Odd ER visit - page 4

Well, my husbands Doc (actually his staff) told me to bring him to the ER. It's a SMALL hospital, and we get seen fairly quickly. The triage nurse asks me to wait in the waiting room while he talks... Read More

  1. by   inshallamiami
    Thanks to all who have replied. Venting here truly helped! I was so upset but I didn't want my feelings to effect my husbands care so I came to Allnurses to "let it out". Frankly I was surprised how strongly I reacted to the jerky er doc. I didn't use ANY of my people skills, or diplomatic skills to make the situation better. I just shut my mouth and tried to think.

    Eventually the patient representative or whatever called but I told her I was too upset to talk so I gave her no details. I did tell our reg dr about it ( an edited version) and he cryptically responded that the er doc is known to be "different" whatever that means!

    So I am working on dealing more effectively with my caregiver stress, listening more, saying less and trying to find the "happy" in everyday life! Thanks to all who posted, I appreciated being taken seriously. And please, don't fight among yourselves
  2. by   bwhiddon74
    I understand what you're talking about. I've been an ER nurse for ten years and I can't stand to see my co-workers having bad attitudes. Whether we believe the pt is sick or not is not our job. If the pt is in the ER, then treat them. If you (nurse, docs, etc) don't believe they have a valid reason to be there then tell them respectfully. For instance, I've heard doctors tell the pt that " in the future, this is something you may consider going to your doctor about." Or I've even told pts, "We can treat you tonight, but your doctor will be able to give you what you need better because he will keep close eyes on you and your health." The point is that we (nurses, docs, etc) are not judges, but caregivers. And if we don't care then we should be in another line of work.
  3. by   inshallamiami
    Quote from bwhiddon74
    I understand what you're talking about. I've been an ER nurse for ten years and I can't stand to see my co-workers having bad attitudes. Whether we believe the pt is sick or not is not our job. If the pt is in the ER, then treat them. If you (nurse, docs, etc) don't believe they have a valid reason to be there then tell them respectfully. For instance, I've heard doctors tell the pt that " in the future, this is something you may consider going to your doctor about." Or I've even told pts, "We can treat you tonight, but your doctor will be able to give you what you need better because he will keep close eyes on you and your health." The point is that we (nurses, docs, etc) are not judges, but caregivers. And if we don't care then we should be in another line of work.
    Our dr TOLD us to go to ER! In fact TWO drs told us to go to ER! Pcp and gi doc. That is partly why I was upset, I wanted to have an office visit, and not necessarily right away. And I explained the problem in depth to the staff of both my doctors and it was midweek around 10 am. Frankly it is possible we WERE turfed but that is not my fault so no lecture is necessary ( to me, maybe the docs could use one)

    Let's face it, Doctors, like all people, come in different varieties. Some are very capable, some are jerks, and some are both.
    Last edit by inshallamiami on Jul 20, '13
  4. by   Altra
    ..........
    Last edit by Altra on Jul 20, '13
  5. by   SweetMelissaRN
    Quote from inshallamiami

    Our dr TOLD us to go to ER! In fact TWO drs told us to go to ER! Pcp and gi doc. That is partly why I was upset, I wanted to have an office visit, and not necessarily right away. And I explained the problem in depth to the staff of both my doctors and it was midweek around 10 am. Frankly it is possible we WERE turfed but that is not my fault so no lecture is necessary ( to me, maybe the docs could use one)

