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.

[Patma]

FOR ER NURSES

1. We know that you have a tough job, but it isn't professional to complain in front of the patients. It makes us think badly of you.

2. Wait till the alcohol dries before giving that shot. We know what you are doing.

3. When we tell you we have a rare disease or condition, we prefer you look it up rather than act as if you know what it is.

4. Don't pretend you didn't hear us. We know you did.

5. If you are rude, we will remember and spread the word. However, you must remember that it is because of us that you get paid. We are your customers. Treat us accordingly.

6. We hope you are having a good day.

7. We remember the really good nurses, and the really bad ones. The average are long forgotten.

8. Nurses are kind, considerate, patient, and compassionate. If you are none of the above, then you are probably in it for the money. We don't need you.

9. We don't want to be here either.

10. Don't laugh and talk about us so loudly. It isn't nice. And no, you didn't earn that right.

11. Tell us our BP. It is our body, not some secret to be kept to yourself.

12. Smile. It is good for you, and it spreads to others.

13. Kind hearted nurses ROCK!!!!!!

YES YES YES!!!! THANK YOU THANK YOU THANK YOU!!!!!! Excellent post.

[RunnerRN, BSN, RN]

Truely, if you aren't an ER nurse, or haven't been one in the relatively recent past, you have no reason to come into this thread. It can make an awful day even worse when you come into this thread to read some venting ("YES! Other people understand how I feel!") and see responses from those who are trying to make us feel bad.

As many of us have tried to explain before, ER nursing is a completely different animal than any other area of nursing. We work in a wildly different environment than others, and have to be versatile and ready to change our thinking patterns in a second (when that "shoulder pain" turns out to be chest pain radiating to a shoulder, or you code a 2 year old, try to console his parents, then have to walk into the room of a 26 year old "ankle pain" who tripped while drunk last night, has a negative xray, and can't do anything but complain about "how long it took you to get in here and see me, and I need pain meds, and I want food, and you have to give me a cab voucher because I got here but I can't get back home.")

We would all appreciate it if you didn't try to ruin our venting and fun. If you'd like to start a thread "Rules for ER nurses from former patients" on our forum, please feel free. But don't come into this thread and make comments that are sure to provoke comments, and eventually get this thread shut down.

By the way, to the PP who wrote "If you are not kind and considerate, you're probably in nursing for the money." If I were in nursing for the money, I would have quit long ago. If I were in any profession for the money, it wouldn't be nursing. I greatly enjoy my job, but my idea of fun isn't standing on my feet for 12 hours without a lunch, pee, or water break, as I attend to the every need of the above mentioned whiny 26 year old.

[aberrn]

FOR ER NURSES

1. We know that you have a tough job, but it isn't professional to complain in front of the patients. It makes us think badly of you.

2. Wait till the alcohol dries before giving that shot. We know what you are doing.

3. When we tell you we have a rare disease or condition, we prefer you look it up rather than act as if you know what it is.

4. Don't pretend you didn't hear us. We know you did.

5. If you are rude, we will remember and spread the word. However, you must remember that it is because of us that you get paid. We are your customers. Treat us accordingly.

6. We hope you are having a good day.

7. We remember the really good nurses, and the really bad ones. The average are long forgotten.

8. Nurses are kind, considerate, patient, and compassionate. If you are none of the above, then you are probably in it for the money. We don't need you.

9. We don't want to be here either.

10. Don't laugh and talk about us so loudly. It isn't nice. And no, you didn't earn that right.

11. Tell us our BP. It is our body, not some secret to be kept to yourself.

12. Smile. It is good for you, and it spreads to others.

13. Kind hearted nurses ROCK!!!!!!

I don't complain in front of patients.As long as they are being seen to,they don't care about anything else.

Why do you assume we don't know about rare diseases?

Sometimes patients remarks are ignored because they are rude,sarcastic,unwarranted,and not in need of a response.

Some people call you rude if they don't like what you have to say.

In nursing because of the money..YOU ARE KIDDING..RIGHT!!!!!

If you don't want to be in the ER, go home,see your private MD.Take some otc meds.

Staff don't talk about you and laugh loudly. We do it very quietly...

[aberrn]

FOR ER NURSES

1. We know that you have a tough job, but it isn't professional to complain in front of the patients. It makes us think badly of you.

2. Wait till the alcohol dries before giving that shot. We know what you are doing.

3. When we tell you we have a rare disease or condition, we prefer you look it up rather than act as if you know what it is.

4. Don't pretend you didn't hear us. We know you did.

5. If you are rude, we will remember and spread the word. However, you must remember that it is because of us that you get paid. We are your customers. Treat us accordingly.

6. We hope you are having a good day.

7. We remember the really good nurses, and the really bad ones. The average are long forgotten.

8. Nurses are kind, considerate, patient, and compassionate. If you are none of the above, then you are probably in it for the money. We don't need you.

9. We don't want to be here either.

10. Don't laugh and talk about us so loudly. It isn't nice. And no, you didn't earn that right.

11. Tell us our BP. It is our body, not some secret to be kept to yourself.

12. Smile. It is good for you, and it spreads to others.

13. Kind hearted nurses ROCK!!!!!!

I don't complain in front of patients.As long as they are being seen to,they don't care about anything else.

Why do you assume we don't know about rare diseases?

Sometimes patients remarks are ignored because they are rude,sarcastic,unwarranted,and not in need of a response.

Some people call you rude if they don't like what you have to say.

In nursing because of the money..YOU ARE KIDDING..RIGHT!!!!!

