An open letter to the ER triage nurse

Nurses Relations

Published

I wrote this letter to a Triage nurse. I don't know her name as she did not introduce herself to me. I haven't decided what I am going to do with it...but I figured I would post it here to start. It's an interesting experience being on the other side of the gurney for a change.

Let me know what you think.

*************************************************************************************

I write this letter to the ER triage nurse who was on duty May 11, 2011 at a local hospital.

On that day I was taken to the ER by ambulance. I had experienced sudden neurological symptoms, was having trouble standing and walking and was very frightened even though I was trying very hard to stay calm. Anyone who's been in that situation knows how awful it is and how your mind races thinking up the worst case scenarios. I had chosen your hospital because I had been there in the past and know it to be an excellent hospital.

When you called me in (the ambulance attendants had to take a number and wait to be called) you sat down in front of your computer and started to take the report from one of the ambulance attendants. You barely looked away from your computer screen, and from my perspective didn't make eye contact with the ambulance attendant. You did not look at me or acknowledge me.

When you were done, I asked you if it was possible for me to go to the bathroom. You waved past the triage room towards the waiting room and said, "There's a bathroom over there, you can walk there."

My friend, who had accompanied me, responded, "But she's having trouble walking."

You responded, "That's not my problem. I can't go to the bathroom for her. There are wheelchairs all over the place."

The ambulance attendants helped me into a wheelchair and my friend took me to the bathroom.

You didn't know this at the time, but I will tell you this now....I am a Registered Nurse and have been for 26 years. I know what it is to be overwhelmed, overworked, undervalued, underpaid and frustrated. I know what it is to be stressed and I know how it feels to burn out. I've been there, done that and have the t-shirt so to speak.

I truly understand that your job can be difficult at best, But let me ask you something....how is all that my fault?

What did I, as your patient, do to deserve to be treated so rudely? Do you think I wanted to be there strapped to that ambulance gurney? Do you think I timed having my bladder being so full it was painful right for that moment? How much would it have cost you to turn to me and actually look at me? A nursing assessment consists of at the very least looking at your patient and not just relying on the report of the ambulance attendants. How difficult would it have been to simply tell me that you would get me a wheelchair once you were done? (There was one right next to my gurney) How difficult would it have been to crack a little smile? I wasn't asking anything complicated, all I wanted was to pee.

Remember, I am one of you. I too have been on your side of the bed and I too have felt the sting of the profession we chose. So I think it is safe for me to say, with some authority borne from experience that there is never an excuse for a nurse to treat his or her patient the way you treated me.

I'm writing this to put a voice to this problem. I know I'm not the only patient who's had to go through this or worse. Sadly, this kind of behaviour has become rampant. I see examples of that everywhere. Our current health care system with all its problems has put our profession is in crisis. The lack of funding, lack of resources and lack of staffing means that nurses are shouldering a huge burden. I get that! But our patients are in crisis as well and we are the professionals who are caring for them. That's why we are nurses, to care for people. Caring means kindness, not rudeness.

My friend, who is not a nurse, was aghast. She later told me that while we were in the triage room she witnessed another nurse yelling at a very elderly woman and dragging her down the hall by the hand. My friend was going to say something but was told by the ambulance attendant not to say anything because the nurse would "make a spectacle of her."

That is a sad statement considering we are talking about a profession known for caring. Have some of us really forgotten who and what we are and why we are doing what we do? Maybe we should all spend some time on "the other side of the gurney" for a change.

I do have to add one thing however, the ambulance attendants were phenomenal. They were caring, gentle, patient and knowledgeable...literally everything a health care professional should be and more.

