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.
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:
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:
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.
Those stupid blankets, if someone is arresting there will be sure to be a family member that feels a chill and wants the CPR, but could you put a blanket on him, he's cold.
1) how would you know if he's cold, he's unconcious!
2) sure, we'll do compressions and zap him through flannel, doubt it will work, but we'll get SUPER PR scores.
As I am cutting the shirt off an elderly man who fell off a ladder and has bruising on his thorax, low O2 sats on RA, hypotensive, and pain in his hips, the son "Dad, are you cold?"
Dad: "A little"
Son, emphatically: "Could you PLEASE get him a blanket?"
All while I am trying to assess the patient, get him on oxygen, get him some pain meds, start a fluid bolus, order xrays and take blood for a blood bank hold.....sure, all those things can wait, so long as Dad is toasty!
Sometimes I hate those damn blankets.
Virgo_RN said:As I am cutting the shirt off an elderly man who fell off a ladder and has bruising on his thorax, low O2 sats on RA, hypotensive, and pain in his hips, the son "Dad, are you cold?"Dad: "A little"
Son, emphatically: "Could you PLEASE get him a blanket?"
All while I am trying to assess the patient, get him on oxygen, get him some pain meds, start a fluid bolus, order xrays and take blood for a blood bank hold.....sure, all those things can wait, so long as Dad is toasty!
Sometimes I hate those damn blankets.
Hehe...
This is why we minimize our visitors to the PACU because that is the main focus.
Example:
Patient is post anesthetic, vomiting.
states, "Oh my mouth is so dry and feels gross. If only I can have water."
I explain to the family that drinking will only make the vomiting worse, and yes, we can rinse out her mouth, but to please "not to swallow the water".
Mr. Family member, posturing:
"If my dad wants water, I expect you to get him water to drink."
(Me) I respond in a soft, and even soothing voice:
"No problem, Sir. If I may, Mr. Family Member I just want to inform you that I cannot be a participant to the following exchange. Please understand that you will be taking responsibility for the horrible feeling he will get when he vomits twice as hard and screams out in horrible pain from the soreness of abd sutures, for which no medication will cure instantly. He will go through several minutes of intense and probably agonizing discomfort--he may scream and writhe, but he should be--actually, will be allright again. As he curses through it and probably feels like he wants to die, know that it is a temporary issue. I wanted you to know so that when he screams murder and you are expecting some sort of fix for it--the only fix for it is no water at this time."
Silence.
FM: "No water Dad."
Virgo_RN said:As I am cutting the shirt off an elderly man who fell off a ladder and has bruising on his thorax, low O2 sats on RA, hypotensive, and pain in his hips, the son "Dad, are you cold?"Dad: "A little"
Son, emphatically: "Could you PLEASE get him a blanket?"
All while I am trying to assess the patient, get him on oxygen, get him some pain meds, start a fluid bolus, order xrays and take blood for a blood bank hold.....sure, all those things can wait, so long as Dad is toasty!
Sometimes I hate those damn blankets.
I tell them, yes I will. But that isn't the priority right now, keeping him alive is. Usually shuts them up.
