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.

[LeahJet, ASN, RN]

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 get cussed at, spit at, disrespected, and various other forms of abuse. Do I "hate" those patients? No. Would I do something to intentionally hurt them? NEVER. Do I talk about them to other nurses? You betcha.

But the bottom line is, even if you were to cuss,yell, and spit..... we aren't going to hurt you. At the most, we will talk and laugh about you. Big woo.

Your fear may be a tad unfounded.

[Patma]

I get cussed at, spit at, disrespected, and various other forms of abuse. Do I "hate" those patients? No. Would I do something to intentionally hurt them? NEVER. Do I talk about them to other nurses? You betcha.

But the bottom line is, even if you were to cuss,yell, and spit..... we aren't going to hurt you. At the most, we will talk and laugh about you. Big woo.

Your fear may be a tad unfounded.

Leah, no way would I EVER spit, cuss, hit or do anything to a Nurse or anyone for that matter. Like I said, you need a place to vent and I meant it. I sit here and laugh and giggle at them too.

One of the reasons I read this site is to learn. In the last ten years I have been diagnosed with CAD, ASHD, COPD, Hypothyroidsim, rectal cancer and by the grace of God, due to excellent Nurses and Doctors, I'm still around at the ripe old age of 52! I've spent a lot of time under a Nurses' care.

I guess what scares me is that it is hard for a Nurse to not take it out on the next patient when they've been thru hell with the last one. I just don't want to be the patient on the receiving end if I don't deserve to be threatened with little or no meds for pain, the largest needle for a stick, catherization if I'm needing more time, all of which has happened to me over the years.

But, the most awful thing in my book is when a few select medical personnel talk about a patient and say hateful things. It hurts and I wish they didn't feel the need to do it or at the very least do it when the patient can hear what they are saying.

Again, The vast majority of Nurses are wonderful, intelligent, kind, caring people and I could not have lived this long without them!!!! They deserve a site to vent on and pick up a few laughs along the way.

BTW, what does it mean, "nurses eat their young?"

[CritterLover, BSN, RN]

i guess what scares me is that it is hard for a nurse to not take it out on the next patient when they've been thru hell with the last one. i just don't want to be the patient on the receiving end if i don't deserve to be threatened with little or no meds for pain, the largest needle for a stick, catherization if i'm needing more time, all of which has happened to me over the years.

actually, for me, the best "thearpy" for dealing with a rude, abusive patient is going into the room of someone who truely needs to be in the er. working with those kinds of patients reminds me why i do what i do, helps me calm down, and puts me in a better mood.

[twotrees2]

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

ROFLMAO

[LeahJet, ASN, RN]

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

ROFLMAO

I thought that was funny, too.

[33-weeker]

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

Actually, the one that was closed was

Rules that SHOULD exist and be enforced in OB

'Rules for the OB unit' is still up and running.

[33-weeker]

Perhaps a new thread should be started for the eye opening and informative "Rules for ER NURSES"

Otherwise, the thread is being hijacked and not to mention killing our fun.

Thanks.

Awwww. You can dish it out but you can't take it.

[LeahJet, ASN, RN]

33 weeker,

you came to our "fun vent" thread and gave us some "rules" and advice on how to do our jobs.

the following is a quote from you on the "ob rules" thread:

i know we birthing unit nurses can have rather sharp tongues when it comes to venting, but we really are just blowing off steam. we need to blow off steam in a venue like this so that we can be kind to our patients to their faces.

and another thing, you have no clue to what i can take....

i am an er nurse!

[CrazyPremed, MSN, RN, NP]

For all of the people that think some ER nurses are not compassionate:

EVERY area of nursing has someone who needs to vent. This thread could - just as easily - have been in the Med/Surg, OB, or rehab nursing sections. Secondly, every one from respiratory therapists to ER techs vent just as much - if not more - than the nurses. Third - even with the comments here - nurses pale in comparison to doctors, medical students, and premeds in their comments. Check out some of those forums. You'd be surprised.

ER nurses are some of the toughest, smartest, and hardest workers in the country. They put up with **** that would send most people running, and do it on a 12+ hour shift with few - if any - bathroom breaks. They grab meals on the run, give care to people who they would run from on the street, and keep - through all this - a running list of meds, dosages, and reactions in their heads. They really belong to a small group of unsung American heroes. If I have what it takes (I start nursing school in next year), maybe I can join the ranks. Keep up the good work, folks.

CrazyPremed

BTW - why is it that every 300+ lb pt with a 300+ BS wants 'something to eat'?

[CrazyPremed, MSN, RN, NP]

I apologize if these have been repeated:

1. If your nurse hasn't seen you for 15 minutes, make sure to remind everyone on staff. Sometimes they sit in the breakroom and forget about all of their patients.

2. Just because one patient is coding, and two traumas are coming in, be sure to tell us when your girlfriend (with the twisted ankle) wants a warm blanket and ice water. That always takes top priority.

3. When waiting for a room upstairs, be certain to check at the nurses station every five minutes. The hospital always keeps spare room for pt's that complain loud enough.

4. If you've been waiting long, just walk into the doctor's dictating area and ask personal questions. They have just spent five minutes with you; you guys are old friends! Edit: once you get home (a week later), if you have any questions, feel free to call the ER and ask for the Dr. by name. I'm sure he/she will remember you and drop everything to take your call.

5. That pain that has been nagging you for months is always best fixed in an emergency room!

6. Always refuse to see a PA/NP and ask for a doctor only. Especially if you don't know what an NP/PA is.

7. Even though you've been diagnosed with diabetes and have a BS of 500, ask for something to eat. Hospital food - especially in the ER - is very tasty. Sometimes even catered.

8. Even if you don't have a high BS or diabetes, ask for something to eat. Nurses love to bring food for patients. Waitressing in covered - in depth - in nursing school and those pesky meds can wait.

9. After arriving by ambulance in the ER, refuse all treatment for you/your mother/ your child/ except for PO meds. Anything that can be done to you (IV's, resp treatments, minor surgery) can be solved with a PO medication. ER nurses just do the painful stuff cause they are 'meanies'.

10. Tell the nurse starting your IV that you tend to hit people when you get stuck with needles, and you can't control the reflex. This way, he/she will be extra careful when starting the IV. Otherwise, they don't even look for good veins.

11. Finally, call ahead to the ER and ask what the average wait time is. The ER is like a restaurant and can tell you - to the minute - how long it will take to be seen. As a matter of fact, just make a reservation. Bring a couple of extra bucks to tip the triage nurse/host/ess. Good taste goes a long way.

12. Oh, yeah. For those of you taking 5-10+ medications. Don't worry about keeping track of the names and dosages of your meds. There is a universal computer system that every ER has access to that will look up your own personal prescription history. Besides, if you tell the nurses the colors and shapes of your pills, they will automatically know what you are talking about. They learn that stuff in school!

Disclaimer: please don't flame me too hard, I'm just a lowly ER tech!

CrazyPremed

[CritterLover, BSN, RN]

btw - why is it that every 300+ lb pt with a 300+ bs wants 'something to eat'?

hyperglycemia makes you hungry. hypoglycemia doesn't (often makes you nauseated). now, that is irony for ya. go figure. as for the 300# part, well it's a viscious cycle....

[Patma]

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

ROFLMAO

After my heartfelt post, you take a part of it and make a joke. I hope you feel better now.

It's things like this that make me afraid of Nurses!