ED given a bad rap

imintrouble, BSN, RN · Jun 7, 2010

I also had to go to the ER for an abscessed tooth. Being an RN I know the bad feelings ER staff have for people with tooth complaints. Drug seekers frequently present to the ER with similar complaints. On Saturday afternoon after calling every dentist in the phone book, I broke down and went to the ER. I didn't have to wait 5 hours, but I was treated with disdain by everyone I came in contact with. I deliberately refused pain meds. I repeatedly said, "I just need some antibiotics." Not one person believed my story, even though my face was obviously swollen. I'm a nurse, and I was shocked at the way I was treated.

If my face had not been swollen the bad treatment may have been understandable.

If I had demanded pain meds, and been specific about my drug of choice, the bad treatment may have been understandable.

I have a mouth full of crowns, bridges, fillings. I obviously go for routine dental exams. And yet I was treated like a scummy drug addict.

My complaint is not that I was seen last. Or even that I was made to wait. I expected that. I just never expected to be treated with that level of disrespect from a fellow nurse.

Editorial Team / Moderator · Jun 7, 2010

Being an RN I know the bad feelings ER staff have for people with tooth complaints.

Hey, I'm nice to my dental pain patients. I've seen some terrible looking teeth in my ER, and I have no doubt they hurt. Sorry you were treated poorly.

What I took away from that article was that the author really didn't have a clue why the other people were there, which is as it should be ... HIPPA HIPPA hooray. Ha ha. If I got upset over every single complaint/article about nonemergent patients made to wait, I'd never smile again. He's also no so bright for insinuating that somehow, ERs earn more money if we keep patients in the ER longer ("overnight admission$"). Ummmm ... quite the opposite. Why else would ERs be trying to reduce door-to-discharge times? I know! So we can free up beds to see more patients. Durrrr.

roser13, ASN, RN · Jun 7, 2010

"ED given a bad wrap"

Sorry, but I just had to giggle at this title. It made me envision the ED being gifted with spoiled tortillas.

I think you might mean a bad "rap." :clown:

Scooty Puff Jr · Jun 8, 2010

This past Sunday my 25 bed, 12 fast track ER had 21 boarded legal holds. So I can guarantee you that the tooth abcess, the foot fracture, and anyone else that wasn't going to die in triage had to wait a very long time. I too have avoided eye contact with patients, because except for an ice pack there is not much I can do for them.

I can't wait for health care reform fixes the system, then lollipops and gumdrops will fall from the sky. Did that sound jaded? I can assure you I'm not jaded, just a sense of humor that doesn't tranlate well via the written word. :jester:

Editorial Team / Moderator · Jun 8, 2010

then lollipops and gumdrops will fall from the sky

No doubt they'll be Fentanyl lollipops and Vicodin gumdrops ... (Okay, the "Vicodin gumdrops" thing is a bit of a stretch, I admit it!)

raine · Jun 8, 2010

Can't really say that "drug seeker" has EVER been the first thing that comes to mind when a patient presents at triage with dental complaints. I think that possibly ALL of the dental complaints I've triaged are, in fact, legitimate. The disdain displayed toward this writer's friend is, I believe, out of character for the majority of triage nurses. It also doesn't sound like this patient was ever "triaged" in the real sense of the word. P.S. Hope his tooth is all better.

BrnEyedGirl, BSN, MSN, RN, APRN · Jun 8, 2010

I don't know how many times someone has walked to me at triage and said "I've been waiting for 2 hours now,.and I've seen people go back who are no sicker than I am." Really? and just how do you know that? This statement always infuriates me.

That's when I want to say "Well, remember that sweet little lady with the red dress? She kept her scheduled appointment with her doc today and they just called to say her INR is 6.2. Do you know what can happen to a person with an INR that high? No, I didn't think so. And that sweet little blonde baby that came in,..her temp was 105.4, she was moving no air in her right lung and her room air O2 sat was 68%. That big burly guy in the blue jeans,..his heart rate was in the 250's. That guy in the suit and tie,..he was at meeting at work when he suddenly couldn't move his R arm and his speech became slurred. Do you know the cut off time to safely give the drugs that can restore his neurological function? No,.I didn't think so. That's why I'm behind the triage desk and you are sitting in the waiting room!"

