How honest are you? - page 2
Venting on another thread got me thinking about this. In our ED, all the rooms including the trauma bays are private, with both curtains and doors that close. Because of this, it's very easy for... Read More
Nov 6, '11some ppl are just oblivious. Back when all our beds were semiprivate, we were in the process of coding bed 2 while bed 1 was raising caine that we weren't "paying attention to me and I'll be telling my husband about this!!" She was just that self-absorbed. In cases like that, it doesn't matter what you say or do. They believe they should be the most important.
Nov 6, '11If we receive a trauma or code that is going to suck all of our resources into a trauma bay (because we are a small facility, and such an event, which does happen often on nights, will bring other workups to a halt), we inform the waiting room and other patients to expect a delay. We just usually leave the explanation rather generic. Usually they're good with it ... those who aren't, never will be.
I had a patient recently who (somewhat adamantly) asked to see the ACNP who was her provider for the visit because she was "ready to leave," and I explained that I'd be happy to pull her IV and let her walk because we can't force her to stay, but that her provider was busy putting a tube down someone's throat so they could breathe. She apologized and waited patiently. Really, she was more concerned about getting her kids home to put some food in them, so I brought them a snack and some juice, and they were happy campers. Sometimes it's a simple thing that can make the difference, and I don't mind doing that at all.
Nov 6, '11I do not offer any more than a generic explanation that patients are seen in order of medical priority. Occasionally I pull out my old joke, "you don't want to be the patient we're rushing to, because it means you might be dying." When I'm able to use that, it is generally effective in at least ending the toe tapping, standing in the hallway with arms crossed behavior. I offer to bring another chair, and place it in the room facing the patient, not the hallway.
I also utilize the electronic tracking board to rein in the "we've been waiting for hours" complaint -- if gentle reassurance doesn't work, I can refresh their memory that they first crossed the threshhold of the ED 38 minutes ago.
Nov 7, '11edited because I responded to the wrong thread! lol
I am usually very honest..." ER's go by the acuity of the patient, not how long you've been waiting. The people who are trying to die get seen first."
I sometimes will add, "I am not saying you do NOT need to be seen...it's just there are some patients who must be seen quickly/first because of how sick they are."
I also get that some people will never be happy no matter what. I'm ok with that.Last edit by TeresaEDRN06 on Nov 7, '11
Nov 7, '11Yes, I've used the "It's actually a *good* thing you don't see doctors and nurses hovering over you right now" one on several occasions. It does help get the point across in a humorous way.
Funny, when I first thought of it years ago, I thought it was something I had thought of myself! Come to find out, it's not original at all!
Nov 7, '11The ones who are complaining the loudest are usually the ones who have no business being in the ER for their non-emergency. I remind them that they are free to leave at anytime and to "just sign here, please." Our ER is too busy and too crowded for me to even waste my time trying to point out what is plainly obvious to anyone who's head is not firmly implanted into their own ass.
Nov 7, '11I'm not in ED but I think this is an issue that's hospital wide so I'm butting my med-specialty head in
I, too, explain to patients who are unhappy about waiting (for radiology, surgery, medical review) that this is a good, if frustrating thing: "The best thing about being here is that you've got the best staff looking after you. The worst is that we've got some of the sickest patients in the state, and they'll die if they don't go first. If you're ever told you're going for a test and they take you straight away, either we're quieter than I've ever known, or you're really not well. I hope you always have a wait!" It usually gets a smile.
And when patients complain about a long wait, especailly for an unvital thing, and the delay was something critical elsewhere, I'll start with "I'm sorry, we've got a very unwell patient." But I've gone as far as "There's someone who's trying to die on the other side and your nurse is doing CPR. I'm sorry you've had to wait but their life comes first."
Nov 7, '11Having been to the ED multiple times in the past 6 months for myself, and once for DH's car wreck. I don't mind waiting. Our local ED is good about announcing wait times.
Once when being I was being seen, myself and 4 other pts got called back at once. We were called back down the "exit" door versus the entrance. You could see security cordoning off the hallway, and hear the most heart wrenching wails. A middle aged women was kneeling in the hallway clawing at her chest sobbing in agony, and if she could have physically ripped her heart from her chest to stop the pain, I believe she would have.
I knew, without being told, that it was her child that died. I don't know how, I just had that feeling.
It's amazing everyones different reactions.
DH just gripped my shoulder, and told the nurse he would push my w/c for her. However, from then on, he held my hand, stroked my hair, as if to reassure himself I wasn't leaving him.
One of the pts being wheeled back just griped and complained about the wait, and about the long walk to the rooms. Another asked what had happened, and his wife yelled at him for rubbernecking.
The resident who examined me, remembered me from his internship, and was all apologetic, he said there was a traumatic code.
Most of the staff were very very kind. From the way they treated me, you would have had no clue that just a few short hours before there was a traumatic code brought in by helicopter, a young man, worked on frantically for over an hour, that didn't make it.
I didn't look up the details or his name in the news, I felt like just seeing his mother in her moment of grief I was intruding on something private that I had no right to. This time I wasn't a nurse, I was just a pt. I already intruded enough.
The staff didn't have to be honest with me, but they did. It was well apparent. I don't know if it was professional courtesy because the doctor knew me.
I don't work the ED, but I have told pt's that I or a coworker have had an emergency with a different pt and that is why meds or treatments are late. Sometimes it helps, sometimes it doesn't. I think it depends on the pt.
Nov 7, '11I'm not normally too affected by posts but your description of that poor woman's grief, and the responses of your husband and the other patients, mean my keyboard's blurry.
Nov 7, '11Quote from talaxandraI think the woman who yelled at her husband...she wasn't yelling at him to be mean, I think it was to protect the mother who lost her son. It's the same feeling I have about not wanting to look up any news reports about that day. It was gut wrenching.I'm not normally too affected by posts but your description of that poor woman's grief, and the responses of your husband and the other patients, mean my keyboard's blurry.
Nov 7, '11I wasn't calling him mean, I meant that my keyboard was blurry as a result of having tears in my eyes.
Nov 7, '11Quote from talaxandraOh, I understand completely...I just reread my post and wanted to clarify. Sometimes I wish I could be as elegant as some of the other posters when it comes to phrasing things, unfortunately I am not. For me it is a struggle to put down in words a scene I wish to convey, that is so poignant yet I feel important to share. I often feel I don't do it justice in my attempt to find the right words.I wasn't calling him mean, I meant that my keyboard was blurry as a result of having tears in my eyes.
Nov 7, '11Quote from maelstrom143it's interesting, isn't it, that the daughter who really needed you was grateful and apologetic. someone who just wants more ice for their soda will be neither grateful nor apologetic.i have been very lucky (but then again, i have not had too many years experience yet) because most of my patients are very understanding and willing to deal w/a little wait time since when their turn comes i will strive to give them as much attention as i give the other patients.
one time i had a patient start crashing and we took an hour to stabilize him...we finally managed it. i turn to see a family member of a patient across the way at the door hesitating. i moved toward her and asked what was wrong. she stated, "something is not right with mom...she just lays there and has stopped talking." this was an acute cva we had admitted earlier.
well, my patient was now stable and good to go, so i let the charge nurse know i was going to check on my other lady. i walk into the room, lady turns to look at me...and proceeds to seize. later on it was determined she had also had another stroke! daughter was right to come get me, but when i first saw her at the door, for a split second i was annoyed...lol. i am so glad it only lasted for that split second. thankfully, rapid response was still across the way.
oh, and i forgot to mention: the daughter was very grateful and kept apologizing for coming to get me.