Real ER vs TV ER

  1. Reading another post re defib use in the ER vs on TV made me think about all the other things that are factored in to add drama to TV ER shows. I think it would be interesting to see what are real ER nurses pet peeves about these shows- also to show some of the students/ non nurses who are considering ER what its really like. I admit I watch ER every Thursday for entertainment value, but I also like to pick it apart.

    Like when the ER docs wait outside for the ambulances coming in- okay I've never seen an ER doc step outside the ER doors for any patient, EVER. Nor do the nurses. Our ER docs don't see ANYONE (excluding codes in progress and trauma alerts) until they've been completely triaged by one of the nurses.

    I've also never seen any ER staff, MD or nurse, leave the unit to go check on or follow up on any pt. We may make an occasional call to the unit on an interesting case or really bad pt to see if they made it, but that's as far as it goes.

    I've never seen more than one ER doc care for a pt (excluding trauma alerts, where it's the trauma surgeon and one ER doc). Even if they're coding, there is only ONE ER doc in the room. (granted, I'm not at a teaching hospital- I'm sure its probably different)

    Add to the list..........
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  2. 32 Comments

  3. by   suzanne4
    When we have received a patch that one ambulance was bringing in two patients from an accident, always a nurse was there to meet the ambulance, and many times even a physician.....................Any helicopters arriving are met with a nurse many times, this will depend on your facility.
    If we had an unusual type of trauma come in, or any other unusual type of case, it wasn't unusual for the doc to do a follow-up on the patient. More for learning than anything else.

    With teaching hospitals, you may see three or four different doctors with one patient. And this isn't limited to trauma patients.

    As with anything else, it depends on the number of doctors that you having working per shift, time of day, acuity of the patients arriving, etc.
  4. by   veetach
    I dont know about everyone else but our nurses do not have time to stand around and talk about this and talk about that, while the entire dept is is total chaos behind them.

    It also irritates me when they show ER nurses not actually touching patients. When nurse Hathaway was on the tv show ER, she didnt touch anyone, she just ran around hailing doctors and looking important! LOL

    It is useful to be bagging the patient when auscultating for ET tube placement, (on ER they fail to do this) AND.... we dont stand by with defibrillator in hand when giving Adenosine, like they did just last week.

    I want to see the whining drunks, the parents who bring their screaming kids in at 1:00am because they cannot sleep because the baby is crying.

    also those "emergent" knee pains or sore throats at 2:00am, and the absolute multitudes of people with dental pain and headaches in the middle of the night. They probably wouldnt keep viewers if they should it as it really is....

    for the record, there is NO WAY our docs meet the ambulances as they are coming in, the ems crews have to transport the patients down a tunnel and through 2 hallways to get to the ER. The docs cant go to the ambulance bay.
    its too far away, and they wouldnt do it anyway.
  5. by   harley_fan
    How about when the tv ER NEVER knows what the ambulance is bringing in! Do they NOT use a radio to communicate?? AND the tv ER keeps the patient in the ER for observation. What about sending them to the unit for observation?!?!
  6. by   iy0ga
    I agree totally that the show does have its shortcomings. I watched a discovery channel documentary on the real "ER" in England. The major things i've noticed is the pace of the treatment of the patients. In their hospital, the patients came in slow with no screaming and commotion, but I know their is times when their is a rush surgery and such. Another point that one of the England doctors made was that many of their patients die and only a few actually make it. In contrast, ER has these surgeries that turn out with a happy ending that puts this mentality into the viewers that whoever goes in the ER will come out alive. ER is entertaining but you got to separate reality from fantasy.
  7. by   Stitchie
    We don't do internal cardiac compressions or crack chests in the ED. We may send them up to surgery, or to Heaven, but chests get cracked in ICU or OR.

    We're a dirty ER, for heaven's sake! There's no better place to get an infection than any old ED!

    Also, when we're in all that isolation gear -- we sweat like pigs, and we wear masks, goggles, face shields, etc.

    Our hair isn't perfect, we seldom have perfect makeup (well a few do, but they do minimal work) chaos reigns, I make tons of mistakes that screw up my day but do not kill people. I have not seen any co-workers making out in any rooms, and we swear much, much more than they do on TV.

    OK, rant over. Can't help it. I love the ER show and have seen every single episode.
  8. by   aurora_borealis
    At least on ER they portray nurses as professionals who know what they're doing, and confront the docs when there is disagreement. I think this may be a first.

    No one EVER washed their hands. You see them, usually the docs, going from one bloody trauma to the next without washing their hands. YUCK!

    As far as meeting ambulances, a few years ago there was a case in Chicago where a 15 y.o. kid was shot, and somehow he made it to the steps outside the hospital, about 35 feet away from the ER door. The cops ran inside pleading for help, but the staff refused to go out there, as it was against hospital policy. After getting nowhere with them, the cops grabbed a wheelchair and managed to get the kid in the door themselves, wasting precious time. The staff was more than obliged to care for him. Only it was too late, he died. Needless to say the media got a hold of this story, and all hell broke loose. To this day I don't understand why the staff prioritized hospital policy over a person's life. I know, without a doubt, I would have said policy be damned. It was just so ****ing senseless.
  9. by   RNin92
    Quote from mwcia12
    At least on ER they portray nurses as professionals who know what they're doing, and confront the docs when there is disagreement. I think this may be a first.

