A Headache is not an emergency

Specialties Emergency

Published

I just don't understand!!

Why are patients using the ED for a simple headache just to get??? Tylenol. That stuff doesn't even work. It's more like placebo pills!

Insurance pays $5,000 for a freaking headache

My insurance rates go up because you decided to read in the dark.

Move to Barrow, Alaska to have 24 hour sunlight..

Specializes in ER.

I have no problem with people signing in to be seen in our ER with nonurgent complaints. BUT if they complain about sicker people going ahead of them, then I have a problem. We have only so many beds, and so many docs, and we're staffed for EMERGENCIES. We need to take care of the sickest first, and fit everyone else in where we can. The guy with the hangnail should be ready to wait five hours, his visitor wont get the special comfortable armchair, and we don't serve meals. I'm tired of the verbal abuse, and heavy sighs.

Any of the posters here can sign in with their earaches or headaches, I'll try to pick out the life threatening symptoms, and send those people right back. For the others, Tylenol and a chair, not because you're not sick, just we've got others that are sicker. We'll see you no matter what, but IMO you'd be happier staying at home.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
The guy with the hangnail should be ready to wait five hours, his visitor wont get the special comfortable armchair, and we don't serve meals. I'm tired of the verbal abuse, and heavy sighs.

In my former ER (military), everyone has a primary care provider, but it is difficult to get appointments and patients are commonly directed to the ER by their clinics when they call for same-day appointments for nonurgent issues. This creates long waits in our ER. Patients complain, but I often pointed out that even with waiting a few hours, that's a heck of a lot faster than the two to six weeks that was offered by their primary care provider. That usually gave them pause/perspective. Not always, but yeah.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I have no problem with people signing in to be seen in our ER with nonurgent complaints. BUT if they complain about sicker people going ahead of them, then I have a problem. We have only so many beds, and so many docs, and we're staffed for EMERGENCIES. We need to take care of the sickest first, and fit everyone else in where we can. The guy with the hangnail should be ready to wait five hours, his visitor wont get the special comfortable armchair, and we don't serve meals. I'm tired of the verbal abuse, and heavy sighs.

Any of the posters here can sign in with their earaches or headaches, I'll try to pick out the life threatening symptoms, and send those people right back. For the others, Tylenol and a chair, not because you're not sick, just we've got others that are sicker. We'll see you no matter what, but IMO you'd be happier staying at home.

I know what the protocol is for the ER & will wait if there is someone who has an emergent situation. Thankfully the couple of times I went to the ER there was either no one there so I was taken back quickly or they had the clinic part open. I know you guys put up with a lot of ******** & respect you guys for it.

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Yeah, no. It is actually lose-lose.

I didn't become a nurse - especially an ED nurse - for "job stability." In as much as I didn't become a nurse to treat "customers" instead of "patients."

This is exactly the kind of hokum peddled by un-supportive management to ensure a continuation of ED abuse and over-crowding. A few years ago at my old ED job, management tried to convince ED nursing staff that an establishment of an "Observation Unit" (monitoring admitted, stable Observation patients - usually for chest pain/ r/o ACS) was in our best interests. More "hours posted" for nurses/techs to pick up, hence bigger paycheck etc.

NONE of the nurses/techs 'assigned' the Obs Unit liked working it - for obvious reasons (not all that different from taking care of holds/boarders!)

And let me remind everyone - ED overcrowding is as serious as a heart attack, and can be just as deadly! How many of you would like to bring your Father or Grandmother to the ED with complaint of chest pain and be told to wait in the waiting room? Or let us assume the initial EKG shows an acute MI but the ED is so full (with emergent and 'non-emergent' complaints), the staff has to "create a bed" to accommodate an obvious emergency - would you like the nurse taking care of your Father or Grandmother, to also be responsible for 5 other patients? Or would you prefer that the nurse be able to hand off her patient load momentarily so that s/he can pay undivided attention to your loved one in their hour of crisis?

Or let us even assume that the initial EKG at triage was normal or borderline - how many of you would want the triage nurse to send you back to the waiting room instead of a monitored bed? Be truthful!

I had one a few months ago.

Very young, adult female. Came in by EMS. I triaged her out to the waiting room because I had no open beds. At 0830 in the am. She huffed and certainly appeared offended that she was going to the 'waiting room' even though "I came by ambulance."

As the EMTs were wiping down their stretcher and getting ready to head out, I noticed that their radios were going off constantly. The EMTs looked upset. I leaned over and asked "Y'all ok?"

"No. Not ok. That's the third call out requesting an ambulance to transport a critical patient but nobody in the township or county can respond because we're tied up with BS calls!"

The very young, adult female that came by EMS? Her chief complaint?

'lady partsl discharge'...

Nope, not kidding.

* Have you EVER had to take a "chronic headache patient" and smile about it, when it is the patient's 240th visit in the ED in 2016? For the same "chief complaint"?

The ones who are allergic to everything except Dilaudid and Benadryl/Phenergan? None of which are drugs recommended to treat chronic migraines or headaches?

* The ones who refuse Imitrex (for example) because "it doesn't work. That drug what starts with the D... Dilauntin.... usually helps."

* The ones who occupy a stretcher in the ED with their chronic, non-emergent complaint - while 80 year old gramma lies in withering pain in the waiting room!

Not burned out - but I am certainly very frustrated!

cheers,

The vag discharge/yeast infection could go to a GYN Clinic or Fast Track area if your hospital had one.

We never sent chest pains to the waiting room, especially if they were 80 y.o. grannies such as you described. The stretchers have wheels and they can be moved out of the room with non-emrgent patients on them so you can then put the CP Grannies in That's what we did anyway, back in the Dark Ages.

