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.
* * * * * * * * * * * * * * *
Please tell me I'm not the only one who has felt this way from time to time!
it is funny how an er rn's humor is sooooo perversely different from any other field... this is however what keeps us going..
in my ed we were having a particularly bad month - so we were sitting around - here's some we came up with... (some of them are rather tasteless - so the easily offended may want to just skip this one...)
1. if you overdosed and called 911 - you didn't wait long enough
2. do not smoke an eight ball and call 911 complaining that you can't hold still - that is what happens when you do too much crack
3. when it is 30 degrees out - please dress your child in more than a diaper
4. when this said child has a fever of 105 - medicate them - do not tell us "i wanted you to see how high the fever was"
5. any symptom that has been there more than 24 hours can wait another 24 hours
6. there are no appointment times - wait quietly or leave
7. you are right - you would not wait as long at the hospital down the road - go ahead - leave and go there.
there were so many more - but i am too tired to remember them all - we however had a real kick thinking them up.
you think there should be valium salt licks in the waiting room
you believe that all bleeding stops eventually
you wish you had discharge instructions labeled "suicide, how to do it the right way."
you can tell bad jokes during a code
you think "too stupid to live" should be a nursing diagnosis
I could go on and on, not only from ER perspective but from and paramedic for 13 years perspective. I have always said that anyone in the emergency services field (police, fire, ambulance, ER, even RT) must have a perverted sense of humor. It keeps us sane to be able to relieve stress by poking fun at stressful situations.
I think Todd needs to lighten up. It's easy to be judgemental and idealistic when you have never been there. I was that way myself when I was a student. That being said, I love my job and I love taking care of patients. I have been without insurance and I understand how it feels to be unable to afford a doctors visit or wait a month for a clinic appointment when you are sick NOW. However, some of the stuff patients come in for boggles my mind. And while I understand that even though their problem may not seem like a crisis to me, it IS a crisis to them. THAT being said, I have noticed that the group of people with the least urgent medical problems also seem to be the rudest, the loudest and the most obnoxious. Like the ones who come in for a pregnancy test and ask me " Do you know how many minutes it's going to take?" Or the ones who think they are the only pt in the entire hospital and wonder why it takes so long to get her UA results back since it " only takes 20 minutes," As though the lab has only one UA to perform. As far as eduacating the public Todd, I have come to the conclusion that there are some people who just aren't willing to listen and will do what they will no matter how much you try to inform them. So until you have walked a day in the shoes of an ER nurse, please PLEASE LET US RANT!
One of the nurses I work with has a T-shirt that says, "I am an ER nurse - my job is to save your as#, not kiss it" Not true, but I had to laugh. (No, she doesn't wear it at work)
Todd, I understand how the twisted ER staff humor is not amusing to others, but I guess you have to walk the walk to comprehend the talk. The main reason ER staff get so aggrivated with non-emergent visits from patients is the fact that those are usually the ones that complain and get irrate with staff. I had a lady threaten bodily harm to me because I called back a patient into triage before her ... she was there with cold symptoms x 2 weeks and the 84 year old lady checked in after her with SOB. When I called the elderly lady, the other lady jumped up and said, "Oh no you don't! I was here FIRST!" I tried to explain that triage was based on acuity, not in order arrived, but she wouldn't even listen - she went on a rampage causing a huge scene. She ended up escorted out by security.
After patients are placed in exam rooms, the Docs see patients based on acuity as well ... thus an even longer wait which leads to more complaining and verbal attacks on staff. Once you deal with this type of behavior day in and day out, you become accustomed to this type of treatment and if you can't make light of the situation and shrug it off, you would surely nut up. Sorry you found it offensive.
I really enjoyed your postings. C'mon, it's true, if we don't see SOME humor in these things, we'd all go nuts, then these patients would have NO ONE to put up with them!
All of the points you guys made are true and valid, I don't care
what the others say, yes, we all know about lack of insurance, lack of private MD's, the high cost of healthcare, the long waits
for clinic appts., etc. However, we are professional emergency
health care providers and deserve to be treated with respect!
We know people get frustrated waiting, but the loudest voices
are usually the least in need of emergency support, otherwise
they wouldn't be able to be as obnoxious as they are being!
I mean, these people have to see how out of control the ER is
at the time they are complaining, and they DO think they are
the sickest patient! I've had frustrated patient family members
step behind the curtain while I was in the middle of a code to inquire when THEIR family member is going to be seen....when you tell them you are in the middle of an emergency and to
please step out, they get offended! I sometimes wonder how
these people get around outside the ER in real life!
I've just come off a particularly busy night in a normally busy
level I trauma center where the big concern of the family
members ,as they filed in to see the trauma victims, was "where is his/her money, jewelry, etc." Now, I don't know about you guys, but I, as the trauma nurse, do NOT know where the money and valuables of my patient are, nor do I particularly care at that point in the resuscitation period. Of course, when I verbalize this, I am verbally assaulted about being "uncaring"! I swear, I could write a book! I should point out that we do have people who are responsible for collecting and accounting for all clothing and valuables (most of the time!), but it is certainly not the nurses!
Anyway, cudos to those who put these complaints in writing, I
Todd, don't be so hard on yourself or us! Please stick around, you never know, you could start to see things our way and convert to ER nursing! I have to admit, among nursing colleagues, some of the most enigmatic personalities are the ER nurses!
