Real ER vs TV ER

[neneRN]

Reading another post re defib use in the ER vs on TV made me think about all the other things that are factored in to add drama to TV ER shows. I think it would be interesting to see what are real ER nurses pet peeves about these shows- also to show some of the students/ non nurses who are considering ER what its really like. I admit I watch ER every Thursday for entertainment value, but I also like to pick it apart.

Like when the ER docs wait outside for the ambulances coming in- okay I've never seen an ER doc step outside the ER doors for any patient, EVER. Nor do the nurses. Our ER docs don't see ANYONE (excluding codes in progress and trauma alerts) until they've been completely triaged by one of the nurses.

I've also never seen any ER staff, MD or nurse, leave the unit to go check on or follow up on any pt. We may make an occasional call to the unit on an interesting case or really bad pt to see if they made it, but that's as far as it goes.

I've never seen more than one ER doc care for a pt (excluding trauma alerts, where it's the trauma surgeon and one ER doc). Even if they're coding, there is only ONE ER doc in the room. (granted, I'm not at a teaching hospital- I'm sure its probably different)

Add to the list..........

[tiredfeetED]

We don't do internal cardiac compressions or crack chests in the ED. We may send them up to surgery, or to Heaven, but chests get cracked in ICU or OR.

We're a dirty ER, for heaven's sake! There's no better place to get an infection than any old ED!

Also, when we're in all that isolation gear -- we sweat like pigs, and we wear masks, goggles, face shields, etc.

Our hair isn't perfect, we seldom have perfect makeup (well a few do, but they do minimal work) chaos reigns, I make tons of mistakes that screw up my day but do not kill people. I have not seen any co-workers making out in any rooms, and we swear much, much more than they do on TV.

OK, rant over. Can't help it. I love the ER show and have seen every single episode.

Three weeks ago, we had a 20ish female involved in a MVC, Head on. Her 2 kids did ok. She came in with gcs 8 and quickly got worse. After a few min she lost her pressure. We are a little ER ( 20 Bed). Doc grabbed a blade and some rib spreaders and started cardiac compressions.. She had no time for ICU or surgery ..It was now or never. She was crossed clamped for 15 min before the OR was ready...liver, spleen and multiple arteries destroyed.

Sometimes a Dirty ER is a afterthought! There was 2 ED docs and about 6 RNs..the emotion can never be described of her toddlers crying for mommy in the background ....still gives me chills!

[traumaRUs, MSN, APRN]

The never changing gloves thing always bothered me. Yuck! I work in large teaching level one and our docs don't go the ambulance bay either. For traumas - and we had an awful peds trauma yesterday - we had trauma attending, ER attending and three trauma residents plus two RNs pluse an ED tech plus me (case manager) and pastoral care. We are very pro-family presence and I was able to have these parents present to see their son before he went for CT. That's another thing on TV - where are the families???

[RNin92]

I live in Chicago, and this case got massive media coverage.

None of the staff involved ever mentioned an ongoing gun fight in the parking lot. If that was were case, then why didn't anybody mention that, as I doubt anyone would blame them for not being willing to put themselves in harm's way. Think about it, which would elicit more public support: fear for their lives, or flat out refusing to help some kid due to a hospital policy. Instead they call 911 rather than rendering immediate care. What I find stunning was the fact the the doctors and nurses were more interested in upholding policy than they were in a human life.

I live in suburbia of Chicago...we heard that there was still some question about gun shots in the parking lot. Staff wasn't talking because their "legal eagles" weren't letting them. Who knows for sure except those who were there that night.

But you are 100% correct...Forget policy there's a kid dying on your doorstep.

[RNin92]

We don't do internal cardiac compressions or crack chests in the ED. We may send them up to surgery, or to Heaven, but chests get cracked in ICU or OR.

We're a dirty ER, for heaven's sake! There's no better place to get an infection than any old ED!

Also, when we're in all that isolation gear -- we sweat like pigs, and we wear masks, goggles, face shields, etc.

