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.

[I love my cat!]

Disorders such as these should not be treated in the ER but by the patient's primary care physician!!!

I am very well aware of that. I've been an ER Nurse. Not very long though..it wasn't my area.

I would say that 80% of ER visits should be seen by a PCP.

[kimbernurse]

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[kimbernurse]

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[kimbernurse]

Good grief. We do care about your pain, but when we a prioritizing care, we only give a squat about the pain that is an indication you are about to DIE. Hey, give me a hot minute to stabilize this acute MI and I'll be right on your renal colic!

[kahamom]

You know the nice blue and white signs along the road to guide you to the ER? PLEASE understand these big 'H's stand for hospital, not HILTON!!!!

[LMPhilbric]

You know the nice blue and white signs along the road to guide you to the ER? PLEASE understand these big 'H's stand for hospital, not HILTON!!!!

That is so true. We often refer to our hospital as the Ritz Carlton Hospital when we get someone who wants 1000 thread count sheets on their stretcher or some other such ridiculous demands. "Pardon me, while I stop the CPR that I'm doing so that I can freshen your water for you while you wait to be seen for your toothache."

[mmutk, BSN, RN, EMT-I]

"I am allergic to naloxone (narcan)"

I said..."What?!" Automatic bs alarm.

[kimbernurse]

Yes sir/mam, I understand narcan makes you feel like poop, but you are not experiencing an allergic reaction. It's called us killing your buzz. And just to ensure decent press gainey scores, I would then proceed to apologize for any inconvience and offer some zofran. But we all know that phenergan would be the only medicine that would help.

[moeluvrn]

You bet it's over. Take it from someone who has almost died twice in the ER, primarily by being blown off by the RN in the ER.

what exactly did you consider "almost dying"??

[ThrowEdNurse, BSN, RN]

Oh, I know you just had a bad day and all, but I would take issue with #5. There is actually substantial disagreement within medicine whether the symptom of moderate fever in children should be treated with antipyretics. Furthermore, a child who already has a high fever is at very low risk for a febrile seizure. Febrile seizures most often occur when fever comes on quickly and spikes quickly-often before anyone even realizes the child's temperature is above normal. And lastly, febrile seizures rarely cause any lasting damage, other than scaring parents to death. I find it questionable whether children should routinely be medicated at the first sign of fever just to prevent them.

Again, I know you said you just had a bad day. But I also think all ER workers should remember that patients can and will vote with their feet based on word of mouth about ER experiences.

BLAH-BLAH-BLAH!!!!!

[TraumaNurseRN]

Originally Posted by schooldays

Oh, I know you just had a bad day and all, but I would take issue with #5. There is actually substantial disagreement within medicine whether the symptom of moderate fever in children should be treated with antipyretics. Furthermore, a child who already has a high fever is at very low risk for a febrile seizure. Febrile seizures most often occur when fever comes on quickly and spikes quickly-often before anyone even realizes the child's temperature is above normal. And lastly, febrile seizures rarely cause any lasting damage, other than scaring parents to death. I find it questionable whether children should routinely be medicated at the first sign of fever just to prevent them.

Again, I know you said you just had a bad day. But I also think all ER workers should remember that patients can and will vote with their feet based on word of mouth about ER experiences.

BLAH-BLAH-BLAH!!!!!

Give your children tylenol if they have a fever for goodness sake. Also, Vote with your feet, walk them down to the next ER if you like as far as I'm concerned. If your child has a fever, treat the fever. If the child needs proper care, give proper care.....and I also say...blah blah blah...

[TraumaNurseRN]

what exactly did you consider "almost dying"??

I agree.....almost dying means someone saved you life...hahahahaha