Re: Triage, I have one episode that sticks out in my mind!
Having recently started working at a large, inner city trauma
center, I triaged a homeless man who was wearing multiple
coats and other paraphenalia. He had a couple of scarfs on
also. Now triage in the middle of winter in a poor, inner-city,
is no piece of cake. You can't visualize much, and everyone
knows that the story is never complete at the triage level!
Well, he was here because he had a fight with his significant
other and he felt his blood pressure was up. He also had
multiple defensive superficial cuts to his hands that he told
me were from her trying to cut him with a kitchen knife.
Well, B/P was normal, and he was triaged to wait in the
waiting area.
Several hours later, his time came, and he walked into the
ER with the nurse, past my desk.....
minutes later they called me to the trauma room. There was lying a man with a large, gaping stab wound to his neck, bleeding
profusely. It was this patient that I had triaged. Apparently
the significant other had connected with the steak knife to
his neck, however, the scarves that he had in place created
a tourniquet effect. When they undressed him...he spouted!
How about the ones who take the ambulances in, then walk past you perfectly able-bodied? They definitely need to have a surcharge for the ambulance service. They do not seem to think that maybe they could've taken a cab for their toothache, lady partsl discharge, or the back pain they've had for 6 months now! In NJ, EMS must transport anyone who calls for an ambulance, no matter what the chief complaint. And the bleeding heart liberals wonder why people die of cardiac arrest because here were no
ambulance units available! Also, what about these same people who, when they're done being treated for these non-emergent complaints, look at you directly and ask, "now how am I going to get home?" They actually expect an ambulance ride back from
whence they came! When you try to educate them that ambulance vehicles are for emergencies only, they argue that they DID have an emergency and now they need EMS to take them back home! THEY DO NOT GET IT!
no lie at least once per wkend i have an ambulance arrive w/ a pt c/o "toothache"
i once had a 2y/o who shoved one of those "micro machine" cars up his nose - well we finally got it out -poor guy!!
dad finally got there from work - wouldn't believe us that we pulled that out of his nose - called us liars etc - accused us of making his son's nose bleed - etc... you know the deal -
2 hours later - guess who is back???? dad - with a micro machine up his nose (thought he would see if it really could be done)
UNBELIEVABLE!!!
but my MOST FAVORITE
is our paraplegic , one armed man from the nursing home who felt constipated - so he was attemtping to sqeeze "lotion" from a bottle up his rectum
wouldn't you know he lost that bottle in his rectum - and we aren't talking one of those little travel sized bottles - we are talking prell shampoo bottle - had to show the family the xrays - they also wouldn't believe us.....
I too have had some pretty UNBELIEVABLE expereinces in the ER
1. The young man who apparently wanted to please his girlfriend all night LONG that shoved beebees up his member since he assumed they would help HIM stay up all night long..ummm guess he never thought about HOW he was going to get them out?? The surgeon did it for him since we couldn't get them either.
2. When I was triage one night a young guy came in and told the triage secretary a long long story about how he was hit by a car..We were actually pretty slow at the time so I sat and listened from my cubicle then when he cam in to see me he stated, 'You better call mental health" when I ask why he exposed his wrists out of the bulky jacket he was wearing and he had cut them..my first response, "Oh Je^^&^ Ch%^%" Wasn't ready for that one!!
3. The 14 yr old who I decided to take..read the intake sheet which indicated she had a "sliver" in her privates..it was summer I was thinking dock and water skiing or something similar? When I went in and asked her she calmly told me that she mastubates with wooden dowling rods??? Again my response, "Oh good god".. Wasn't ready for that one either...!!
It is amazing what people will do...Had one guy call to ask if his girlfriend could get pregnant by rectal sex and he was serious..the ER gives you a whole different outlook on society!!
I can appreciate the frustration here. I have felt that way myself but it didn't come off as the mild rant you may have desired...And I wouldn't send it to patients because they are not as educated in the ways of the ER or any other place. The rest really don't care...When I am there for my baby, all I care about is my baby..
Its a tough job....Deal with it...Still, some of the content was kind of funny, to nurses anyway....They just don't approach the health system with the same knowledge that we do..Doesn't mean I haven't and don't often feel the same way...
Please tell me I'm not the only one who has felt this way from time to time!
athomas91
1,093 Posts
it is funny how an er rn's humor is sooooo perversely different from any other field... this is however what keeps us going..
in my ed we were having a particularly bad month - so we were sitting around - here's some we came up with... (some of them are rather tasteless - so the easily offended may want to just skip this one...)
1. if you overdosed and called 911 - you didn't wait long enough
2. do not smoke an eight ball and call 911 complaining that you can't hold still - that is what happens when you do too much crack
3. when it is 30 degrees out - please dress your child in more than a diaper
4. when this said child has a fever of 105 - medicate them - do not tell us "i wanted you to see how high the fever was"
5. any symptom that has been there more than 24 hours can wait another 24 hours
6. there are no appointment times - wait quietly or leave
7. you are right - you would not wait as long at the hospital down the road - go ahead - leave and go there.
there were so many more - but i am too tired to remember them all - we however had a real kick thinking them up.