When is a situation considered an Emergency? - page 3

:D Hi, I am not a nurse yet, so I would like to ask ya'll a question. This post is a little long, so just try to bare with me. What makes a situation an Emergency??? I will explain myself: ... Read More

  1. by   gr8rnpjt
    I picked my 4 yr old son up at daycare the other day, he was sleeping when I came in. (which was not usual) After working to get him in a standing position for about 20 minutes, he finally woke up enough to put his coat on. By the time we got to the front door, He said his leg hurt a lot. 2 more steps and he said he could not walk on that leg. I tried to get him to walk down the 5 steps from the front door at daycare and he was screaming that he could not walk down the steps. This is a kid who jumps from one piece of furniture, who takes swan dives off the couch and throws himself to the floor playing superhero. He is the toughest kid I know and he would not walk.
    By the time we got home he was screaming in pain. I made him take his pants off (a feat in itself, I had to literally lay him on the floor and take the pants off myself) I observed both legs and did not see anything wrong. He screamed in pain when the pants came off and on again. At this point I am sure he had jumped off something at daycare and broke his leg. I called the pediatrician office after hearing him screaming in the background they said take him to the ER! Off we went, with him screaming all the way, getting him into his booster seat was difficult, he did not want to bend the leg. He would not point to the pain, just said it hurt so bad. He screamed and cried, "I don't want them to cut off my leg, I just know they are going to cut off my leg!" I was trying to console him, telling him they will probably only have to put it in a cast, dont worry etc. We get to about 3 blocks from the ER and he became strangely quiet. By the time we got to the ER parking lot. He looked at me and said, Mom my leg is fine now. I made him get out and he started running around kicking his leg and acting like himself. He was fine, the pain was gone. I think his leg just fell asleep.
    The point I am trying to make, is even as a veteran nurse, I still fall apart in emergencies dealing with my kids. And when your loved one is in pain, all you want to do is make it go away. You did your best to help your husband and you wanted to make the pain go away. You did good. Any time a loved one is in pain, it is an emergency to you.
    We left the ER without being seen. but if he had still been in pain, I would have brought him in only to have the drs and nurses tell me his leg fellasleep. My bad, but at least they can't say I don't care about my little boy.
  2. by   ShayRN
    I am going out on a limb here and disagreeing with everyone, I think. I feel the way that she and hubby were treated was deplorable. If someone is very obviously in pain, that needs to be addressed. We don't have pain without reason. To be in such awful pain and to be treated like you were less than human in INEXCUSABLE to me. To say pain has never killed anyone is a cop-out. Tell that to the MI patient, tell that to the cancer patient, tell that to the patient with a DVT. No that pain won't kill them, but the REASON THEY ARE HAVING PAIN WILL!!!! I wonder if the scenero would have been different if they knew someone at the hospital or were friends of the board.

