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.

[bigjim]

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!

I have long held the opinion that there would be no nursing shortage if nurses got to have Tasers. If nothing else, you'd have a flood of new male nurses.

[Treat et Street]

When the patient asks for the pain med that starts with a "d", I begin with the following:

Me: "Detrol!"

Pt: "No..."

Me:"Disulfuram?"

Pt: "No, it's like di.. something"

Me: "Diflucan!"

Pt: (Now really trying hard to hold on to their lie...) "Dil,... dil..."

Me: "Yes I have it now! - Diltiazem!!"

Pt: "NOOO!"

Me: "Oh yes, dilantin!"

Pt: "No, that's not it either." (They are busting now, wanting to scream dilaudid)

Me: "I have no idea what you are talking about, maybe the doc will."

And then I walk away. The look on their face is priceless. BTW, this is the fully assessed classic fibro-migraine pt who is talking on the cell, eating, and watching high volume tv at the same time ...

[CrunchRN, ADN, RN]

I have long held the opinion that there would be no nursing shortage if nurses got to have Tasers. If nothing else, you'd have a flood of new male nurses.

:lol2::lol2::lol2::lol2::lol2::lol2::yeah::yeah::yeah::yeah:

That one cracked me up!

[squeakykitty]

I have long held the opinion that there would be no nursing shortage if nurses got to have Tasers. If nothing else, you'd have a flood of new male nurses.

:bowingpur:D:bow:

That would be great!! I don't know how it would affect the Press-Ganey scores, though.

[Spidey's mom, ADN, BSN, RN]

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

True . . . . . but . .. .. there is something about the "nether region" that especially begs to be washed before I check your cervix.

steph

[bigjim]

:bowingpur:D:bow:

That would be great!! I don't know how it would affect the Press-Ganey scores, though.

So make them fill out the score right then. If they don't "strive for five", they can "ride the lightning" again

[squeakykitty]

So make them fill out the score right then. If they don't "strive for five", they can "ride the lightning" again

Now that's a very good idea. And it would also discourage the complaints about the wait times.

[LMPhilbric]

I'd be willing to settle for a blowgun or a tranquilizer gun from Fish and Game. I'm not picky. I think it would be really cute to watch someone run around the ER for a couple of minutes, like the lions on the savannah do, and then have them collapse in a gentle heap of the floor. Save me a lot of time doing tie downs too.

[squeakykitty]

I'd be willing to settle for a blowgun or a tranquilizer gun from Fish and Game. I'm not picky. I think it would be really cute to watch someone run around the ER for a couple of minutes, like the lions on the savannah do, and then have them collapse in a gentle heap of the floor. Save me a lot of time doing tie downs too.

That I'd love to see.:yelclap:

[Toquay]

OMG made me think of Will Ferrel in Old School when he shot himself with the tranq gun LMAO. "You're my boy Blue!"

Toq

[DebanamRN, MSN, RN]

"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."

Yeah, and don't get mad when:

I throw your clothes across the room instead of folding and placing them in a bag, stick those nasty cold ekg leads on you, give you a nasal canual for sob, get the iv on the first stick even thought you require a butterfly (no we can't use a butterfly, this is an iv line). Tough, I don't want to bag you if you die.

Pump fluids into you because you are drunk/have low bp/are dehydrated.

Won't let you walk to the br w/cp/cva/syncope/narcs on board/nitro on board, or get upset when you threaten to mess the bed because I won't let you up - see that cart full of clean linen and the dirty linen cart? I'd rather change your bed than get my a.. cracked because you fell.

Tell me you haven't eaten in days, complain about the sandwich I offered you, want the hot tray, know when it comes and know that it's chicken parm Thursday.

If I had a dollar for everytime someone told me "I know so and so" or "I'll sue" I wouldn't need student loans to get my RN.

If you tell me one thing and the RN another and the DR another, guess what, we talk to each other.

I don't care if you can't pee, I will go in after it. Wow, now you can pee?

I'm an LPN, not a waitress. I'd be making way more money as a waitress.

If you know certain meds better than I do, doesn't this tell you something? It sure tells me something.

If you smoke in the bathroom, I WILL catch you. And I will not be happy.

And you will know it.

If you don't understand the nature of this post, come work with me. I'll be happy to show you around the second busiest ER in the US. And yes, this is the reason for the 9 hour wait for minor stuff.

[frenchfroggyAPRN, MSN, LPN, RN, APRN]

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.

:bow::bow::yeah::yeah: