情境模拟:Dialogue 1 as Nurse Lucas

发布者:吴春英发布时间:2016-04-05浏览次数:245

Dialogue 1: Patient Registration

 

(Patient Maria Anderson is at the Emergency Department (ED or ER). Nurse Amy and Lucas are the registration clerks who help Ms. Anderson with registration. Locus is a new nurse graduated from nursing school last year. )

Amy: What’s your name, please?

Ms. Anderson: Maria Anderson.

Amy: And your date of birth?

Ms. Anderson: October 12th, 1975.

Amy: Ms. Anderson, why have you come to the Emergency Department?

Ms. Anderson: I have had back pain for about a week, and it’s getting worse.

Amy: Are you able to walk OK or do you need a wheelchair?

Ms. Anderson: No, I can walk OK. Thank you.

               Amy: Good. Ms. Anderson, please go over to the booth at the end of the information? That way she wouldn’t

                        have to come back.counter. A nurse will do a medical screening examination. When that is finished, come

                        back here and we will continue with your registration.

Ms. Anderson: Thanks.

(Ms. Anderson goes to the screening room)

              Lucas:                                                    

                Amy: Well … the law, I mean … in the American health system at least, when patients come to the ER they

                          must be screened medically before we can ask any questions about insurance.

             Lucas:                                                     

                Amy: Specifically, the US Emergency Medical Transfer and Active Labour Act (EMTALA), requires that

                         anyone requesting emergency care must receive a medical screening examination immediately to determine

                         whether an emergency medical condition exists. In other words, examination and treatment cannot be delayed

                         to inquire about methods of payment or insurance coverage. You can’t even ask about a patient’s citizenship

                         or legal status.

              Lucas:                                                    

Amy: The patients must be seen and stabilized medically, regardless of insurance. Only then can we ask about billing and insurance. Typically, the patient comes in and tells us his chief complaint. He is given a rapid screening examination, and only then is registration information and insurance information collected.

Lucas:

Amy: Ms. Anderson, have you been here as a patient?

Ms. Anderson: No, this is the first time I have come to this hospital.

               Amy: You are a new patient, so we have to do some paper work. Ms. Anderson, please fill out these forms.

(Nurse Amy gives a clipboard with about 8 pages of paper to Ms. Anderson for her to fill out.)

Ms. Anderson: Thank you.

               Amy: Please take a seat over there. Take your time. Just return the forms to the counter when you have

                        completed then.

Ms. Anderson: All right.

(Patient Ms. Anderson completes the admission forms. She gives the forms to nurse Amy.)

              Amy: Thank you, Ms. Anderson. Please take a seat. I’m going to put your information into the computer. I

                        may need to ask you some questions as I do this.

Ms. Anderson: OK.

(Nurse Amy begins entering information into the computer.)

             Amy: I’d like talk to you about methods of payment, all right? Do you have health insurance?

Ms. Anderson: Well, I don’t have health insurance.

              Amy: Ok … Um … How much is your monthly income?

Ms. Anderson: About $ 2000.

              Amy: You may meet the criteria to apply for Medicaid. Here are more forms for you to fill out.

Ms. Anderson: Do I fill them out now or take them home?

               Amy: Please fill them out now. Then we are going to help you apply for Medicaid.

 Ms. Anderson: All right. Let me fill out the forms.

(After filling out the forms, Ms. Anderson returns to the counter.)

                Amy: Ms. Anderson, I need to make a copy of your driver’s license.

  Ms. Anderson: Here you are.

                Amy: Thank you, Ms. Anderson. Please take a seat. I’m going to put your information into the computer.

 Ms. Anderson: Am I going to be covered for today?

                Amy: Yes, if you are approved for Medicaid. You will have one month from today to apply for a regular

                         Medicaid Card. During this month you can go to see your doctor. In certain cases, Medicaid may also

                         cover your dental work. If you need any help with the application, I can refer you to our social service

                         specialist, or you can apply at our local Social Services Office.

 Ms. Anderson: Yes, I need help, please.

(Nurse Amy gives Ms. Anderson a paper with the address and telephone number of the local Social Services Office.)

               Amy: Ms. Anderson, here is the address and Telephone numbers of the local Social Services Office. Please

                        call them to make an appointment to help you with the Medicaid application, OK?

 Ms. Anderson: Thank you.

 

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