Whats your biggest pet peeve working in the ED? - page 15

by Whts_Ur_Emergency? 63,127 Views | 264 Comments

Id have to say my biggest pet peeve is when someone hands you a medicaid card as they pull it from their Louis Vuitton handbag with bling on their hands after having rolled up to the ER in their Mercedes Benz! After that I'd say... Read More


  1. 2
    Quote from nurseladyk
    I literally want yell at people when I ask them to rate their pain 0-10 and the tell me 12, 20, 50, whatever....I said 0-10, 10 is the worst people!!!! Not that big of a deal, but it drives me nuts!
    More than that, I'm irritated when people start using fractions.

    I already believe that 0-10 is much too fine a scale but then they start breaking out halves and quarters. Um, OK...

    I think about it in quartiles... none, a little, some, a lot... that's sufficient for what we're doing particularly given most PRN orders either say "for pain" or "for mild/moderate/severe pain."

    The decade scale is silly and a decimal scale is completely absurd.
    hiddencatRN and psu_213 like this.
  2. 1
    Quote from emtb2rn
    Probably already mentioned but mine is "i can't swallow pills" and they're over the age of 6. Seriously? How do you eat? And yeah, that's what i ask them.
    No kidding. I understand that we have some horse pills, and I am willing to give them a pass on that. Sometimes, though, the pill is tiny and I have a 30 year old choking, gagging, and asking for a bucket. Maybe not a pet peeve, but very annoying.
    Altra likes this.
  3. 2
    So basically every pet peeve listed here has been about patients, and I agree with the vast majority of them. However, I wanted to mention one that deals with fellow ER staff.

    We all have annoyances with certain docs. There are some the move really slow--we will have patients who have been there for an hour and they are only seeing 3 patients. There are docs that take forever to give dispositions--all the lab work, rad test, etc. are back, the patient is sitting there getting antsy, and the doc is not doing anything to get the patient out the door. There is the doc that orders every possible lab, a scan, and then does an LP....for knee pain (OK, so the last part was a bit of an exaggeration, but I think you know what I mean).

    Those just irritate me though, they are not real 'pet peeves.'

    The pet peeve: staff (particularly non-licensed staff) who question the competency of the doctors. The doctors went to med school for 4 years. They had 3 years of an intensive EM residency. With a very few exceptions, they know more than I do and I darn well know that they know more that the techs and secretaries do about emergency medicine. Despite this, these situations have happened (names are changed to protect the innocent/guilty):

    1. A doctor who is one of those docs known for ordering a gazillions tests for a simple CC calls the ID doc after such a workup. Based on his conversation with ID, the patient is going to be admitted with a dx. of Rocky Mountain Spotted Fever. One of the techs (one of the real obnoxious know it alls) says: "oh yeah, look at that. Leave it to Dr. Smith to make up some diagnosis like that just to make it look like he knows what he is doing for once." Uh, excuse me? Dr. Smith did not "make up" this disease (plus it was ID that 'gave' him this dx.) and Dr. Smith, although he is not my favorite doc, knows a heck of a lot more than you do.

    2. Tech: "oh, we have to work with Dr. Harris today. She is such an idiot." Me: "Karen, I really don't think it is appropriate to call her that. She is good at what she does." Karen: "No, I don't like her. She is unsure of herself. She is an idiot."

    3. Pt with left sided neck pain, no chest pain. Tech: "Why did Dr. Gold order an EKG? She is not having chest pain. This is just ridiculous. I am going to email Mary (our NM) because I am so tired of doing EKGs on all these people who aren't having heart attacks. This person I fine, I'm not doing this EKG."

    4. Secretary to the charge nurse: "I refuse to work in that section today." Charge nurse: "Why? What is the issue." Secretary: "Dr. Williams is back there. He orders all these silly tests, makes me call doctors for no reason and really just doesn't know what he is doing."

    (This is already a long post, so I will spare you all the details of the conversations that followed with the individuals who said these gems. Of course they are also the ones who, when you ask them to be more respectful towards others, say "but I have a First Amendment right to free speech." Ugh...not worth getting into that one!)

