Rules for the ER (long)

[EDValerieRN]

The Emergency Room

1. The world of ER does not revolve around you. There are sick people here, and you aren't one of them.

2. Our definition of sick is not your definition of sick. If a member of the ER staff says that someone is sick, it means that they are in the process of DYING. They have had a massive stroke, are bleeding out, having a heart attack, or shot. We don't consider a tooth injury sick. Painful, yes. Sick, no.

2. At any given time, one nurse has four patients. One doctor has up to 15. There is a law (similar to Murphy's) in the ER. If you have four patients:

• One of them will be sick (see #2 for definition)
• One of them will be whining constantly
• One of them will be homeless
• and one of them will be the delightful patient.
• Don't be the whiner. Please.

3. Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonalds, and you very well may NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets, the lights dimmed, and the TV on channel 14, go to the Ramada.

4. If you have one of the three, go to your own doctor in the morning:

• A cold
• The flu
• A stomach virus

5. If your child has a fever, you had better give him tylenol before coming in. Do NOT let the fever remain high just so I will believe the child has a fever. Do you want your child to have a seizure? Do you?

6. We have priorities. We understand that you have been waiting for two hours in the waiting room. If you don't want to wait, make an appointment with a doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. That's why she goes first.

7. Do not ask us how long it will be. We don't know. I don't know what's coming through my door 30 seconds from now... so I surely don't know when you'll be getting a room upstairs.

8. We are not for primary care. Get a family doctor, and go see them.

9. If you have diabetes and do not control it, you are committing slow suicide.

10. We know how many times you've been to an ER. We can usually tell if you are faking it on the first 5 seconds of talking to you. Do not lie to us. If you lie about one thing, we will assume you are lying about everything. You don't want that.

11. If you are well enough to complain about the wait, you are well enough to go home.

12. If your mother is a patient and we ask her a question, let her answer it.

13. If you see someone pushing a big cart down the hall at full speed and you hear bells going off.... do not ask for a cup of coffee. Someone is dying, you inconsiderate %#@^. In the ER, bells don't ring for nothing. Sit down, shut up, and let us work.

14. If you have any sort of stomach pain and you ask for something to eat, you are not that sick.

15. If you can complain about the blood pressure cuff being too tight, or the IV needle hurting, you are not in that much pain.

16. If you want to get something, be nice. I will go out of my way to tick off rude people.

17. Do not talk badly about the other members of staff I work with. The doctor that you hate? I work with him every day, and I know that he knows what he is doing. I trust him a lot more than I trust you. I am not here to be your friend, and neither is he. I will tell him what you said, and we will laugh about it. If you want a buddy, go somewhere else.

18. Every time I ask you a question, I learn more about what is wrong with you. I don't care if I ask you what day it is four different times. Each time I ask, it is for a reason. Just answer the questions, regardless of if you have answered them before.

19. Do not utter the words "It's in my chart." I don't have your chart, and I don't have the time to call and get it. Just tell me.

20. Do not bring your entire posse with you. One person at the bedside is all you need. It is really difficult to get around seven people in the event that you are really sick.

[carolmaccas66, BSN, RN]

I hate the ones that say 'I'm on that little white tablet that you get for high blood pressure' (or whatever).

Me: Do you know the name of this little white tablet?

Patient: No sorry.

Me: How long have you been taking this tablet?

Patient: 20 years.

And you DON'T know the name of it? *sigh*

[Guest219794]

AngelfireRN said:

Not only do I have to stand it, I have to deal with these jokers every day I work, too.

"I'm trying to get my disability."

"For what condition?"

"My nerves. I just can't handle life. I never have been able to."

But yet , we have to handle life and take care of your sorry, lazy, leech of a self.

You are heartless. I truly hope you never have to undergo the kind of stress your patients feel. Why are you even a nurse id you are incapable of empathy?

Some people just can't cope, and thank god we have a safety net for them.

[Murse901, MSN, RN]

hherrn said:

You are heartless. I truly hope you never have to undergo the kind of stress your patients feel. Why are you even a nurse id you are incapable of empathy?

Some people just can't cope, and thank god we have a safety net for them.

You've got to either be trolling, or you're taking Angelfire's post on a personal level.

I think the point of Angelfire's post is the ridiculousness of someone attempting to get on disability for "nerves", which does happen. I realize (and I'm sure that Angelfire realizes) that some people have a harder time than others at dealing with stress. Some people do not have a great support system. Some people are more emotionally fragile than others.

But I draw the line when someone attempts to collect disability for a condition that can be treated with medication and counseling. It's not like they have MS or have had a massive CVA. But there are people... LEECHES, as Angelfire correctly stated... who will exaggerate their condition in an attempt to get disability benefits.

True story - I once knew a 30-something year old woman who was on disability for... I kid you not... bipolar disorder. It sounded ludicrous to me at the time, and it still does. She functioned fine. She took her meds. She seemed like a normal person. In fact, if she'd never told me this, I probably would have never guessed that she was bipolar. She seemed very normal to me. She did not have any physical handicap. As I said, she functioned at 100% of what I believe a normal person functions. Yet, she was on disability. Her check was decent enough that it paid all of her bills and left her with a little spending money each month.

Meanwhile, we're busting our asses on 12-hour shifts just to scrape by, working a job where we have to see the worst of the worst in life on a DAILY BASIS, and we're not out there asking for a hand-out.

