overreacting or not, that is the question!?!

Katie5 · May 17, 2011

Why would you even go to your own ER? Just curious.

wwfd · May 17, 2011

I am not trying to be appear callous but I too am questioning why the OP went to her ER...a couple of statements in her post lead me to believe that she expected special treatment since she was an employee....and the fact that she "had to hunt down the doctor" really clinches it for me...does she allow her ER patients to wander around the ER hunting down the doctor? i would bet money no.

Altra, BSN, RN · May 17, 2011

I read the OP to mean that she went to the ER at the hospital where she works -- not that she works in the ER. Her post does not convey an understanding of typical ER course of treatment.

Anna Flaxis, BSN, RN · May 17, 2011

My feelings are so hurt about this, but could possibly be overreacting!
So here is what happened: I have been sick with URI since this past Friday, throat so sore I could hardly even swallow my own spit (sorry to be so graphic), coughing my head off, SOB, fever, and my lower back was hurting so bad I could not sit still. After couple of days like that, on antibiotics and getting worse I broke down and went to ER, (where I work).

What did your PCP say when you called him or her?

First off the nurse I had ordered urine preg on me and I have had complete hysterectomy-DUH!!

Smart nurse! If you still have ovaries and fallopian tubes, you could have a tubal pregnancy, which would be a very dangerous situation that would warrant presentation to the Emergency Department.

Then I told them I couldn't take Morphine or Lortab so doc said he wasn't sure what to give me for pain since I was allergic to so much stuff. I hardly think 2 things qualifies as so much stuff!! I see them give our frequent flyer drug seekers less of a hassle about getting something for pain as they did me! Finally after getting to point of tears, I got an IM shot for pain.

True, there are a lot of alternatives to morphine and Lortab. What did you end up getting IM? Was it effective?

Had pretty significant amount of blood in my urine so they ordered CT with stone protocal-had stone in left kidney.

Just a little bit of info for future reference, since you'll be seeing a lot of ureteral stones as an ED RN; when in the kidney, stones do not cause discomfort. They cause discomfort when they move out of the kidney and into the ureter. So, your stone was not in your kidney, but rather, your ureter.

My nurse was one to tell me this which was no big deal, but then she added "o by the way, you have a rt sided soft tissue mass in pelvis that they are unable to identify, so here is prescription for you to come back and have another CT as outpatient with triple contrast". I asked her, "and why are you the one telling me this insead of Dr"? Her reply was "well when you first came in we only had 4 patients, now we are full". "SOOO" was my next response. Maybe I expect too much, but I would think as a nurse that works side by side with this Dr that he could have at least called radiologist and asked for some more specifics, or for sure made sure that I didn't leave ER that night freaked out!

Yes, the doctor is the one who should be giving you your diagnosis, in person, so that you have the opportunity to have your questions asked and answered. And NOT because you are an RN who works with him, but because you are a patient. On the other hand, consider that this soft tissue mass is not immediately life threatening. The role of the ED is to rule out life threatening conditions, and they did that.

I had to hunt Dr down before I left to get him to sign my work excuse and only then did he see how upset I was and said well why don't we just go ahead and order that scan tonight so you won't have to go home worried sick. Why he didn't think enough of me to do that earlier is beyond me!! I mean I already did not feel good, was in a lot of pain and then to hear that just threw me over the edge!

In my ED, the doctors never sign work notes, the RNs do. Also, in many instances, the ED discharge paperwork is adequate documentation if you're not asking for additional time off, but rather, just want to be able to prove that you were ill when you called out sick.

So, you got a second dose of radiation in a very short period of time and took up an ED bed and time in the CT room for a nonemergent procedure, for something that was completely appropriate for for being done on an outpatient basis. This is an abuse and misuse of the ED.

I thought that it was truly unprofessional and tacky of Dr to send Nurse in my room to give me that kind of abnormal test result. I had 2nd CT which was still inconclusive, so now my next stop is my OB/GYN per ER Dr suggestion.

So, the same outcome as if you had just followed up outpatient, as per the doctor's first suggestion.

I agree with you that finding the time to go in and talk to you about your diagnosis and test results is the doctor's responsibility, no matter how busy he is. If it means you have to sit and wait while he takes care of critical patients first, then you sit and wait.