    No one EVER washed their hands. You see them, usually the docs, going from one bloody trauma to the next without washing their hands. YUCK!

    As far as meeting ambulances, a few years ago there was a case in Chicago where a 15 y.o. kid was shot, and somehow he made it to the steps outside the hospital, about 35 feet away from the ER door. The cops ran inside pleading for help, but the staff refused to go out there, as it was against hospital policy. After getting nowhere with them, the cops grabbed a wheelchair and managed to get the kid in the door themselves, wasting precious time. The staff was more than obliged to care for him. Only it was too late, he died. Needless to say the media got a hold of this story, and all hell broke loose. To this day I don't understand why the staff prioritized hospital policy over a person's life. I know, without a doubt, I would have said policy be damned. It was just so ****ing senseless.
    The infamous "Ravenswood" case is what you are talking about. But you left out the part about gunshots still going on in the parking lot where the kid was. Scene was NOT safe. Of course now we all have the "250 feet Rule" because of that case. But if guns are blazing in my parking lot...not sure Iwould go out there either?!!?

    And by the way, if the cops could make it inside to ask for help, why didn't they bring the kid in with them? There is of course, more to the story.
  10. by   RNin92
    As far as ER goes...

    I, too, admit I watch the show pretty regularly...but I LOVE to find their "misses"!!

    The no washing of hands thing always gets me, too! Could they at least change their gloves when going from one trauma to the next!!!!!

    As one poster said, the nurses have no problem disagreeing with the docs...but could they DO something once in awhile?!!?
    Besides have sex in the supply room?!!?
    (Now we all have time for THAT at work, right?!!?)

    And whose ER has a doc on staff that is more concerned for saving money and resources than protecting his a$$?!!? How many tests are run in your ER for no other reason that CYA?!?

    And I have always wondered about their radio room...or lack there of! I know it is supposed to be Cook County Hospital...which used to be a very old building...but I am pretty sure they have radios!!!!
  11. by   Stitchie
    In one episode, the one w/George Clooney in a storm tunnel, saving a kid, they did have a radio, they even called it 'Merci' system. I think that season had a few radio calls, nothing like real life though!

    But I point out to my DH that we always know what's coming in and how. He's an electronic engineer so he's always looking for new stuff to minimize and make better.

    It's frustrating to see those docs with their dramatic bloody gloves going from one room to the next. They did better hand hygiene with the episodes in Africa -- with little supplies and little running water!
    Last edit by Stitchie on May 4, '04
  12. by   SickleMoon
    And I don't think the nurses on ER chart...or at least not nearly as much as we have to!!
  13. by   aurora_borealis
    Quote from RNin92
    The infamous "Ravenswood" case is what you are talking about. But you left out the part about gunshots still going on in the parking lot where the kid was. Scene was NOT safe. Of course now we all have the "250 feet Rule" because of that case. But if guns are blazing in my parking lot...not sure Iwould go out there either?!!?

    And by the way, if the cops could make it inside to ask for help, why didn't they bring the kid in with them? There is of course, more to the story.
    I live in Chicago, and this case got massive media coverage.
    None of the staff involved ever mentioned an ongoing gun fight in the parking lot. If that was were case, then why didn't anybody mention that, as I doubt anyone would blame them for not being willing to put themselves in harm's way. Think about it, which would elicit more public support: fear for their lives, or flat out refusing to help some kid due to a hospital policy. Instead they call 911 rather than rendering immediate care. What I find stunning was the fact the the doctors and nurses were more interested in upholding policy than they were in a human life.
  14. by   tiredfeetED
    Quote from Stitchie
    We don't do internal cardiac compressions or crack chests in the ED. We may send them up to surgery, or to Heaven, but chests get cracked in ICU or OR.

    We're a dirty ER, for heaven's sake! There's no better place to get an infection than any old ED!

    Also, when we're in all that isolation gear -- we sweat like pigs, and we wear masks, goggles, face shields, etc.

    Our hair isn't perfect, we seldom have perfect makeup (well a few do, but they do minimal work) chaos reigns, I make tons of mistakes that screw up my day but do not kill people. I have not seen any co-workers making out in any rooms, and we swear much, much more than they do on TV.

    OK, rant over. Can't help it. I love the ER show and have seen every single episode.

    Three weeks ago, we had a 20ish female involved in a MVC, Head on. Her 2 kids did ok. She came in with gcs 8 and quickly got worse. After a few min she lost her pressure. We are a little ER ( 20 Bed). Doc grabbed a blade and some rib spreaders and started cardiac compressions.. She had no time for ICU or surgery ..It was now or never. She was crossed clamped for 15 min before the OR was ready...liver, spleen and multiple arteries destroyed.
    Sometimes a Dirty ER is a afterthought! There was 2 ED docs and about 6 RNs..the emotion can never be described of her toddlers crying for mommy in the background ....still gives me chills!

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