Hello all-I found your site while doing a search for standard of care in the ER. I'm going to be the first to say, the only nursing experience I have is as a patient as I have just been accepted to a program. I will introduce myself more later, but currently typing this with one hand do to surgery yesterday (which is how I found this site)
Anyway, on Sunday I was getting ready to make dinner & handed my husband a sharp knife by handing it handle out. You can probably guess what happened next. I wanted to wait & see since I'm not one to head to the ER unless I think I need to go by medic. But this time, I knew the cut on my index finger was DEEP (arterial blood was squirting out). We have several major hospitals near us, we chose the closest because the bleeding was so heavy (soaked 3 bath towels in 15 mins)
So we arrive at the ER, lots of blood, taken immediately to a room, BP check and questioned by a few different people (a nurse and some others, not sure what they were, never saw them again). Nurse hands me a gauze pad and tells me to hold my hand over my head and keep the pressure on it. She goes over my medical history and then leaves. The clerk comes in to collect my $150 copay. About 20 mins have now passed with me spurting blood & everyone that comes into the room saying "wow, you're making a mess". 30 mins, doc comes in, pours saline on the cut and say "holy crap, we need a hand surgeon, I'm not touching that" and leaves, saying he will go page one. Now we've been there an hour, I've soaked my entire sheet, gown (they removed my shirt). I'm doing the best I can to keep my arm above my head and hold pressure, but I'm feeling sick, clammy and very dizzy. A radiology tech comes and when I get to the xray area, she tells me to take the pressure off and remove the gauze pad. I warn her I am bleeding a lot she says "I have to xray without the pad" so I remove it and blood immediately sprays all over the room. her clothes, etc. She gets upset, takes the xray while yelling at the other tech that "she made a huge mess, ugh I guess I will clean it up"
Then she wheels me back to the exam room. The ER is practically empty except for me, another guy who cut his hand and a teen with a sore throat, an ENORMOUS woman who wants pain meds because her knees & hips hurt and a bunch of toddlers crying and screaming (they are there with the "sick" people who bring the entire family) The nurse ONLY comes to check on me when my husband, who sees the large pile of bloody towels and then she finally says "I guess you want something for pain" to which I say "No, I want to stop bleeding!!". She sends in an aide who can only say "no, must keep pressure" and grabs my injured hand trying to twist it to put a new gauze bad, more blood squirts on HIM and he ends up scraping my leg with something in his pocket (leaving a 16cm cut on my thigh) and I yell in pain & he runs out of the room. Noone comes to check
Now we have been there for 3.5 hours and the bleeding has not stopped, even with pressure & holding it above my head (I can't do it forever I am getting weak). I feel like I'm going to pass out, I'm very thirsty and the nurse comes in with a percocet & a cup of water. My husband asks how much longer & what are we waiting on. She says "Oh, they're just working through the others (sore throat, hip/knee pain and other cut finger - they are treated first because they are there first, she says. He says "even with all of this bleeding?" and she shrugs, checks my BP again (which has dropped to 85/56 from 142/90 when I arrived) and leaves. My husband goes back out to the desk & is told they took the OTHER guy to surgery so it'll probably be 12+ hours longer wait for me. A physcian's assistant overhears and says "I'll sew her up but you need to have a surgeon come check her first" So I've gone from emergency, to ignored, to a dr afraid to sew me up because it's too deep to a PA saying she will do it.
My husband finds someone else who pages the surgeon, who leaves surgery to come check me. He asks how long I've been bleeding like that and everyone makes excuses. He VERY annoyed. He checks my cut & says "you've cut an artery, a bunch of nerves and the tendon, you have to have surgery but I'm in the middle of sewing the other guys thumb on, you should have been first!" and gives me a nerve block and instructs the PA how to put loose sutures in and tells me to be in his office at 8 the next morning (Monday), I'm immediately booked for surgery which has been done.
Is this the standard of care for an emergency? Should I have gone to urgent care instead? We went to the ER because it was 5 pm on Sunday and everyone else was closed. I thought bleeding like that IS an emergency, not a sore throat or something. I feel really traumatized. I was in HORRIBLE pain the entire 5 hours we were there, the surgeon said I lost A LOT of blood (the only way he knows is because I just had a CBC a week ago at a checkup and I guess he is able to figure it out from the blood he took from me?) He is SO upset that I wasn't given any pain med to take home, no IV, no blanket and wasn't kept warm with the blood loss, no antibiotics, nothing in the ER) The surgery took nearly 4 hours to repair because it was such a mess. I feel REALLY terrible and sudden lost my hearing in my left ear when I felt like I was fainting (and did lose conciousness for 2-3 mins until the PA came in and flicked me or something, it is all a nightmare to me.