Am I overreacting to this, expecting too much? As a nurse, I would have told Dr, I think this is news that needs to come from you and not me! Thanks for letting me vent!

I can't tell you if you're overreacting. You are entitled to feel how you feel. I do agree with you that the doctor should have been the one to interpret your test results for you, give you your diagnosis, and answer your questions. However, I don't agree that you needed to take up ED time and resources for that second CT. That should have been done on an outpatient basis. Perhaps if the doctor had taken some time to speak with you personally in the first place, then that's what would have happened.

I might be irritated that the doctor didn't give me my diagnosis, and would have insisted that he come into my room to talk to me, but I would not have "hunted him down", and my feelings would not be hurt. But, that's just me.

Anyway, I'm with the others. Why in the world would you go to the ED where you work? My God, you'd have to drag me in kicking and screaming to the ED where I work. Otherwise, I'm going to the one across town where I don't know anybody.

Altra, BSN, RN · May 17, 2011

Anyway, I'm with the others. Why in the world would you go to the ED where you work? My God, you'd have to drag me in kicking and screaming to the ED where I work. Otherwise, I'm going to the one across town where I don't know anybody.

Again -- I read the OP to mean that she went to the ER in the same hospital where she works -- not that she works in the ER. Her post is just not one that indicates an understanding of how the ER works.

But I do agree with you -- being female, and having a chief complaint between the neck and the knees means getting undressed -- and that's not happening for me in front of my own coworkers, unless I'm a hypotensive, unresponsive trauma patient. Then, and only then, does my modesty go out the window.

Anna Flaxis, BSN, RN · May 17, 2011

being female, and having a chief complaint between the neck and the knees means getting undressed -- and that's not happening for me in front of my own coworkers, unless I'm a hypotensive, unresponsive trauma patient. Then, and only then, does my modesty go out the window.

BINGO!!!

As an aside, I think the OP does work in the ED. I read a post somewhere on this site where the OP says she's been on her own in the ED for 1.5 months now.

Ah, here:

https://allnurses.com/general-nursing-discussion/i-need-some-565429.html#post5121959

Altra, BSN, RN · May 17, 2011

Good catch, ~Stargazer~ ...

Makes the OP in this thread a bit more puzzling.

LTCangel, ADN, BSN, LPN · May 17, 2011

When I worked in the hospital if we used our ER we didn't have to pay a dime but if we went to another we had to pay 80%. This also included labs and tests. This may be why she went to the ER where she works. I had to do it many times for myself and my family just because it was free. I was always treated well because a lot of people knew I was an employee. Just sayin'

Anna Flaxis, BSN, RN · May 17, 2011

When I worked in the hospital if we used our ER we didn't have to pay a dime but if we went to another we had to pay 80%. This also included labs and tests. This may be why she went to the ER where she works. I had to do it many times for myself and my family just because it was free. I was always treated well because a lot of people knew I was an employee. Just sayin'

That's good info. In my ED, employees pay the same as anyone else.

MassED, BSN, RN · May 17, 2011

I wouldn't have done the second CT, just because you had the first and now dosed your kidneys again in ONE DAY. I'm surprised they did that.... granted you didn't get contrast for the stone study, but sill the rad exposure.... good grief!

I would hope you'll get into your ob/gyn asap to get the mass evaluated. Good luck to you. Don't let that process irritate you, I usually am the one to let patients know the status, results, plan, etc.... most docs gloss over or forget or assume the patient already knows, apparently by osmosis. Don't take it personally.

Next time ask for Toradol or something.... so they don't think you're drug seeking... you know how ER docs and nurses are... but usually we take good care of our own. Unusual to have such crappy service from your own doc.... do you have a reputation of calling out or being seen as a patient there often???

