Do you have an ED "greeter"?

[ItsThatJenGirl]

And if you do, what does the role entail?

I volunteer for a hospital, but up until this point they didn't allow volunteers in the ED. They are now developing the position and I get to be a part of it :)

Right now they want someone to help make sure patients are in the waiting room when it's their turn (apparently people wander off). That's all I really know so far.

If you have a volunteer greeter, what do they do? Or what do you wish they did?

Any input is appreciated!

[ItsThatJenGirl, CNA]

Oh no! My best advice for your first paragraph is to never reply in kind, that is the basic rule. Keep yourself emotionally separated from the words you hear spewing forth. This is such a great opportunity to practice skills that you will need to have well in hand as an RN. Look at yourself as a student of social pathology.

This next comment is not in regards to your responsibilities - but I'm curious whether these triaged patients who are going to billing are waiting in a backlog of patients that need rooms. If they are, that's one thing, but if they just by convention go to billing before going to the treatment area, that is a situation ripe for EMTALA violation. Personally I think it's an unfortunate set-up either way; I can almost guarantee you it isn't helping their satisfaction scores. Again, I know that's not on you - but hey, you can be informed and ready in case you have an opportunity for input!

I look forward to your next update!

Yeah, I killed them all with kindness. I know most people are in pain, frustrated, tired, etc so I tried to answer with empathy.

It's definitely a lack of beds situation. We grab them when they are waiting - for xray, blood work, etc. Their treatment is priority over any billing information we need - and they are free to refuse me as well.

[ItsThatJenGirl, CNA]

Ohh noooo! That stinks.

Just speaking from my own experience as an ED volunteer, I think things will get better. 90% of ED confrontations tend to fall into a discrete set of scenarios (I'm mad because this is taking so long, I'm mad because I feel ignored, I'm mad because I didn't get the pain pills I want, I'm mad because I'm NPO and I haven't eaten in 8 hours, etc.) As you practice, you'll figure out the best response to these inevitable uncomfortable situations with an internal script for the different common scenarios.

In my experience, many people in the ED just want to feel as though their frustrations are being validated. They feel sick, tired, and miserable, and want the ED staff to acknowledge and appreciate those feelings.

If I could sense that a patient's frustration was escalating, I usually used this script: "It sounds like you're feeling very frustrated/upset/ignored. Can you tell me more about it, and I'll see if there's anything I can do to resolve the issue?" Usually once people were able to express their frustrations and felt as though someone actually cared they would calm down, even if there was literally nothing I could do to improve the situation. (However, if you feel that your safety is being compromised, immediately remove yourself from the situation and get help; this probably goes without saying, but just wanted to throw it out there).

It might not always feel like it, but the work you're doing is important and valuable. Learning how to respond to these scenarios will be so advantageous when you start out as a new grad nurse; when I applied for new grad jobs I actually made the emotional maturity I learned from my ED experience a hallmark of my applications, and it was a big hit. Also, as you demonstrate your value to the ED staff, they may allow you to become more involved 'behind the scenes' as I described in my earlier post.

Best of luck! Keep us updated, and let us know if there's any way we can help. You've got this!

Thank you!! I appreciate the advice!

[JKL33]

I know most people are in pain, frustrated, tired, etc so I tried to answer with empathy.

Touche!

Sorry if I seemed callous. I'm actually a lover of triage - - but I have observed some distinctions over the years that formed the basis of my reply. :)

Carry on!

[ItsThatJenGirl, CNA]

Touche!

Sorry if I seemed callous. I'm actually a lover of triage - - but I have observed some distinctions over the years that formed the basis of my reply. :)

Carry on!

Oh no, you didn't come across as callous at all! I really appreciate your insight!

[JKL33]

Thanks for humoring my own paranoia with regard to my "social pathology" comment.

Honestly, kindness/empathy is the basic rule anyway!

[ItsThatJenGirl, CNA]

Thanks for humoring my own paranoia with regard to my "social pathology" comment.

Honestly, kindness/empathy is the basic rule anyway!

You're not wrong about lessons in social pathology though!

[Lunah, MSN, RN]

Yeah, I killed them all with kindness. I know most people are in pain, frustrated, tired, etc so I tried to answer with empathy.

It's definitely a lack of beds situation. We grab them when they are waiting - for xray, blood work, etc. Their treatment is priority over any billing information we need - and they are free to refuse me as well.

I was going to say kill them with kindness, without killing them for realz. Though you might want to! I am so sorry it was so rough. Spitting is no bueno and is actually considered to be battery. If you work in a state where battery of healthcare workers is a felony, well ... they need to think twice. Don't hesitate to keep yourself safe!!! *hugs*

[jdub6]

Spitting is no bueno and is actually considered to be battery. If you work in a state where battery of healthcare workers is a felony, well ... they need to think twice. Don't hesitate to keep yourself safe!!! *hugs*

You probably already know that spitting into the eye or mouth areas is also a body fluid exposure and should be reported immediately. And at the same time security should be called. Perhaps they can give you a panic button if you're going to be dealing with patients in areas where there may not be other staff.

If the waiting room is where youre assigned you'll definitely need to develop thick skin and scripts to address the common complaints-"why did he go first?" "how long do i have to wait?" "my primary doctor/sister/mother/wikipedia said i need xyz immediately-why am i still waiting?" "can you get me a sandwich?" "i came by ambulance, why am i out here?" "why is it taking so long? I've never waited this long before" "can't you just give him a bed to lay down while he waits?" "i need something for this pain right away" "i see that nurse just sitting there doing nothing..."

Some of those questions should be referred to nursing but it's okay you reiterate the rules after they've been told by triage who is aware of the patients concern/.

If the triage nurse knows about their pain and has told them they can't get meds until seen for example i think its fine for a volunteer to just reinforce the policy.

Sadly, it's vital that you also know how to respond to insults, threalts of complaints, demands for something that's not possible or not allowed, passive aggressive comments-especially when made to other patients-and threatd to leavee. Don't take anything personally and it helps me to have standard lines all ready for the nasty ones.