Another triage vent thread

Altra, BSN, RN · Jul 10, 2007

I totally hear you on this ...

You have to try to keep a sense of humor. I've heard the joke that, some days, instead of treatment rooms what you really need in the ED is several candy dishes - one filled with Tylenol, one filled with Vicodin, and one filled with work excuses.

Many things that bring people to the ED can be lumped under my own personal nursing dx of "Inability to Cope."

BTW, use of the ED as primary care in the USA is frequently blamed on lack of available/affordable health insurance. Interesting to hear that this occurs in Australia too.

Keep at it ... vent away when necessary.

biker nurse · Jul 10, 2007

NO WALMART PAYS BETTER!! Serioulsy, we all have bad days, and as my adopted brother says, StUPID PEOPLE!! :banghead:

bill4745, RN · Jul 10, 2007

At least once a shift I repeat to myself: "If it wasn't for stupid people, half of us would be unemployed".

purple1953reading · Jul 10, 2007

OF course the ER is abused, as they don't ask for money up front, many times there is no open pharmacy, so for at least a few doses,meds are supplied free, you don't need an appt. , you won't have to wait for weeks, etc. etc. In addition, the dr. doesn't know you, unless you are a ff. The new director of our ER, is actually mean, rude to patients that are not trauma, cardiac, etc. The ER also gets all the patients that the docs are tired ofdealing with. Nurses do feelabused in this situation. IT never fails to amaze me when 7 family members are eating Mc donalds, and playing games, switchingchannels on the tv, etc. and they don't care if they have to wait for 2 hours or more, it is like a social occasion.

CritterLover, BSN, RN · Jul 10, 2007

i had a group of three friends check in last night for relativly minor complaints (minor knee pain, no limp; minor back pain; "spider bite")... :confused: ....isn't that how we all want to spend an evening out with friends?

funny thing.....i think i ruined their plans for an evening out together, because they didn't all get to stay together. the back pain went to fast track, which has a separate waiting room. the knee pain couldn't because she also (once in the triage chair) had some vague abdominal pain complaints. and the "spider bite" got triaged too late to go to fast track.

it is interesting to see that this kind of stuff happens in australia, too. i'm guessing that it can take a while to get in to see a pcp sometimes, so they come in because they don't want to wait? i see that with many of our medicaid patients. they can get an appointment, just not one that want to wait for (or are able to wait for). is there a "minor med" system in australia, like there is here for some insurances? i don't see nearly the number of er visits for minor complaints with patients of certain insurances (the ones that have minor meds linked to their insurance. mostly medicaid patients (which the minor meds in our area unfortunatly do not accept).

Djuna · Jul 10, 2007

Thanks for so many nice replies, it's really good to know there are people who actually understand what we go through as RNs.

CritterLover, I live in rural Australia in a town of around 25,000 people so there are no after hours Medical Centres like in the bigger cities. In addition there are few Drs who bulk bill, which means almost everyone has to pay for their Drs visits and then claim a certain proportion back from Medicare (Government Health Organisation). These factors mean our ED sees approximately 80% GP (or in US terms, PCP) cases.

In the larger cities you would wait up to 10 hours for a triage category 4 or 5 (minor stuff) and this acts as a deterrent for many people as they hate the waiting time, but in the rural area our waiting times are seldom longer than 3 hours at the most, so people get the benefit of a free Dr, some free meds, and a short wait.

Knoodsen · Jul 10, 2007

We are devo! They were right. It disturbs me, but I have come to appreciate the view of our culture that the ER provides. Seriously though, I have found great success with the advice I was given just prior to joining the Army as a 17 year-old. "remember, it's really all funny as hell. just make sure you are always seeing the humorous side of whatever is going on" It worked for me. The patients, family members, EMS folks, police officers, and, yes, even hospital staff can provide endless entertaiment. There's no reason why emergency nursing can't be enjoyable. We do important work. It is frustrating to see how the system operates and who is attracted to our ER's. It is an afront; our ER is sacred ground where lives are saved and suffering is alleviated. Who are these other people? .........trying to convince me they are a victim. I know exactly who the victims are around here. But, hey. Enjoy yourself. Learn and do your job well. Treat the patients the way you would want to be treated. Maintain your professional bearing. Take great pride in knowing that you provide a vital service to your community. Emergency nursing is extremely challenging, right? Be proud! We're the best. And, don't forget to laugh your butt off.

Knoodsen · Jul 10, 2007

oooh, I thought of a good one. CritterLover got me to thinking about those package deals we get. Thanks. I triaged two 18 year-olds in a row one night. (They were slick. They didn't come into the triage booth together so I would never realize they were partners.) Both of 'em had a toothache. They then sat, briefly, together in the waiting room. Then they went out to the parking lot and were in the process of stealing tools out of a pickup truck when they were apprehended by our police officer. This is a funny story. No, really. Here's why. Think about it. These two will no doubt reproduce. I'll be busting my hump soon caring for their kids. They'll be on Medicaid and present for every fever, belch, and fart. At least one of the baby mommies will come in OD'd at least once. (Who am I kidding. OD, OD, OD, siezure, OD, wants detox, OD, OD, etc........... both of 'em.) Think about these fellow's parents. Oh boy. We were lucky that night that neither of the perps came back to the ER. You know, one of those arrest-induced anxiety attacks, chest pain, whatever. The police bring him in from jail, in cuffs, and announce that he is not in custody. Thanks, Big Daddy. So, we call his mom thinking he's good to go home (i.e., leave the ER) with a "responsible adult". Turns out she's in an ER bed herself what with her being disabled from fybromyalgia. Okay. She's the one with the slurred speech that I saw heading toward the smoking area. I overheard her asking the ERMD when we stopped giving demoral. It's the only thing that works for her, you know. I call them "ER people". I can spot one anywhere and they crack me up.

rgroyer1RNBSN, BSN, RN · Jul 10, 2007

Oh yes I can to that is spot the er demerol people a mile away lol. I love they vaguely tell you they have a migraine then when you want to get an order for immetrex or ketoralac (toradol) but I call it by its generic so the druggies dont know what it is but if you even start to say immetrex or toradol they stop you and say there allergic to everything under the sun thats not a narcotic. Then they tell but the demerol does wonders for me. :nono:

ERRNTraveler, RN · Jul 10, 2007

haha- I just posted something very similar on the "Chronic Pain Patients pain in the Butt" thread in the General forum..... about the patients who magically develop more & more allergies when you go to give them something that isn't dilaudid or demerol..... I kind of got reamed for that one- the non-er nurses didn't seem to agree with me..... oh well.... :uhoh3:

teeituptom, BSN, RN · Jul 10, 2007

I dont get mad a triage for all these minor problems that dont belong in the ER I just smile and pass them through.

does it do any good getting mad---NO

dont let it stress you, messes up your golf game