MassED, BSN, RN · May 17, 2011

what did your pcp say when you called him or her?
smart nurse! if you still have ovaries and fallopian tubes, you could have a tubal pregnancy, which would be a very dangerous situation that would warrant presentation to the emergency department.
true, there are a lot of alternatives to morphine and lortab. what did you end up getting im? was it effective?
just a little bit of info for future reference, since you'll be seeing a lot of ureteral stones as an ed rn; when in the kidney, stones do not cause discomfort. they cause discomfort when they move out of the kidney and into the ureter. so, your stone was not in your kidney, but rather, your ureter.
yes, the doctor is the one who should be giving you your diagnosis, in person, so that you have the opportunity to have your questions asked and answered. and not because you are an rn who works with him, but because you are a patient. on the other hand, consider that this soft tissue mass is not immediately life threatening. the role of the ed is to rule out life threatening conditions, and they did that.
in my ed, the doctors never sign work notes, the rns do. also, in many instances, the ed discharge paperwork is adequate documentation if you're not asking for additional time off, but rather, just want to be able to prove that you were ill when you called out sick.
so, you got a second dose of radiation in a very short period of time and took up an ed bed and time in the ct room for a nonemergent procedure, for something that was completely appropriate for for being done on an outpatient basis. this is an abuse and misuse of the ed.
so, the same outcome as if you had just followed up outpatient, as per the doctor's first suggestion.
i agree with you that finding the time to go in and talk to you about your diagnosis and test results is the doctor's responsibility, no matter how busy he is. if it means you have to sit and wait while he takes care of critical patients first, then you sit and wait.
i can't tell you if you're overreacting. you are entitled to feel how you feel. i do agree with you that the doctor should have been the one to interpret your test results for you, give you your diagnosis, and answer your questions. however, i don't agree that you needed to take up ed time and resources for that second ct. that should have been done on an outpatient basis. perhaps if the doctor had taken some time to speak with you personally in the first place, then that's what would have happened.
i might be irritated that the doctor didn't give me my diagnosis, and would have insisted that he come into my room to talk to me, but i would not have "hunted him down", and my feelings would not be hurt. but, that's just me.
anyway, i'm with the others. why in the world would you go to the ed where you work? my god, you'd have to drag me in kicking and screaming to the ed where i work. otherwise, i'm going to the one across town where i don't know anybody.

"so, you got a second dose of radiation in a very short period of time and took up an ed bed and time in the ct room for a nonemergent procedure, for something that was completely appropriate for for being done on an outpatient basis. this is an abuse and misuse of the ed."

no it wasn't. this was for a further evaluation of a mass in her abdomen, remember she had been having back pain/abdominal pain? other than a stone, this diagnosis was found. this is not unusual to further determine what is going on by ordering a procedure that is a bit more invasive (as with contrast). it is not a misuse or abuse. and took up on ed bed? to determine if her mass might be emergent?? you are heartless to even write this in your post. truly.

think about this: how many nonemergent patients take up rooms and share air space with us? how much disdain do you have for these patients, who don't even have a need to be in the ed???

shame on you. get over yourself and try to have some compassion for someone who has a diagnosis that might be terrible. stop berating her for her choice, the doctors decision to look into it with another ct, and for her "taking up a bed." seriously.

Anna Flaxis, BSN, RN · May 17, 2011

NO it wasn't. This was for a further evaluation of a MASS in her abdomen, remember she had been having back pain/abdominal pain? Other than a stone, this diagnosis was found. This is not unusual to further determine WHAT is going on by ordering a procedure that is a bit more invasive (as with contrast). It is not a misuse or abuse. And took up on ED bed? To determine if her mass MIGHT be emergent?? You are heartless to even write this in your post. Truly.
Think about this: how many NONemergent patients TAKE UP ROOMS and share air space with us? How much disdain do you have for THESE patients, who don't even have a need to be in the ED???
Shame on you. Get over yourself and try to have some compassion for someone who has a diagnosis that might be terrible. Stop berating her for her choice, the doctors decision to look into it with another CT, and for her "taking up a bed." Seriously.

I stand by my post. I don't know how it works in your ED, but we do not routinely work up incidental findings that are asymptomatic. Once the emergent (as in an immediate threat that requires intervention, otherwise death or disability will result) medical condition is ruled out, incidental findings, such as a soft tissue mass (NOT acute appendicitis, NOT ovarian torsion), the patient is referred to the appropriate outpatient health care provider for follow up. The part I agree with the OP on is that the doctor should have given her the diagnosis in person so that all of her questions and concerns could be addressed. Maybe if the doctor had taken the time to do that, her fears would have been allayed and all of the hurt feelings and distress would have been avoided.