My daughter's experience today in a Phoenix Emergency Room

[PeaceonearthRN]

I am appalled at the treatment my daughter received tonight in Arizona while visiting an ER.

She is in Arizona because her fiance is in school there; she was mugged a few months ago and fell hurting her knee, her leg etc. She is unable to see a primary doctor until she has a well visit.

Tonight, she went to an ER with complaints of knee swelling, nausea and an earache. She has had chronic ear issues since she was born. The type that 'there is nothing there' and five hours later she is getting narcotics for pain and the ER doctor sees fungus growing inside her ear! She was mugged two months ago in Phoenix!

Today, she was desperate to get some relief for this knee pain. It is swollen, her hands are edematous , she feels sick to her stomach from the pain etc. Some of this could be from anxiety due to their financial roller coast and trying so desperately hard to find jobs. Some of this, I am certain, is from being in pain.

When the ER doctor 'Ken' saw her, his response was " 'if you want a pregnancy test, you can buy one at the dollar store'. As well, he informed her that he did not want to waste the ER's resources and x-ray her knee.

Unfortunately due to her difficulty in locating a job, she is currently on Mercy Care. I am all too aware of the low reimbursement rates for Emergency Room Physicians as well as ER visits and testing. We are going to write a fact filled letter to the CNO; however, this is unacceptable.

She tried to get treatment at Urgent Care but their x-ray machine being broken.

This is a despicable state of affairs in our Country.

How ironic that I wrote a thesis back in l993 about 'Women, Mental Illness and Misdiagnosis'. How deplorable that this is 2009 and this type of activity is continuing! She realizes at 21 years of age that an ER is NOT a walk in clinic. Unfortunately, she has had a heck of a time getting established in Arizona; the mugging was just one of the many highlights of her last sixteen months of residency.

As a nurse and a mother, I feel helpless. I am thousands of miles from her. My advice 'take 600 of Motrin , put ice on it and find another hospital to treat you'.

Not everyone that walks in an ER is just looking for hand outs!

[Vito Andolini]

the first words out of the doctor's mouth was, "you can get a pregnancy test at the dollar store'.

yes, they treated her like a dog. my case in point. yes, er 's are for urgent matters; however, we have a moral obligation to treat people with respect and dignity. the kid couldn't walk! this is highlighted for the poster previously who thought she could walk.

but thank you for your input.

yes, it is a tragedy to move away from home, get mugged, get hurt and have reoccurring issues and not enough resources to address them.

however, she didnt need a pregnancy test.

i wonder if a social worker could help her get to the right place(s) for care. how is she doing today? has her situation changed? what if you were to call up and talk to that er doctor? ask for his help in getting proper referrals then let him know that his preg test comment was inappropriate. did he do anything for her at all? any brace? prescription? referral? exam? anything?

also, if you have an orthopod where you live, could that doctor possibly run a little interference for your dtr by contacting some orthopods out there? you know, professional courtesy, get her in sooner, whatever. same with your fam practice/internal medicine doc?

[Batman24]

I'm glad she got a referral to an orthopedist. That's exactly what she needs. I hope she gets the medical attention she needs and starts on her road to recovery.

[PeaceonearthRN]

I wonder if a social worker could help her get to the right place(s) for care. how is she doing today? has her situation changed? What if you were to call up and talk to that ER doctor? Ask for his help in getting proper referrals then let him know that his preg test comment was inappropriate. Did he do anything for her at all? Any brace? Prescription? Referral? exam? Anything?

Also, if you have an orthopod where you live, could that doctor possibly run a little interference for your dtr by contacting some orthopods out there? You know, professional courtesy, get her in sooner, whatever. Same with your fam practice/internal medicine doc?

Yes that is a good idea. I want to give her a chance to contact the orthopod herself and address this. She has until Monday!

Thank you again. Until you are three thousand miles away from your child, it's a hard situation to perceive. I hope if I ever am back in the ER I am able to remain focused on the patient with compassion and integrity.

She is better today and as I said, she will hopefully obtain an appointment with a doc/ortho, and address this on-going knee issues. It is hard to locate regular employment when you can't walk:!:)

I have witnessed ER doctors treat drug addicts very poorly. I will not post the behavior I witnessed but I have NEVER forgotten what this doc did to this patient. Other nurses reported him .