If we can work our best to save a child's life, only to watch him die... if we can watch Grandma being sent in by ambulance because her family wants to go out of town for the weekend, and we get to document all the new pressure ulcers and wonder if we should call social services for the 15th time... if we can comfort a 24-year-old hopeful mother who's just lost her baby in a miscarriage... if we can do all of this in a single shift, and come back for more the next day... I'll be DAMNED if someone is going to tell me that they deserve to be on disability for "nerves".

But hey. That's just, like... my opinion, man.

[AngelfireRN, MSN, RN, APRN]

Murse, you said it better than I ever could have. Thank you.

Hhern, you don't get to ask how or why or anything else, because you DON'T see the people I refer to. I do. Every blessed day. I know a nervous condition, and they DO. NOT. HAVE. ONE. What they have is terminal laziness, can't-help-it syndrome, and a complete unwillingness to even try.

For your information, the person I had reference to is a female about my age, with several children, all by different fathers. She functions well enough to be out partying every weekend, but yet comes into her bi-monthly appointments carrying on fit to be labeled a basket case. We have referred her to numerous specialists, but she either will not go because "Something came up", "They didn't like me", or "I didn't feel like it". We have tried her on numerous meds, against Doc's better judgement, but she always stops them herself, because "They didn't work" (after 4 whole days), "They made me feel funny", or various and sundry other excuses. No matter HOW or WHAT we try, there's always a reason it will not work. And all other suggestions are met with refusal, but also with the wailing, bawling, "But what am I gonna DO?"

And yes, before you ask, these meds and referrals are always accompanied with instructions about proper use, side effects, time before an effect is expected, likely routine of office visit/eval, etc.

She just does not want to try, plain and simple. She wants it handed to her.

So, don't you DARE judge me, not until you've done my job for a month or so. I'm not a nurse, dear, I'm an NP, and I have a practice full of patients who are in such misery that they can barely get around. I have all the empathy in the world for them, and I do my darnedest every day to help them.

But when people like that who are hard-working and deserving can NOT get disability, and someone like HER comes in and just expects mine and every other taxpayer's hard-earned money to pay for her partying and cigarettes, well, if getting peeved makes me heartless, so be it.

Good luck with your safety net and your high horse. I hope you continue to have luck with them. I'll just keep on thrashing it out here in the trenches with the rest of the heartless public who actually expects effort for reward.

[CrunchRN, ADN, RN]

Why of why can people not remember this is a vent thread?

Look it up in the dictionary!

It really ticks me off that people cannot allow nurses to have one dang thread to just blow off steam.

Go away! ?

It in no way reflects how they actually are as a nurse in reality. For the love of my sanity how many times do we have to say that and why can some people just not get it!

[frenchfroggyAPRN, MSN, LPN, RN, APRN]

AngelfireRN said:

Murse, you said it better than I ever could have. Thank you.

Hhern, you don't get to ask how or why or anything else, because you DON'T see the people I refer to. I do. Every blessed day. I know a nervous condition, and they DO. NOT. HAVE. ONE. What they have is terminal laziness, can't-help-it syndrome, and a complete unwillingness to even try.

For your information, the person I had reference to is a female about my age, with several children, all by different fathers. She functions well enough to be out partying every weekend, but yet comes into her bi-monthly appointments carrying on fit to be labeled a basket case. We have referred her to numerous specialists, but she either will not go because "Something came up", "They didn't like me", or "I didn't feel like it". We have tried her on numerous meds, against Doc's better judgement, but she always stops them herself, because "They didn't work" (after 4 whole days), "They made me feel funny", or various and sundry other excuses. No matter HOW or WHAT we try, there's always a reason it will not work. And all other suggestions are met with refusal, but also with the wailing, bawling, "But what am I gonna DO?"

And yes, before you ask, these meds and referrals are always accompanied with instructions about proper use, side effects, time before an effect is expected, likely routine of office visit/eval, etc.

She just does not want to try, plain and simple. She wants it handed to her.

So, don't you DARE judge me, not until you've done my job for a month or so. I'm not a nurse, dear, I'm an NP, and I have a practice full of patients who are in such misery that they can barely get around. I have all the empathy in the world for them, and I do my darnedest every day to help them.

But when people like that who are hard-working and deserving can NOT get disability, and someone like HER comes in and just expects mine and every other taxpayer's hard-earned money to pay for her partying and cigarettes, well, if getting peeved makes me heartless, so be it.

Good luck with your safety net and your high horse. I hope you continue to have luck with them. I'll just keep on thrashing it out here in the trenches with the rest of the heartless public who actually expects effort for reward.

Way to say it AngelfireRN. I completely agree with what you say. I cant remember how many times, I have had some one come in our ER and say they have a "disability" and both they and I know they are full of $%#@. It makes me so mad when there is someone who NEEDS to be on disability and cant get on it and then there are those who get it HANDED TO THEM One of my friends had peritonitis, nearly died, has had several surgeries and still could not get on disability( kept getting denied) He is 5'9" normally weighed 240, got down to 150, nearly skin and bones. Was told he was not SICK enough to get on disability. This was 4 years ago, and he has finally been able to go back to work, of course he cant lift more than 10 pounds( due to colostomy, hernias). He had a wonderful landlord who did not make him pay rent while he was down, Thank God. We, and others helped pay his bills, and the hospital put him on Charity since he NEVER was able to quality for MEDICAID---he made too much money prior to getting sick. He makes just enough to pay his bills and live on.