now I know why patients have ER problems...

  1. So when I did go to the ER recently, I went to my hospital(45 mins away) rationalizing that "if I wind up admitted, I want a private room on my floor"....while I was there, I understand why pt satisfaction scores are so low.....few issues:

    1. I didn't constantly play the "i'm a nurse here" card, but I let it be known that I was having 15/10 pain and I needed some pain meds asap....45 minutes later, the doc finally sees me and takes another 30 minutes for the nurse to come start my IV and start a bag of fluid and give me some toradol and zofran...I understand the acuity of the ER, but seriously, 75 minutes to start treating pain? I felt bad about it too, I was the patient yelling that you could hear in the waiting room.

    2. while said nurse was starting IV...she had the extention in her mouth! YIKES!..I was going to say something, but I just wanted my meds....then my IV had 50 left before I went to US, so I asked if she could just lock me off if I wasn't going to have more fluids..."well, once it's done, I'll lock you off." needless to say it was very clotted off by the time I made it back....

    3. while waiting between CT of abd and us of gallbladder....didn't even get told about ct results until I hit the button 45 minutes later and wanting to know what was the situation.....

    anyone else have bad er expierence at their own hospital?
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  2. 12 Comments

  3. by   gibson0726
    That sounds terrible! I'm sorry you had to go through that!

    I was in a car accident when I was a first semester nursing student. I was brought in via EMS to the hospital I was doing me clinicals at. No one could get an IV started on me..there were 7 unsuccessful attempts before they paged anesthesia to come down and try.

    I had a broken radius and a dislocated tib/fib ankle fracture and the ER doc decides to pull on my foot with ZERO pain meds on board!! Needless to say, I was screaming! I was pretty po'd after that as well. I wound up having ORIF surgery, 1 plate with 7 screws. Then when I got up to the floor, the RN would only give me 1mg morphine q4hrs, even though I could have 1mg q1hr and my pain was 10/10..it was worse after surgery than before! Then they switched me from morphine to regular vicodin. Yeah, that didn't do squat. Then my IV went bad and they didn't restart it so I had to get IM morphine. Again with the 1mg BS, even thought I could have had more. I told them I needed percocet, but I never got it.

    Got sent home on norco 7.5mg and was finally able to control my pain. It was so ready to get out of there! It was a truly horrible experience. I later had clinical on an ortho unit and was shocked at how freely the narcotics were given out..made me wish I had my surgery there!
  4. by   jeckrn
    Quote from locolorenzo22
    so when i did go to the er recently, i went to my hospital(45 mins away) rationalizing that "if i wind up admitted, i want a private room on my floor"....while i was there, i understand why pt satisfaction scores are so low.....few issues:

    1. i didn't constantly play the "i'm a nurse here" card, but i let it be known that i was having 15/10 pain and i needed some pain meds asap....45 minutes later, the doc finally sees me and takes another 30 minutes for the nurse to come start my iv and start a bag of fluid and give me some toradol and zofran...i understand the acuity of the er, but seriously, 75 minutes to start treating pain? i felt bad about it too, i was the patient yelling that you could hear in the waiting room. i am not going to take anything away from your pain but as a past er nurse way to often we here that pain is >10/10. also you do not say how busy the er was on that day and why you had pain. this is not a excuse of why it took so long but if the er is very busy and other then you rating your pain high are you where not showing anyother signs of pain you are placed on a lower priority list. this is not an excuse for them but only some reasons why it can take so long. there was times that it would take over a hour just to see the triage nurse other then a quick look over when you walked into the waiting room.

    2. while said nurse was starting iv...she had the extention in her mouth! yikes!..i was going to say something, but i just wanted my meds....then my iv had 50 left before i went to us, so i asked if she could just lock me off if i wasn't going to have more fluids..."well, once it's done, i'll lock you off." needless to say it was very clotted off by the time i made it back....
    as a nurse you need to speak up when you see unsafe practices, understand why you did not want to speak up at that time. a good way to do this is to write it up and send it to your infection control nurse. as a nurse you should have "locked off" your iv when it ran out, even thou it was not your job to do.

    3. while waiting between ct of abd and us of gallbladder....didn't even get told about ct results until i hit the button 45 minutes later and wanting to know what was the situation.....
    45 minutes to get ct and us results back is good, remember that your test needed to be read by a radiologist not the er doctor.

    anyone else have bad er expierence at their own hospital?
    until the unnecessary visits to the ed stop experinces like yours will only continue. as stated before i am not discounting your pain or need to go to the ed, but this is what happens with er overcrowding, ed's having to be holding areas for the floor etc.
  5. by   locolorenzo22
    crx, YIKES! I'm sorry to hear that about yours. I work ortho and pain is a BIG issue on our floor....I give the meds as often as i have to to make patients comfortable...working it makes me see the other side.

    jeck,
    1. I understand that it was a bad day, they had 1-2 codes...I was just upset about my pain management...at least something IM quickly...but not a big deal, I forgot about it after my iv shot.
    2. I tried to have my finance find a flush in the room i was in....no flushes in there. I asked the 2 paramedic students, my transporter, etc....I understand...I wanted to lock myself off, kept saying "I'm a nurse, I'll take responsibility, etc...." just didn't happen.
    3. It wasn't post us results...it was after the CT before the US, and they knew already when I hit the light that the CT was negative....the US took another 30 but I understand.

