I know it is cynical, uncaring, and abrasive to say these things.... and I would never actually say them. I really do love my job, I just had a day where everything was wrong... I guess I'm just venting. Feel free to add to the list.
1. The world of ER does not revolve around you. There are sick people here, and you aren't one of them.
2. Our definition of sick is not your definition of sick. If a member of the ER staff says that someone is sick, it means that they are in the process of DYING. They have had a massive stroke, are bleeding out, having a heart attack, or shot. We don't consider a tooth injury sick. Painful, yes. Sick, no.
2. At any given time, one nurse has four patients. One doctor has up to 15. There is a law (similar to Murphy's) in the ER. If you have four patients:
3. Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonalds, and you very well may NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets, the lights dimmed, and the TV on channel 14, go to the Ramada.
4. If you have one of the three, go to your own doctor in the morning:
5. If your child has a fever, you had better give him tylenol before coming in. Do NOT let the fever remain high just so I will believe the child has a fever. Do you want your child to have a seizure? Do you?
6. We have priorities. We understand that you have been waiting for two hours in the waiting room. If you don't want to wait, make an appointment with a doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. That's why she goes first.
7. Do not ask us how long it will be. We don't know. I don't know what's coming through my door 30 seconds from now... so I surely don't know when you'll be getting a room upstairs.
8. We are not for primary care. Get a family doctor, and go see them.
9. If you have diabetes and do not control it, you are committing slow suicide.
10. We know how many times you've been to an ER. We can usually tell if you are faking it on the first 5 seconds of talking to you. Do not lie to us. If you lie about one thing, we will assume you are lying about everything. You don't want that.
11. If you are well enough to complain about the wait, you are well enough to go home.
12. If your mother is a patient and we ask her a question, let her answer it.
13. If you see someone pushing a big cart down the hall at full speed and you hear bells going off.... do not ask for a cup of coffee. Someone is dying, you inconsiderate %#@^. In the ER, bells don't ring for nothing. Sit down, shut up, and let us work.
14. If you have any sort of stomach pain and you ask for something to eat, you are not that sick.
15. If you can complain about the blood pressure cuff being too tight, or the IV needle hurting, you are not in that much pain.
16. If you want to get something, be nice. I will go out of my way to tick off rude people.
17. Do not talk badly about the other members of staff I work with. The doctor that you hate? I work with him every day, and I know that he knows what he is doing. I trust him a lot more than I trust you. I am not here to be your friend, and neither is he. I will tell him what you said, and we will laugh about it. If you want a buddy, go somewhere else.
18. Every time I ask you a question, I learn more about what is wrong with you. I don't care if I ask you what day it is four different times. Each time I ask, it is for a reason. Just answer the questions, regardless of if you have answered them before.
19. Do not utter the words "It's in my chart." I don't have your chart, and I don't have the time to call and get it. Just tell me.
20. Do not bring your entire posse with you. One person at the bedside is all you need. It is really difficult to get around seven people in the event that you are really sick.
Oh my...how quickly we get off the beaten path. I'm not in the ER anymore, but I do plenty of EMS, so here is my list...
Please don't spit on me. I don't like spit at all and I like it even less when it is on my face. If you must spit, please spit into the basin that I have provided for you.
Please don't go to a concert, smoke marijuana that is laced with who know what, completely flip out, call me names for ruining your high and putting you in 5 point leathers, and ask me for a job application on your way out the door. Sure I'll give you an application...I'll also give my manager heads up that you will be calling her to ask about setting up an interview.
Please don't tell me that you just KNOW Dr. So and So will come in to see you even though he is not on call. He won't and he will be mad at me for calling to ask. Everyone deserves a day off and if his colleague that is seeing you has any questions, he will call your doctor.
Please don't refuse to see "those doctor wash-out" PAs and NPs or have the LPNs or CNAs check your vital signs...we wouldn't be there if we weren't competent and you will eventually see an RN...she is busy pushing meds on a pulseless and apenic three year old right now.
Please don't yell at me when I bring you a ham sandwich. I had no idea that you don't eat pork and you are lucky I was able to find you a sandwich in the first place. Since someone started stealing from the kitchen, all we usually have is cheese and crackers and fruit cups...they took everything else away.
Please leave the TV in the waiting room. It is not included in the things you get to take home and I worry that you might strain your back or fall off the table while you are trying to unscrew it from the wall. The chairs, tables, toys, coffee pots, and wall decorations are also not included in your bill.
