Are there doctors on duty in the ER? - page 2

Non medically fragile adult woman in her mid forties with mother and grandmother in tow, c/o nausea and body aches x5 days. Previously diagnosed with "the flu or something" (actually viral gastroenteritis, according to the... Read More

  1. 2
    unquestionably, ed crowding is one of the most visible problems hospital administrators face, and it's also a fairly expensive one. however, most hospitals have been hesitant to address it, in part because federal law requires doctors to treat anyone who turns up at the ed. consequently, a small fraction of people who visit ed each year account for a huge percentage of the costs in emergency care. with that said, this is true of healthcare in general and it's known colloquially as frequent fliers, these individuals visit ed repeatedly throughout the year; often because they're chronically ill, uninsured, alone, or a combination of all three.
    BCgradnurse and Esme12 like this.

    Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  2. 1
    This is why I don't work ER. I have a way of being too blunt, and I don't like to handle the PITA ones. I took my one-year old granddaughter to the ER due to severe dehydration and diarrhea. This was our third visit to the ER in a week. The first ER said just give her some pedialyte (kinda hard when she is too sick to drink it.) The second one gave her a 250 cc saline bolus and sent us home. You all know how quickly a baby can dehydrate! She was very lethargic and not taking anything at all by mouth. Constant diarrhea. While we sat in the waiting room on our 3rd ER visit, a woman about 50ish was talking, laughing and having a good time with the 2 women who came with her. When they called us back, this woman became livid and claimed her pain was a "12." Another woman with a little child with her started World War Three, just because we were called back first. The nurse's time was completely taken up, with trying to calm everyone down. I just don't want to deal with that kind of drama.
    ~*Stargazer*~ likes this.
  3. 3
    I ended up being in charge last night, with 2 floats and a FULL ED, as well as my nursing student. SIGH. After 2300, my triage nurse was going home, so I got to do that as well. At 2305, I went out to the WR, introduced myself, and apologized to everyone. I then went on to explain that every bed, as well as hallway space was filled, and that the ambulances were coming in frequently. I explained how we had to treat the sickest people first, and that they were WELCOME to stay and be treated, but that they were probably looking at a few hours wait time. Amazingly when they heard that, more than half decided that they weren't "That sick" and LWBS> Amazing- they are CURED!!! People make me crazy.
    LalaJJB, wooh, and SHGR like this.
  4. 3
    I don't work in the ER, but this reminds me of a patient on the floor (a 21 yo admitted with a migraine) whose mother complained about everything. She went so far as to complain that her daughter wasn't the first one seen on rounds because she assumed that "they'd start with the sickest patient." Um yeah... they did... the sickest patient would be the child with Marfan syndrome s/p CVA on a heparin drip whose room is directly across from the nurses' station. The fact that your kid is in the room furthest away should give you a clue about how "sick" she is.

    The problem is everyone thinks their problem should be the everyone's priority. The first time I ever got fired from taking care of a patient was because I took too long to bring the mother more water for his G-tube (which she could have helped herself to from the kitchen) because I was busy dealing with my other patient... a vomiting baby with a venous bicarb of 9 getting continuous and bolus bicarb infusions needing levels checked something like q 2hr. I once got yelled at by a father for explaining how radiologists prioritize MRIs... his child needed one but it wasn't going to impact his treatment in the least and he felt the need to tell me that he didn't care if another child had been admitted with newly diagnosed cancer overnight and needed a stat MRI to begin treatment, his son's should come first.
    VICEDRN, wooh, and SHGR like this.
  5. 6
    Quote from shoegalRN
    I hate it when we are coding someone, or have a trauma going on that has taken a turn for the worse, and all the other pts SEE the doctors and nurses running towards a certain room and this is the time they want to ACT OUT!

    And granted, they have been waiting patiently for the last 4+ hours without any complaint, but the moment the attention is not on them, they want to loudly complain about the wait.