Specializes in TELE, CVU, ICU.
your letter is unbelievably touching and is unfortunately more common place behavior than it should be. i know i have experienced it as a patient, and it always left me dumbfounded as to why these people are nurses. nurses have such a critical role in how a patient responds to care that it just boggles my mind. i do understand being overworked, understaffed, and downright overwhelmed, but every patient should be cared with dignity and respect. i am rn nursing student and a career changer. let me first say that it was a career change by choice and a stirring passion that i am finally fulfilling. there are two instigators to this unacceptable behavior 1. nurses that have lost their passion and 2. people entering nursing because it seems to be "the thing to do" in today's challenging economy and they think that it is a sure thing (which it is not). nursing is a whole lot more than "employment". you see i don't even know if i am going to have a job but i am on my journey with eyes wide open because i want to help people. of all the ebn care that is available at the top of the list would be patient comfort, empathy, and comfort.

ps. to all of the nurses out there that are thinking... what is she smoking, and that i may be looking through rose colored glasses i say it may be time for you to rethink why you became a nurse in the first place.

:nurse:

i have only in thing to say in response.

just. you. wait.

good luck in school, try volunteering at a hospital. or get a job as a caregiver at an assisted living or as a na at a hospital orltc.

there is an excellent cope student program

Specializes in M/S, Travel Nursing, Pulmonary.
I pondered my use of the word hysteria all afternoon. But it means "excess anxiety" and that is what I noticed in many of the posts, especially at the beginning of this thread. It made me think of . . . .

off_with_her_head.JPG

My question is not whether the nurse was rude or not. She was rude.

But to contact the CEO, the local newspapers, etc., over this seems . . . . . over the top.

So, I'm perplexed about that too.

I made it all the way to page 9 or 10 and quit reading. I have to say, as I truged through the posts, this is pretty much what went through my head too. "Local newspapers, contacting the CEO etc" definitely over the top, IMO anyway.

To the OP, if there were a way to get your letter to the triage nurse without it landing in anyone else's hands, I'd be all for it. I've had my moments of weakness and witnessed some pretty scary ones by other nurses. BUT.......(there is always a "but"), we can't take a still picture and judge this nurse by it.

I think the biggest unknown in all of this is............what is she like normally. Are comments like the one's made to you the norm, or was this a true and rare moment of weakness. I kinda see the assumption that this is the tiage nurse's norm in a lot of the replies. For me, that is the one thing that gets me most about nursing. I can be so perfect and give so much more than should be expected, and than BAM..................I'm a horrible nurse because I forgot someone wanted water or something.

I must say too, its the "critiques" that come without threat of punishment that seem to reach me best. I'd be willing to bet, if you could make your point to the triage nurse without her having to get dog piled on by admin./management (and certainly not the local newspaper), your point would be much the more powerful to her too. Hanging her on a cross will only serve anyone IF you are 100% certain that her behavior that night was her "norm". Then you can say you've done future patients a service. On the other hand, eh................what if she is an outstanding triage nurse who ends up being fired? Not doing anyone, not even yourself, much of a service then.

IDK. For me, if you go overboard like some people are suggesting, I'd be willing to be it'd be something you ended up regreting later on. So, my advice comes from the viewpoint of taking a lighter hand in making your point (lighter than going to the CEO and local newspaper is what I mean) with her, it will be better for you as well as her.

"if you could make your point to the triage nurse without her having to get dog piled on by admin./management (and certainly not the local newspaper), your point would be much the more powerful to her too."

That's why, I believe, communication at the immediate point of contact is the best thing. If confronted, the nurse may have apologized, and/or explained why she said what she said the way she said it, no excuse, but maybe she was just having a bad day and admitted it. And, this goest both ways. Both patient and caregiver should be willing to deal with this kind of conflict at the initial point. But caregivers are still in the driver's seat, psychologically,in cases like this and need to take the lead.

And, yes, see what happens when no attempts are made to solve communication problems at the lowest level? People get angry and start thinking revenge instead of just solving the problem. BTW, several medical studies have indicated that had communication been better, had honesty prevailed, laws suits could have been prevented.

