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.
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:
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:
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.
I was told by an ER nurse once that if a patient has a court date, or meeting with his/her probation officer and can produce some evidence (i.e. discharge instructions) that they were in the ER.....that they will get rescheduled with no discipline against them.
How nice when you know your probation officer is planning to drug test you today and you will fail it......go to the ER and complain of abd pain....you might get lucky and get some drugs.....and avoid jail for another week!!
For the few people that have come into this discussion and insinuated that we are AWFUL people who shouldn't be allowed to live anymore.....WE ARE VENTING!! No, we do not say these things to our patients, and 99 times out of 100, I treat everyone the same. No, I won't be in the stable abd pain pt's room as much as the unstable GI bleed with no blood pressure, but all of my patient's immediate medical needs are met.Until you train your ass off, learn how to care for 1000 different kinds of illnesses, and work in the ER for a time, you cannot begin to comprehend the crap we deal with. It is a chaotic atmosphere, and we must prioritize our time and energy. Wouldn't you rather I spend my energy on the sick sick (see post 1) patient rather than the non-sick abd pn patient? And yes, a lot of us CAN tell pretty quickly who is sick and who isn't.
I am not saying that the ER is "better" than anywhere else. Although to me, it is.....I could never work anywhere else in the hospital. It is impossible to describe what it is like to do compressions until you're sweaty and your arms are ready to fall off, call that code, then walk into another patient's room (not sick pt) and hear a bunch of complaints about how mother is cold/hungry/hasn't been to CT yet. The thing is, most people don't stop to think about the other things that may be going on....maybe mother hasn't been to CT yet because we were holding it for the 5 level 1 traumas that came in at the same time (happened to me last weekend).
Emergency rooms are for emergencies. Urgent cares are for urgent needs. The doctor's office is the place for that annoying arm pain that has been going on for 2 months. I wish people could walk 100 feet (it wouldn't even take a mile) in my shoes before calling me a "bad nurse". And yes, I have been on the opposite end (the pt) and I make it a point to be as calm and easy going as possible. Because, as long as I'm still breathing, there are people that are sicker than me.
I couldn't have said it better.
Please DO NOT come to the ER for constipation unless you are over 90 years old or have a medical reason for having this condition!!!! I would do everything short of using the garden hose before I went to an ER to ask that they "dig me out" or give me an enema. We seem to have had a rash of people coming in for this lately. Stink up your own house instead of our ER......
If you just came in by ambulance, the medics are still outside your room writing their report, and are warmed up after carrying you down those stairs. so...
Don't threaten the nurses or docs, we like the nurses and will kick the **** out of you if you touch the nurses.
if you give them a hard time they know we are less gentle with restraining someone, and we are thrilled by the idea of doing our work someplace with a roof and lighting.
"the ambulance driver already asked me that" is not an acceptable answer to a question. answer it, they already know that EMS asked it, and know the answer you gave EMS.
when EMS says 'no, you can't have something to eat until the doc sees you', don't bother the nurse with the same question.
yes, that 'ambulance driver' also works in the ED, don't complain about not having a nurse start your IV, they are busy with the patients who can't complain
(thanks to all the ER nurses and staff for the great job you do with the problems I have to bring you)
(thanks to all the ER nurses and staff for the great job you do with the problems I have to bring you)
And thanks to EMS as well, for all that you do without a roof, without lighting, and up & down flights of stairs.
This is why we share food, coffee, stories, support ... and ETOH after the shift ends. :biere:
I also agree 100%!
*Secretly saying voodoo chants and sacrificing small chickens...*
Hey - maybe if we sprinkle holy water on them as they come in???
Please DO NOT come to the ER for constipation unless you are over 90 years old or have a medical reason for having this condition!!!! I would do everything short of using the garden hose before I went to an ER to ask that they "dig me out" or give me an enema. We seem to have had a rash of people coming in for this lately. Stink up your own house instead of our ER......
Nothing better than the 30 or 40 year old coming in telling me he is constipated and the doctor orders a suppository and he wants me to insert it:barf01:
Ado Annie, ASN, RN
1,372 Posts
Technically, my former HMO, and maybe the current one, require(d) this ... I always hated calling the doctor's answering service to get "permission" to, for instance, take son with gushing gash to ER for stitches at 8 p.m. Learned eventually that the dr. could retroactively OK the visit.