Rules for the ER (long)

[EDValerieRN]

The Emergency Room

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:

• One of them will be sick (see #2 for definition)
• One of them will be whining constantly
• One of them will be homeless
• and one of them will be the delightful patient.
• Don't be the whiner. Please.

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:

• A cold
• The flu
• A stomach virus

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.

[TinyNurse, RN]

This thread is hilarious. Some people need to lighten up. Afterall, it does take some light heartedness to deal with what we deal with on a daily basis. Nurse Erica cracks me up! turkey sandwiches are our ER specialty too!

[TazziRN, RN]

TinyNurse said:

turkey sandwiches are our ER specialty too!

We have one frequent flyer who used to ask for egg salad sandwiches on white all the time, until someone asked him if he always planned his ER visits around mealtime. He hasn't asked for them since then!

[Uptoherern, RN]

if you are a brand new er doc, and you announce to no-one-in-particular that you want a rectal temp on the guy in bed 8 (who by the way had a normal po temp) just because it is the "most reliable".......the entire er staff from secretary to volunteer will come to a complete standstill and stare at you while you mumble "I'll do it myself" and then observe that you never order that again.

[TazziRN, RN]

erdiane said:

if you are a brand new er doc, and you announce to no-one-in-particular that you want a rectal temp on the guy in bed 8 (who by the way had a normal po temp) just because it is the "most reliable".......the entire er staff from secretary to volunteer will come to a complete standstill and stare at you while you mumble "I'll do it myself" and then observe that you never order that again.

We have a new doc who is fresh out of residency, and we've fallen in love with him. One night when the oncoming shift got there one nurse mouthed, "How is he?"

I said loudly, "I really LIKE him, he does what you tell him to!!!"

[carlarn, BSN, RN]

I couldn't help myself, I just had to read all of these and add my own two cents.

Sugar: ED nurses, hell all nurses for that matter, have EARNED the right to vent about their patients. As most of the other posters have pointed out, it is a VENT. Do we really say some of these things to our patients? Well, I have said things to patients that needed to be said. No I wasn't sorry I said them and no I wasn't rude about it. I used to tell patients who threatened to hit me, "I have a right to defend myself so I will hit you back." It shut them up every time. I would also tell them to stand in line when they said they were going to sue me and that I didn't have anything anyway.

I do recognize the fact that everyone who comes to the ED has a need. Am I able to fulfill these needs all the time? F*** no. And it shouldn't be my job to try. I worked the ED for over ten years and in that time I had my share of frequent flyers, homeless people, drunks, abused children and adults. I have had to tell a man his wife died in a car accident he walked away from unhurt.

I had to go to court and testify in a murder trial because for whatever reason the murderer decided to confess to me. Do I look like a priest?!

So, all of you out there who have decided ED nurses, or any other nurse, have no compassion--piss off. Life is too short and I don't have time to molly-coddle you and your feelings.

I am a VERY good nurse; I am compassionate and caring. I took VERY good care of my patients REGARDLESS of why they came to the ED, but it didn't mean I was their best friend, their mother or their confidant. I took on those roles at different times but it was because I wanted to. I comforted the ill, the sad, and those that weren't either.

I have loved this thread because I can empathize with all the nurses out there who put up with the same crap every day and still go to work. It is because of this site we can hold our heads up high and say "I am a good nurse because I didn't kick the s**t out of that patient or their family member when they deserved it."

Don't let the kill joys bring us down. We need this and it has been a hoot!

By the way, I am still a DAMN GOOD nurse and continue to treat my patients like they are the only ones I have to take care of; I am just not in the ED anymore.

[annabanana5876, BSN, RN]

1. When I ask you to rate your pain from 1-10 and 10 is the worst pain you have ever had in your life do not yell out any number higher than 10. Yelling your pain is a "20" is not going to get you any different medication or get it any faster than the 10 would have.

2. If I tell you to call a dentist, (and I give you a number of a dental clinic) you need to make an appointment to see that dentist. Don't take all the antibiotic and pain pills then return to ER for more. Cuz chances are you will have the same nurse both times and she WILL remember you!

3. If you have swallowed a handfull of pins, nails, and needles then get abd pain, don't come to the ER and say "I think I have kidney stones again." You know what is causing that pain!!!!!

4. No I will not ask the doctor to write you a prescription for Tylenol or Motrin for your child's fever. If you can afford that pack of cigarettes in your pocket or those fancy nails on your fingers you can buy your child some Tylenol or Motrin.

5. If you have had that pain in your leg, arm, etc for a week you can wait another 2-3 minutes for the pain medicine the doctor told you he was going to order 2-3 minutes ago.........I need time to get the med out of the pyxis and draw it up into the syringe.

Those are the only ones I can think of that haven't all ready been posted. I so love being an ER nurse but it does get frustrating some days. And these things happen in every ER I have worked in as a traveler! The entire country is full of people that think they do not have to be responsible for their own care. Therefore we will always have a need for nurses in ERs. Someday I think I will write a book entitled "Job Security"

[likemike, BSN, RN]

My friend sent me a stream like this. The funniest was:

You know you are an E.D. Nurse when:

You encourage your patients to sign out AMA.

LEGAL DISCLAIMER

I would never do such a thing.

[Ruby Vee, BSN]

likemike said:

You know you are an e.d. nurse when:

You encourage your patients to sign out ama.

We have a few in icu, too, that threaten to sign out ama if they don't get what they want. fine with me! i won't miss you!

What I don't understand is why the patient views it as such a big threat!

[LeahJet, ASN, RN]

Sugar9486 said:

Yes I have worked in the ER and yes I have dealt with these people, so don't tell me that I do not understand? I am a nurse and I do know what I'm talking about.

Wow...you are an ER nurse at 19 y/o?

I am impressed.

[barbiedee]

I am NOT an ER nurse, and after reading this thread, probablly never will be! A note to Sugar...when people get stressed out, burnt out, have bad days/months/years, etc, there are two things they can do.,...cry about it, or laugh about it. Obviously these dedicated nurses are laughing about it. (good choice) . Not only are they laughing about it, they are sharing their humour so I can laugh too. THanks for sharing. OH, and thanks for caring. Millions of legit ER patients appreciate you!

[Bill_ER, BSN, RN]

Erica, when I first saw your name out of the corner of my eye, I swear I thought it said NurseErotica.......I was like .

[Pheebz777, BSN, RN]

Very entertaining thread!