Here are some of my rules. Feel free to add your own.
When I ask you what brings you in today, please don't tell me your life story. I just need to know what symptoms you are having Right. This. Minute. that are concerning enough to bring you to the ER.
Please be ready for me to take your VS. I know it's starting to get a little nippy outside, but when I have to wait for you to take off your three sweaters and overcoat before I can take your BP, it really bogs things down. You did know you were going to have your BP taken, right?
If you tell me that you've been having your symptoms for over a year, please know that your acuity level will be downgraded accordingly.
If you have multiple complaints, pick one.
Don't ask me how long the wait will be. The nature of ER flow is unpredictable. If I tell you an hour and it turns into two, you're going to be grumpy and take it out on me. Also, on a related note, don't ask me where you are "in line". That's not how it works.
Don't tell me you have an appointment/have to be at work/have to pick up the kids in a specified amount of time, as if I'm going to whisk you right back and get the doctor in the room right away just so you can make it to your thing-you-have-to-do. That's not my priority or my problem.
When you come in for a stuffy nose and have to wait, please don't stand in my line of sight and give me the stink eye while I triage another patient. I did not drag you in off the street to come in here for your stuffy nose. You do know what the word "Emergency" means, right?
Sincerely,
Spending Too Much Time In Triage, Somewhere In The USA
If I recognize your name, you are gonna wait a little longer. Sorry but I know you, I know why you are here, we have other people here that are probably, doubtful but probably more sick than you are.
What's worse is when we can identify them by the EMS radio call. That's when they are super duper frequent fliers. Sigh.
We have a guy who comes in almost every day for CP. Some docs will do a trop to CYA, others don't bother. He gets an EKG every day. Tylenol, and then sleeps in the waiting room til someone takes him back to discharge him. :/ I'm weary of the day he actually decides to have a NSTEMI after waiting in our ER for 18 hours.
As you step off the scale and I ask you what brings you to the ED today - please don't ask me to convert your weight from kgs to lbs before telling me what your emergency is. I have had people that refuse to provide any information until I give them their weight in pounds.
If you don't want your family and friends to know that you came to ED because you think you have an STD, don't bring them with you.
And please don't be shocked when I pull out a blood draw kit after you just told me you are vomiting blood and having abd pain. "Why do you need to draw blood!!" My response " I left my crystal ball at home today so we have to do blood work to help diagnose your emergency"
As you step off the scale and I ask you what brings you to the ED today - please don't ask me to convert your weight from kgs to lbs before telling me what your emergency is.
We only weight pediatric pts. in our ED, not adults (unless they are getting tPA)…but I would love to say "125 times 2.2."
Specializes in Pediatric ED;previous- adult Ortho/Neuro.
When I start with "what is your emergency this morning" and the reply begins something like "oh, it's not really an emergency....." Smh
I know you are scared about whatever brings your child to me today, but that doesn't require your entire extended family to also come to my tiny triage room, and please don't give me the stank eye when I say so.
If I call your kids name, and you are on the phone/at the vending machine, and hold a finger up for me to wait, sorry, I'm grabbing the next patient.
If you child is here for vomiting, don't get ****** at me when I make him NPO. Stop shoving things down his throat so he has a chance to stop throwing it back up!
Please don't act like I'm violating your infant when I take a rectal temp, when you brought him in for fever.
I will take your word for it that your child had a fever/was in miserable pain at home. For the love of God, don't deny them some ibuprofen/Tylenol "so I see how high the fever is/how miserable". That's the first thing I am going to do, and 99% of the time, 45 minutes later the kid is brand-new. Might have saved a trip and ER bill!
Ok, enough for now. Flu season isn't even here yet, and I'm in rant mode. Ruh-roh, may be a long winter! =)
When I start with "what is your emergency this morning" and the reply begins something like "oh, it's not really an emergency....." Smh
I always start with "what brings you in today?" I'll decide if it is a true emergency. While we evaluate them and treat them even it's not a true emergency, I don't want to validate their unneeded visit by starting it off by calling it an emergency.
Specializes in Pediatric ED;previous- adult Ortho/Neuro.
I always start with "what brings you in today?" I'll decide if it is a true emergency. While we evaluate them and treat them even it's not a true emergency, I don't want to validate their unneeded visit by starting it off by calling it an emergency.
Agreed =) I more often say the same as you, but sometimes ask what is the emergency more because they usually seem to stop for a second to realize "oh, yeah, this isn't an emergency". Probably comes out more when I am to the point of being "over" all the non-emergent complaints, that are the first to complain about wait times. =) but, then we have a crap day when a kid passes, or an ugly abuse case, and it reminds me I prefer the ear aches and crap way over something like that any day.
Specializes in Emergency Department; Neonatal ICU.
Ha! That is the best when they get done triage and they tell me that they are going to "run across the street to Del Taco" and to make sure they don't lose their place. Aaaaannd you just went from an ESI 3 to a 4, and documentation as to why.
I had a guy stroll casually in. I was about to ask him if he needed help but he turned away from the desk and went into the bathroom. He was in there a few minutes and he came out and up to the desk. I was preparing for him to ask me about a patient he was visiting and he said "I'm having chest pain." That went in my triage note. And he wasn't a STEMI :)
i had a pt come in for some non-sensical pain that she couldn't pin point an event leading up to the pain. got sent back to the waiting room. 30 mins later i get another sheet printed out with the same name as the pt i triaged ... IT WAS THE SAME LADY, she got tired of waiting so she RE-REGISTERED
I have actually had to stop people mid sentence and ask what ONE thing made them walk through the door this very minute, and they look at me like a deer in the headlights and I swear I hear cricket chirping EVERY TIME!
While we evaluate them and treat them even it's not a true emergency, I don't want to validate their unneeded visit by starting it off by calling it an emergency.
SionainnRN
914 Posts
What's worse is when we can identify them by the EMS radio call. That's when they are super duper frequent fliers. Sigh.