I don't want to be a nurse if this is the standard of care (which I am pretty sure it is not, I have been in other ER's for bleeding kidney cyst and was cared for VERY well in the ER and as an inpatient, this was a different hospital, a foofy suburban hospital. I am still feeling a sense of shock over all that happend
Goodness, woman! ...just don't pick up a knife by the blade again! Problem solved.
yes, exactly - I've learned my lesson for sure :) I was always taught to hand the knife by the blade, handle towards the person so they're not grabbing the blade either but it didn't work out so well this time. And it was a new knife.
The timeline for the unbeliever: The injury happened Sunday evening. I finally got home late Sunday/early Monday (around 11:30 or midnight). I was given 16 sutures in the hospital & told that I needed surgery because the cut was too deep & needed a hand or plastic surgeon because of the nerves, arteries, veins, tendons, etc.
Monday -went for the consult with different surgeon that our insurance company suggested because the surgeon who consulted with me via the surgical resident was not covered on our plan. He would have been had I gotten surgery that night because it was an emergency, but since he was already tied up with the other person, I would have had to wait. They said I could stay overnight if I'd like, I declined.
Tuesday - arrived at other hospital, had surgery on my rt index finger. He was able to repair the tendon, the nerves but not the arteries, he said they were too mangled (his words). I had general anesthesia and it lasted 4 hours. So forgive me if I've gottne the days confused, I was thinking today is Wednesday. This is really disheartening to be attacked this way over minor details when I was just asking a question and was hoping for some answers from some professionals in the field.
I do have the names & times. They're on the records they gave me this morning. How is that unusual? I'm also one of those patients that fills out the comment cards that because a nurse friend told me that when those get read at the end of the month, they get rewards & sometimes gift cards or some special thing and I want the people who take good care of me know that I appreciate them. So whatever, if that's weird, troll-like, unbelievable, etc I guess I don't know what to say.
Names and times are not ever included in any records routinely given to pts, such as discharge papers. They would be included in whatever parts of the chart that were requested by the pt. However those requests are made through medical records and can take a day or two.
Not sure why you've posted here, but you are correct in one regard. My posts were mean and sarcastic. For that I apologize. I have no excuse. Please forgive me.
Yes, it is the chart that I have, not the discharge papers and I did get them from medical records, I picked them up today so it has been a few days. I'm not sure why I posted here either - I originally just wanted to find out if what happened to me was normal and typical and standard because it felt very wrong. And I've just been accepted into a nursing program, after that experience it made me really think hard about if I want to do that, everyone seemed so disconnected & like they were all separate from one another, not a team and that isn't what I'd like to do either. I suffer from a chronic and painful illness, I thought maybe I could bring a different type of care to patients from my own experience, maybe I could relate to them or something. But I don't know, maybe not because I didn't fit in here very well. I accept your apology.
I take it back. I think this did happen. I think you cut your finger, it was bloody and scary, you went to the ED expecting a certain sequence of events to occur, and when your expectations weren't met, you got upset.
A finger lac is not a high acuity complaint. It does not require labs to be drawn, nor IV insertion. The typical sequence of events would be that you are triaged, roomed, and seen by a doctor. The doctor will examine the laceration and determine the course of treatment. If it is a clean wound, antibiotics are not necessarily given.
If the doctor determines that specialized intervention is needed (i.e. the hand surgeon), then the doctor calls/pages the specialist. The specialist consults over the phone with the doctor and comes to examine the patient in person if needed.
The specialist determines if immediate intervention is needed, or if the intervention can be done at a later time.
The patient is then discharged or admitted to the hospital, depending upon the specialist's determination.
All of this happened in your case. Five hours start to finish isn't too shabby, really.
I don't believe that you nearly bled out or went into hypovolemic shock. I do believe that your wound continued to ooze, and that this was anxiety provoking to you, that you expected the staff to behave differently than they did, and that was disappointing to you, and that things didn't happen quickly enough for you, and that this was frustrating to you.
But overall, you received appropriate medical treatment.
That's all pretty accurate. Except I was not oozing, it was squirting out with each heart beat unless I kept pressure on it. Had it only been oozing, I would have waited and gone to my regular PCP or something the next morning. The five hours part wasn't so bad. It was the five hours bleeding heavily (not oozing) that was bad. The surgeon (well, the resident that left surgery to come see me & report back) asked if I'd stay the night so I would be ready for surgery in the morning IF they could get me on the schedule and I asked him if there was a temp solution so I could go home & just come back, that's when he told the PA what to do. The squirting of the blood is what distressed me. I am not a freak-out person by nature. But when it kept going on for 2, 3, 4 and then 5 hours, I was worried because it didn't clot, that I was feeling faint (clammy, cold, teeth chattering, BP and temp dropping) - I didn't even consider shock, I was more worried that it would put stress on my kidneys and I didn't want anything to jeopardize them. That was the only reason I started getting anxious, especially before the new shift came in (they all seemed to like each other, work together well, felt like a team, etc.). I don't know how else to explain it....I am just usuallly an easy going person and this just threw me for a loop. Sorry to bring all of this to your nursing website and cause any problems.
