My ER Rant

[us2uk4u]

After being a stepdown nurse for over 3 years I decided to move to the ER. I have to say after being in the ER for less than 6 mos I am beginning to lose a lot of patience with people. Sad to say as a nurse, but it's true.

Some of my pet peeves:

- Please do not bring your healthy baby/toddler/child to the ER to be exposed to sick people. If you are there to visit a patient, please leave them at home or with someone else!

-So, you've had this chest discomfort for over a week and never saw a doctor? Then you complain that the staff in the ER are taking too long to see you?

-We serve meals only to patients, not to your entire family.

-No, you may not have a can of Coca-Cola since you are here with a sugar level of 500.

-The pain level is a 20 out of 10? Yet you want to eat?

-Yes, we do NOT write a 30 day prescription for pain meds. You'll be lucky if you get more than 650mg of tylenol.

-There are 4 urgent care centers within a 1 mile radius. Yet, you chose to come to the ER because you might have the flu (after not getting the flu shot) and then whine and complain about the 3 hour wait?

-I am pretty sure your parent had dementia before he/she came to us. The better question is, when was the last time you saw your parent?

-No, we are not here solve family quarrels.

-If you want to refuse all the tests and medications we are trying to give you why bother coming to the ER?

-And this might be controversial but I think after a certain age, a patient with tons of co-morbidities should really have a DNR signed.

Ok. I'm done. I'm sure I can write more ...

[imintrouble, BSN, RN]

It used to be, before single dose cups, the parent got the whole bottle of Tylenol to take home with them.

That way they didn't have to buy it after leaving the ER. It's OTC so Medicaid won't pay. Maybe that's why they don't give it in the first place.

[firstinfamily, RN]

At my facility, I get upset when the stroke patients are told by the ER staff they can have something to eat when they get up to the floor. Its not like I have a swallow test ready to give them before they want something to eat, and I don't have anything more than crackers and soda. Yes, why do patients wait so long before they come to the ER?? If they have been vomiting for a week, why not see the PCP?? Is it because the ER will not turn them away?? I have always thought patient's families come more to eat and use the telephone, watch TV than actually spend time with the pt.

[Anna Flaxis, BSN, RN]

Yes, that used to be one of my peeves when i worked the floor too, was the patient seemingly expecting a food tray to be waiting for them upon arrival to the floor. So now, I do not make that promise.

As far as why people wait so long before coming in, instead of seeing their PCP, I got a pretty good glimpse into this when I did a short stint in the outpatient setting. For a lot of people, getting in to see their PCP in a timely fashion is problematic. I've taken care of folks with abdominal pain, for instance, who could not get an appointment for THREE WEEKS. They might try and hang in there for a while, and finally can't take it anymore and come to the ER (sure, they could go to Urgent Care, but it's pretty likely they'll just be sent to the ER anyway, so why go through all the hassle and expense?).

It is also really common that when someone calls their PCP, the PCP punts them to the ER instead of squeezing them into their already tight schedule.

[SweetPotatoes]

I'm not a nurse (yet :) ) but I currently work in an underserved area...many gyns and PCPs here send patients to the ER because they're ridiculously understaffed..for things like yeast infections. :/ Also where I am a lot of patients can't get appointments for weeks, similar to what Anna Flaxis said. My job has an ER abuse prevention unit to try to remedy some of these issues.

[LadyFree28, BSN, LPN, RN]

Yes, that used to be one of my peeves when i worked the floor too, was the patient seemingly expecting a food tray to be waiting for them upon arrival to the floor. So now, I do not make that promise.

As far as why people wait so long before coming in, instead of seeing their PCP, I got a pretty good glimpse into this when I did a short stint in the outpatient setting. For a lot of people, getting in to see their PCP in a timely fashion is problematic. I've taken care of folks with abdominal pain, for instance, who could not get an appointment for THREE WEEKS. They might try and hang in there for a while, and finally can't take it anymore and come to the ER (sure, they could go to Urgent Care, but it's pretty likely they'll just be sent to the ER anyway, so why go through all the hassle and expense?).

It is also really common that when someone calls their PCP, the PCP punts them to the ER instead of squeezing them into their already tight schedule.

So true.

There are doctors that do dame day appointments, but that is far and few in between in underserved areas.

I had a child who was in for vomiting state after a PO challenge " I want to eat here" and requested chicken fingers. I gave a smile and said: " If you can eat, then you are ready to go home" and gave her a sticker.

She was discharged-and went to the cafeteria with their parent.

[AdobeRN]

Never worked in the ER but I worked on a Pedi floor. Always cracked me up when I would get a kid admitted for severe asthma episode - will be on continuous nebs, requiring oxygen, IV steroids etc....and the mom is wanting to know when I can help get her child into the bath or shower because he has been so sick for the past few days at home & hasn't taken a bath.