    No, I am not naive, I worked at an inner city jail for 18 months and was lied to daily. HOWEVER, I was also on the other side. My husband c/o pain twice in his life to me, to the point I took him to ER. Once they found a tumor the size of a grapefruit in his lung. (This after the ER doctor told us we should have stayed home with some Advil.) The second time the surgeon told me he was within 24 hours of his appendix exploding. Luckily, the second time I was a nurse at the hospital and they didn't think my husband was drug seeking. I AM NOT THE JUDGE and JURY! It isn't my job to decide if someone just wants drugs. If you have lost your compassion in the ER, maybe its time to move on. SORRY, just my
    Last edit by ShayRN on Feb 1, '07
  3. by   I want to be a nurse
    Quote from gr8rnpjt
    I picked my 4 yr old son up at daycare the other day, he was sleeping when I came in. (which was not usual) After working to get him in a standing position for about 20 minutes, he finally woke up enough to put his coat on. By the time we got to the front door, He said his leg hurt a lot. 2 more steps and he said he could not walk on that leg. I tried to get him to walk down the 5 steps from the front door at daycare and he was screaming that he could not walk down the steps. This is a kid who jumps from one piece of furniture, who takes swan dives off the couch and throws himself to the floor playing superhero. He is the toughest kid I know and he would not walk.
    By the time we got home he was screaming in pain. I made him take his pants off (a feat in itself, I had to literally lay him on the floor and take the pants off myself) I observed both legs and did not see anything wrong. He screamed in pain when the pants came off and on again. At this point I am sure he had jumped off something at daycare and broke his leg. I called the pediatrician office after hearing him screaming in the background they said take him to the ER! Off we went, with him screaming all the way, getting him into his booster seat was difficult, he did not want to bend the leg. He would not point to the pain, just said it hurt so bad. He screamed and cried, "I don't want them to cut off my leg, I just know they are going to cut off my leg!" I was trying to console him, telling him they will probably only have to put it in a cast, dont worry etc. We get to about 3 blocks from the ER and he became strangely quiet. By the time we got to the ER parking lot. He looked at me and said, Mom my leg is fine now. I made him get out and he started running around kicking his leg and acting like himself. He was fine, the pain was gone. I think his leg just fell asleep.
    The point I am trying to make, is even as a veteran nurse, I still fall apart in emergencies dealing with my kids. And when your loved one is in pain, all you want to do is make it go away. You did your best to help your husband and you wanted to make the pain go away. You did good. Any time a loved one is in pain, it is an emergency to you.
    We left the ER without being seen. but if he had still been in pain, I would have brought him in only to have the drs and nurses tell me his leg fellasleep. My bad, but at least they can't say I don't care about my little boy.
    OMG!!! Thank you so much for understanding!!! And everyone else for that matter who understands just how scared we were! We didn't know what to do, for all we knew, it would be another 30 minutes before we would be seen, and he kept saying he couldn't take it.

    But I agree full heartedly...you can't tell what pain is indicating by a persons account because it is so varied from person to person. One person may feel sharp shooting pressure chest pain 10/10 for heartburn or a gall stone and not an MI...but the little old lady in the corner just feeling "uncomfortable" in the chest with no other pain than perhaps "well....4/10 sweety, I have felt this before but it scares me"...could indeed be having an MI!
    I totally understand this. When we were in the ER, I kept thinking, look at all these people just sitting here in no pain (or so I assumed), and my DH is here in OBVIOUS PAIN and no one is coming out to even talk to him. But how did I know that those people weren't in pain or something. You Know??? I was in panic mode just like my DH. I hope that when I am an RN, I learn how to not panic in situations, but I'm sure I will.

    And there is no indication the OP's husband wasn't being eyeballed by the triage nurse while in the WR.
    At the first hospital, there may have been a nurse seeing the discomfort he was in that we didn't notice. But at the second Hospital, (let me explain exactly how it was), we walk in, there is a little desk to the right, I fill out a sheet of paper with all of his info, and put EXCRUTIATING pain on his right side as his symptom. The receptionist took her good old time walking to a drop box and slipped the paper into the room (that had its shades down) that the lady who started yelling at my DH was in. There were no nurses in the waiting room seeing him or his discomfort. We waited for a few minutes (must have felt like forever to him) and then he went knock/open the door to the room. I know he shouldn't have opened the door, he should have waited for her to answer it.

    Thanks to everyone for explaining to me how the ER process goes down. Just for the record, I hope I am never in the position to have to tell someone they have to wait when they are in pain. I am sure it is a very tough position to be in.

    Maya
  4. by   I want to be a nurse
    Quote from ShayRN
    I am going out on a limb here and disagreeing with everyone, I think. I feel the way that she and hubby were treated was deplorable. If someone is very obviously in pain, that needs to be addressed. We don't have pain without reason. To be in such awful pain and to be treated like you were less than human in INEXCUSABLE to me. To say pain has never killed anyone is a cop-out. Tell that to the MI patient, tell that to the cancer patient, tell that to the patient with a DVT. No that pain won't kill them, but the REASON THEY ARE HAVING PAIN WILL!!!! I wonder if the scenero would have been different if they knew someone at the hospital or were friends of the board.

