ER Pet Peeves

When you are lied to at triage. The chest pain at triage is now a rash that has been there for 3 weeks.

Stupid parents

My child is vomiting or will not eat, but is munching on cheetos as you weigh them.

The parents of a blue baby will wait patiently in line, but the parents of a scratch will go blistic if they have to wait longer then 15 minutes.

I work at a children's hospital. Infact it is called Children's Memorial hospital. That doesn't mean if you act like a child you should come here, especially when an adult hospital is less then two blocks away

When people call ahead to make an appointment. My child has a fever of 100 and I will be there in 15minutes can you put me on the wait list

Had another the other night where a guy brought his wife in by car, chased by the police. Turned out he had been driving at speeds over 80 mph and ran several redlights and sideswiped a parked <fortunately empty one> car. And he was intoxicated also. He ran into the ER demanding a WC for his wife. We go out and get his wife as the police are showing up. His wifes problem a small cut on her foot, nothing serious at all. The officers asked me if her condition was serious, I said of course it wasnt.
Needless to say he was arrested and cuffed and stuffed in the back of a squad car and their car was confiscated and towed in. His wife was crying and screaming that we had profiled him and we were predjudiced. That we should have saved her husband from arrest.
Morals of the story

1. I dont expect to be put on their Christmas List

Those 'calls for information'.... one night shift employee actually had the guts to say this (had worked there 15+ years).
Caller: "I have a _______ (fill in the blank - rash, lump, etc). Can you tell me what it is?
Triage: "Why don't you hold the phone up to it so I can see it?"
Caller: Silence. "Well, what do you think"?

One wishes one could say "I'm sorry, my x-ray vision doesn't reach to your location". "Your webcam isn't reaching my PC".

Another pet peeve: Having patients/family members go ballistic because the ambulance takes them to triage. "If I am in enough pain to call the ambulance (broken toe) I am urgent enough to have a room immediately!".
"I thought coming by ambulance meant you automatically get a room!" (cough, congestion x 3 days)
"I called the ambulance because when I called earlier you said there was a 4 hour waiting time. Why am I going to the waiting room?"
"If I knew you weren't going to give me a room, I'd have saved my money and driven myself!" (DUH!!)

1. Pts referred to the ED to be seen by a physician OTHER than the ED docs. "Well our doctor told us to come directly here and the surgeon would be waiting on us, and you're telling me you have a 6 hour wait?" Reply, "Why yes, this is Utopia Hospital and our doctors, surgeons, nurses, etc are all waiting around the last available bed for you with everything you need."

2. upon d/c the pt tells me that they can't take vicodin; only lortab works for their pain. reply, "Did you tell the doctor that?" of course they didn't . now the doctor is in intubating a sick pt, my charge nurse in breathing down my throat for a bed , the pt refuses to leave the room , press gainey tells me to do everything for the pt (even when they're low life, stupid individuals) , JCAHO tells us that the additional script pads are to be locked up and no one can find the key and it's gonna be about another 45 minutes before i can get the daggum script changed .

3. L&D: "this pt is how far along?"
Me: "15 weeks and 5 days."
L&D: "we only take pts who are 16 weeks with abd pain."
Me: "but they're 15 weeks and ......."
L&D: interrupting, "16 weeks with abd pain."
Me: "but...."
L&D: interrupting, "have a nice day."

4. the 650 pound lady placed in 180 degree trendelenburg STILL slides out the foot of the bed. (and my techs/CT staff wonder why i tie the head of the bed sheet?)

5. speaking of CT techs....
sending an outstanding pt with an outstanding supportive family to CT in outstanding fashion and comfort, only for them to return with the bed sheet wadded under them laying on exposed mattress, bed sheet thrown over them without thought, cattywompus in the bed like they were thrown over from the scanner.

6. walking a pt to a room from triage when they've waited 3 hours, get them undressed and as i'm approching the right shoulder with the white lead they ask, "can i go to the bathroom, i've got to pee."

