, the three acute care beds in a pinch, up to six patients could be treated at once. A maximum capacity would of course put extreme pressure on the Emergency Room Service. That is why standards must be followed and it is even more important patients do not abuse the service by using it ‘to make end runs around’ clinic appointments.
We operate under Emergency Room Standards for Canada, explained RN Tammy McNally, Nurse Manager at the Rainy River Healthcare Centre, during a recent interview. Here is briefly what that entails.
When a patient attends the Emergency Room, the RN on duty performs ‘triage’ on the patient. This determines the severity of the problem and perhaps the treatment regimen the patient will receive.
The first level, the most extreme is Resuscitation, where the patient would probably be coming in by ambulance, receiving CPR, or suffering from another condition with imminent threat to loss of life or limb.
The second level would be Emergent, and would include an item like severe angina where perhaps an imminent cardiac event was evident or suspected.
The third level is Urgent, and could be something like severe abdominal pain, where perhaps a gall bladder attack, kidney stones, or severe appendicitis is suspected.
The fourth level Non Urgent might include a high fever, or where a Urinary Tract Infection is suspected and the patient cannot wait to see a physician for a regular appointment at the clinic.
The fifth level is Elective, where the condition is determined to be something that should be treated by the physician or nurse practitioner by the patient scheduling an appointment at the medical clinic during regular office hours.
In each case the RN using their professional judgment will determine when to contact the physician on call. In the levels one through three, that would be immediately, or in a very brief time frame. The physician would then attend as quickly as their judgment deemed appropriate.
In a level four incident, a call to the physician may be made following a more thorough assessment of the problem and the physician may prescribe a treatment regimen by phone to the nurse, based on the RN’s observations.
In a level Five case, the patient may be advised to call the clinic for an appointment, which may be that day or the following one, or wait at the Centre if the physician will be arriving later to see other patients
The number of possible scenarios presented to the RN on duty at the Emergency Room is very wide. That is why we are fortunate to have such skilled professionals on the front line in our Rainy River Healthcare Centre.