As already addressed, headaches can indeed be serious.

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Specializes in Cardiovascular recovery unit/ICU.

Using the ER for Tylenol is not for the ER I agree but I'm a migraine sufferer. I am under the care of a neurologist, have been for 20+ years. When all of the prescription treatments my neurologists has given me fail and I am going blind and vomiting from the pain....YES I go to the ER at her request (after calling the on call neurologist for further instructions). If they tell me to go to the ER I go! Some migraines require a strong opioid to "reset" the pain cycle.

I many time am treated like a drug seeker and it burns me up! One doctor charted a diagnosis of "panic attack" and would not change it. This is disturbing to say the least.

So upset with this experience, I changed to a different ER years later when I couldn't control my migraine and I was treated as a drug seeker there too. This has to stop, though I doubt it ever will.

For all you true migraine sufferers out there my heart goes out to you all.

Your post ruffles me a bit since it flat out declares a headache is Not an emergency. Be careful not to clump everyone into the same stereotypical category of not an emergency. Do some research and have some compassion for those whom truly suffer.

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Specializes in Pediatrics, Emergency, Trauma.
Using the ER for Tylenol is not for the ER I agree but I'm a migraine sufferer. I am under the care of a neurologist, have been for 20+ years. When all of the prescription treatments my neurologists has given me fail and I am going blind and vomiting from the pain....YES I go to the ER at her request (after calling the on call neurologist for further instructions). If they tell me to go to the ER I go! Some migraines require a strong opioid to "reset" the pain cycle.

I many time am treated like a drug seeker and it burns me up! One doctor charted a diagnosis of "panic attack" and would not change it. This is disturbing to say the least.

So upset with this experience, I changed to a different ER years later when I couldn't control my migraine and I was treated as a drug seeker there too. This has to stop, though I doubt it ever will.

For all you true migraine sufferers out there my heart goes out to you all.

***Your post ruffles me a bit since it flat out declares a headache is Not an emergency. Be careful not to clump everyone into the same stereotypical category of not an emergency. Do some research and have some compassion for those whom truly suffer***.

OR...the attitude of "headache is not an emergency" end up with a pt stroked out and a code, or dying , and having to explain why they didn't "believe"...

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Food for thought...a few months ago I had a healthy 25 year old with no history come in for a headache...acting very dramatic about it, etc etc. Doc put in for a head CT and some morphine. After the morphine she was knocked out in her room, snoring and all, vitals holding up ok. One of the times I make rounds she's not snoring anymore - because she stopped breathing! Didn't make it.

After that, I stopped being so dismissive.

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Specializes in NICU.

I have a "migraine" disorder called occipital neuralgia that usually respond to high doses of imitrex but about two or three times a year at least I max out my dose and have no choice but to go to the ER and get a bag of fluids, toradol, reglan and Benedryl cocktai IV. They have it in my chart that this works well for me and to give it. I am usually there for less than 3 hours total. Primary Doctors aren't willing to prescribe narcotics anymore as a possible treatment to try before needing the ER so that's my only choice in those situations. If they would rather me sit in there ER and take up space than give me 5 Percocet to keep at home just in case than that's their problem not mine. But the iv cocktail works pretty well for me, not sure how well Percocet would work but it worked well for post surgical pain for me so I think it could help

break the cycle. But alas narcotics are now too taboo even in minuscule doses.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I have a "migraine" disorder called occipital neuralgia that usually respond to high doses of imitrex but about two or three times a year at least I max out my dose and have no choice but to go to the ER and get a bag of fluids, toradol, reglan and Benedryl cocktai IV. They have it in my chart that this works well for me and to give it. I am usually there for less than 3 hours total. Primary Doctors aren't willing to prescribe narcotics anymore as a possible treatment to try before needing the ER so that's my only choice in those situations. If they would rather me sit in there ER and take up space than give me 5 Percocet to keep at home just in case than that's their problem not mine. But the iv cocktail works pretty well for me, not sure how well Percocet would work but it worked well for post surgical pain for me so I think it could help

break the cycle. But alas narcotics are now too taboo even in minuscule doses.

I was just prescribed Imitrex for my migraines & when I went to the ER I got the same cocktail. I have to say the IV Benadryl knocks me over worse than any other IV narcotic.

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Specializes in NICU.
I was just prescribed Imitrex for my migraines & when I went to the ER I got the same cocktail. I have to say the IV Benadryl knocks me over worse than any other IV narcotic.

I hear you there! At home if I feel a bad one coming on at bedtime I take a muscle relaxer, 800 mg ibprofuen and 50 mg Benedryl and a lot of times those meds and sleep and I will make it to morning feeling ok. The times where I wake back up at 3 am feeling like I am dying and my teeth are exploding I know it's not going to get much better

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I hear you there! At home if I feel a bad one coming on at bedtime I take a muscle relaxer, 800 mg ibprofuen and 50 mg Benedryl and a lot of times those meds and sleep and I will make it to morning feeling ok. The times where I wake back up at 3 am feeling like I am dying and my teeth are exploding I know it's not going to get much better

Omg I feel you. When I get a migraine I will sleep for at best 2-3 hours if I'm lucky.

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Sure, a headache isn't an emergency...except when it is. An OTA I used to work with had an extreme headache at work. 10 minutes later she passed out briefly and was sent to the ER. Turns out she had an aneurysm that burst. She lived just long enough for her husband and three children to get to the hospital and say goodbye.

Oh my word! You just never know with headaches, better to be safe than sorry especially really severe ones!

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