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.

[JessicRN]

He was literally screaming and threatening the whole time in English. Have no idea what he wanted guess for me to say it is ok to cry????

[LeahJet, ASN, RN]

A male called the ER from home and demanded a portuguese interpreter for a newborn who is crying.

Just picturing a portuguese translator standing there saying....."waaaaa...waaaaaa"

[Knoodsen]

kudos!! I am so impressed. And, grateful. A good belly laugh is so theraputic. Thank you fellow travelers.

my humble addition:

all patients are liars. if the patient is incapable of lying, then the family will lie for them.

to those of you out there that have taken offense:

What difference does it make how we talk about the patients? Our patients receive competent and compassionate care. Isn't that the important consideration? We are smart, hard-working people that face, on a regular basis, things that would psychologically traumatize most other people. We voluntarily do a thankless job that just about nobody would want. We know that we, as registered nurses, could make more money doing something much less unpleasant. Why don't you thank us instead of trying to ruin our effort to decompress? (Also, why don't back up, regroup, and read the essay by the ERMD on the "read this" thread?)

[SmileyCNAII]

At work the other night the PA walked by the Dr and asked in a sarcastic tone, "Have you seen any emergencies tonight?". We had been slammed for several hours at that point. The insanity never ends......

[rgroyer1RNBSN, BSN, RN]

These are hilarious!

1) Dont take ems at 2 AM to my ER for a sore throat if you dont have a ride home, dont expect me to give you money for a taxi or authorize ems to take you back home, all I will do is tell you to take your 2 go-go sticks (legs) and where the door is and where to go.

2) Do not tell me you are allergic to everythig for the migraine youre having except there was this one stuff that started with a D or M and it worked wonders chances are you wont get it.

3) Do not tell me youre having trouble breathing when I saw you outside 5 minutes ago smoking a cig.

4) Do not tell me Ive had this before and this is what you guys do for me.

5) Dont ask me to numb you for an IV either I wont if you need to be numbed for a little IV stick then your not sick enough to be here, go see the nurses in preop they numb people.

6)Dont threaten me youll only wait longer or get haulled out by security.

Oh and guys yes Syncope can be in emergency in my case were I passed out and smacked my head and neck on the bath tub lol.

[CritterLover, BSN, RN]

ok, it has been a bit rainy around here the past few weeks. so, for all of the minor mvcs (my hospital doesn't get anything major):

when i ask you what happened, what i want to know is:

1. how fast you were going.

2. how fast he was going.

3. where the impact was, and how much damage.

4. did your airbag go off? (and before you say "no," do you have an airbag?)

5. were you wearing your seat belt?

6. where were you sitting?

7. were the police on the scene? (or do i need to call them to take a report?)

8. where you are hurting, and how bad.

i do not care (really, don't care at all)

1. that it wasn't your fault

2. that the other guy was a maniac and should have his license revoked

3. that it was completely the other guy's fault

4. that the other guy just came out of nowhere

5. that it wasn't your fault.

6. that he didn't have his lights on, otherwise you would have seen him.

7. that it wasn't your fault.

really. i don't work for the police. don't work for the insurance company. don't care one iota whose fault the accident was. i'm going to take care of you just the same, even if you were at fault. same meds, same xrays, same perscriptions. so pllleeeaaassseeee spare me those details. it is raining out. there are lots of car accidents. i have many just like you to triage. the guy that hit you is probably out there, too. i don't have time for this.

[EDValerieRN, ASN, RN]

- Don't dump water down the front of your shirt and tell me you are diaphoretic. People don't sweat like that, genius.

- Dont check in to triage and insist on waiting in the waiting room even though there is an open bed.

- If you paint your toenails in triage, you are not sick.

-You can not request to see a certain doctor. You get whichever doctor is available. We will not call an ER doctor in to work because you are there. If you want the same doctor every time, get a PCP.

[Balder_LPN, LPN]

Rule #724

If you dont want to talk to the police, take the 24,000 dollars out of your underwear and leave it at home!

[BabyRN2Be]

Rule #724

If you dont want to talk to the police, take the 24,000 dollars out of your underwear and leave it at home!

:rotfl:

Why?? I always carry $24,000 in my underwear. My bank says my money isn't good enough for them, I have to keep it somewhere!

Sorry, couldn't resist...

[nrsang97, BSN, RN]

i am not a er nurse but these rules will work on most units:

1. famlies please don't call the floor and ask to speak with the doc! he isn't always on the floor, call his office or answering service this is what it is for!!!

2. if you as a visitior cannot follow simple instrucitons from the nurse, like "please don't touch the iv pump silence button." i don't care if you know how to operate the pump, or just know where the silence button is , your visiting privliges should be revoked because you cannot follow simple instructions. this makes my job difficult. i need to know the pump is beeping, the pca is beeping so i can add more medicine if needed, etc. your ignorance makes my job harder.

3. do not ask me when will the doctor be in and expect me to tell you his schedule for the day. the doctor doesn't tell me. i can tell you if he rounds regularly at a general time. don't sound suprised to hear me say he may be in around midnight or 0100. some docs round very late to avoid family (i never tell them that). some round very early before office hours. so do not keep asking me when he will be here. he will be here when he gets here. and no i will not call him to see if he will be here soon. remeber i am not the doctor's secretary.

4. when calling to check on a family member, use their name. do not tell me you would like to know how your mom is doing because i have no flipping idea who she is.

5. do not panic if the patient isn't answering the phone. they may be out for a test, or actually sleeping. do not ask me to wake someone so you can talk to them. call them later. they may not want to talk right now. people don't get enought rest in the hospital now anyway, so leave them be.

this is all i can think of for now.

i have enjoyed reading all the other posts. so funny. i got a real good laugh.

[TazziRN, RN]

5) Dont ask me to numb you for an IV either I wont if you need to be numbed for a little IV stick then your not sick enough to be here, go see the nurses in preop they numb people.

Ooooh, I have a problem with this one. I tell my pts that they have a right to request this. I warn them that not all nurses will do it, but the pt has the right to ask. This does not mean they are not very sick, it just means they don't like pain. IV sticks are not "little".

[level1_traumaRN]

1. If you come to the ER, think your waiting too long...go back home and call the ambulance to bring you in, we WILL make you wait in the waiting room with everyone else and put your name on the bottom of the list.

2. If you are in pain and refuse to take anything PO because "it don't work fast enough", don't think that the doctor will even give you something IV.

3. If you look at me and pull me aside to say "hey he was seen first", don't expect me to be extremely nice to you at all or give you and explanation of why another patient was seen first.

4. If you are out in the waiting area and continue to come to the window at triage and ask "when is it my turn" i'm going to keep telling you the same thing I told you 10 questions ago.