[Neveranurseagain, RN]

One thing I would like to add...even though she was in the ER for whatever reason, emergency or not, she should still have been treated with compassion and care, not with a flipping attitude!!!!

[Valerie Salva, BSN, RN]

I hate to say this, but if your daughter is (or looks) Hispanic, prejudice may have been a factor.

I'm thinking the response she got had more to do with youth than ethnicity. Young people are often assumed to be "up to no good." Whether it's sex, drugs, alcohol, or whatever, there can be a presumption that the "problem" is at least partially self-inflicted, and that renders such a patient far less sympathetic than someone brought in from, say, a car crash.

.

I am in my mid 40s, pale white, blue eyed, and blonde-and was treated like crap at a Phoenix ER.

The hospital was Mesa General.

I was accused of drug seeking and being "on opiates" by the doc- and a drug screen was run on me (without my knowledge) for which I was charged $500.

It came back totally clean, of course.

I was given a script for an antihisamine and D/C.

Turns out I have a serious autoimmune disease, and was in my initial flare when I got very sick and went to the ER. I was hundreds of miles from home, and all alone. A little human decency and common courtesy from the ER staff would have been appropriate, and appreciated.

Sometimes it's not because a pt is young, looks hispanic, or whatever- it's just because some people are jerks and are going to treat people badly, no matter what.

[mwboswell]

Okay, I've read through the posts and the OP's text and here's my take.

What is being described is NOT unique to any particular area or region.

It happens all over.

Is it the way business is done on a "routine" basis for "everyone" - I challenge this and say "NO".

It is a well-known sociological fact that complaints and "bad experiences" get talked about more than positive outcomes.

I also would go a step further and state that there is NO 100% PERFECT ER that ALWAYS delivers and makes everybody happy, AND, has staff with the BEST bedside manners and courtesey - It just isn't true; It's just human nautre.

What we strive for is that these occurences are the exception, not the rule.

We know everyone has a bad day and everyone is human and has errors.

So long as this behavior is not the "normal" we're doing good.

As most of you ER folks on this list know, the ER is the community "dumping ground" for various/whatever reasons. There are many different types of patients and personal agendas - these things take their toll on the ER staff. And unfortunately it comes out in behavior sometimes.

I would challenge everyone who is affected by events like these to quit complaining and be proactive.

Some suggestions:

-Get involved in your professional nursing organization and work towards community educational initiatives, the ones that teach the community about the "ER" and what it's for

-Get involved in your community; volunteer at one of "those" Free clinics and see how those patients are treated there.

-Advocate for your peers; be proactive in activities which support and encourage the ER staff and promote team building and morale building

-Advocate for your patients via support groups and community outreach activities.

These are just the beginning.

The culture of America in regards to using the ER as a "convenience" (open 24/7) and as a primary care service, AND, not having a freaking CLUE what the ER was intended for, needs to change. Until the public changes their perception of and their use of the ER - things will remain the same.

[BabyLady, BSN, RN]

There is one more thing that you can do that will be more valuable to your daughter than writing letters.

Tell her to stand up for herself and take charge of her own healthcare...she has the right to demand it.

I had an incident when I was on vacation and had a crippling migraine that brought me to tears. I was out of state and when I went through my suitcase, to my horror, I didn't have my medication with me, and to the ER I went. This was after I had tried Tylenol, hot bath, etc. over the course of several hours.

You guessed it, they thought I was a drug seeker and I overheard the physician right outside my room say something to the effect of, "I guess the frequent flyers fly a little further during the summer months, don't they" and he and the nurse had a big laugh and said, "Just give her (I can't remember the name of the drug). Administer IM...she won't know the difference and she'll think she's getting something and just send her on her way."

The nurse came in with the syringe, and I told her that I wished to speak to the physician...immediately. The look on my face probably told her that I wasn't going to be patient.

When he came back in the room I said to him, "The next time you want to talk about your patient behind their backs, I suggest you walk a little further down the hall because these halls echo. I am on vacation, I have chronic migraines and I am not a drug abuser. You are free to test me for anything you wish and you'll be shocked at how clean my system is...if you don't want to treat me, then find someone else who will or come Monday I will not only call the administrator of this hospital, but the medical board is well."

I was 10 out of 10 pain. He had a little bit of an attitude and I just said to him, "I understand that this is a problem for ER doctors...but you are taking your anger out on the wrong patient."