Our hair isn't perfect, we seldom have perfect makeup (well a few do, but they do minimal work) chaos reigns, I make tons of mistakes that screw up my day but do not kill people. I have not seen any co-workers making out in any rooms, and we swear much, much more than they do on TV.

OK, rant over. Can't help it. I love the ER show and have seen every single episode.

We also have done the crack-the-chest-trick in our ER.

16 y/o stabbing...

1 to the back and 1 to the chest

Chest wound went through both ventricles..

Got to us Trauma Arrest...bled out..

We worked that kid forever...

Pushed in 6 or 8 liters of saline...8 or 9 units of O-Neg

Trauma Surgeon cracked his chest and tried to sew up the ventricles...

This poor kid died on the parking lot way before we got him...but it was ALL done for him...after all he was 16.

We are a Level II...with a filthy ER like everyone else...but like I said...

He was 16.

[neneRN, BSN, RN]

How about when the family is at bedside while they're coding the pt or during a bad trauma?

I know there's a debate as to pros and cons of having family in the room- but how many of your ERs actually do allow this? Every code I've done- family is always whisked off to the social worker's office...and thinking about it, I don't know that I've ever had a visitor/family ask to stay in or question why we were kicking them out. Same for trauma alerts- family stays with social worker until pt's been worked up.

I'm anxious to see if most other ERs are like this.......

[Lynn RN ER TX]

I have worked in several ERs Level I and II. I "personally" think that it is a good idea for the older end of lifer's family to watch a code in progress. Let them see this isn't working and how traumatic and ugly it is. Tell them about death with dignity etc...

But I also have seen parents of babies, toddlers, children of all ages - watching in horror with great expectation that their child by force of some miracle would be revived. When they weren't - what's left now but the horror movie of that memory. Switching gears if I may. I again "personally" believe opposite of above, that in the case of children, the parents should absolutely go to the "grief room" and be updated - then informed of their chillds death.

As with millions of other viewers I love ER every thursday. I too can pick those mistakes, but, they are in a time crunch - and who wants to watch people wash their hands anyway? Michael Crighton (did I spell his name right?) has promoted nurses far above the old ladies of Marcus Welby MD or Trapper John MD. Kudos to our recognition, we are strong - we can think - and we have a lot to teach those baby residents.

[TinyNurse, RN]

noone washes their hands in ER show

our docs do

our docs listen to the squad reports and ARE in the room if it sounds serious when the patient coimes in.

never heard nor seen a doc have sex in the supply room but that would be hilarious.......

[Calfax]

Years ago there was a sitcom called "Nurses" where they worked on some kind of ward or something.........never about the work, always about the drama of the ppl involved. At the time I was probably about 12 with no interest in nursing, sick ppl or anything that didn't have Nintendo on it. I caught an episode a few years back.....dreck.

I think back to some of the really great medical movies i've seen "The doctor", "Gross Anatomy", "Article 99", "Awakenings". There are no great nursing movies....well, except for Mash....and it was mostly about doctors too.

Everyone knows what cops do, what doctors do (or rather what we wished they'd do), what lawyers do....but not what nurses do. Except for the L&D shows cluttering up TLC daytime slots.

So this is what I propose........a really great movie about nursing. Local gal graduates.....goes to work....horror at shocking malpractice and depraved indifference of hospital administration. Dates resident and is dumped. Organizes union......takes 51% of common hospital stock and fires CEO. CEO has heart attack and winds up as pt in former hospital....next to stroked out JCAHO inspector. Pt's allowed actual dignity and humane care all due to plucky young lass...in front of whom the former resident is forced to grovel.

Second movie......guy movie......dig Dolph Lundgren out of retirement as travelling nurse in a new town. Cleans up trashed ER, tossing drunks, drug dealers, assorted losers and whackos out of the ER.....saving incompetant MD's butt several times while preventing a major epidemic and managing an MCI due to carnivorous alien invasion downtown. Falls for plucky young but tough and competant stripper turned nurse.......thinking brittany murphy or Jennifer Love hewitt. Spectacular fight scene and huge ambulance chase scene. Steamy love scene. CEO is revealed as both evil mastermind criminal and head alien and is gruesomely decapitated. Four sequals then follow

Third movie: comedy. Gerbils & surgilube featured prominently. Jackass meets Jim Carey. Cameos by Cheech Marin and Tim Conway. Picture Steven Wright as your lovable oddball ER doc, accompanied by Kris Katan as the resident sidekick. Throw in a madcap search for 1 million dollars located somewhere in the ER and Martin Lawrence as the hapless kidney stoner thrown into it all and rate R for the hot-tub scene.