Specializes in er,cvicu,icu.
your letter is unbelievably touching and is unfortunately more common place behavior than it should be. i know i have experienced it as a patient, and it always left me dumbfounded as to why these people are nurses. nurses have such a critical role in how a patient responds to care that it just boggles my mind. i do understand being overworked, understaffed, and downright overwhelmed, but every patient should be cared with dignity and respect. i am rn nursing student and a career changer. let me first say that it was a career change by choice and a stirring passion that i am finally fulfilling. there are two instigators to this unacceptable behavior 1. nurses that have lost their passion and 2. people entering nursing because it seems to be "the thing to do" in today's challenging economy and they think that it is a sure thing (which it is not). nursing is a whole lot more than "employment". you see i don't even know if i am going to have a job but i am on my journey with eyes wide open because i want to help people. of all the ebn care that is available at the top of the list would be patient comfort, empathy, and comfort.

ps. to all of the nurses out there that are thinking... what is she smoking, and that i may be looking through rose colored glasses i say it may be time for you to rethink why you became a nurse in the first place.

:nurse:

i read your posting and really did stop and think about why i became a nurse, honestly i did. i became a nurse to help people, yes i did. i went into nursing with absolutely no experience in the healthcare field, heck i had never even been in the hospital. it was eyeopening to say the least. but i did understand that it was a job, not a call from the divine. yes i think there is more to nursing than clocking in and out, it is a unique job to say the least. however going into nursing with the attitude that it is all about "stirring passion" is asking to be disappointed and frustrated. i also don't understand someone who by your own admission is a nursing student have the for lack of a better word gall to insult working experienced nurses with the question you posed. and as far as your list of things important, yes patient comfort is at the near top but also is patient safety and helping the patient get the care they are in need of, which isn't always delivered in the way the patient expects it. it is about what the patient needs, especially in the ed, not always what they want.

good luck in your nursing career.

An interesting point that comes from reading all the previous posts is how often we have had similar poor experiences of our own when we were sick and needed care. I too was treated badly years ago in the ER. I was told to pee in a cup and pointed the way. I barely stumbled down the hall on my own and collapsed out of exhaustion and dizziness onto the floor. I was conscious but too weak and ill to pick myself up; I stayed on the floor with the door wide open for what felt like 20 minutes before anyone noticed. When a nurse came in she rudely commanded me to get up but offered no assistance.

I was treated like garbage and this experience has made me more determined to be a "nice nurse", compassionate and understanding. May all of our horrible experiences only remind us that we have been in the pt's shoes and to treat them kindly and gently no matter how hectic life gets.

I read your posting and really did stop and think about why I became a nurse, honestly I did. I became a nurse to help people, yes I did. I went into nursing with absolutely no experience in the healthcare field, heck I had never even been in the hospital. It was eyeopening to say the least. But I did understand that it was a job, not a call from the Divine. Yes I think there is more to nursing than clocking in and out, it is a unique job to say the least. However going into nursing with the attitude that it is all about "stirring passion" is asking to be disappointed and frustrated. I also don't understand someone who by your own admission is a nursing student have the for lack of a better word gall to insult working experienced nurses with the question you posed. And as far as your list of things important, yes patient comfort is at the near top but also is patient safety and helping the patient get the care they are in need of, which isn't always delivered in the way the patient expects it. It is about what the patient needs, especially in the ED, not always what they want.

Good luck in your nursing career.

WOW!!! is all I can say to the responses I have received and to all of the responses in this thread. It almost seems that a nurse with years of experience is to be feared and never to be questioned, rather than be humble enough to accept that she/he was not acting with compassion, and in this case safety. As stated earlier in the thread, the patient was needing assistance to go the bathroom not "pillow fluffing". And for all of you negative nellies that are soooooo supportive (not) to new nursing students. It seems like you take every opportunity to remind us how rough it is going to be and almost sarcasticly say "good luck" as if we don't stand a chance in hexx, well you were once a new nurse just like me. My comments is not to be insulting to an experienced nurse but the truth is that the ER nurse treated the patient poorly.

