wasting time?

[smurfynursey]

Hi all,

First off, I am not an ER nurse...

Just wondering what you think of people who come in with something they think is really bad and it ends up being nothing...do you think of that as a waste of time? just curious to get your opinion...

(ie, RLQ abdominal or chest pain that is really nothing, things like that)

[Altra, BSN, RN]

No. Any experienced ED nurse has had "surprises" ... the frequent flyer who presents complaining of the same s/s they complain of every other day of the week -- only this time it's real. Or the young, healthy, low-risk patient who turns out to actually have some bad ju ju going on.

No one should ever ignore chest pain -- I reassure patients of this daily.

[Sassy5d]

Blatant things, while not a waste of time, per se, like 'I need a check up' with no complaints.

I wanted to watch my program, with no complaint.

[mish_RN]

When people come in for things that their PCP can take care of can be "waste of time." However, the simplest complaint can lead to straight to surgery or a common back pain with no health history can be a GI bleed. I've learned with being in ED for a year to expect the unexpected. Because as an ED nurse, you never know what can walk through those doors.

[Lunah, MSN, RN]

I'm glad when an acute complaint ends up being "nothing" - and I don't expect a layperson to be able to make that determination. I tell my patients that if it involves the brain, the heart, or the lungs, don't screw around - come see us. :)

[WAheartnurse]

I also tell people this important lesson (that I was never told during my younger days and visits to the ED for me or my family)- just because we have run a few tests that ruled out the most emergent and dangerous causes of your symptoms- does not mean there is nothing wrong. It means we can safely send you to your primary care doctor another day to do a full investigative work-up if necessary.

I hate the idea that if a patient comes in with "abdominal pain and nausea" and then we check their gall bladder with ultrasound and do a CBC and perhaps a basic chem panel and they all come back normal we might tell them your tests are all normal and you are fine. Well, they still could have pancreatitis (which wouldn't show up on those basic tests) or other causes for their problem. Certainly they should be following up with someone but sometimes we just need to admit that we just want to make sure you aren't dying- if not- then you can go see someone for your problem on an outpatient basis.

A person with chest pain and a clear EKG and negative cardiac enzymes can still have a cardiac problem.

All your tests are normal really means- all the stuff we looked at. Not that there is nothing wrong.

Amy

[Sassy5d]

I also think there are people who believe an ER is the super doctors. When you go in with a problem, it should be fixed before you leave.

[NurseOnAMotorcycle, ASN, RN]

I agree with Sassy5d. And they write for follow ups for a reason. Lots of people never go.

What we don't like is when people are demanding or dramatic.

[danggirl16]

I think really the only thing I consider a waste of time is when people lie about why they are coming in...for example if they say they are having chest pain but really they just ran out of their Xanax. A chest pain complaint requires a ton of interventions and a good deal of time. By lying they really ARE wasting time and resources and increasing the wait time of others. A simple "I need a refill on my Xanax" takes like 15 min vs the 3 hours a complete CP work up takes.

Otherwise I agree with the others; minor complaints can be major problems and negative tests might just mean different tests are required to diagnose. One night a guy came in who said he had gone to a clinic for a bad headache and was told his blood pressure was high. He said two Tylenol got rid of the headache...he felt and looked completely fine when he came in....an hour later I was transferring him to a sister hospital for an intraventricular bleed. ( Had the person lying about chest pain got there first, this guy could have been in big trouble )

[uRNmyway, ASN, RN]

I think really the only thing I consider a waste of time is when people lie about why they are coming in...for example if they say they are having chest pain but really they just ran out of their Xanax. A chest pain complaint requires a ton of interventions and a good deal of time. By lying they really ARE wasting time and resources and increasing the wait time of others. A simple "I need a refill on my Xanax" takes like 15 min vs the 3 hours a complete CP work up takes.

Otherwise I agree with the others; minor complaints can be major problems and negative tests might just mean different tests are required to diagnose. One night a guy came in who said he had gone to a clinic for a bad headache and was told his blood pressure was high. He said two Tylenol got rid of the headache...he felt and looked completely fine when he came in....an hour later I was transferring him to a sister hospital for an intraventricular bleed. ( Had the person lying about chest pain got there first, this guy could have been in big trouble )

Lol yea, but if the guy just says he needs a refill on his Xanax, he is missing out on all that IV morphine! You know, I think all pain meds should be IM. If someone really needs it, they won't care how much the IM hurts! I think the easy, convenient IV access is just enabling their behavior...

[OlivetheRN, ADN, BSN, RN]

Or the young healthy, low-risk patient who turns out to actually have some bad ju ju going on.[/quote']

i.e. The 14 year old girl I had last week c/o and N/V for four days who turned out to be in acute liver failure.

[Altra, BSN, RN]

i.e. The 14 year old girl I had last week c/o and N/V for four days who turned out to be in acute liver failure.

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