Nurse-o-Matic said:So, there I was... feet throbbing, back aching, bladder distended and screaming for relief, stomach rumbling, eyes dry and scratchy, mouth and lips dessicated and cracked from 10 hours with no fluids, uniform damp with perspiration and splattered with blood from a flailing demented man 2 hours ago (okay, also maybe a little bit of a white deodorant stain begining to show around the armpits). I stumble onward, though, proud to be on a mission to deliver the little, fancy cup of PO meds to a sick granny. A smile on my face, but not so big as to cause my dessicated lips to crack and bleed, I explain the medicine to my patient and gingerly pass the cup into her ever so eager hands. "Just lift the cup to your lips and dump in the pills," I say, coaxing her softly. Granny nods, smiles back, then takes a priming sip of the ice water as I secretly fantasize about thrusting the water to my own lips for a few greedy gulps. I look back at Granny and nod. She's ready to take the pills....a dramatic pause....and then.....NOOOOO!!!!! Too late! She has already disobeyed and is now overturning the little cup of precious pills into her gnarled, arthritic, coumadin-bruised, parkinsonian-tremor hands! I dive to the bedside, a desperate attempt to at least keep the pills somewhere on the bed. "Ooops!" She says with that cute little old lady giggle. I am able to recover the pills and place them back, safely, into the cup. Phew, a close one. Still patient, I reach to hand her the water but when I turn around, the greedy gnarled fingers have already been digging in the cup trying to get the pills out! The white pills (it's always the white pills) have bounced out and onto the bedsheet! "Don't move", I instruct as I search for the missing offenders. This is when granny's family crowds in and starts moving the bed up and down and flipping the sheets around to "help." The pills start plinking musically to the floor right at that moment. I sigh and go to see what pills are left in the safe little cup. Meanwhile, granny and her magically gnarled finger (that is almost the same circumference as the cup) has managed to somehow dig more pills out and actually get some in her mouth. She chewed them a little and then spit out "the bitter shells" as she put it. Pill fragments are now everywhere...on the bed, on the wall, on me. Lord help me, it's like pill pirrannas were here! The front of my uniform is now speckled with debris. Hmm...Despite dehydration, the vein on the left side of my neck is now distended and throbbing, and I feel what could be horns? starting to grow out of my head....Face red, I reassure granny that all wll be made right as granny's family starts demanding that it "took so long to get the pills, now we'll be here forever! We need blankets, and a phone, and food, and blah blah blah!" Also it the faint distance....I hear a voice...."Nurse! I need you to get over here and start an IV on this hyperactive 5 year old, get a stat NG in room 6, and did granny smith in room 11 get that medication yet?!?"........
OMG!!! ROTFMAO- this was soooo stinking hilarious!!!!
suzyskinurse said:I was on my way to what was supposed to be my first day of nursing school when I was hit head-on by a drunk, who pinned my Isuzu Trooper up against a stone wall with his Jeep Wagoneer. Luckily, the family nearby was home & had an extinguisher to put out my engine fire.After pulling my IV's out twice on Life flight & having grand mals, I made it to the trauma center, where I could hear people talking about me. Your First ER Rule should be:Remember, your patient may be bleeding profusely, fractured, incontinent, delirious & often unresponsive, BUT We Can Hear, & often remember. Please don't make doomsday pronouncements.. if it wasn't for a few nurses & Drs, my 2 sons would probably be motherless now. Although I don't remember seeing anything until my 3rd day, I Heard, & Desperately hung onto some of the words of My Heroes. Not ALL ER patients are there by choice!!
So sorry to hear about your accident. It's obvious that you posted in the wrong thread. This is not about doomsday pronouncements or taking away hope.
so everyone complaining about us venting- do you ever have a bad day at work? You never vent or complain about anything? You don't joke about things that happen in your life? Wow you're so perfect!!! :eek:Could you please enlighten me on how you do it? And do you think it's appropriate for a pt to come into another pt's room during CPR lay on the ground and fake a seizure for attention? Really?!?!?!
I have no problem with you peeps venting!I myself have been to the ER five times for Diabetic Ketoacidosis(two times last year,three this year). And I'm a 4'11,92 pound active,disiplined 19 y/o girl(in all my nine years as a diabetic haven't touched table sugar).My point is I've seen the people who go for the smallest things ,and they catch attitude when somebody with a life threating condition gets seen first.They roll their eyes and scream at these poor nurse for doing their job!I mean how would thes people with attitude like if the nurses treated them this way?!I may not be a nurse yet but I definitley understand where you guys/gals are coming from!I actually plan on being an being an ER nurse myself,so this thread sorta prepares for what I should expect in the future!Props to all you ER nurses for what you deal with everytime you go to work!You all rock!
ECRN4 said:And do you think it's appropriate for a pt to come into another pt's room during CPR lay on the ground and fake a seizure for attention? Really?!?!?!
Of course it is. Us callous, uncompassionate, burnt out nurses should put ourselves in that patient's shoes. That poor patient just has an unmet need, and as professional nurses, it is our job to hold that person's hand and just....be there. :redbeathe
Virgo_RN, BSN, RN
3,543 Posts
Please do not come out into the hall and flag me down to ask me if your loved one can have a blanket. Can you not see that my arms are full of medications, syringes and tubing and that I am walking very quickly? I'm not even your loved one's nurse! I will tell you "Yes, she can have a blanket" as I continue to walk very quickly to my patient's room, where they are in respiratory distress and need my attention NOW, leaving you standing out there in the hallway flabbergasted by this poor customer service.