    And it goes on and on. I'd hate to hear what they say about nurses behind our backs.
    uRNmyway and canoehead like this.
  4. 0
    Quote from psu_213
    So basically every pet peeve listed here has been about patients, and I agree with the vast majority of them. However, I wanted to mention one that deals with fellow ER staff.

    We all have annoyances with certain docs. There are some the move really slow--we will have patients who have been there for an hour and they are only seeing 3 patients. There are docs that take forever to give dispositions--all the lab work, rad test, etc. are back, the patient is sitting there getting antsy, and the doc is not doing anything to get the patient out the door. There is the doc that orders every possible lab, a scan, and then does an LP....for knee pain (OK, so the last part was a bit of an exaggeration, but I think you know what I mean).

    Those just irritate me though, they are not real 'pet peeves.'

    The pet peeve: staff (particularly non-licensed staff) who question the competency of the doctors. The doctors went to med school for 4 years. They had 3 years of an intensive EM residency. With a very few exceptions, they know more than I do and I darn well know that they know more that the techs and secretaries do about emergency medicine. Despite this, these situations have happened (names are changed to protect the innocent/guilty):

    1. A doctor who is one of those docs known for ordering a gazillions tests for a simple CC calls the ID doc after such a workup. Based on his conversation with ID, the patient is going to be admitted with a dx. of Rocky Mountain Spotted Fever. One of the techs (one of the real obnoxious know it alls) says: "oh yeah, look at that. Leave it to Dr. Smith to make up some diagnosis like that just to make it look like he knows what he is doing for once." Uh, excuse me? Dr. Smith did not "make up" this disease (plus it was ID that 'gave' him this dx.) and Dr. Smith, although he is not my favorite doc, knows a heck of a lot more than you do.

    2. Tech: "oh, we have to work with Dr. Harris today. She is such an idiot." Me: "Karen, I really don't think it is appropriate to call her that. She is good at what she does." Karen: "No, I don't like her. She is unsure of herself. She is an idiot."

    3. Pt with left sided neck pain, no chest pain. Tech: "Why did Dr. Gold order an EKG? She is not having chest pain. This is just ridiculous. I am going to email Mary (our NM) because I am so tired of doing EKGs on all these people who aren't having heart attacks. This person I fine, I'm not doing this EKG."

    4. Secretary to the charge nurse: "I refuse to work in that section today." Charge nurse: "Why? What is the issue." Secretary: "Dr. Williams is back there. He orders all these silly tests, makes me call doctors for no reason and really just doesn't know what he is doing."

    (This is already a long post, so I will spare you all the details of the conversations that followed with the individuals who said these gems. Of course they are also the ones who, when you ask them to be more respectful towards others, say "but I have a First Amendment right to free speech." Ugh...not worth getting into that one!)

    And it goes on and on. I'd hate to hear what they say about nurses behind our backs.
    Oh wow! Sounds like you work with a bunch of ***holes! I hate people like that, know-it-alls who really end up being the most uneducated idiots you've ever seen. They are so quick to judge others whom have a higher degree or more experience because they are secretly miserable with their own lives, whether its because they never went back to school and wish they had or they are just plain jealous of something that person has... It's awful working with people like that. You just want to knock some sense into them and say, "Hey, you want to act like you're in his/her shoes, then put in the work that they did and get those initials after your name. Then you can talk."
  5. 0
    Quote from N1colina
    Oh wow! Sounds like you work with a bunch of ***holes! I hate people like that, know-it-alls who really end up being the most uneducated idiots you've ever seen. They are so quick to judge others whom have a higher degree or more experience because they are secretly miserable with their own lives, whether its because they never went back to school and wish they had or they are just plain jealous of something that person has... It's awful working with people like that. You just want to knock some sense into them and say, "Hey, you want to act like you're in his/her shoes, then put in the work that they did and get those initials after your name. Then you can talk."
    It's definitely the minority of people and it's only occasionally that they act like this. The person who referred to the doc as an idiot is a very hard worker and is something with whom I want to work. However, sometimes the filter is missing between her brain and her mouth.
  6. 1
    Me: Dr, little girl in room 5 is here with 4 days of fever at home, with history of febrile seizures. Mom gave weight appropriate dose of ibuprofen about 30 minutes ago but she's still got a high fever. Can you write me an order for XYZ mg of tylenol?
    Dr: I don't know how much she weights.
    Me: I do and calculated for 15 mg/kg. Here's her weight. XYZ is just shy of 15 mg/kg of tylenol, rounded for ease of measurement.

