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.

[abbythetabby]

the sponge that's used for birth control is *not* the same cello sponge you use for the dishes. that's why you can't get it out now.

yep, the idiot of the year award did this one a few years back! ... should've seen the thing when it came out!!

holy.........

Oh my gosh. This is right up there on the stupidity list next to my pt who was eating spermicidal jelly on toast for breakfast every morning and was confused as to how she ended up pregnant.

[WDWpixieRN, RN]

Oh my gosh. This is right up there on the stupidity list next to my pt who was eating spermicidal jelly on toast for breakfast every morning and was confused as to how she ended up pregnant.

:barf01:

[BabyRN2Be]

littleRNthatcould,

That was one of the funniest posts I've read in a while. Thanks for the laugh! :)

[Monica RN,BSN]

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.

Now THAT is fantastic and very funny. I will always remember this one :)

[squeakykitty]

Oh my gosh. This is right up there on the stupidity list next to my pt who was eating spermicidal jelly on toast for breakfast every morning and was confused as to how she ended up pregnant.

ICK!!!!:smackingf :uhoh21: :barf01:

[littleRNthatcould]

I can't believe I forgot this one...we LOVED it.

If you come in with an "adult toy" jammed firmly in your colon, the words, "Yeah and we ALL looked for it",:chair: had better be followed by some sort of explanation!!!!!

[bigsyis]

What has happened to you in your 18 years of life that you have been exposed to these medications? Are you a burn patient?

:rollYou're killing me here.

[Toquay]

For foreign objects in the nether regions....don't use the excuse "I just got out of the shower and fell on (insert object). Try the truth we don't believe the above anyway.

Don't ask us to forget to take IV's out when you are discharged and an IV drug abuser. Won't happen.

Remember if you are having a real seizure, you can't stop and sign the registration paperwork. Funny how that works.

Three rules to live by so you don't lose your rights. Never say "bomb or gun" in airport, don't yell "fire" in a theater, and never tell ER nurse you wish you could die!

Please don't use our wheelchairs for toothaches, papercuts to the finger, when we are busy wheelchairs are in demand and people with serious complaints need them.

Toq

[doa-again]

Oh man, this one's going to get good :)

Here's mine.....

1) If you had a room, you would be up there. I am not keeping you in the ER for my health. Trust that the second you get a room assigned and the nurse upstairs will take report that you will be on your way.

2) I do not get paid extra for starting more IVs. I don't enjoy sticking people more than once - it adds to the number of minutes I'm stuck hearing about your stomach pain (and the BK you had on the way here).

2a) No, I can't guarantee getting a good vein on the first stick. See #2.

3) If I am listening to lung sounds, please be kind enough to exhale away from me.

4) Please don't complain about being pulled into the hall. If you're in the hall, you probably aren't dying. And if you are dying and in the hall, at least I will be able to see when it happens to get an accurate TOD.

5) If you come in by ambulance (that you called) don't get upset when I try to put in an IV.

6) If you come in for CP, please don't get loud when I put you on the monitor, stick you for blood and an IV, start O2, get an EKG, and give you aspirin. If you weren't worried about the pain, you shouldn't have come in. PS- you'll probably be admitted to get a stress test tomorrow.

7) No, I don't know if your insurance will cover this.

8) If you know what pain meds to ask for, then you know too much and are probably a drug seeker.

9) There is an inverse relationship to the loudness of the vomiting and the actual sickness of the patient.

10) The fact that you are lying in bed moaning does not lead me to believe you are more sick. It leads me to believe that you are more of a pain in my @ss.

11) GET OFF THE %^&$$#&& PHONE!!!!!!!!!

12) If you can breathe well enough to yell at me "I can't breathe" then you're breathing juuuuuust fiiiiine.

13) Just a hint....if you're going to play possum, don't play it in my ED. I can get really personal with a foley catheter really quick. Hey, if you are unresponsive then I want to make sure you won't mess my bed.

14) Just because you or your family member says "I know you're busy" or "I'm sorry to bother you" before making another dumb request (another blanket, when will my room be ready, etc) does not make me less busy or you less of a bother.

15) I am not your glorified personal servant (hell, I'm not a glorified anything).

16) I don't care that you're having pain unless it is in your chest, or related to the leg that just fell off.

17) Is it the flourescent lights in here, or the O2? Because I'm pretty sure you walked to the BR at home and in the WR, and really sure you wiped your own rear end afterwards. Just because you are in the ER does not make you an invalid. (See #15).

18) I don't do anything in the ER for fun (except Narcan ODs - love stepping on buzzes!) so if I ask you a question or ask you to do something, it is for YOUR health, not mine.

I think that's all I have! Does it mean I'm burned out if I haven't worked since Tuesday and still can come up with all of those?

19.) the size of the job is directly proportioned to the amount of beer they drink (i.e. 2 beers fix the vacum 10 beers fix the roof and end up in the ER)

[DachRN]

REALLY..........right next to the EMTALA sign that says you have a right to be seen in an "Emergency"

[DachRN]

We CAN'T say NO here.............reason they don't go to Urgent Care or Clinic is they are MADE to pay $45 up-front. ER cannot force payment up-front...so we have to deal with "emergency rashes, tooth pain, earaches, paper cuts etc"

STINKS!

[andhow5, BSN, RN]

And, NO!

You will NOT receive a work statement because you were seen here 2 weeks ago. To get one, you MUST be a patient that is seen TODAY, and I will only write it out to state you were seen in ER today. The only way I will write a work statement for time OFF is if you have a condition that actually will cause you to have work restrictions.

And, NO!

If you are sitting in the waiting room, and decide to leave BEFORE being triaged and receiving your medical screening exam by a doctor, I will NOT write a work statement for you.

Screaming at me, calling me names, and threatening me because I won't write your desired, dictated excuse is not a good idea - because I will have ZERO sympathy for you, and will not ask the COP to remove his K9 partner from the hand you have just had a knife in while attempting to "scare" me.