    Let's face it, Doctors, like all people, come in different varieties. Some are very capable, some are jerks, and some are both.
    I don't think bwhiddon74 was trying to lecture you or directing the "can see your doctor for this" comment to you, but was maybe generalizing. Everyone knows chest pain unrelieved by 3 nitro with a prior history of MI should immediately go to the emergency room. Those caregivers were out of line. Plain and simple.
  6. by   NO50FRANNY
    A few years ago, early evening, I discharged myself from my hospital in the city following an umbilical hernia repair that morning. I was adamant that my pain could be managed at home with oral analgesia and was determined to be at my mothers' place and not burden the ward with my presence any longer than absolutely necessary. The charge nurse tried to talk me out of it, but I did it anyway - mum dutifully drove me the 3 hours back to her place. It was a very foolish thing to do and around 2am I was battling. At the time, I was an oncology nurse and had no idea how I was about to be perceived by the staff at the regional hospital ER. I knew I needed narcotics, so mum took me to the local hospital. I was lucky my physiological signs reflected the pain I was in and I'm fairly certain if I didn't have a surgical wound I wouldn't have been given anything. It was only many years later, after becoming an ER nurse and dealing with rubbish for 7 years that I understand the appalling attitude I was subjected to, I won't go into it but it wasn't pleasant. At the time I didn't realise that all the things I was saying made everything worse. I was from out of town, I told them that pethidine IM had worked really well post op, I told them that I had taken tylenol, digesic and tramadol and nothing had worked... I was distressed because I had put up with the pain for so long and it would have looked like I had an enabling mother. She was getting angry because the nurses were ignoring me- I needed a pan, I couldn't get off the trolley, I was crying and my bladder was full (after 2 stat bags of saline). Possibly the most humiliating experience of my life. I filled that pan... I know my fellow ER nurses reading this are cringeing....

    What makes me so sad, is that I know why ER nurses can become unkind, why so often I hear stories like the OP. The malingerers and non-genuine patients, crippled, understaffed, overcrowded and overrun Emergency departments, tiresome complaints that are truly non-urgent, flagrant abuse of EMERGENCY services. People complaining to you about how long they've waited with a minor complaint not seconds after you and your team have given up resuscitating someone. It upsets me that genuine patients become the victims and I agree that there is absolutely no excuse for rudeness and poor attitude, but sledging ER nurses isn't going to fix it. I've watched some of the most caring and devoted nurses lose their cool with patients on occasion and assigning blame doesn't get us anywhere. You did well not to lose your cool, I didn't lose mine completely thanks to some IV MS04 but I've never forgotten that night. Give appropriate feedback to the facility, and vent on AN- I wish I had. Hope your hubby is ok
  7. by   Anna Flaxis
    Since syncope can have life threatening causes, plus he is on chemotherapy, it's really possible that his PCP does not have the resources readily at hand nor the clinical expertise to rapidly diagnose and treat life threats, and so instructing him to present to the ED for evaluation was the safest course.

    Regardless of whether or not he was turfed or whether or not his complaint was appropriate for an ED visit, there isn't a valid excuse for treating him poorly that I can think of.

    From the information provided, it does sound like morale at this ED is low, which can be for a lot of different reasons. When staff morale is low, it can be easy to take it out on the patients. That's not meant to excuse it, but just to point out that ED staff are only human.

    I'm sorry you had a bad experience in the ED. At least you had that one good nurse that you liked. Maybe instead of complaining about the things that were upsetting, you could write a letter to the ED thanking that nurse.
  8. by   green34
    Quote from inshallamiami
    I don't know just going by a big white board and what I could see. I actually I didn't mind the wait at all, I brought iPad and books etc. my complaint is not the wait, I didn't feel ignored, just felt that when they DO interact not to be nasty. Is that too much to ask? I didn't need pillows or food or accommodation. And I didn't need sarcasm and being caught in this turf war. And again our nurse was great! Just the Snotty triage and ***** ER doc
    An ER dept can clear out really fast. It also does not rule out the possibility of someone being seriously sick in one of the rooms. If you are a small hospital, they could have had a patient who was crashing and they were busy stablizing to transport him to a larger hospital. I worked in a rural hospital and we would often have serious patients that we would need to transfer out to another ER.

