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.

[whichone'spink, BSN, RN]

Virgo_RN said:

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

[VSpinRN]

If you can go to the bathroom for a BM at home, get up and go the the bathroom in the ER (do not poop in my stretcher) Do not call me to wipe your butt when you are done you are 40 yrs old and fully functional! And no, I don't want to see what came out, just flush it!!

[VSpinRN]

Thank you for taking this patient

[CrunchRN, ADN, RN]

VSpinRN said:

If you can go to the bathroom for a BM at home, get up and go the the bathroom in the ER (do not poop in my stretcher) Do not call me to wipe your butt when you are done you are 40 yrs old and fully functional! And no, I don't want to see what came out, just flush it!!

Seriously? Some people are amazingly freaky!

[princess2b]

Sugar9486 said:

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...

Very nicely stated, Sugar.

It's obvious that some nurses here believe that patients can't know anything, since they are a patient --- unless maybe they see the M.D. after the patient's name. It's very sad. There can be lots of reasons why patients are knowledgeable about their own health, drugs, needles, or what have ya. They could be a cancer patient, have an elderly grandparent that they help care for, have a chronic condition that causes them more specialized visits, and/or have allergies galore to name a few.

The butterfly needles are not just for the size of needle's gauge but are for less pressure of the vials being taken.

Yes, no one of any background cannot guarantee that the patient's vein will not roll or have a hard time for some other reason. Tip: Listen to the patients that tell you which vein(s) are their best ones; they are usually right.

Tip to Patients: Bring in a copy of a list of your medications, allergies, medical history, age, gender, et cetera. They can easily add to or edit it as needed. The Universial Medical Form is easy and free to use -- just ask your doctor or hosptial for couple copies of it.

Patients: Have a relative order the pizza and have it delivered right outside of the ED. The only downside to doing so is that you still can't eat until given premission.

[I_LOVE_TRAUMA, RN]

I may be wrong here, but I thought this was a nursing site, not a patient advocate website. We use it to vent, it is very helpful, it keeps us sane. Especially since we are so uncaring & uneducated as the last few posters have pointed out. I have been a nurse for 14 years-all in an ER, please do not preach to me about how to care for a patient, what is best for them, what I am doing wrong, and especially about choosing veins. I think you would be see things much differently if you actually worked ER, or especially if you or a loved one were one of my patients, you would be very thrilled at the knowledgable, compassionate, care I give, even when I stick a 14 gauze in your high an mighty AC. We really don't care what you think of us, just don't forget you can always just NOT read posts you don't like. Its easy, just don't look...we'll be fine without you here, we'll manage...somehow.

[CrunchRN, ADN, RN]

Geez. Let the poor ER nurses blow off steam. That is the purpose of this thread.

[I_LOVE_TRAUMA, RN]

and just for the record, the only patients I let tell me where to start their iv is heroin user, they are always right, & if you tell me they can only get an iv in such and such place, I will NOT stick you there, just b/c I get a lot of satisfaction from smiling at you when I get 2 big ivs in you elsewhere. I've already started at least 20 tonight, and if I can get the dehydrated 3wk old's hand/scalp, the 400+lb guy, the trauma who lost his bp 10 min ago, the 90lb 88y/o grandma who has cancer and looks like a pin cushion, & the 40 y/o who has done heroin for 20+ years, trust me your little "rolling" veins don't stand a chance.

[echo23, RN]

you're lucky ed you only got 4 patients. I usually have minimum 15patients at ED in an 8hour shift. but still i love my job. =)

[zoinks22]

Nothin wrong with a little venting. We who have to deal with the yahoos of this world have all the right to do so. Its what prevents us from actually carrying out the things we say in here. I think all would agree that on a given day, at least 85% of the people who come in the door are not emergent. More to the point, every facility has the patient who comes in at least 2 times every day, ******* the entire time and leaves AMA every time after the doc gives Dilaudid in order to keep his Press Ganey score up. Now just wait until those of us who work for a living have to pay higher higher insurance premiums to foot the bill for these deadbeats to continuously come in for their "hydros"......

[NB RN, BSN, RN]

I'm surprised too! I was waiting to read that post.

[ThrowEdNurse, BSN, RN]

Suspicious when people don't have their education or profession/licensure listed under their info. I was really hoping that I could fine out what princess2b does for a living so I could find a web site dedicated to that professional, especially if I know nothing about it, and drag out a soap box and a high horse and antagonize people I don't know who are venting so they may go to work every day and still be sane.