Originally posted by haji:
You are right about the ER nurse often taking the brunt of the anger and demands of patients and their families.
Last night was a prime example for me.
EMS delivered a severely intoxicated 39 y/o female who was drinking because of a severe headache she had been experiencing all day. When she came in her initial GCS was 14. Within 5 minutes she had a grand mal seizure which knocked her GCS to 3, we intubated, attempted and got multiple IV lines into her and was doing things that all emergent patients get. (labs, foley, x-rays and in her case trying to stabilize her enough for trip to CT).
While this was going on there was another family in the room next to us, her 53 y/o MR daughter had swigged about 3-4 TBS of a pine oil, isopropyl alcohol mixture. She was in no distress, and had recieved copius amounts of water in accordance with the Poison Control Center recommendations. She was in a room where frequent visual observation could be made. As we were reasonably busy last night her wait time in the room had been about an hour, but she had been assessed by the physician and was being observed. After bringing our 39 y/o back from CT, still bagging..this mother walked up to me and started complaining how the nurses were spending their time with this patient when her daughter was not getting any atention. Was I polite to this mom, yes and no, I explained how her daughter was stable, breathing and in no imediate danger. I said I would be happy to look at her daughter again if she did not mind the if EMERGENT patient we were dealing with expired because she was not breathing on her on. At this point the mom stated that if she knew it would have taken this long she would have just stayed at home. Being the smartass I am, I naturally asked why she came in the first place then, and if she felt that way she could pack up her kids, sign out AMA and get out of our way. She went back to her room sulking. As I was transporting our subarachnoid bleed to ICU, a code blue was called overhead for the ER, EMS was bringing in a gentleman who was down for ~10 min prior to EMS and then had a 20 min transport time, we naturally proceeded with this patient rather than the pine oil girl. as EMS wheeled the guy into the trauma bay this mom asked "well, how long am I going to have to wait for something now?" This time I ignored her, was busy doing something else.
So, do people only think of themselves when in the ER....you better believe it. They have no idea of acuity levels, priorities or why they should not be there in the first place. What really burns me is the frequent fliers who need a pain med refill, or the ones who decide to walk out if they wait more then an hour or so. If it was bad enough to bring them in in the first place, why don't they stick around.
I realize that if it weren't for the clinic type of patient most ER's would close down, but why do the patients feel that their cold/cough/runny nose is on the same level as an acute asthma attack, an MI, or even a lacration. I have become the target of many irate patients lately, when we are busy I will triage and bring in patients not according to how long they have been waiting but by their acuity level, even the clinic types. This is a change at this hospital, it used to be first come, first served if not truely emergent.
Sorry for the long post, I just needed to vent where it may be understood.
BTW..I have no idea what happened to the girl who drank the pine oil and her mother. After our code expired, my priority was cleaning the room and the gentleman so I could allow his family some time alone with him, which I still considered more important than a demanding mom with a non-emergent daughter. She and her daughter were gone when I finished up with my other duties.