I'm in no way familiar with the ER in the article,.but at my hospital the ambulance bay is in the back,.past four sets of double doors and there is no way you can see what's coming in from the waiting room. I will never understand why people think we leave them in the waiting roomer longer than we have to. Do they think we get some pleasure or benifit from leaving people just sitting out there? We will often place our dental pain, earache, spider bites, in our "eye" room. This room doesn't have a place to lay down,.just a chair. It's fine for the real simple pts but not appropiate for a full exam. Patients often get upset when they see the toothache go back before them, then I explain about the room situation,..they assure me that they would be happy sitting in a chair if they could just be seen,...I have to explain that the doc can't assess a belly pain in a chair,.............etc,.etc,...it's a no win situation. I just wish people would believe us when we say we are doing the best we can and we really are trying to get the sickest people back first!

This is just one more article from someone who really doesn't have a clue what goes on day in and day out in the ER.

Altra, BSN, RN · Jun 8, 2010

I don't know how many times someone has walked to me at triage and said "I've been waiting for 2 hours now,.and I've seen people go back who are no sicker than I am." Really? and just how do you know that? This statement always infuriates me.
That's when I want to say "Well, remember that sweet little lady with the red dress? She kept her scheduled appointment with her doc today and they just called to say her INR is 6.2. Do you know what can happen to a person with an INR that high? No, I didn't think so. And that sweet little blonde baby that came in,..her temp was 105.4, she was moving no air in her right lung and her room air O2 sat was 68%. That big burly guy in the blue jeans,..his heart rate was in the 250's. That guy in the suit and tie,..he was at meeting at work when he suddenly couldn't move his R arm and his speech became slurred. Do you know the cut off time to safely give the drugs that can restore his neurological function? No,.I didn't think so. That's why I'm behind the triage desk and you are sitting in the waiting room!"
I'm in no way familiar with the ER in the article,.but at my hospital the ambulance bay is in the back,.past four sets of double doors and there is no way you can see what's coming in from the waiting room. I will never understand why people think we leave them in the waiting roomer longer than we have to. Do they think we get some pleasure or benifit from leaving people just sitting out there? We will often place our dental pain, earache, spider bites, in our "eye" room. This room doesn't have a place to lay down,.just a chair. It's fine for the real simple pts but not appropiate for a full exam. Patients often get upset when they see the toothache go back before them, then I explain about the room situation,..they assure me that they would be happy sitting in a chair if they could just be seen,...I have to explain that the doc can't assess a belly pain in a chair,.............etc,.etc,...it's a no win situation. I just wish people would believe us when we say we are doing the best we can and we really are trying to get the sickest people back first!
This is just one more article from someone who really doesn't have a clue what goes on day in and day out in the ER.

AMEN! :bow: *wine

allnurses Guide · Jun 8, 2010

"ED given a bad wrap"
Sorry, but I just had to giggle at this title. It made me envision the ED being gifted with spoiled tortillas.
I think you might mean a bad "rap."

It made me wonder who would give someone an ED for a present no matter how it's wrapped. . . but I'm a tad strange, or so I've been told. :)

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jun 8, 2010

RN Cardiac, you've said it quite eloquently. Maybe we've worked the same ER's. Has anybody ever had the top of his head blown off at your ER entrance? If not, we've worked different but very similar places.

ER nurses have trouble not being judgemental. We want to get the beds empty and give great care, but we get the anger of people who are healthy enough to complain, while others will sit there quietly and die. The hardest part of the job is to forgive the patients.

Drug seekers, people wanting prescriptions for OTC meds, people trying to get ongoing care when they actually need a primary doc, and a million others that are inappropriate for the ER, still need our care in some way. They are still displaying needs not being met otherwise. They are part of the job.

When I start getting mad about it all, I just start keeping a mental list of in what order I'm going to shoot patients and staff when I finally flip and give them all the high velocity hot lead enema, and retroactive abortions. It helps me to refocus and reduces my stress.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jun 8, 2010

Here on the border we appreciate that a "wrap" is just a name given to burritos so gringos will eat them. When tortillas spoil, we call them taco shells. Crispy tacos are an American invention, never found South of the Rio Grande.

Via con Dios mi enfermeros e enfermiras.