1. Visitors who approach the front desk and say "My mother/wife/brother/sister/iguana is in the ER and I need to see them...then stare at you waiting for you to pull out your crystal ball and say "Ah yes, your eye color and strong noseline tell me you must be related to the patient in room 5, please go back and get in the way of the nurses along with the other 50 people who jumped the security door and are milling around uselessly"

2. Nurses who think that its possible to throw yourself in front of a stampede of drama queen family members jumping the security doors. Its YOUR patient, YOU tell them why they cant hang out there. Or get the security gaurd. (Yes i know he is 12yrs old and underpaid, but thats what hes there for)

3. Going outside for some fresh air and watching a new patient walk in upright and laughing with thier family/friends, only to come back inside and see them doubled over moaning about the wait time.

4. Computer Illiterate nurses who call the census desk because there is no tech support on the night shift. These are usually the same ones who think the paperwork on thier drugged-to-the-teeth-in-ER pt with a bellyache takes priority over the guy with the subarachnoid bleed and the coding NICU premie. Or maybe in general just people who dont know that at night there is ONE clerk for the whole of the hospital and barely have an idea of how their own job works let alone anyone elses.

5. Pts with supposed migraines laying in the dark #itching loudly on their cell phones about how long it takes to get a pain shot then insist "please, dont speak so loudly" when you ask them important questions.

6. Pts who think if they sneak out the backdoors we cannot charge them for their visit (even though we have thier name, address, social, cell number and name of their firstborne child) Because they never signed the paper giving permission to treat.

7. Pts who threaten to sue the hospital because their stitches are infected and it must be that "RSV/Avian Flu/MRSA/West nile/floccinoccinihilipilifacation" and not the fact they havnt bathed in a month.

8. Pts who come in with whatever the news says is "going around" this week and then actually get mad when you tell them its not West Nile, just a plain ol case of viral meningitis.

I could go on and on i think..lol But i think the thing thats gets us all through isnt the dozens of morons, but rather the few, the grateful, the truly ill....

my top 10 -
1. The person that got arrested for doing something illegal who now magically has chest pain or is suicidal and needs to come to the er.
2. The bum who spent all his SSDI on booze who now has no place to stay who is suicidal or has a new complaint when you try to discharge them for clearance of the prior one.
3. The drunk that PD doesnt want to do paperwork on and throw in detox who is now in my hallway for the ever popular emergent alcohol intox.
4. Baby - crying, enough said.
5. people putting bedpans in the commode - they usually explode onto the floor when the patient has filled them with something.
6. Having to sit through an ER meeting every month to learn about how bad of a job were doing and by the way you have a few more duties at the same pay rate for 4 years.
7. The ER doc who will look at anyone and tell you to do this and that on this patient - hello - can they read the assignment board?
8. The fact that there is an accessible vending machine in the ER lobby.
9. Pts that come in and need socks or diapers/formula/
10. The fact that everyone else you work with can get away with murder and you tow the line and get written up for so much as an unapproved abbreviation in the middle of a code!!!!!!!!!!!!!!!!!!

oh and the admissions rep that calls to tell you there is a toe injury outside - the patient was ever so thoughtful to make sure we knew they had cardiac history

How about - I need to eat because Im a diabetic - did anyone tell these 300 pound 5 foot people where alot of insulin resistance stems from?

Some of my Favorites:
"I take a little white pill for my blood" (don't you want to hand them the PDR and tell to call you when they find it!
The ventrillouquist- When you ask the pt. a question, his wife answers and you never see his lips move!
No, I don't know what your Doctor in (name the city across the country/ state) told you.
Walgreens and other Pharmacies have lots of things for what ails you.
The non-local family members who haven't seen Grandma for years, and demand you move Heaven and Earth to cure them. I guess they still want to be in the Will!
Emergency Department- Primary Care 24/7! Payment Optional!
Thanks for letting me vent. "And now, for something completely different!"

I'm gonna use that one!!!!!!!