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.

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 Emergency.

Don't request that I send room service to your room.

We don't serve liquor here anyway.....

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

don't know who Les Miles is ........ :)

Specializes in M/S,TELE,ORTHO,ER.
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!

where do i get a mgr like that???

I'm not this way anymore after being through two pregnancies (one of which was complicated by a kidney infection that had spread to my blood...found out about eight months later that the kidney infection had been caused by a large kidney stone) and had two c-sections but I definitely used to be a patient that could be in pretty major pain and still complain that I had to have a needle stick....I had a phobia of needles after a resident had to stick me 15 times to get an IV started when I was having minor surgery on my knee at age 11. I agree with all of the other rules, though.

Specializes in Emergency.
don't know who Les Miles is ........ :)

Too bad. Is famous LSU football coach who dressed down the press 2 years ago and ended it with, "Have a nice day." T-shirts were made. It was great.

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

ahhhhhhhhh. nope, never heard of him. but i'm a big fan of "have a nice day" lol

Specializes in Rescue+Medic+ER ER ER ER.

If you work for the cable company, I am going to charge you for a foley catheter, 4x4's, various specula, IV set, multiple oximetry tests, and possibly 1:1 critical nursing care for your sore throat.

WHAAAT???

Yes sir, I did not ask for all those religious, shopping, sports, foreign language, soap opera channels either but you are making ME pay for them!!!

Does anybody else have suggestions on how we as nurses can better treat bankers, oil executives, lawyers, politicians, and hospital management? (Can we have fun with this? Moral high-grounders please "red x" now!)

Specializes in Emergency.

For the cable company: tell them to wait in the waiting room after triage and when they ask how long it will be, tell them it will be "sometime between 2p and 5P." Then get them back at 5 til 5.

If you work for the cable company, I am going to charge you for a foley catheter, 4x4's, various specula, IV set, multiple oximetry tests, and possibly 1:1 critical nursing care for your sore throat.

WHAAAT???

Yes sir, I did not ask for all those religious, shopping, sports, foreign language, soap opera channels either but you are making ME pay for them!!!

Does anybody else have suggestions on how we as nurses can better treat bankers, oil executives, lawyers, politicians, and hospital management? (Can we have fun with this? Moral high-grounders please "red x" now!)

Wow, sir it looks like your potassium is a little high--rectal tube and kayexalate infusion, please turn to your side!

Fellow members that find this offending --well I don't know what to say. This thread had me feeling better about myself, it let me know that others in my field feel the same way sometimes--and I am NOT an insensitive, cold nurse for not being over concerned with grandma's terrible pain, brought to my attention by family at bedside while grandma snores!

Specializes in ER, ICU, cardiac.

Okl, so I didn't get to read this all, but what I have read is hilarious!! Here are a few rules I am adding:

1. If you plug in your cell phone charger into the wall when the ambulance drops you off for your "severe abdominal pain" It isn't that severe!!!!!!!!!!

2. If you walked into the ER, do not expect me to push you around (unless you have a broken limb or are over 65) That annoys the CRAP out of me!!!

3. Just because you are a diabetic (and obese) you do not have to eat every 3 hours. If you are NPO it is for a reason, I have checked your blood sugar, you will live I swear!

4. I don't want to hear you badmouth the other staff/ doctors/ PA I could care less what you think. I like them alot more than I like you so save it for your survey

5. If you tried to commit suicide by taking 3 valium, you get no visitors, an overnight stay, and charcoal you big jerk. Attention seeking gets you no where with me!

6. Take a pregnancy test at home!!!!!!!

7. If you worry about your kid doing drugs, we can't fix that only you can!!

8. And please, before you act like you know everything because you are somewhat connected to the medical field, know what you are talking about ("He has a great vein in his anticubical area" "He has a hyena hernia??")?????????

I could go all night!!

Specializes in Emergency Nursing.

I'm not sure if anyone said this yet but...

The ER is not the place to come and get a refill on your birth control.

!Chris :specs:

Specializes in ER, ICU.

"all patients are liars. if the patients is incapable of lying, the family will lie for them." - anonymous USN ER nurse.