Rules for the ER (long)

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. Specialties Emergency Article

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.

Specializes in ICU,ER.

These are hilarious....I can SO relate to every one of them......

Here are a couple:

~Standing and glaring at the door of the exam room only makes us move slower. And for every crossed-armed, squinty-eyed, throat-clearing, heavy- exhalation....there will be another 15 minutes added.

~PLU--EZZEE leave the attempts at humor home. For every goober head huckleberry that quirps "needles" when asked about allergies, there is a nurse tasting her own bile.

~Do NOT tell me that 98.9 is a fever for you because you "run low" and do NOT tell me that "they" can only use butterflys on you.....if only knew how much we hear that.....ggrrrrrrrrr.........

~Do not let your nasty little hellion kids breath Funyuns on me in that tiny little Triage room. ughh...I hate Funyuns and Doritos.

Like I said, we can all relate to these....but everyone KNOWS what is coming....lol...... just get ready to be chastised..(surprised no one has given us a nice healthy dose of righteous indignation yet)

badBAD ER nurses....ya'll should be ashamed!! :)

Hello all, I am starting nursing school this fall and I am very excitied. These postings are very funny but it makes me a little nervous. I guess after so many years in any job you will have some complaints.

Specializes in ER, OR, Cardiac ICU.
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Hello all, I am starting nursing school this fall and I am very excitied. These postings are very funny but it makes me a little nervous. I guess after so many years in any job you will have some complaints.

Not so much complaints but observations on behavior we ER nurses have seen time and time again. There's a little bit of truth burried in each of these quips. It's letting the frustrations out- you could have a trauma code in one room and in the next room you have person with a sore leg (x1 week, walks fine) writhing in agony when you walk by but carries on conversations using her cellphone...

Specializes in Emergency Room.

After a good night sleep, I have a few more (and yes, I'm starting to scare myself).....

Do not pull the race card. Yes, I am a white professional, but I did not go into nursing to discriminate against anyone. Well, actually, the only people I discriminate against are the stupid and non-sick. Rest assured, if I haven't been into your room yet, it has nothing to do with the fact that you are black/asian/indian/etc and everything to do with the fact that a)ER is no place for hangnails b)you've been glaring at me from the doorway (do you really think making me feel "threatened" is going to get me in there any faster?) c)there are other people here who are SICK (see definition of sick in post 1) d)I know you were out in triage irritating my friends out there....yes, they are my friends, and yes we talk.

Please say "hello" to me and allow me to actually get within 3 feet of you before screaming "We want plastics" or "Only anesthesia can get my blood"

If I am in your room, I am in earshot of you. Please don't scream.

Your "migraine" complaint loses all validity when you are in the room with the lights on, the tv on, on the cell, and laughing loudly with your friends. If you're going to be a drug seeker, at least be a smart one.

Just because your stomach gets a little upset when you take Advil does not mean you are allergic to it. When I ask you what kind of reaction you get when you take a drug you are allergic to, please answer....I'm not asking because I'm really interested, I'm asking because I worked hard for my license.

Don't get upset if I ask you if you have any allergies every time I give you a medicine. See above re: my license.

Kids fall down and go boom all the time. Most of them do not need a CT. I'm sorry your pediatrician's nurse told you to come here to get one.

Specializes in ER, Peds, Charge RN.

Call your doctor for a refill BEFORE YOU RUN OUT OF MEDICINE. If it isn't important enough for you to get refilled, don't come whining to us at two in the morning on a Saturday night.

The ED is not for well-child checkups. Just because one has a fever doesn't mean all six should be evaluated. Better yet, leave the other five at home altogether.

No, we do not give out free samples of lortab. Ever. Try the dealer instead.

NurseErica said:
? If you know what pain meds to ask for, then you know too much and are probably a drug seeker.

