So, last night was the last night of a 9 day stretch. (I'm picking up hours for frivolous spending on Vacation!!)
My phrase for my triage shift last night (12 hours in the penalty box) was "Hi I'm The triage nurse, what's your emergency tonight?"
Well, the usual "I need a preg test, I have this bump, my knee hurts for 5 weeks" I guess maybe I was moody I don't know. But I thank asked "This is an emergency Now why?"
This made people angry. I was told I was uncompassionate and rude? I don't understand why this is rude. If you tell me your pinky hurts for 1 year and some months, I'm going to ask why you came to the ER. Really. I am.
My topper was with a patient as I was going through her triage, Allergies, meds, hx, why she's here, we have a series on social, (smoke, drugs, drinking) I asked "do you use any recreational drugs like marijuana/cocaine" She went all spastic on me and starts screaming. "WHY ARE YOU ASKING ME THIS YOU HAVE NO RIGHT!!" (well granted I have in the past 24 hours had a drunk who urinated on himself during triage. I than informed her that I needed to know as this could interfere with medications. She goes "oh okay". Same patient later on I asked her LMP. She than starts screaming at me again. Than she ends with "I'm a LESBIAN you b...." I looked her in the face and I said "So, um, being a lesbian excludes you from your menses Why?"
I took her to her room, she informed me on the way In multiple 4 letter words that i was uncaring, rude, unprofessional, I was (fill in your blank with multiple words)
She told the charge nurse I was rude and I was hateful. She went on to say I insulted her sexuality? Huh? What?
Am I the ONLY one who had odd patient weekend where I had to step out and say What is the actual reason your here ... or my favorite new phrase
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Once we all come to the realization that the "ER" (ED) doesn't just treat "emergencies" any more - we all can move on to another level of understanding.
If anyone in this business assumes even for a minute that all we do is "emergency" they are sadly mistaken.
We are an "Emergency Department AND a 24 hour-walk-in-no-pay-upfront" clinic.
Trust me, once I came to realize that and understand that society has changed what we think the traditional "ER" does, it makes it a whole lot easier to do my job.
Anyone feel free to comment.
Thank you for you insightful words.......that's exactly what I try to tell people amd they look at me like I have snakes comming out of my ears.....
I like mwboswell's advice. I had to change my way of thinking in order to not tear out my hair by the end of the night. Triage, for me, sucks the life and compassion out of my soul, but I try to keep my sanity by just trudging along to finish the day.
I try to say something like this, "So it's my understanding that you have had this bump on the knee for 4 months. Have you spoken to your doctor about it before today? No? Well, what made worse or different today that made you seek medical attention?"
I still want to yell, "COME ON.....REALLY? REALLY??!!!" but that would just yank people off and make a longer day for me.
Specializes in psych, addictions, hospice, education.
Sometimes behavior just floors me. At times when I just have nothing polite to say, and might be thinking, "do you think I just fell off the turnip truck?" or "You MUST be kidding!" or something more colorful, I try to control my mouth. I've been known to say a simple, "Wow, that must be difficult for you!" when I want to say "Wow, you should have an Oscar for that." I could go on, but I shall go be quiet now....
We have "Phrase of the Week Fridays" at my work. During our morning meeting we will decide on a phrase like:
"It's like you have won the lottery"
"Stop me, if we are moving too fast"
"Cmon, lighting doesnt strike twice"
1-point for every time the phrase is used, the winner gets lunch from the cafeteria. Its not the most professional thing in the world but it sure is fun. You can be having the worst day ever and then hear your co-worker tell a patient "It's like you've won the lottery!" Talk about a moral booster!
I work in a clerical role in the ER. I like to think of stupid people as my job security. As I'm sure it is for the doctors, nurses, techs, unit secretaries, and registration clerks too.
Specializes in Infusion Nursing, Home Health Infusion.
I think by saying"This is an emergency Now why?" you put the patient on the defensive . There is a huge percentage f the population that have no idea how the human body works...they do not really know what an emergency is or it not! Then there are those that use the ED as if it were a clinic...the frequent fliers..the ones that go from one ED to the next..that leave one ED and go home and call 911 (saw this the other day and she really was sick)....... the patient does need to to explain why they chose to use the ED...they just did....once you accept that and get your emotions out of it..you can get to the business at hand. Once treated you can always educate on health care options in the community..BUT only after providing the treatment.
THE NINE DAYS IN A ROW IS QUITE A BIT..SO if you are going to do that try to schedule a breather in there...maybe work 4 on one off..4 on..or 5 on 2..off 3..on. You were physically and mentally fatigued so you were probably irritable...BUT it is not fair to take that out on your patients...SO if you can not do the 9 days in a row and maintain the level of care you can be proud of..do not do that to yourself anymore. Generally speaking,your employer will not police you..they are just glad to have person to fill the slot. I have been scheduling for 23 years now and I am very aware how good scheduling promotes good nursing care.
The other lady was acting a bit nutty.....I would just kindly say...."This is all just part of our assessment we ask every patient these questions. I am sorry if it is making you uncomfortable but it is very important that we know so we can provide you the very best care." They really do not need to hear examples of other pt issues..they just want to be taken care of and have their needs met. So seek to understand..validate their feeling....it it exhausting sometimes...yes I bet it was after nine days...so take a break for yourself and your patients.
For starters: I completely understand your frustration. Just got home, back out for another 12 hours in the morning.
The issue is that you don't work in an ER. You work in a free 24/7 clinic that can also handle the occasional emergency.
If we worked in in ER's, there would be no advertisements about how convenient our services are. The fire department doesn't advertise. People know that if there house is on fire, they should dial 911. If we worked in ER's, the primary concern would be patient outcomes. Patient satisfaction would be a distant second. you would be praised for not getting a minor patient a snack because you were focusing on a truly sick individual.
My only suggestion is o not focus on the people who use the system that's just human nature. It is a bad system, and our frustration should be focused changing it.
Esme12, ASN, BSN, RN
20,908 Posts
Thank you for you insightful words.......that's exactly what I try to tell people amd they look at me like I have snakes comming out of my ears....
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Thanks....for the affirmation...
:yeah: