Rules for the ER (long)

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. Specialties Emergency Article

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.

Specializes in OR, ER, TRAVEL, SURGICARE, WOMENS HOSP.
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)

Man I love that INCARCERITIS can I use that?

Specializes in Emergency.

Heres one:

If the patient fails my bedside swallow screen and they are NPO, do NOT feed them from your KFC value meal, it just creates more work for me when they aspirate.

Specializes in Emergency.

Don't come to ED and request a script for medical marijuana. Medical marijuana isn't even legal in this state. Where are you going to get it filled? You obviously can't afford soap and toothpaste so how are you going to afford the weed? Does medicaid cover it? GET OUT!!!!!

Specializes in Emergency.

Don't pace around the room and say you are in too much pain to lay down and vomit repeatedly in the garbage can. Don't at some point decide you can lay down and when you chose to vomit on the floor. Don't allow your wife to show up an hour later and complain there is vomit on the floor. Don't continue to vomit on the floor after it is cleaned and then you are given an emesis basin. Don't give me a look when I give your wife the same attitude she gave me about the vomit when you puke on the floor, knocking the emesis basin over in the process. Don't scream and yell at me as you wait on the md exam and then after your family shows up, become a kitten and smile at me and apologize as I push your morphine....then vomit on the floor. JUST DON'T VOMIT ON THE FLOOR. If you have never had to vomit on the floor in your house, I will assume you can avoid doing the same in MY HOUSE!!!

If you are an ambulance coming in with a patient that is unreponsive but breathing on their own please do not foget to mention that the patient also has 2 blown pupils except of course when your are placing him on my cart to give him to me. Liek a little more warning about my trauma codes instead of thinking I am getting a seizure patient.

Specializes in ER, ARNP, MSN, FNP-BC.

Hi all, I just joined, have been an ER nurse for 16 years, soooooooo glad to see this site! I have a little venting too, sorry if these rules have already been addressed:

1. Baker and Marchman acts (aka "sandwich seekers"): nobody who really wants to kill themselves really cares about their next meal. GO HOME (or where every it is you go)

2. To the patient who tells us their family member is a doctor/nurse...... so? They should have told you to see your own doctor. Notice THEY aren't here with you???? Cause they know you're full of *&*%

3. To the ER patient's visitor with a hospital employee id badge hanging on their chest............... the fact that you work in human resources isn't getting your friend or family member any attention points! We don't care if you work at our hospital, in ANY capacity. We don't care if you're the CEO. Wait, yes I do, if you're the CEO you should be answering call lights while we are saving people from the ever-circling drain!

4. We don't do pelvic exams because we WANT to. If you are a female of child-bearing age with abdominal pain, please take out your piercings and take a SHOWER before you come here.

5. I am not a television repair technician.

6. If you are a family member of a patient, we don't CARE about your medical history.

7. If your veins "roll" , don't worry, they can't roll out of your body and we will be able to jab around until we find them.

8. AMA: the form we will GLADLY have any competent adult fill out if they are unhappy in any way with our care.

9. Hold button: the button I push when I have a sudden impulse to expel expletives while talking to a floor nurse, primary doctor, or family member on the phone.

10. Yes, people have died in the waiting room of ER's around the country..... because people like YOU are crowding them from our view. Go to your doctor in the morning so we can see the dead ones.

thanks for listening :)

Specializes in ED/trauma.

Welcome, you reminded me of last week. Had a young trauma MVC pt. She had extremity fxs. Before we could do anything to her she kept asking her male visitor (one of 5,000), if he agreed with our plan, and would not let us touch her until he did. The whole family was worshiping his advice. He was questioning the heck out of us. When I finally questioned where he worked and if he was a doc or a nurse, he said he was a first year PT student! I almost lost it. Later he said,"Are you one of those hospitals where the nurses have to chart every hour whether or not the call light is in reach?" I said yes, and he said, "Well just so you know, I did a rotation at a place like that, and if the nurses charted that it was in reach and it wasn't, I would write them up." ?!!? You would think that that wouldn't matter since 5,000 people were always in the room, and she had him to take care of her. He even questioned the meds we were giving and the ortho surgeon's plan! Don't know how he could even stand up straight with a head that big, especially because it was all hot air!

Specializes in ER, ARNP, MSN, FNP-BC.

what a putz. Here's my response to THAT one: "it must be nice to have a job where you actually have time to write people up. I don't have time to urinate let alone complete a write up. Are you signing the surgical consent form for the patient? By the way , here is my first name, we don't give out our last name, but for you i'll make an exception. spell it right. And by the way, my manager knows what its like here in the trenches, so she and I will have a nice laugh over any write up you give me" Have a NICE day!

Ugh, I got sent to he ER yesterday for an allergic reaction. I kept thinking about this thread and it made me feel badly. ROFL.

Some lady was there having an MI and the person (nurse) that came with me kept arguing that the nurse needed to come help me and I kept saying 'no, they are busy, I can wait.' LOL.

I understand this post is in reference to the jerk patients but all I could think about was if I was being a PIA to the nurses. LOL.

Oh well. Turns out, I was downplaying the serious condition and the person with the MI was only 'anxious.' That's life I guess.

Specializes in ED/trauma.

Yeah, he was hilarious! We are still laughing at this one. I would rather deal with a babbling drunk anyday. I'm pretty sure that he heard us laughing at him on more than one occassion, but we could hardly keep a straight face before we even left the room. It's funny, usually when someone is in some sort of program like that, they are usually like, hey I'm a (blank) student, I'm interested in why you are doing that, they want to learn more. But not this guy, he knew it all, and her and her family thought so too. They all looked like educated, smart people, just goes to show you how much the public really does not have a clue about how things work in the hospital.

Specializes in Emergency.
Welcome, you reminded me of last week. Had a young trauma MVC pt. She had extremity fxs. Before we could do anything to her she kept asking her male visitor (one of 5,000), if he agreed with our plan, and would not let us touch her until he did. The whole family was worshiping his advice. He was questioning the heck out of us. When I finally questioned where he worked and if he was a doc or a nurse, he said he was a first year PT student! I almost lost it. Later he said,"Are you one of those hospitals where the nurses have to chart every hour whether or not the call light is in reach?" I said yes, and he said, "Well just so you know, I did a rotation at a place like that, and if the nurses charted that it was in reach and it wasn't, I would write them up." ?!!? You would think that that wouldn't matter since 5,000 people were always in the room, and she had him to take care of her. He even questioned the meds we were giving and the ortho surgeon's plan! Don't know how he could even stand up straight with a head that big, especially because it was all hot air!

Would have lost my job that day.

Specializes in Emergency.
what a putz. Here's my response to THAT one: "it must be nice to have a job where you actually have time to write people up. I don't have time to urinate let alone complete a write up. Are you signing the surgical consent form for the patient? By the way , here is my first name, we don't give out our last name, but for you i'll make an exception. spell it right. And by the way, my manager knows what its like here in the trenches, so she and I will have a nice laugh over any write up you give me" Have a NICE day!

out of curiosity, are you Les Miles fan?