One thing I keep thinking about: If a nurse FILED A COMPLAINT about YOUR care, why would that same nurse ignore your obvious stated signs of shock while you were there? I am SMH here....
OP, I'm really sorry that your ER experience and this forum are examples you've come across of how nurses treat others. I just want to say in my admittedly somewhat limited experience that this is NOT the norm. As they say an anecdote does not a pattern make. Also, I'm sorry you feel the need to have to explain yourself here.
But, WOW! Witch hunt! I can't believe the nit picking going on! Although I did see the thread a previous poster mentioned where someone made up a story and came clean by the end of the post, so I can see why people can be suspect, but really?! If you really suspect someone is not telling the truth, why not just stop responding to them? Do you really need to try to "call them out" and potentially scare someone away from the profession entirely? What purpose does that serve?
I would think that when you post here the nurses are going to question things that make no sense in their opinion, it is their which the OP is asking for by posting here....Right?
So um, how did a couple of loose stitches stop an arterial bleed?
The thing I find really suspect is this is the only thread the OP has posted on since joining AllNurses
In addition to that, I find it really insulting that the OP has the gall to say: "Nursing Specialty: E.R., renal (as a patient only)." No matter how bad (or good) your experience with a specialty of nusing, that does not make it you specialty.
OP, I'm really sorry that your ER experience and this forum are examples you've come across of how nurses treat others. I just want to say in my admittedly somewhat limited experience that this is NOT the norm. As they say an anecdote does not a pattern make. Also, I'm sorry you feel the need to have to explain yourself here.
But, WOW! Witch hunt! I can't believe the nit picking going on! Although I did see the thread a previous poster mentioned where someone made up a story and came clean by the end of the post, so I can see why people can be suspect, but really?! If you really suspect someone is not telling the truth, why not just stop responding to them? Do you really need to try to "call them out" and potentially scare someone away from the profession entirely? What purpose does that serve?
The OPs story changed from start to finish of this thread. Which would lead one to believe parts of it was untrue.
People come to this site for professional opinions and insight. To allow the OP to post such a story about nursing, without a challenge, maligns every nurse here. That is partly why I responded. I did not believe her which is my prerogative.
As to "scaring people away from this profession", well................
It was a really bad decision to read this long very dramatic posting after working a 12hr shift in a level 1 trauma ED. I tried to hang in there with the OP, i tried honestly,but i can only suspend reality for so long and then i have to cry foul. I agree with most the points my fellow skeptics have posted here....bleeding "with every heartbeat" for 5 hours? and still able to be discharged home? nah...cold clammy losing consciousness and no IV or fluids? nah.....a nurse from the er filing a complaint on her behalf? where was this angel of mercy when this tragedy was unfolding? watching from the sidelines to see if the poor bleeding almost in shock pt actually bled out? sounds reasonable to me....
several things in the OP followup postings lead me to believe that she has spent quite a bit of time in ers. "always have an iv started first thing" friends that work in ERs, an ER doctor that is a friend......makes you wonder i guess.
okay blast away but at least i am going on record here with saying No Way this happened the way the OP laid it out.
I accept your apology.
which the OP is asking for by posting here....Right?
keikei
28 Posts
yes, exactly - I've learned my lesson for sure :) I was always taught to hand the knife by the blade, handle towards the person so they're not grabbing the blade either but it didn't work out so well this time. And it was a new knife.
The timeline for the unbeliever: The injury happened Sunday evening. I finally got home late Sunday/early Monday (around 11:30 or midnight). I was given 16 sutures in the hospital & told that I needed surgery because the cut was too deep & needed a hand or plastic surgeon because of the nerves, arteries, veins, tendons, etc.
Monday -went for the consult with different surgeon that our insurance company suggested because the surgeon who consulted with me via the surgical resident was not covered on our plan. He would have been had I gotten surgery that night because it was an emergency, but since he was already tied up with the other person, I would have had to wait. They said I could stay overnight if I'd like, I declined.
Tuesday - arrived at other hospital, had surgery on my rt index finger. He was able to repair the tendon, the nerves but not the arteries, he said they were too mangled (his words). I had general anesthesia and it lasted 4 hours. So forgive me if I've gottne the days confused, I was thinking today is Wednesday. This is really disheartening to be attacked this way over minor details when I was just asking a question and was hoping for some answers from some professionals in the field.