I told him I didn't care if it was a pills or an injection, I told him I didn't even care what drug it was, I just needed it to stop and just told him what I normally took...but I would leave it up to him if he felt like he needed to give me something different.

He apologized to me before I left, he even handed me a prescription and I noticed it had 30 pills on it, I handed it back to him and said, "I only need about 5, just enough in case this happens again to save me a trip back here...I have pills at home."

After I said THAT...he was practically kissing my rear as I was heading out the door...he knew he had made a huge mistake.

[traumaRUs, MSN, APRN]

I hope your daughter is doing better.

[canoehead, BSN, RN]

I agree with trauma- the first few years on your own are hard, and even if there was some misjudgement on her part it's no sin. Forgiveness should be instant and come with a gentle explanation.

Tell your daughter some crabby ER nurses wish her the best.

[Footballnut]

It is really hard to be far away when your kids need help learning to cope in the world. I have been there. And my son was treated rudely. I recall coming over the top on the phone to the person who was being unkind and rude to my son. I am sorry to hear how your daughter was treated. The lesson learned here is to find a place, ED or otherwise, who will help her. If this is an ongoing practice of this MD and/or ED it will affect their business.

That being said, I don't know why you are continuing to bring up "horror story" after horror story. It strikes me as a little much for this situation. Of course your friend who had the valve problem never had a "full workup" in the ED. Three visits in the ED do not generally add up to a full workup. She should have had a referral or worked with a ongoing MD for that. Again, I am very sorry for your friend. We all know what EDs are for. Every single day I kindly explain to a client the scope of what we will do in the ED. I also strongly encourage them to follow up with the MDs and specialists we refer them to if they are not admitted.

All the best to your daughter as she continues to make her way in the world.

[Vito Andolini]

Yes that is a good idea. I want to give her a chance to contact the orthopod herself and address this. She has until Monday!

Thank you again. Until you are three thousand miles away from your child, it's a hard situation to perceive. I hope if I ever am back in the ER I am able to remain focused on the patient with compassion and integrity.

She is better today and as I said, she will hopefully obtain an appointment with a doc/ortho, and address this on-going knee issues. It is hard to locate regular employment when you can't walk:!:)

I have witnessed ER doctors treat drug addicts very poorly. I will not post the behavior I witnessed but I have NEVER forgotten what this doc did to this patient. Other nurses reported him .

Maybe her boyfriend's family can help?

[PeaceonearthRN]

Hello.

The reason I have brought up a few stories is this: "Attitude is EVERYTHING in life" even the ER. You never know where a person is coming from, their circumstances, etc. Presuming something about someone can mean misdiagnosis and sometimes death. None of us have a right to JUDGE anyone. We are supposed to be health care providers, not judges, not saints. We are nurses, physicians, PA's., NPs, etc.

I think AWARENESS is the key! Next time you ASSUME something about someone, think again! :)

Thank you to all the kind people who wished my daughter well. Thank you also to the people who responded the way I would believe they would - defending their territory, actions or attitudes. Remember, I did work in an ER and heard it all for eight years. I also used to cringe each time an individual with mental illness came in. I knew that no one knew or understood the type of emergency this individual was experiencing. In 'my' way of thinking, each person deserves consideration and respect; not a presumptive attitude!

I, personally also ended up with emergency surgery shortly after an ER visit. The doctor could not have been bothered with my pain, gave me Torodol, never diagnosed me and told me to follow up with my family doctor. It was great advice! However, I was already too sick for what a family physician could do for me. After they shot me up with Torodal, I could hear the assigned nurse doing her Christmas shopping on the internet. This is the same ER I used to work in but the staff had changed.!

You see, I have worked on both sides of the tracks. I do understand what each and everyone of you has stated. I understand the 'perspective' that ER's are for EMERGENCIES. I also know and understand that there are JACHO requirements for emergency rooms and that making assumptions about a patient can be devistating to the patient as well as their well being. I also know that ATTITUDE is EVERYTHING. I also know that as one poster mentioned, it certainly would help if there were Urgent Cares or Fast Tracks attached to each ER; however, the hospitals rarely keep these open because they do not meet their boards financial criterias.

I have seen some great care in emergency rooms as well. Doctors with well defined boundaries that do not have an attitude. Nurses with open minds and compassion that treat each individuals with dignity and respect recognizing that 'this may not be an EMERGENCY' but to the individual, it is an emergency.

Have a wonderful weekend. Thank you again.!