    Dr. orders XZY mg minus 1 mg (I'd rounded to get a nice, even ml amount, his dose would require 5 decimals to give exactly) AND orders a dose of ibuprofen for her.
    canoehead likes this.
  7. 1
    My "working-in-the-ED" pet peeve this week is dealing with the floor. I am seriously getting so sick of doing their jobs for them, calling to give report and they act like they are too busy after 3-4 calls, and them deciding that it is perfectly ok to write us up for not "'properly dating and timing" an IV site with the correct sticker. Seriously. I am not going to put MY initials on an IV that the paramedic started in the truck. It isn't MY site.

    Here lately we are having to do print and put a lot of protocol / order sets on the pt's charts that are admits but yet not ONE single box is appropriate for the ED to complete - it is ALL stuff done on the floor one they get there (re: TEDs, SCDs, foleys, etc).

    I've gotten a write up "attempt" from the floor recently because I didn't treat a 210 BS - I did not have an order for any insulin, the pt was NPO, and the K+ was 2.2. My NM and I sat down and I refused to sign anything with that QRR. It was ridiculous.

    I just very sick of the floor thinking that all we must do down in the ED is sit around and eat cheese puffs! The patients just do not quit coming if we are busy. We don't get to "divert" sick people when they are sick like the floor does. They don't have 2-3 hall patients on top of their room patients like we do but yet we never do enough to suit them. I am not saying they do not work hard. I am just tired of a lot of floor nurses getting their scrubs in a wad because we didn't do XYZ but we DID get that patient stable enough to come up there.

    As far as the patient pet peeve goes, I'm very tired of seeing the same azzhats day after day complaining about their wait and saying "I just saw 4-5 people go back that aren't as sick as I am." Oh really? Where did you go to med school?
    I do work triage / front desk quit a bit and I am pretty good about explaining the whole fast track process / acuity thing and diffusing that but I still get sick of *those* people that try to tell me how to do my job.

    Oh! And I am sooooo sick of seeing able-bodied people WALK through the door and grab a wheel chair and suddenly become totally incapacitated right before my very eyes but yet they can yell at their kids and text and stand up to get a Mt Dew out of the vending machine. I even ask them how they go to the ER and 9 times out of 10 they say they drove themselves. I just don't get it.

    I'm so glad I have a few days off. The past 3 have been H E L L
    Lynn Jenkins likes this.
  8. 1
    I just got home from work. Can't complain and call it a 'pet peeve' more of a laugh.. The Pts that are brought into a room.. You haven't even taken their temp and their family bum rushes in 'What's the matter with them? Are you going to keep them?'

    I had an easy shift.. Minor issues that got the big ole work up but after line/labs/liter/blanket they were pretty much set for me except checking on them and vitals.. But I got a kick out of the family members tonight.

    I guess the highlight was the LTC tele report of 'agitation' at 9 pm. I asked when it started they said 6pm. Are they throwing things? Striking? Yelling? Nope, just telling staff they want to leave.
    canoehead likes this.
  9. 1
    When parents don't know their kids birthday

    When a kid is brought to er for a fever, parents have not given Motrin or Tylenol and guess what the kids temp is 36.7. Why ru here again?

    The wait complaints

    Pts that co SI but when u get them back to a safe room they state that they r not suicidal but are just looking for a bed tonight...

    And my favorite... Is dr whatshisname here? (Pcp) o yes actually ur doctor has no life and waits around in the er for you to become ill. Seriously??

    Pts that return to the er for the tenth time for the same thing and don't ever follow up with a provider.

    Pts that are just plain rude. Hello I'm trying my best to put a smile on and take care of you but you being an a hole doesn't help!

    Thanks for letting me vent!
    DeLanaHarvickWannabe likes this.
  10. 1
    Consult docs that don't bother to read orders placed by the other consult docs. Everything is in the system CPOE so it's not like they can't see 'em.

    How many ns @ 75ml/hr do we need? And exactly which of this plethora of bp meds ordered actually gets administered?
    Altra likes this.


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