Specializes in Rodeo Nursing (Neuro).
Wow...having just read this entire thread or as I have taken to calling it the circle of repeating the same comments by a few select posters, I have come to the conclusion that this thread is continuing because people apparently like beating a not only dead but badly mutilated horse. Anybody interested in forming a support group of readers who endured the entire thread?

(sacrasm applied there)...geeze come on you know that was funny...

I think some of the posters continue to participate because they relate it in some way or another to their own experiences and have become emotionally invested in persuading others to see their point. Then there are those who apparently just don't have anything to do but read page after page and gripe about how boring it is.

ETA: LOL

Specializes in er,cvicu,icu.
WOW!!! is all I can say to the responses I have received and to all of the responses in this thread. It almost seems that a nurse with years of experience is to be feared and never to be questioned, rather than be humble enough to accept that she/he was not acting with compassion, and in this case safety. As stated earlier in the thread, the patient was needing assistance to go the bathroom not "pillow fluffing". And for all of you negative nellies that are soooooo supportive (not) to new nursing students. It seems like you take every opportunity to remind us how rough it is going to be and almost sarcasticly say "good luck" as if we don't stand a chance in hexx, well you were once a new nurse just like me. My comments is not to be insulting to an experienced nurse but the truth is that the ER nurse treated the patient poorly.

First off, I was truly wishing you luck on your nursing career..but hey if you are going to accuse me of something well let me accomadate you by doing it at least. Yes experienced nurses, especially the fear inspiring ER nurses, just may know a little tinny bit more about this than you do. Secondly, as far as the safety of this patient, she had a friend at her side as well as 2 "ambulance attendants". She obviously was able to be put back in the waiting room, aeb by her being triagable not having to be rushed to a room and a stroke code called. She was obviously alert and oriented enough to make note of the triage nurse's lack of eye contact and devil's horns sticking out, so i think her getting to the bathroom with her friend's help was a reasonable thing to expect. And for the record all the triage nurse did was be short and not warm and fuzzy with the patient. she did not verbally abuse the patient or endanger her well being.

I think some of the posters continue to participate because they relate it in some way or another to their own experiences and have become emotionally invested in persuading others to see their point. Then there are those who apparently just don't have anything to do but read page after page and gripe about how boring it is.

ETA: LOL

Surely you are not referring to me? ;);)

I think what holds my attention is the justification for how one person aptly put it - a revenge mode reaction to a nurse's rude comment.

But now we've got another line of thinking and that is the one that causes long long threads here on AN all on its own. Whether being a nurse is a calling.

Personally - it was not a calling for me. However, I have chosen jobs that are helpful to others in some way. I like interacting with people.

And even if you answered a call to become a nurse, that does not guarantee you a Teflon smile and nerves of steel and the ability to ALWAYS stay in control of your fatigue-related behavior/comments.

Even "called" nurses get tired and grumpy.

No one is perfect. But, this ER triage nurse does need to hear about the OP's reaction to the treatment she received - one on one. Then I'd let it go.

edited to add - And by the way, the OP DID ask for any and all advice.

Specializes in geriatric, ER.

I worked in an Emergency Setting as a Medic (talk about burn out city!) before I became a nurse. I know all of your amazing ER nurses get burnt out but I believe when you get to that point its time to change floors or places in nursing. If you are burnt out you are not going to provide excellent care (even if you want too!) Trust me, I have been there as a medic!

Specializes in Education, FP, LNC, Forensics, ED, OB.

Closed for review.

Specializes in RETIRED Cath Lab/Cardiology/Radiology.

After Staff discussion, it was decided the thread will remain closed.

A few words to the wise:

* Post only to the thread subject.

* Personal attacks will not be tolerated.

**Report questionable posts rather than engaging the member.

* Please take a few moments to review the Terms of Service for future posting guidelines.

+ Add a Comment