Please let me know what they did last time you had this problem and what worked and what didn't. I don't really like the idea that we HAVE to do what they did last time, but it gives us a good start. A lot of people will disagree with me on this one, but more often than not, it makes sense.
Please don't call everyone in your family and tell them you are in the ER. Please don't ask them to bring you a pizza. Please don't order us to bring them drinks, snacks, diapers, or newspapers.
Please know what medications you are on and what you are allergic to. Go through all of your prescriptions and make a list of them to carry in your purse, wallet, car, or whatever. Do it now, before it is too late.
Please do not allow your child to climb on the counters, fill the containers of cotton balls and 4 x 4s with water, pull all of the linen out of the cabinet, and draw on the wall with his crayons. If your child has that much energy, it is probably a bit distressing to the patient.
Please don't ask me who is on call when I load you into my ambulance. I have no idea who is on call...I work for the ambulance service, not the hospital.
Please don't ask me how much your helicopter ride is going to cost. I don't know and if you are that sick, it doesn't matter. Get better and then worry about it...we are not going to somehow reverse the treatment if you don't pay right away. Concentrate on getting well.
That's my list...Im sure I have more, but look at the time! Who can be expected to think at this hour?
~Don't make a nurse call to my ER, spend 10 minutes giving me a run down of your entire medical history, then finally get to your complaint....THEN ask if you should come in. We both know you are coming in anyway.......just save us both the time. oh, and when we say "we'd be glad to see you"....we are rolling our eyes.
~The 15 million "family calls" gets old after a while. Designate ONE person to call and check on Grandma. Answering your calls keeps us from our job and annoys the crap out of us.
~Do not ask me to call your boyfriend/wife/husband/cousin/whatever....I am not your secretary.
~If you answer that cell phone while I am triaging you, you may talk all you would like but you will finish the conversation in the waiting room. In the meantime, I am off to the next on the list.
Sugar9486 said:But when it comes down to comments where the patients really can't help the situation, then you need to stop, it's not fair to them.
Therein lies the fault in your continuing argument. The VENTING here is about the patients that CAN HELP the situation, not the ones that can't help it.
I'm not a nurse yet(still a student) but I have been a patient in the ER many times (and other parts of the hospital) and I can tell you that YOU GUYS ROCK!!! I don't care what profession you are in, everyone needs to vent about the bad patient, customer, client, etc they had earlier in the day. In a perfect world everyone would be nice and polite, but that is not the world we live in. A lot of people are rude and demanding, that is the world we live in. That is why ER nurses (and other nurses) need to vent, so they don't explode and quit helping people who really do need help.
Every time I have been a patient, I have been treated great. I'm going to stand by what my mother told be "treat people the way you want to be treated". I treat people with respect and I've been lucky enough to get respect in return.
JMO
Erin (who is still an nursing student but can understand why nurses need to vent. SO vent away!!!)
I realize that a lot of the 'rules' are written by people to let off steam & are not entirely serious. Wanna hear something really scary? An ER doc in my local paper had a serious list of ER do's and don'ts. One of the don'ts was "do not physically assault members of the staff". The fact they anyone even has to SAY that speaks volumes about our society.
Sometimes I don't wonder why there is a nursing shortage. The real wonder is that people still want to be nurses.
From an ER Nursing Assistant who loves her ER Nurses:
There are no magic words that will get you taken to xray, CT, discharged or up to your room any sooner. No matter how many times you ask or how you phrase it my answer will be the same. It's not up to me, your nurse or the doc. Relax.
Your nurse and I are on the same team don't talk badly about her or I will tell her and you will get as little attention as we can possibly give you.
If I know your first and last name before you pop up in the computer odds are you are here to often. Find a new hobby, we are not your friends and didn't miss you during the two days you weren't here.
Don't try to trick me by telling me the doc told you to tell me to tell your nurse that you could have whatever you wanted for pain...I'm not dumb.
I didn't take this job to torcher people everything is done for a reason. Stop trying to make me feel guilty. I am not denying you water cause I am mean. I did not come to do orthostatics to annoy you. The bloodpressure cuff hurts cause there is no other way. (and it's not so bad)
Be happy that you are being treated in the hall it means you probably aren't going to die today.
Ruby Vee, BSN
17 Articles; 14,051 Posts
Well said!
But let me add that the student nurses who are in here stomping on our good time rather than taking this wonderful opportunity to learn something probably aren't the student nurses who are going to do well as real nurses. It's really hard to teach someone who is already convinced they know everything.