    No, I am not naive, I worked at an inner city jail for 18 months and was lied to daily. HOWEVER, I was also on the other side. My husband c/o pain twice in his life to me, to the point I took him to ER. Once they found a tumor the size of a grapefruit in his lung. (This after the ER doctor told us we should have stayed home with some Advil.) The second time the surgeon told me he was within 24 hours of his appendix exploding. Luckily, the second time I was a nurse at the hospital and they didn't think my husband was drug seeking. I AM NOT THE JUDGE and JURY! It isn't my job to decide if someone just wants drugs. If you have lost your compassion in the ER, maybe its time to move on. SORRY, just my
    Thank you for your message.

    If we would have know that it was a Kidney Stone that was causing this, and known that it would have passed, I'm sure he wouldn't have been so scared and persistant. But he didn't know what was going on, he thought something really bad was happening. I had never seen him like this before, in the 7 years we have been together. I could see the fear in his eyes.

    But it's over now and he's fine, just hoping that he never has to experience that again.

    Thanks again for your understanding.

    Maya
  5. by   canoehead
    Another problem I see is that even if the triage nurse knows it fits the symptoms of a kidney stone, and that the patient won't die in the next few minutes, he/she can't communicate that to the patient because they can't officially diagnose. We all know that is part of what the triage nurse does- makes a mental list of all the things it could be and thinks about the possible consequences of waiting. Just knowing the findings of the triage nurse would have helped this couple.
  6. by   I want to be a nurse
    Quote from canoehead
    Another problem I see is that even if the triage nurse knows it fits the symptoms of a kidney stone, and that the patient won't die in the next few minutes, he/she can't communicate that to the patient because they can't officially diagnose. We all know that is part of what the triage nurse does- makes a mental list of all the things it could be and thinks about the possible consequences of waiting. Just knowing the findings of the triage nurse would have helped this couple.
    When we got to the last hospital, and the nurse took him into triage, she was asking him if he still has his appendix, we said yeah, blah blah blah and then we said that he kept felling like he needed to urinate alot and only a little bit would come out. She said, Oh that sounds like it might be a Kidney Stone. Just hearing her say that calmed my nerves.

    Thanks for the reply

    Maya
  7. by   allantiques4me
    Im sorry about your horrible,scary situation.I think I wouldve called 911.They at least would have assessed him,and got medical assistance quicker.What ashame.also on behalf of the ER,they might see lots of persons who overreact or are drug seeking on a daily basis.Remember your ABCs.That is usually the precedence.Try C/O of difficulty breathing,youll have a better chance of getting to see the DR more quickly.
  8. by   allantiques4me
    Quote from ShayRN
    I am going out on a limb here and disagreeing with everyone, I think. I feel the way that she and hubby were treated was deplorable. If someone is very obviously in pain, that needs to be addressed. We don't have pain without reason. To be in such awful pain and to be treated like you were less than human in INEXCUSABLE to me. To say pain has never killed anyone is a cop-out. Tell that to the MI patient, tell that to the cancer patient, tell that to the patient with a DVT. No that pain won't kill them, but the REASON THEY ARE HAVING PAIN WILL!!!! I wonder if the scenero would have been different if they knew someone at the hospital or were friends of the board.

    No, I am not naive, I worked at an inner city jail for 18 months and was lied to daily. HOWEVER, I was also on the other side. My husband c/o pain twice in his life to me, to the point I took him to ER. Once they found a tumor the size of a grapefruit in his lung. (This after the ER doctor told us we should have stayed home with some Advil.) The second time the surgeon told me he was within 24 hours of his appendix exploding. Luckily, the second time I was a nurse at the hospital and they didn't think my husband was drug seeking. I AM NOT THE JUDGE and JURY! It isn't my job to decide if someone just wants drugs. If you have lost your compassion in the ER, maybe its time to move on. SORRY, just my
    Very well said!!
  9. by   Antikigirl
    Quote from I want to be a nurse
    When we got to the last hospital, and the nurse took him into triage, she was asking him if he still has his appendix, we said yeah, blah blah blah and then we said that he kept felling like he needed to urinate alot and only a little bit would come out. She said, Oh that sounds like it might be a Kidney Stone. Just hearing her say that calmed my nerves.