    I don't get all the people siding with the ER. If you're mad because a doctor consistently turfs his patients to the ER, that has nothing to do with the patient who is just following recommendations from his physician. Yes, syncope is a frustrating complaint, but generally you can rule out serious causes fairly quickly, hydrate and fix electrolytes and such to make them feel better, and refer for further work up as an outpatient if necessary. That is all the ER needs to do. I'm sure the syncope is still more frustrating to the patient. We all have busy days, but being rude doesn't make your day any less busy.
    I'm just inherently skeptical of what constitutes as rude. A lot of patients feel like the staff is rude when they are not. Also, when a family member or patient is stressed, anything can seem like an attack. What could be grilling could be the doctor trying to make sure that the story is consistent and not a "well, I don't want to make a big deal of it so I will say no to passing out." Or "I am not sure so I probably didn't pass out so I'll say no." Did your husband state that he passed out to the doctor just the triage nurse? I try to put down everything the patient tells me in the triage notes so in case they forget to tell the doctor something.

    This has saved me time and time again, especially if the story changes between triage and the time back to the room.

    Well sure, you probably are a nice person and wow that the complaint is frivolous, but this doc doesn't seem to be a nice person and my complaint is a little more serious than salad dressing. Of course he may have been having a bad day but I can't take a chance with my hubbies care and assume the doc will thoughtfully consider my complaint and aim to do better
    Another consideration. Were you giving them an attitude when you did not mean to? A lot of people give off an attitude when they are stressed. Some people can take that personally.
    That way things can be resolved faster. And be careful about taking out your family member's IV's--you've stated that you were happy with your nurse. What if another IV med was ordered and now there is no access? Your nurse would be taking the fall for that one, not the doc.
    Also, did you really take out your husband's IV? That should have been a big no right there. No offense, but why would you do that? Yes you are a nurse but you are not employed there. They do not know that you are a nurse. If you make that a habit, they may begin asking you to remain in the waiting room if he is to be seen there because you become a liability. Yes you are a "nurse," but you are not working. They also do not know you are truly an RN.
  9. by   Altra
    Quote from green34
    What could be grilling could be the doctor trying to make sure that the story is consistent and not a "well, I don't want to make a big deal of it so I will say no to passing out." Or "I am not sure so I probably didn't pass out so I'll say no." Did your husband state that he passed out to the doctor just the triage nurse? I try to put down everything the patient tells me in the triage notes so in case they forget to tell the doctor something.

    This has saved me time and time again, especially if the story changes between triage and the time back to the room.
    Bingo.

    Feeling dizzy/woozy/near-syncopal vs. actual loss of consciousness is a key assessment point, and in the absence of anything else that emerged during the workup -- most likely the key decision point for admission vs. discharge.
  10. by   inshallamiami
    Quote from green34
    An ER dept can clear out really fast. It also does not rule out the possibility of someone being seriously sick in one of the rooms. If you are a small hospital, they could have had a patient who was crashing and they were busy stablizing to transport him to a larger hospital. I worked in a rural hospital and we would often have serious patients that we would need to transfer out to another ER.

    I'm just inherently skeptical of what constitutes as rude. A lot of patients feel like the staff is rude when they are not. Also, when a family member or patient is stressed, anything can seem like an attack. What could be grilling could be the doctor trying to make sure that the story is consistent and not a "well, I don't want to make a big deal of it so I will say no to passing out." Or "I am not sure so I probably didn't pass out so I'll say no." Did your husband state that he passed out to the doctor just the triage nurse? I try to put down everything the patient tells me in the triage notes so in case they forget to tell the doctor something.

    This has saved me time and time again, especially if the story changes between triage and the time back to the room.

    Another consideration. Were you giving them an attitude when you did not mean to? A lot of people give off an attitude when they are stressed. Some people can take that personally.
    Also, did you really take out your husband's IV? That should have been a big no right there. No offense, but why would you do that? Yes you are a nurse but you are not employed there. They do not know that you are a nurse. If you make that a habit, they may begin asking you to remain in the waiting room if he is to be seen there because you become a liability. Yes you are a "nurse," but you are not working. They also do not know you are truly an RN.
    The er doc initiated his interaction with us by repeatedly asking us if we spoke with our specialist . I said I called and explained situation to staff. They spoke to specialist and relayed info. The er doc asked this question at least Six different ways so yes it did seem like a grilling like he didn't believe us like we were tring to abuse the er system

    Then when my husband had difficulty explaining what happened, to the Er docs satisfaction , the doc was obviously annoyed. And was sarcastic . I'm sorry my husband couldnt explain better. But when someone states that his vision became tunneled then all black and as this happens he lowers himself to the ground in a shower that is very small and that he lost track of time. That sounds like losing consciousness to me but my husband was alone and can't remember any more than that. It's not like he was in a room of people, sighed , clasped his hand to his head then Swan dived to the ground while I patted his hands in dismay.

