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.

[JessicRN]

WOW! This thread is so freaking funny.... I thought stoopid people only lived here! LMAOOO!!! OK here are mine:

DO NOT come into triage and tell me about the heart trouble your 3rd removed cousin has. I don't care!

You have a toothache? *** made THIS an emergency at 0350 in the morning??

After giving you an IM injection (exactly where YOU told me too), if you start to rub/massage the area, you will be labeled a druggie. Period.

NO You can't JUST have the Lortab filled on that prescription and not get your antibiotics. It's a package deal... all or none!

Do not come into MY ER faking a stroke. #1- my mother died as a complication after a stroke...this strikes home with me. #2- we have easy ways to determinie if your faking. If I hold your arm out and pretend to be looking for an IV site and let your arm go, it damn well better flail back to the stretcher! If you are able to hold it up, YOU ARE A FREAKING FAKER!

I cannot give medical advice over the phone. Don't call me when Aunt Sally's BP is up and what should you do? I can't tell you b/c she isnt in front of me for evaluation! Geeeesh

No, I will NOT be dispensing you a couple of doses of your narcotics just to take home. That's illegal and you arent worth me losing my license over. There is a 24 hr pharmacy 10 miles up the road.

If you come in c/o SOB, don't let me smell fresh cigarette smoke on you. You WILL wait in the lobby with everyone else!

OK sorry if any of these are repeats but I dont have the energy to read ALL of the previous 54 pages!

We have too many people who fake unconsciouness, many are inmates and do not want to be in jail and many are homeless and want a bed for the night. They know to flop their arms when you let go. Our doctors do the slapped face test. They raise their arm over there head so if you let go they will hit themselses in the face if they truly are unconscious. They let their arm fall to the side avoiding their face and we know they are faking. We only do this for the ones we know are faking. (we are ready to put our hand before it hits their face if it happens but it never does. go figure:uhoh3:.)

[canoehead, BSN, RN]

I think I would have to rupture something before I'd come in complaining of constipation. It's just a matter of pride, and common decency.

[ERRNTraveler, RN]

I think I would have to rupture something before I'd come in complaining of constipation. It's just a matter of pride, and common decency.

Sometimes, I just want to hand these people a pair of gloves, and tell them to go home & take care of it themselves.....

[trudlebug]

" Anyone who says a GI Joe in the rectum isn't funny should see a therapist. "

OMG!:lol2::lol2::lol2:ROFLMAO!!!!!!!!!!

[SDS_RN, RN]

I do treat all of my patients with respect and dignity when they are in my ED but just because people are venting on this site does not make them a bad or uncaring nurse. We all need to vent and you eventually get the jist of who should be there and who shouldn't. It's good to get this stuff off your chest get a good laugh and go to work and do it all over again day after day. Don't tell me that you have never complained about or judged a patient because that's a load of BS in my book. With that being said....

Don't complain about having to wait for an hour or longer in the waiting room before getting a room because honey where we live the next closes ED is an hour away and I gaurantee you you will wait much longer if you go there.

If you know your next stop is going to be the OR please please don't ask if you can have something to eat or drink becasue it's not an option unless aspiration,perforation, or death is something you fancy

Do not come in and say that you are constipated when you just had a BM today

Oh and the one I just had yesterday Mom "My son has not been voiding." When did he last void? In the waiting room just before we came to the room. Are you f...ing crazy? What the hell are you doing here????? Wasting my time the docs time and your time. I guess you did get a few hours off of work for the visit that I will most likely be paying for. Thank you for that.

Do NOT come in and say Oh Toradol does not work for me I usually get 75 of demerol if you know the dose and what you "usually get" then you have been here one too many times and you should find another dealer because I will strongly try to deter the doc from giving it to and chances are I won't have to try too hard.

Do not come in at 2200 and say you were at the doc yesterday and the meds he gave you aren't working yet chances are you will end up with a big bill and a whole lot of nothing else

I love this thread and I look forward to reading more. If you don't like what you read on this thread then go somewhere else and preach.

[SDS_RN, RN]

Oh and one more thing probably my favorite.

If you are brought in by the cops please don't get up from you w/c and try to run away the cops will tazer your ass and you'll be worse off then when you came in. I wish we could have tazers!

[crystal22]

I am new to Allnurses and have found it most insightful!!!! Working in L&D brings up many of these same things.

If you come to the L&D floor thinking you are in labor, with the possibility someone will be near your nether regions...for god sake, WASH IT.

EMS does not need to be called to bring you to the hospital because your sig other is at the bar, out with his other girlfriend, etc.

You call EMS, only to have half of your family and friends arrive before you do.