    Thanks for the reply

    Maya
    Actually Maya...when you told of this story I wondered about appendix rupture or kidney stones before I got to the end of the story! You described the story so very well!!!!!!!

    I agree with you, with pointed out mistakes of going hospital jumping and all (and if your hubby says so...heck...you do it, you love him and want to do things for him!!!! I let my hubby drive himself during a heart attack to the hospital totally white nuckled waiting to take over the wheel because he wouldn't let me drive! I know...very much so I know!!!!!!!!!!).

    But it was the fact that you had no clue..hubby had no clue...and you had pleanty of time to wonder of the worse....and well...nurses and their compassion should be consistant..but human beings are not...especially in emergencies! SO no matter where you go...I think it is a Murphys law..you will encounter someone that will not share your feelings in the way you do! (medically speaking or not)...

    It would be a great world if nurses in ER could have the chance to share their love and compassion..but ER isn't that place! You have to deal with here and now...put your emmotions aside (IE the burn out potential, and the feeling you did so much, maybe saved someone but you feel empty!)... But rest assured...they do care! Trust me..they do!

    Sadly your hubby came in for good reason...but the system...gives ER an open ticket to help anything...and it stalls those that need it! And someone somewhere will come up with a better idea for how to handle it...and more than likely will be ignored...LOL!

    Huggles to you and your hubby....even with the hospital jumping you did...you tried your best to do what was right for your loved one! And well....loved ones can have you doing whatever to help them! Including letting a man drive when you knew he was having a heart attack!!!
  10. by   CritterLover
    Quote from shayrn
    i am going out on a limb here and disagreeing with everyone, i think. i feel the way that she and hubby were treated was deplorable. if someone is very obviously in pain, that needs to be addressed. we don't have pain without reason. to be in such awful pain and to be treated like you were less than human in inexcusable to me. to say pain has never killed anyone is a cop-out. tell that to the mi patient, tell that to the cancer patient, tell that to the patient with a dvt. no that pain won't kill them, but the reason they are having pain will!!!! i wonder if the scenero would have been different if they knew someone at the hospital or were friends of the board.

    no, i am not naive, i worked at an inner city jail for 18 months and was lied to daily. however, i was also on the other side. my husband c/o pain twice in his life to me, to the point i took him to er. once they found a tumor the size of a grapefruit in his lung. (this after the er doctor told us we should have stayed home with some advil.) the second time the surgeon told me he was within 24 hours of his appendix exploding. luckily, the second time i was a nurse at the hospital and they didn't think my husband was drug seeking. i am not the judge and jury! it isn't my job to decide if someone just wants drugs. if you have lost your compassion in the er, maybe its time to move on. sorry, just my


    i think we all agree that pain needs to be addressed.

    in the op, maya stated that there were about "100 people" waiting at the first hospital. many of them were probably in pain. it isn't as though the waiting room was empty and they just left him out there to suffer. i don't blame her for asking for pain meds (and maya, it may have been a nurse but was probably a clerk), but of course they couldn't give him anything yet. (i hear that some hospitals are starting to give pain meds in triage -- scary, scary -- but there is no way anyone would be given as much as a tylenol without going through triage first).

    as for the attitude encountered at the second hospital, i'm really sorry you were treated that way. however, the clerk (i'm assuming it was a clerk) never should have told you to knock on the triage nurse's door. she is in there trying to see to a patient, and it really isn't acceptable to interrupt. had i been the triage nurse, i would have been ticked, too. (though more at the clerk than you). i get mad at my co-workers when they interrupt triage, too. it is really a privacy issue and a respect issue for the patient in the triage chair. i try to be nice about it, but if you were the 50th person to interrupt me that night, it would be hard to keep the irritation out of my voice.