Not necessarily...I am allergic to pretty much anything besides fyntilal (sorry dont know how to spell it) I am allergic to morphine, dilaudid, and oxycodine so if i need a STRONG pain reliever I think that is the only one I can take. and i am NOT a nurse yet or a nursing student

Specializes in ER, Peds, Charge RN.
HopeToBeANurseSoon said:
Not necessarily...I am allergic to pretty much anything besides fyntilal (sorry dont know how to spell it) I am allergic to morphine, dilaudid, and oxycodine so if i need a STRONG pain reliever I think that is the only one I can take. and i am NOT a nurse yet or a nursing student

That's why the original poster said "probably" a drug seeker, not "always" a drug seeker.

You would be amazed at the number of patients who are "allergic" to everything except (insert drug of choice).

Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.
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Call your doctor for a refill BEFORE YOU RUN OUT OF MEDICINE. If it isn't important enough for you to get refilled, don't come whining to us at two in the morning on a Saturday night.

A corollary: don't wait until 15 minutes before closing time on Friday to get your refills when you didn't keep your last two appointments.

I'd like to paint in big letters on the waiting room wall:

"A lack of planning on your part does not constitute an emergency on mine!"

-Midget- said:
Do people really order pizza, Chinese food, etc? :p Which really gets confiscated and consumed by staff? :p

A handful of times a crowd in a room will order out. When the pizza or Chinese guy comes, we're all asking around at the desk....'who ordered the pizza?' The pizza guy comes to the desk and his little receipt will say er.

It's a riot! We start saying loudly 'oh, someone must have seen how busy we were and ordered it for us! How nice!'

Then someone from a room will suddenly appear claiming it.... Which we promptly inform them the pt can not eat it bc.... XYZ and therefor, you can not eat in front of him either, so please eat it in the waiting room.

Specializes in ICU.

These are all so freaking funny! LMAO here! I worked in a pediatric ER for over 6 yrs and I had to leave eventually because it got to the point where all this stuff would happen in one shift on a regular basis!

Funny to read but not funny to go through over and over again!

My hats off to you! Stay strong.....

GOD! I wanted to say some of this stuff so bad!

One that I wanted to say every shift to at least 5 of them were

I don't give a rat's ass that you have to go to work or you have another child in daycare to pick up ! Why do you think that is my problem? And that I have to find a solution for you? Everyone here has something better to do... DEAL!

I didn't subpoena you down here! FIGURE OUT YOUR OWN DAMN LIFE!

Oh and the "what's your name?"

You think that's going to scare us? Or give you faster care? Think again Go sit your ass down!

How many times have you heard that one? or " I know so and so " He's a doctor in this hospital, or on the foundation.. or a lawyer..."

Yeah ok buddy..... that's nice.

Or people complaining they're hungry from being NPO , how much longer is it going to be?

I know it sucks, but I'm not your mother.. I don't know!

And parents that complain about us not feeding their kids pre op. Ok.. do you want your kid to have a hot dog? Or would you like us to put his leg back together as it looks like a chicken wing right now....

Don't ask me to call your boyfriend to let him know you're here and when I tell you that you will have to call him yourself, reply "But I don't know his phone number." If you don't know it how the h*** and I going to?

Specializes in ER.

If your mother is a patient and we ask her a question, let her answer it.

YES

This drives me to drink. Ninety percent of the time I just repeat the question to the patient and they have (shock!) a different answer that makes a difference in treatment. When ambulances come in I keep family outside for 10 minutes so I can get the patient's story before the relatives come and "just want to make sure Gram told you..."

If you come to the ER, and get brought right back, and two nurses descend on your loved one, don't repeat "aren't you going to get her a blanket?" five times. We won't be stopping the EKG, IV, moniters etc and tucking her in gently. It may be your priority but not ours.

I can't make the doctor, Xray, or lab, hurry up. I'm completely sure of this, and making a phone call to ask them will actually slow them down.

When the doc says "the nurse will discharge you in just a few minutes" they don't take into account that we need to wait for them to dictate, write discharge orders, get the equipment or meds ready, and do a final assessment, before you can actually leave the room. They definitely can't predict that ambulance arrival in the middle of the process. Just because it takes longer than 15 minutes to get discharged doesn't mean you are being disrespected.