    And to add to it all. The er doc eventually comes and says your doc said that if you passed out it has nothing to do with your new meds/chemo so u must be admitted but if u didnt lose consciousness then i wll discharge you and u have to stop your meds and chemo. And you have to decide now cuz i have four ambulances coming in soon.

    We felt overwhelmed. I said give me a moment. Doc left. We talked. Decided The whole idea (albeit the doctors idea) was becoming a clusterf$@$ Let's go home. I told the nurse will take curtain no 2 ( didn't really say that). She told the er doc . I'm upset , dc hep lock ( at this point I don't give a damn) wait for our meaningless dc papers and go home. The nice er nurse did apologize although we did not complain to her. Guess it just took one look at my face

    And to all you er nurses and docs I am SO SORRY that my husbands complaint is not exciting. I m sorry he didn't have a golf club stuck thru his brain or swallowed a live lizard or something. He was worried we called our doc. He said go to er period. No need to treat us like criminals

    I didn't have an attitude when we walked in. I have one now though
  11. by   Anna Flaxis
    The more I read, the more I agree this truly was an odd ER visit. The evaluation of syncope is pretty straightforward.

    This part is especially confusing:

    The er doc eventually comes and says your doc said that if you passed out it has nothing to do with your new meds/chemo so u must be admitted but if u didnt lose consciousness then i wll discharge you and u have to stop your meds and chemo.
    This makes zero sense to me. I don't blame you for feeling unsettled about this visit, if things are as you describe.

    It's true that there could have been things going on of which you were unaware, but that doesn't invalidate your experience of feeling mistreated. It's true that EDs can be like little worlds unto their own, where staff can be really unkind without meaning to be. Having worked in an outpatient capacity for the last year, I have seen how people have to bend over backwards while jumping through flaming hoops to get their needs met medically, and I am far less judgmental about how people utilize the ED. It's been an eye opener.
  12. by   inshallamiami
    Maybe I didn't describe it well. Er doc says he talked to our specialist who said if hubby DID pass out it wasn't due to new meds and chemo(hubby has a lot of side effects from both) and that he should be admitted to determine cause. But if he didnt pass out he should be discharged and see specialist as he would need to have his new meds possibly stopped thus stopping treatment. And there were four ambulances coming he so he can't deal with this much longer. ( our dr face to face maybe 3 mins). Note - doc not sure hubby passed out. Hubby could only repeat what happened re going black etc

    So "a pox on both your houses" we opted to go home. Saw our P C P. made appt with specialist.( which we wanted to do in the first place but were instructed to goto er by both)
    Last edit by inshallamiami on Jul 22, '13
  13. by   Altra
    Quote from inshallamiami
    Maybe I didn't describe it well. Er doc says he talked to our specialist who said if hubby DID pass out it wasn't due to new meds and chemo(hubby has a lot of side effects from both) and that he should be admitted to determine cause. But if he didnt pass out he should be discharged and see specialist as he would need to have his new meds possibly stopped thus stopping treatment. And there were four ambulances coming he so he can't deal with this much longer. ( our dr face to face maybe 3 mins). Note - doc not sure hubby passed out. Hubby could only repeat what happened re going black etc

    So "a pox on both your houses" we opted to go home. Saw our P C P. made appt with specialist.( which we wanted to do in the first place but were instructed to goto er by both)
    This was my thought -- that the crux of the matter was whether or not there had been an actual loss of consciousness.

close