    another thing, sometimes it is easy to misinterpret someone's attitude. i tend to be fairly laid-back. i don't get excited all that easily. i try to be calm and even. it doesn't matter if your toe is stubbed or if you are turning several different shades of blue due to hypoxia. i have found that getting anxious and excited doesn't do anyone any good. the patient and their family are already all worked up. if i get worked up, too, it makes the situation worse. generally, it works well. sometimes, though, i get accused of being cold and indifferent. it is especially easy to misinterpret attitude when you are upset/concerned.

    i'm not really trying to tell you that you are wrong about how you were treated, because i wasn't there. you may be dead-on, they may have been completely inappropriate and rude. there are people like that, and some of them are (unfortunatly) nurses. but i wanted to give you something to think about.

    by the way, i wanted to thank you on how you approached this here. it is so nice to have someone ask why things went the way they did, rather than outright blasting er nurses for being such horrible, mean, uncaring people. we appreciate the opportunity to explain ourselves without having to get defensive.
  11. by   TazziRN
    Quote from allantiques4me
    I think I wouldve called 911.They at least would have assessed him,and got medical assistance quicker. What ashame.also on behalf of the ER,they might see lots of persons who overreact or are drug seeking on a daily basis.Remember your ABCs.That is usually the precedence.Try C/O of difficulty breathing,youll have a better chance of getting to see the DR more quickly.
    Whoa.....I hope I'm reading this wrong. Let's take it piece by piece.

    "I think I wouldve called 911.They at least would have assessed him,and got medical assistance quicker."

    Not necessarily. When someone comes in by ambulance, they have already been assessed by the medic and a report has been called to the ER. If there are no beds and the problem is not emergent, the pt can be sent to the WR. For someone to call 911 because they're scared is fine. To call just to get seen faster is wrong.

    "Remember your ABCs.That is usually the precedence.Try C/O of difficulty breathing,youll have a better chance of getting to see the DR more quickly"

    I most certainly hope that this was not an encouragement to people to lie about their complaint to get seen faster. Nothing, and I mean nothing, p***es us off more than a faker taking advantage.

    Please tell me I read that post wrong.........
  12. by   AggieQT
    I am a chronic stone forming factory myself. My heart goes out to your s/o. As I found out the hard way, sadly the chances of him passing another stone are quite high. Every time I start to feel that severe "I just wish I were dead and I can't even think to tell you my name correctly" pain I just dread the trip to the hospital. Hopefully this was a one time deal, but if it wasn't my advice to you is to just suck it up and wait. I have to remind myself everytime that I will not die and that there are people in the back that really are life and death. *Best Wishes*
  13. by   chuck1234
    Quote from chuck1234
    I have never been working in the ED or ER before....
    But I know ER nurses always pay great attention to patients who have airway problems...think about it...patient die very quickly without oxygen.
    In the case of your husband, he showed the ER nurse that his airway had no problem...and he was walking around...
    I hope this will help you understand better how the ER/ED nurses function in the ER/ED. I felt sorry for what you had gone through...it must have been a very scary experience.
    As I stated, I have never been working in the ED., but nurses in the ED and the nurses in the ICU have the similar goal...they
    do not want to see any patients die under their care...so...it is really the priority thing..let's say I am assessing your husband's pain..while the other patient is having a SOB...who am I really going to assess first...is it the 1st come 1st served thing...as I stated, the experience you underwent must have been scary to you...but let's say your husband is having a SOB...and the other patient is having kidney stones...should I see the patient with the kidney stone first...then when I finish him...do you think your husband still around...I have seen a few notes written by some nurses right here...if I have to follow what they say...many of my patients would die...sorry!...nursing is not about how much education you have...it is about how much common sense you really have....

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