1. Please fill out the triage form completely. We specially like it when you fill out the part that says "reason for coming to the hospital" as it prevents us from having to use our magical ESP powers to determine if you have chest pain or just a hangnail.
2. Do not disturb the triage nurse while she is with a patient. She is giving the patient her full attention. When you get into triage, YOU will get her full attention. Wait your turn.
3. Unless you are on fire or in full arrest, you can wait just three seconds for the triage nurse to acknowledge you before you start shouting at her. Believe me, if you shout at her near the end of a difficult twelve hour shift, she is liable to shout back.
4. After you have been triaged, please take a seat in the lobby and do not come to the triage desk every five minutes asking "When am I going to see the doctor?" Like we told you the first time, you'll see a doctor AS SOON AS POSSIBLE. No, we don't know exactly how long that will be.
Rules for the treatment area
1. Answer the nurses' questions honestly and completely. If you lie we WILL find out.
2.Do not go to the nurses' desk every five minutes asking how long it will be before the doctor sees you. We don't know. Again, unless you are on fire or in full arrest, please accept that there are probably patients in the ER who are sicker than you. Yes, I know you FEEL like the sickest patient in the ER; so does everyone else. However, the nice gentleman down the hall with a Sat of 70% trumps your earache.
3. Do not act like it's the end of the world when I tell ou I need to draw some blood. You knew it was coming. If you will sit still and follow my instructions, I will get the blood with a minimum of pain and difficulty. If I have to chase you across the room and hold you down, there will be no such guarantee. Nobobdy likes having blood drawn (inclucing me) but it's a fact of life that sometimes it has to happen.
4. I'm sorry that you have to stay on a stretcher in the hall. I wouldn't like it either. However, all of our rooms are full. The only other option is for you to continue waiting in the lobby. Your call.
5. Family members, please do not assume that I am going to abuse mawmaw if you leave the room. If I ask you to step outside while I draw blood or place a foley, please do not get all huffy about it. The rooms are small and you are in my way. Don't take it personally. I promise not to smother your loved one with a pillow while you are gone. The nursing staff is not your enemy.
6. If you have a complaint of abdominal pain, nausea, and vomiting, you may not have anything to eat or drink. So don't ask.
7. Lastly, please remember that we nurses are only human. You can look around and see when we are very busy. Please take that into consideration. If we forget to bring you that extra warm blanket or another glass of water, don't blow a fuse. Please just assume that maybe we were busy saving a life next door.
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Please tell me I'm not the only one who has felt this way from time to time!
I don't even work in an ER, but I know the ER is abused, not being used for emergencies but for routine care.
I agree with whoever said the public doesn't want to be educated, some people use the ER because they can't be turned away, it's free, and they don't want to bother to go to and pay a doctor or clinic, or can't afford to.
I saw just a bit of Nightline, I think it was, the other night, and an ER somewhere is charging people if it's not an emergency, if they want to be taken care of they pay a charge up front.
Of course, I realize that some people don't have health insurance and can't afford it and can't afford to pay, but that's a different problem.
Maybe society or whomever, needs to come up with another system whereby people can get free care from a 24 hour clinic or something and not have to go to the emergency room for non-emergent care.
Well - I vacillated between posting or not posting to this thread, then decided what the hay - I'll do it! So, my idea of educating the public is that we should encourage the ENA (Emergency Nurses Association) to get a grant from the goverment and advertise to the public about the REAL reasons to show up in my ER at 3am (and no guys its not because of a rash you've had for six months). I also think there should be a co-pay for Medicaid cllients who use the ER more than three times in a one month period without being admitted - maybe just $5-10 but enough so that they would have to think about it. In our ER we make it clear (through posters, pamphlets, etc) that an ER visit is for bonafide emergent issues. We as a nation need to take a look at our overcrowded system. Thanks for the forum guys.
I don't know about elsewhere in the country, but here in MN we have a place called "Urgent Care". It is just basically a clinic that is open past 5pm. For people with normal jobs that are sick, but can't take time off during the day to see a doctor. Seems like a pretty good idea to me!
Todd, you are assuming that patients actually want to be educated!!! Most people just want their problem fixed immediately. If they vomit once, they come into the ER to have it stopped. People don't care about taking care of themselves and preventing illness. They don't want to learn what is an emergency or not. People want the quick fix, like most American's do. I think the rules posted are quite appropriate. ER nurses, and frankly all nurses, are hard working and want to help the sick. We just get tired of taking care of people who could take care of themselves but won't!!!
The only problem with posting rules, is that people either don't read them, assume it doesn't apply to them, or can't read English/Spanish. After all, they have to be posted in two languages.
We have signs in two langages on the nursery door, explaining the visitor policy, it's even in bigger than usual print.........but many visitors have never seen them!