    I did tell the follow up person the next day about the IV lock thing, and they filed it for their department head.

    the one positive was my status got me a room vs a bed with a curtain between it.
    Last edit by locolorenzo22 on Dec 4, '09 : Reason: forgot to add
  6. by   jeckrn
    Pain is also a big issue with me. If a person is having pain I want to treat it appropaitely(sp). Totally understand why you were upset about your pain, its hard to wait when you are hurting. But until the physician sees you the nurses hands are tied. There have been many times when I wanted to give something but it took along time for the physician to see the patient then order the medications. Some of the time it was because the physician was juggling 10 patients and others because the physician was just slow that day. If the IV was just NS or LR a flush was not needed, but it sounds like you tried to work within the system the right way. Having a room vs a bed with a curtain is plus. That is a thing to come in all ED's as they update them. Glad it sounds like you are doing better.
  7. by   Altra
    You mention that your "status" got you a treatment room instead of a hallway bed ... and that pretty much sums up your post.

    Pain sucks. But as an ER nurse, dysrhythmias, SOB and neuro s/s will get my attention before pain, every time. Actually, if I am an inpatient, I would hope that the same would be true of any nurses taking care of me. You acknowledge that there were codes going on during your ER visit.

    An IM shot of something would have taken effect at approximately the same time as your line was started 45 minutes after the MD examined you, so no time difference there in terms of pain relief. You're also assuming that s/he wrote the order promptly after examining you - that may or may not be the case.

    A radiologist either in house or off site does not necessarily read your films the moment your testing is completed. 45 minutes for CT or US results? That's damn prompt, in my experience.

    As a patient, it does not matter what my occupation is -- I would never ask to "take responsibility" for my IV. It's just not appropriate. If I find family members rummaging through supplies in rooms, they get asked to step out to the waiting room.
  8. by   locolorenzo22
    ok....i guess maybe it was a little half assed for me to 2nd guess the staff...I don't work there. all complaints...except the infection control issue....retracted.
  9. by   Altra
    Wishing you a speedy recovery from your lap chole ... hoping you're among the many who say, afterwards, "I feel so much better!"
  10. by   caliotter3
    One time when I was in an ER bed waiting and waiting, all the visitors that came traipsing through would look at me as they went past my door; occasionally an employee would glance through the door at worthless me, until somebody got the bright idea to close the door so they would not have to acknowledge through eye contact with me that they were, indeed, ignoring me. Did I find it funny? I doubt it, the monitor leads fell off of me and I couldn't reach down to the floor to grab them and put them back on. It dawned on me that the monitor must not really be working or even on, because nothing alarmed that I could hear. I was unable to move due to pain and weakness, otherwise I would have put my clothing back on and walked away. Don't ask me what the bill was for being ignored. The mentally ill drunk who spent part of the time in the same room was not ignored.
  11. by   gonzo1
    The situation in ERs is very bad today. I can get hit with 4 new patients at a time. If I have to start an IV and draw labs on each one, then it could very well be 1 hour before I get to the last person, and that's if everything goes well.
    It is so frustrating to me to not be able to take care of everyone in a timely, fair manner. All I can say is that I often have the rooms that are only divided by curtains and my patients can see that I am trying hard to meet their needs.
    Today I worked 12 hours with no break and kept up pretty well until the last hour, when I quess I was just so tired I was working pretty slow and felt like I was slogging through molassis.
    I hope your nurse was just busy and not "uncaring".
    I hope that your recover is quick and you feel better soon. I consider you a allnurses friend and hate to think you are scared or sick.
    hugs
  12. by   psalm
    I was in my hospital's ER as a patient in mid November with chest pain. I was seen and set up with a hep lock and monitor quickly, labs & ekg done quickly and seen by a doc. I had pain meds promptly when I needed them.

    I could hear my call light go off. The first time I used it, it took about 13 seconds for someone to come to my room. 13 seconds!! The second time I used it, it took about 11 seconds; and I was calling for the patient in the room next to me who was calling out for a nurse.

    Yes, I was there for chest pain; but I am very grateful for the staff who took care of me for the 7 hours I was there. It was a busy night for them; police bringing in the winner and the loser of a fight; others like me...lots of activity.

    Thank you, ER nurses & staff!
  13. by   locolorenzo22
    thanks for all the replies....it's just with work/money/sickness/recover/going back to work/holidays.....it's a lot going on right now....I am sooooo thankful that I have my fiance to help take care of me. Couldn't imagine this at this time last year.....thanks for all the support.
    I'm sure she was busy...I felt bad by the end. The only thing I mentioned to the follow up person was the IV lock mouth issue. will keep you all updated.
  14. by   Virgo_RN
    Quote from locolorenzo22
    2. while said nurse was starting IV...she had the extention in her mouth! YIKES!..
    Extension in the mouth...yuck!

    It just sucks to be sick and in the ED, and I think that time passes sooo much more slowly for the patients than it does for the staff. Even if the staff is super efficient, it can probably seem like an eternity for the patient. I'm glad you got a diagnosis and treatment, and I hope you're feeling better!

    anyone else have bad er expierence at their own hospital?
    Why yes, just tonight. We were slammed, and I got chewed out by a doctor because 30 minutes had passed between his order to start PO contrast on a patient and the time I actually started it. Why, you may ask, did it take me so long? Because I was taking care of another patient who was actively having an MI and I was just a little preoccupied....and it was the same doctor that had this patient too! Let's see...what's more important, treat the MI, or start the PO contrast, because I can't do them both simultaneously! :angryfire

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