If you don't want to be in the ER, go home,see your private MD.Take some otc meds.

Staff don't talk about you and laugh loudly. We do it very quietly...

If you want to know your BP. Ask.I will tell you,it's not a state secret..

[hungarianchere]

loved those , here's some more.

Teenagers when you come in from a car accident and you have been drinking both the police and your parents WILL be called. you have nothing to bribe me with so dont try, i dont take well to threats either.

I have a french 24 cath and i know how to use it!

Yes, sometime the nurses when starting an IV will draw lab blood, it doesnt make the catheter that is in your arm hurt anymore than usual and I'm actually trying to be nice and save you an extra poke!

PLEASE, get a baby sitter and only bring the sick child/baby to the ER. there is a limit as to how many screaming kids/babies/parents we can tolerate.

[LeahJet, ASN, RN]

This was tried with the similar OB thread and the "Rules for OB nurses" thread was closed saying that there was already something going like that.

tvccrn

No, people coming on here and trying to enlighten us ER nurses is the opposite of why this thread was started.

It is to have fun and vent.

People have a choice whether to read this thread or not.

Likewise, people have the freedom to start a thread about how ER nurses fall short of their expectations and give us advice on how to do our jobs.

I, in turn, will exercise my right of NOT to read that thread.

[blueyesue]

Frustration is on both sides I'm sure. The patients are in the middle of having a bad day, and the nurses have just helped out 30 other people's bad days. No one knows what the other has just been through, or is dealing with. The patient could have recently lost a loved one, or, could have been a recent victim of a crime etc. etc. The nurse could have just finished saving a life, or, was just helping a drunken man when he kicked her in the kneee, and she feels that your broken toe is not top priority at the moment. .

:balloons:

[tvccrn, ASN, RN]

No, people coming on here and trying to enlighten us ER nurses is the opposite of why this thread was started.

It is to have fun and vent.

People have a choice whether to read this thread or not.

Likewise, people have the freedom to start a thread about how ER nurses fall short of their expectations and give us advice on how to do our jobs.

I, in turn, will exercise my right of NOT to read that thread.

I didn't say I didn't enjoy reading this thread. I have laughed more while in here than I have in a while. I was merely pointing out that an OB thread that spun off this one also had a new one started from it about rules for the OB nurses and THAT thread was closed because it was similar to the rules for OB.

tvccrn

[LeahJet, ASN, RN]

I didn't say I didn't enjoy reading this thread. I have laughed more while in here than I have in a while. I was merely pointing out that an OB thread that spun off this one also had a new one started from it about rules for the OB nurses and THAT thread was closed because it was similar to the rules for OB.

tvccrn

Oh, I know...... After I posted I thought that "no" at the beginning sounded a bit more harsh toward you than I intended. Sorry!

I think that the mods needed to take into consideration that it was exactly the opposite of what the original thread was.

This thread isn't about pointing out our shortcomings or chastising us. It's not even about "trying to see both sides". When we come to this thread, it is to laugh, relate, and vent. Not to take an introspective look deep inside. The fact that we probably do too much of that anyway gives us the need to lighten up and have fun and laugh.

[tvccrn, ASN, RN]

No problem, Leah.

I have been out of ER nursing for quite a few years, but to read this thread has brought it all back for me and I find myself remembering "the good ole days".

tvccrn

[Patma]

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".

Thank you Tazzi. You seem like a very kind caring Nurse...wish I had had you when I had a bypass last year. You are right, even though I was suffering from the pain of the bypass, routing around jabbing for a vein is not fun in my book, and YES, it hurts!

After reading some of these remarks from Nurses, I will never ever say a word again when a Nurse is trying to start an IV on me. I'm afraid if I do, that they will find the largest needle available and do everything in their power to hurt me.

I understand that Nurses need a place to vent, but I wonder if deep down, some of them really hate their patients. I probably shouldn't read this site, because it scares the hell out of me sometimes!

[RunnerRN, BSN, RN]

Thank you Tazzi. You seem like a very kind caring Nurse...wish I had had you when I had a bypass last year. You are right, even though I was suffering from the pain of the bypass, routing around jabbing for a vein is not fun in my book, and YES, it hurts!

After reading some of these remarks from Nurses, I will never ever say a word again when a Nurse is trying to start an IV on me. I'm afraid if I do, that they will find the largest needle available and do everything in their power to hurt me.

I understand that Nurses need a place to vent, but I wonder if deep down, some of them really hate their patients. I probably shouldn't read this site, because it scares the hell out of me sometimes!

I can only assume this was directed at my "numbing" post. In my ED, we don't have the luxury of an hour to wait for EMLA to work. And in the past, I've had nothing good come from attempting to numb a site. Either you can't see the vein, or can't feel it as well because of the wheal produced, or that site ends up blowing and you have to go through the whole process again. I personally would rather have one stick w a 20 or 18 than go through multiple sticks.

I don't care if my patients want to speak up about something when I'm getting ready to stick. I love when someone will say "Don't bother looking there, my only good vein is in my Rt AC" or "I really prefer to have the IV in my hand instead." If there is a problem (ex: we're ruling out PE and need to have a 18/20 in the AC) then I will explain. But I hate when I haven't even gotten the tourniquet out, and someone is already saying "You have to call anesthesia."

Never have I done "everything in my power" to hurt anyone. I did get into nursing, and ER nursing, to help people (and I have a stack of letters from patients to prove than I AM a good, compassionate RN). But as we've explained multiple times, venting can be a necessary and very healthy part of our jobs.