Reality show: 5 new nursing grads, including a community health nurse. Follow them for 2 years as they make their way thru the trenches, navigating the crucial apprenticeship we all go thru. See them win, lose and draw....and go back to grad school.

What do you think?

[RNin92]

Years ago there was a sitcom called "Nurses" where they worked on some kind of ward or something.........never about the work, always about the drama of the ppl involved. At the time I was probably about 12 with no interest in nursing, sick ppl or anything that didn't have Nintendo on it. I caught an episode a few years back.....dreck.

I think back to some of the really great medical movies i've seen "The doctor", "Gross Anatomy", "Article 99", "Awakenings". There are no great nursing movies....well, except for Mash....and it was mostly about doctors too.

Everyone knows what cops do, what doctors do (or rather what we wished they'd do), what lawyers do....but not what nurses do. Except for the L&D shows cluttering up TLC daytime slots.

So this is what I propose........a really great movie about nursing. Local gal graduates.....goes to work....horror at shocking malpractice and depraved indifference of hospital administration. Dates resident and is dumped. Organizes union......takes 51% of common hospital stock and fires CEO. CEO has heart attack and winds up as pt in former hospital....next to stroked out JCAHO inspector. Pt's allowed actual dignity and humane care all due to plucky young lass...in front of whom the former resident is forced to grovel.

Second movie......guy movie......dig Dolph Lundgren out of retirement as travelling nurse in a new town. Cleans up trashed ER, tossing drunks, drug dealers, assorted losers and whackos out of the ER.....saving incompetant MD's butt several times while preventing a major epidemic and managing an MCI due to carnivorous alien invasion downtown. Falls for plucky young but tough and competant stripper turned nurse.......thinking brittany murphy or Jennifer Love hewitt. Spectacular fight scene and huge ambulance chase scene. Steamy love scene. CEO is revealed as both evil mastermind criminal and head alien and is gruesomely decapitated. Four sequals then follow

Third movie: comedy. Gerbils & surgilube featured prominently. Jackass meets Jim Carey. Cameos by Cheech Marin and Tim Conway. Picture Steven Wright as your lovable oddball ER doc, accompanied by Kris Katan as the resident sidekick. Throw in a madcap search for 1 million dollars located somewhere in the ER and Martin Lawrence as the hapless kidney stoner thrown into it all and rate R for the hot-tub scene.

Reality show: 5 new nursing grads, including a community health nurse. Follow them for 2 years as they make their way thru the trenches, navigating the crucial apprenticeship we all go thru. See them win, lose and draw....and go back to grad school.

What do you think?

:rotfl:

LOL!!!

:rotfl:

I think you did toooooo many drugs in your past my friend!!!!

:chuckle

[MrsWampthang, BSN, RN]

So this is what I propose........a really great movie about nursing. Local gal graduates.....goes to work....horror at shocking malpractice and depraved indifference of hospital administration. Dates resident and is dumped. Organizes union......takes 51% of common hospital stock and fires CEO. CEO has heart attack and winds up as pt in former hospital....next to stroked out JCAHO inspector. Pt's allowed actual dignity and humane care all due to plucky young lass...in front of whom the former resident is forced to grovel.

Hmmm, I had a dream like that once but I was naked through the whole thing! :rotfl:

[RNCENCCRNNREMTP]

AND.... we dont stand by with defibrillator in hand when giving Adenosine, like they did just last week.

:

I do if there is a chance for WPW. Can easily go into VF.

my 2 cents.

But it is fun to laugh at the show

[Repat]

Instead of laughing, look what's being done!

http://www.nursingadvocacy.org