    I had a pt come in because her toenail was about to fall off, not her toe being broken, or her foot being broken, her freaking toenail was ABOUT to fall off and we were coding someone at the time. When I finally got to her room, I apologized for the delay, explained that I was tied up with a very deathly ill patient and the doctor will be in shortly. Her 20 something daughter had the nerves to say "there is not any other doctors in the ER? Everybody HAS to work on that one person". I looked at her in the eye and said "yes, that patient is actively dying right now. Their family is outside the room and is not doing well right now, your mother is here for a broken toenail, God forbid if your mother was deathly ill, you would WANT all of us to work on her and save her, right? And how would you feel if another family would be questioning our decision because they had to wait to be seen for a broken toenail, but yet, still breathing, walking and talking? You wouldn't like that now, would you?"

    She then tried to attempt to argue why her mother was more critical than the dying patient. I told her I'm not gonna argue with her and politely had security escort her out the hospital.

    I am waiting for the day that a family member of a trauma/coding pt hears another patient complaining about the wait and then says something like "it takes everybody to work on that one patient" and that family member punches them.
    In my many years in the nursing profession and my many years spent in critical care/emergency medicine.....I have witnessed one family member cold cock the whining family and I had an all out brawl in the waiting room when the family of the coding child overheard the complaints and snide remarks of the waiting family.

    It's really hard to put a stop to the behind wiping that was occurring to the whining jerks......Sigh, but I had to...

    I have found that in this present instant gratification society....instant text messages, instant e-mails, instant access to news/events. That people get really annoyed if they can't find you immediately. They want instant cures, instant treatment, instant satisfaction. There was something to the meaning good tings come to those who wait.... but no one wants to wait anymore. Everyone is wound up in their own little world......at the end of their hands (in more ways than one...) Sorry I regressed.........that they have lost the ability of compassion, the art of empathy, the class of tact, and the humanity of manners.

    I have truly lost patience, right to the face of the offender, but a few times in my career because I usually don't deem them worthy of my time and energy. One Time was this crazy family that came into the trauma room while we were coding a young girl from cheering the football game from anaphylaxis and wanted to know if any one was going to get them something to drink and did we know THEY were waiting for 20 mins. I turned and in one fell swoop removed this jerk from the room, pointed him to the water fountain and told him I'd have him removed from the premises by the police if he dared enter that room again or opened his mouth just one more time. I think he knew I meant business because he shut up and sat down.

    In the ED you deal with the general public and it has it downsides. I always consider the source and that they aren't worth the words spoken from my mouth.
    VICEDRN, NO50FRANNY, Altra, and 3 others like this.
  6. 7
    Esme... I was just talking to a friend about the whole "instant gratification" culture that exists in this day and age. I think it's a lot of what's wrong with the world... people don't know how to wait because they don't have to. Think about even something simple like wanting to get a song... a kid today will just take out his iPhone and download it in about 5 seconds. In my day, if you wanted a song, you found a blank cassette tape, put it in your stereo and you waited. And when that song finally came on the radio, you were ready to push the record button. And there was gratification in your hard work.
  7. 8
    several years ago, about an hour before we expected four other couples for dinner, i was cutting veggies and the knife slipped and cut the space between my thumb and index finger. despite having applied both pressure and ice, it absolutely would not stop bleeding or even slow down much. so right before our friends were due, i walked to the hospital which was right around the corner.

    it was a zoo! i checked in, they gave me a fresh icebag and i went to the waiting room. almost immediately, some irate middle-aged woman demanded to know just why the triage nurse had "treated me like a real human being" while she had been so "hostile" with her.
    she had a severe stomach pain after all... uh... because i didn't swear at her, maybe? the woman had been right ahead of me.

    another ambulance rolled in with a dying elderly woman and, after the initial exam, her family was escorted back. the waiting room
    people were outraged and i tried to explain why she had gone ahead of us and why her family was rushed back. the mother of a fussy
    toddler said she thought all kids should be seen first no matter what was wrong. sorry, but it doesn't work that way.

    another ambulance with an unconscious tiny baby they were working on. one woman was upset because i got myself more ice and another icebag. i was waved back to the ice machine when they saw me coming that direction. i explained again about the sickest
    being seen first. one man was just sure i was bleeding to death and another that i would surely infect them all with aids. shouldn't she be put somewhere safer?

    i had been told that i would be next when a mom arrived with a screaming shrieking toddler. when they came to get me, i suggested
    that they take them next. soon, it was my turn, and after an exam, cleaning up, and some steri strips, i was on my way home.

    yikes! er nursing should come with combat pay!
  8. 5
    A few years back I was working as an ER tech. It was a tough night, lobby full, ER full, pts in hallways and to make matters worse we has three codes running--one patient was a toddler. I was literally running in the hallway back from the pharmacy with a drug needed for the pedi code a woman got in my path. I stepped around her and said I'd return in a minute as NO question was more important that trying to save the life of an actively dying innocent baby. (I was asked to run to pick op the meds as I wasn't assigned to the rescus rooms but the main ER and all the docs were handling the codes.) I finished my task and since I wasn't needed went back.


    The woman who was now sarcastically tapping her foot with a scowl on her face. She wasn't a patient or even the relative of a patient. Her friend was there for a chronic back pain that for whatever reason was declared an emergency. The patient was waiting patiently as he had enough common sense when he saw staff running and heard "code blue" called 3x in a half hour. He didn't even rate his pain highere than a 5

    Now normal human beings have sme compassion t hey may not care too much when it is a 95yo crashing but if told a child is critical they usually step aside realizing tht their crisis is not on the same level as that of the child and family.

    Not this chick. She wanted a doc to come see the patient right away. She had some not s nice things to say about me and the dying child. She was a large, intimidating woman and I am guessing most people just give in to her. No logic worked (she had gotten so loud that security was approaching) I just looked for her and simply smiled and said "I'm sorry your feel that way and walked off to do my job. ".

    When it was determined that she wasn't even a relative and thus has no legitimate business on the property. She was escorted out with local PD on scene if she decided to try and re-enter.

    Latero the guard came up to me (and after wrote a really nice complimentary letter to my DoN) and said he was impressed how well I kept my cool and professionalism. He said when she started to raise her hand as I turned around (I didnt see that) he was ready to knock her out on my and the patient's behalf
    Last edit by JustBeachyNurse on Apr 14, '12
    Esme12, Epic_RN, SHGR, and 2 others like this.
  9. 2
    Quote from KelRN215
    I once got yelled at by a father for explaining how radiologists prioritize MRIs... his child needed one but it wasn't going to impact his treatment in the least and he felt the need to tell me that he didn't care if another child had been admitted with newly diagnosed cancer overnight and needed a stat MRI to begin treatment, his son's should come first.
    We had a woman on the floor screaming that we should get the surgeon to SCRUB OUT OF SURGERY to come see her kid for whatever non-emergent issue she had decided he now had.
    People are just selfish. This is one of the many reasons I don't work ED. I have a hard enough time keeping my mouth shut when parents are whining that they haven't been discharged yet or that we aren't getting them 24 hour in home nursing care just because their kid has a G-tube. I want to take them to one of our PICUs and say, "Your kid could be this bad off, be thankful and shut the [bad word] up."
    Unless I'm in charge, I've only got my little group to deal with. If I ever got stuck in triage, I'd be initiating, "Smack family member upside the head" long before I initiated any labwork or IVs or boluses, etc...
    KelRN215 and sharpeimom like this.
  10. 4
    Quote from wooh
    We had a woman on the floor screaming that we should get the surgeon to SCRUB OUT OF SURGERY to come see her kid for whatever non-emergent issue she had decided he now had.
    People are just selfish. This is one of the many reasons I don't work ED. I have a hard enough time keeping my mouth shut when parents are whining that they haven't been discharged yet or that we aren't getting them 24 hour in home nursing care just because their kid has a G-tube. I want to take them to one of our PICUs and say, "Your kid could be this bad off, be thankful and shut the [bad word] up."
    Unless I'm in charge, I've only got my little group to deal with. If I ever got stuck in triage, I'd be initiating, "Smack family member upside the head" long before I initiated any labwork or IVs or boluses, etc...
    It's always the ones who don't have an actual problem who are the most demanding too... have you noticed that?


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

A Big Thank You To Our Sponsors
Top