I agree that someone needs to educate the public, but I also agree that some people can't be educated. There are still people that are frequent flyers where I work that I'm sorry to say get a cold shoulder from a lot of the staff when they come in. Guess what, it doesn't stop them from coming in!
It's sad especially when parents bring children in and the parents are obviously from the shallow end of the gene pool, and shouldn't be caring for animals, let alone children. It isn't just the need to educate the public about when it is appropriate to use ER, but when it is appropriate to give your child tylenol, or when you shouldn't smoke around your child, or many, many other things that we ER nurses see that can frustrate and irritate us.
Whoever it was who volunteered to write a letter to the editor, put this in the letter: Keep a PRINTED list of your medications, allergies, and medical history on your person at ALL TIMES! At 3am we don't have access to your doctor's office where your current list of medications is. We can order an old chart from medical records, but that list may not be current. And PLEASE refrain from bringing the suitcase-o-meds! It takes too much time to sift through all the medications to see which ones you're taking and which ones expired 10 years ago! So please, write your editor, your congressman, Santa Claus.........KEEP A LIST OF YOUR MEDICATIONS, ALLERGIES AND MEDICAL HISTORY ON YOU AT ALL TIMES! Tattoo it on your body if you have too. (remember to keep your list of medicines up to date!) Ok, I'm done with my personal rant!
Specializes in LTC,Hospice/palliative care,acute care.
Originally posted by tonchitoRN
where is the compassion people?
Where is the funnybone? I cracked up...and I have waited in the ER for hours on a Saturday night with my cancer ridden septic mother while some chickie came in for a pregnancy test.....Triage problem but it was taken care of when I waited my turn and spoke nicely to the staff...She had ca of the vulva and they brought out an old fashioned highbacked wooden wheelchair for her....But they remedied that fast,too...While kids with earaches screamed and a lady with rash smoked and cursed....But I did not act like an azzhole and neither did my mom...but we felt like we were at an azzhole convention...I watched several frequent flyers come in,read the board to see which docs were on and then leave if the doc on was one that "Won't give me anything-I might as well come back tomorrow" I guess that was not a real emergency ....Let's not forget that this board is a place to vent.....
I agree with the post about Medicaid patients but I also feel that others who abuse their insurance by going to the E.R. because it is "convenient" for them should also be made to pay a larger copay. I don't mean the ones who have a child screaming in agony from pain, or a serious symptom, that turns out to be no big deal, but the ones who come in for a rash, or constipation, or a cold. Now mind you, if your sats are 76%, you are having costal retractions and grunting, ok, that's not a cold, that is an emergency. I have seen so much crap come through the pediatricians office where I worked, that it made me sick. People would come in for a *&^^ mosquito bite for pete's sake. And YES, it was mostly people on Medicaid! Sorry if that ruffles feathers, but it's the truth. And YES, I was once on Medicaid and NO I did not abuse it in any way. I felt that it was a blessing that I got assistance at a time when I needed it............not a RIGHT like most people think it is. It is meant to HELP, not as a continous perpetual insurance plan. I have heard it referred to as a "Magic Kingdom" card. It's true. Summing up, the E.R. is there for a reason. I take my kids to the Urgent Care Center for a reason if it cannot wait until office hours. I will not abuse my insurance.
I understand what you are saying, and I cracked up at your vent too. BUT... here is a situation that happened TODAY.
One of my classmates had to come to clinic or she would be dropped. This am, her 3 yo daughter started complaining of pain in her ear and had a temp. The student came to clinic, explained the situation and was given permisssion to call her pediatrician to make an appointment for later that day. We are working peds, and strangely enough she was caring for one of her kid's docs patients. But could she get an appointment? No way, can't be seen until Wednesday. THE DOC'S OFFICE said GO TO THE ER or wait until Wednesday. Her insurance limits the docs she can go to in this town, so changing doc's or going elsewhere isn't an option for her. So what can she do with a child in pain, with a temp?
So, I can see that sometimes this isn't the patient's problem with not understanding WHEN to come to the ER. Rather, it is the Doctor's not having left enough time in their schedules to deal with non-emergency emergent problems. They are so busy over booking appts. that they can't see patients on the same day and would make the child either wait to Wednesday, or spend untold hours in ER.
Please tell me I'm not the only one who has felt this way from time to time!
cannoli
615 Posts
I don't even work in an ER, but I know the ER is abused, not being used for emergencies but for routine care.
I agree with whoever said the public doesn't want to be educated, some people use the ER because they can't be turned away, it's free, and they don't want to bother to go to and pay a doctor or clinic, or can't afford to.
I saw just a bit of Nightline, I think it was, the other night, and an ER somewhere is charging people if it's not an emergency, if they want to be taken care of they pay a charge up front.
Of course, I realize that some people don't have health insurance and can't afford it and can't afford to pay, but that's a different problem.
Maybe society or whomever, needs to come up with another system whereby people can get free care from a 24 hour clinic or something and not have to go to the emergency room for non-emergent care.