Labor is not easy, it is not my fault...I really had nothing to do with it.

"I thought I would come and see if I was in labor because my friend is here having a baby and it would be great if they had the same birthday.." ( no contractions, no rupt of membranes, and 30 weeks pregnant)

These are all I can think of right now, but I'm sure many more will come.

[scott_EMT]

"EMS does not need to be called to bring you to the hospital because your sig other is at the bar, out with his other girlfriend, etc.

You call EMS, only to have half of your family and friends arrive before you do."

yeah, because I can do a whole lot other than crap my pants and drop everything in the OB kit all over the floor. Give me trauma or complex medical but OB is something we are so not ready for.

though please call before you walk to the car with the baby crowning... My guess is L&D doesnt like it when you waddle in with the baby sticking out.

I think "wash it" applies universally to every patient and every body part.

[Vikingkitten]

Do people really order pizza, chinese food, etc? Which really gets confiscated and consumed by staff?

Of course! Has to be checked for the proper Health Certificates and to make sure it hasn't spoiled on the way there. Besides, this is an Emergency Department, not the local fast food place. We get hungry too!

[LMPhilbric]

We have too many people who fake unconsciouness, many are inmates and do not want to be in jail and many are homeless and want a bed for the night. They know to flop their arms when you let go. Our doctors do the slapped face test. They raise their arm over there head so if you let go they will hit themselses in the face if they truly are unconscious. They let their arm fall to the side avoiding their face and we know they are faking. We only do this for the ones we know are faking. (we are ready to put our hand before it hits their face if it happens but it never does. go figure:uhoh3:.)

We have found tremendous success with the "therapeutic foley". I have all but risen the dead with that.

[eccentricRN]

i know where you are coming from. look at the situation from the other side though, yes, there are people that go to the er for the drug habits, but many of the people who may not have an emergency by your terms are scared, or they would not be there. most people do not like to spend their time in the er and if they were not scared or in pain then they would probably not be there. i have been to a few er's in my area and i noticed that many of the nurses do not seem very satisfied with their jobs and therefore are right out mean to their patients, this is not fair. this may be your place of work, but it's the patients right to come there... if you are an er nurse that doesn't think a patient has the right to be there, then i think you are working in the wrong part of the hospital. i went to one hospital that advertises that they are working on happiness and cheerfulness. these were some of the best er nurses that i have met. they were caring and happy and even if your problem really did not mean much to them they acted as if it did anyways. that night i did not see very many people at all that were angry or yelling. the patients were then taken care of faster. maybe instead of complaining all the time you should just smile and say okay i understand you hangnail hurts. it may not be an emergency at all, but you do not have to waste your precious time that can be used caring for someone who really needs your help arguing with the person that has a hangnail.

i know that everyone needs to vent sometimes and that it actually makes you feel a lot better about your job, but just think about the other side of the situation.

if your going to spend your life caring for people, then you really need to care for people.

if nurses didn't truly care for people they would simply not be nurses. however, everyone has the right to blow off steam as is the intent of this thread. i don't understand the misconception that because someone is a nurse it is okay to be abusive & expect to be waited on hand & foot. our job is to help "nurse" you back to health... we are your advocates & we are the ones who continually assess your situation & encourage a change to the plan of care as needs change. we are there to provide a service of healthcare... our job is to assist you to a return to health, and provide you with services you cannot perform yourself, however, i am not your maid & i probably have several other patients that may or may not be sicker than you... point is you are not my only patient & they have just as much right to be there & receive care as you do. i'm not a dietary aide, nor am i housekeeping... not down playing their very important roles... my point is i am paid to provide nursing care... if i have time i may fluff a pillow or bring you a drink... if i have not provided you with an estimated time of return to your room it means i don't know when i'll be back.

i could go on & on, however the bottom line is this... just because i chose to become a nurse doesn't mean i'm not entitled to have a bad day or hate my job a little at times, i'm sure the same goes for anyone of any profession. i became a nurse because i do genuinely care for people & mostly love my job, it's not going to hurt anyone to vent a little & i'm sorry to see several people get their dander up... as someone else posted if nurses don't have a sense of humor they won't be a nurse for long. when you can honestly say you have never felt used or abused by another human being then go ahead & speak up, i went to school to be a nurse not a punching bag... i deserve just as much respect as those i care for.

[bigjim]

We have too many people who fake unconsciouness, many are inmates and do not want to be in jail .......

Ah yes, incarceritis. It's common around here too. What sucks is that it often works. The cops are happy to get rid of their dumb ass and they just drop them at the ER (depending on what they did, of course)