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 ER, TRAUMA, MED-SURG.
For bankers:

You are charged an interest rate of 11% of your total bill for every ten minutes you are here.

If we call your name more than once to go back, you will be charged a $5.00 late fee for each time we need to call you.

There is a $10 surcharge charge for each time you hit the call light.

The first blanket and pillow are free. After that each item will cost you $15.

If you have a question about your bill, please dial 1-800-555-5555 for out autmated question and answer system. If you prefer to speak to a live person, press 5. There will be a $25 charge for every minute you speak with our live customer service representative.

And the pillows and sandwich trays are for the PATIENT, not for the 7 kids that are of the age that could be at home, or AT SCHOOL on days for goodness sake, please don't ask for 8 plus of everything.

Anne, RNC

Specializes in ER, TRAUMA, MED-SURG.
When you bring your kids to the ED you must stay with them the entire time stay, I am not a babysitter no I will not watch your kid while you go eat or go for a cigarette or visit another family member who is upstairs especially when there is nothing seriously wrong with your child and it was more convenient to bring your child to the ED then to a clinic.And do not test me and see what I will do when you take off anyway.

I am sure the DSS will love to sit with your kids.

When I tell you not to let your toddler run and jump on the bed because it is dangerous

I mean it. Don't tell me it is OK your watching.

THANK YOU THANK YOU!!! That is one that drives me NUTS!!!!

Anne, RNC

Specializes in Med/Surg, ICU, ER, Peds ER-CPEN.

originally posted by sugar9486

i have been in the er and i know quite a few people who work in the er and agree with me, so you can all get off your high horse and give it up.. if you want to talk badly about your patients thats fine we all need to vent one way or another, but when it comes down to comments where the patients really can't help the situation, then you need to stop, it's not fair to them. if you don't like your job, then quit... whoever said you wouldn't have a job without your patients was right...

there are 3 kinds of people in the world:

1. those that know

2. those that don't know

3. those that don't know that they don't know

the #3's are the scariest of them all, i think i'll just leave it at that for now......

Specializes in ED/trauma.
originally posted by sugar9486

i have been in the er and i know quite a few people who work in the er and agree with me, so you can all get off your high horse and give it up.. if you want to talk badly about your patients thats fine we all need to vent one way or another, but when it comes down to comments where the patients really can't help the situation, then you need to stop, it's not fair to them. if you don't like your job, then quit... whoever said you wouldn't have a job without your patients was right...

there are 3 kinds of people in the world:

1. those that know

2. those that don't know

3. those that don't know that they don't know

the #3's are the scariest of them all, i think i'll just leave it at that for now......

uh, what???

originally posted by sugar9486

i have been in the er and i know quite a few people who work in the er and agree with me, so you can all get off your high horse and give it up.. if you want to talk badly about your patients thats fine we all need to vent one way or another, but when it comes down to comments where the patients really can't help the situation, then you need to stop, it's not fair to them. if you don't like your job, then quit... whoever said you wouldn't have a job without your patients was right...

there are 3 kinds of people in the world:

1. those that know

2. those that don't know

3. those that don't know that they don't know

the #3's are the scariest of them all, i think i'll just leave it at that for now......

are you talking about patients or staff. :chuckle

Specializes in ER.

:yeah:She's talking about posters on this board that don't know what it takes to do ER nursing, and don't care that they have no clue- they post anyway.:p

Specializes in ER, TRAUMA, MED-SURG.
:yeah:She's talking about posters on this board that don't know what it takes to do ER nursing, and don't care that they have no clue- they post anyway.:p

You're right. There is a big difference between a nurse getting pulled/floated to the ER and a nurse working for weeks, months, ect as a regular staff member. Sure if you're in the ER for a small amount of time, they may "think they know" about it. It would surely be a different story after these same people see the clinic patients arriving, the lawsuit happy accident victims, the paople that call 911 at 0300 because they don't want to sit in the MDs office, ect.

I'm not saying these patients should not come to the ER, it is difficult to take care of the trauma patients, codes, and on and on when the clinic patients roll through. It is compounded when they are making demands on the staff - guest trays for 4 or 5 people, family following the MD and/or staff to the nursing desk in the nurses station to talk, the ones that come in making the threat/promise they will sue because... (any number of the reasons they threaten it for.

Like I said, I'm not judging, I have worked days, nights, weekends, holidays in the ER of different facilities, and it seems to me that the more they complain or threaten, the less sick they are.

Anne, RNC

I feel like all of as nurses or other staff do need the opportunity like we have on a thread such as this to vent or trade stories about their "problem patients". Just my opinion, it may not be the same everywhere. Our ER has the fast track in the ER for the clinic patients, but when it's full, the fast track patients spill over. I hate to tie up a trauma/recuss room for an earache , flu, cold, that type of thing that I may need with little notice when the ambulance line rings.

Specializes in ER, TRAUMA, MED-SURG.

There is also a difference in what you see when you come in as a family member vs. being a nurse in the ER.

Anne, RNC

Specializes in Med-Surg.

Ha Ha...these are all great...I have a few

1. Don't use sliced potatoes as a form of birth control and expect us to fish it out for you! Sliced potatoes is not a form of birth control!

2. Don't come in with a migraine headache and leave all of the bright lights on, talk on your phone. When the doc doesn't give you the medications you want but gives you a prescription for narcotics and tells you thats the plan, don't suddenly not have the money to get them filled!

3. Please do not call for an ambulance to bring your 2 week old baby to the ER because the umbilical cord fell off!! It's supposed to happen!!

One thing I can't stand is when patients come in with nausea/vomiting/abd pain and they either bring food in with them, have someone bring them food, or ask for it!

one in the er i had pushed the nurse out of my way so i could puke in the bathroom, and i was shocked when she thanked me.

Specializes in Cardiac Telemetry, ED.

Do not bring your 14 year old son in for abdominal pain, then the first time I walk into the room, before I've even opened my mouth to introduce myself, start telling me how he hasn't eaten in a few hours and how hungry he is. Quit being passive aggressive and just ask me if he can eat. I will tell you "no".

Do not, the second I poke my head around the curtain because I hear a monitor alarming, point to the patient and say "ice chips for her" as if you are ordering at a restaurant. For one thing, I'm just checking to see why the monitor is alarming. For another, I'm not even her nurse and have no idea if she can have ice chips, and I don't have time to track her nurse down to ask. Lastly, it's just plain rude.

Please do not bring both of your daughters to the ED and then lie to the triage nurse about why they are here. While you were in the other room with your other kid, this one told me that the "migraine" you told triage she has been having is really just a "really bad cold". Our ED is full, the lobby is full, and the ambulances keep rolling in. You are wasting resources and taking up two beds that could go to people that really need them.

Ah, that feels better!!!!

Specializes in Cardiac Telemetry, ED.

If you feel like you are going to throw up, do not call out "Nurse! Nurse!!!!" expecting me to drop everything and come running. There is a puke bag sitting right there on your lap. I suggest you pick it up and hold it to your face. What do you want me to do, hold your hair?

To the visitor who keeps making jokes about how the patient should share the "good drugs" I'm giving him for his testicular pain and then remark that I have no sense of humor when I don't laugh.....it's not funny. That's why I'm not laughing. I have a very good sense of humor, thankyouverymuch and right now, I'm laughing at you, not with you, on the inside.