What is your opinion of care??

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Several weeks ago I went to ER at 3:45 in the am. I had been having alot of GI pain-nausea-dryheaves-diarrhea and it was getting worse by the hour. The triage nurse had on country music and was chomping down on her gum to the music and I guess I really put a dent in her quiet time!! I have a history of autoimmune colitis and pancreatitis. She acted annoyed that I was on so much medicene and it had been 3 1/2 years since I had been to the Er and there were lots of changes. I did get escorted back right away and was placed on the bed and not even given a gown. the doc came in and I explained what had been going on and he kind of patted my tummy with his hand!!!!! I did not let on I was a nurse, and could not believe what was going on!! The triage nurse did give me a good iv and I did had a liter of fluids.reglan.zolotf and small dose of Dilaudid. Then the x-ray gal came to get me and I had a chest x-ray and abdominal series. They also did lab. The doc did not even do a physical not even the minimum of heart and bowel sound check with stethescope. They did say there had been alot of flu symptoms that night!!! Well, you still do an exam. I told them I was having chest-shoulder pain also. I was just baffled at this lack of exam on the docs part. I am going to get the ER reprot and see what he put down on his symptom review- it ought to prove interesting. I am not sure what I will do if I find he has filled it out!!! Just wanted your thoughts. This is a Magnet hospital also!!too!!!!!

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Specializes in Adult and Pediatric Vascular Access, Paramedic.

There are two sides to every story. I do not judge other medical professionals based on one person side of the story. I am not saying that you are exagerating or not telling the complete truth; however I work in an E.D. and know that a lot of patients call and complain, but they also exagerate about their presumed "poor" treatment as well. There would be no reason for the doctor to listen to your heart, and I am assuming you would have Bowel soudns since you had diareah. It sounds like you just had some viral gastritis, not a big deal. Just my oppinion.

Sweetooth

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Specializes in Emergency & Trauma/Adult ICU.
I did not let on I was a nurse, and could not believe what was going on!! The triage nurse did give me a good iv and I did had a liter of fluids.reglan.zolotf and small dose of Dilaudid. Then the x-ray gal came to get me and I had a chest x-ray and abdominal series. They also did lab.

Not sure what, in this case, separates a "good" IV from a bad one ...

I'm going to assume you received IVF, Reglan, Zofran and Dilaudid for pain control while x-rays & lab studies were completed.

Were your symptoms of this exacerbation of your chronic condition relieved? Have you had any further complications?

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Specializes in ER, NICU, NSY and some other stuff.

So you got right back, got IVF, meds, labs and xrays..... This all sounds like all of the appropriate interventions.

All of these things sound like the appropriate care. Do you have an issue with the radio on? was it too loud? Do you just not like country music?

I couldn't possibly comment on the physical exam or lack of one since I wasn't there.

I guess what I am wondering what is your basic complaint?

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Specializes in ER, telemetry.

If the doctor did not do a complete exam (at least lung/heart/bowel sounds), then I can understand your concern, but there are some crappy doctors everywhere. It sounds, though, that in regards to treatment and diagnostics, you were treated accordingly in respect to your complaint.

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The doc should have done a complete abd assessment, but I don't grade a doc's abd exam on how hard he palps a tummy. Some docs can assess with a light touch. If you were having chest and shoulder pain that still doesn't necessarily require a chest assessment, because (as you know) abd pain can refer to the shoulder.

If he truly did only a minimal abd exam then he was probably assuming that you either had the flu bug going around or were having an exac of your chronic problem and treated that. Should he have done that? No, but it happens.

I'm not trivializing your concerns, but as another poster said, we see complaints without basis all the time. I remember reading surverys that complained "The nurse hardly came in and didn't tell me what was going on", and I remembered spending a lot of time with that pt and doing detailed education.

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Specializes in ER, Outpatient PACU and School Nursing.

I think that is great that they brought you right back and started IV's etc. we have some doctors that are not that aggressive. I have some that if your vitals are stable and you didnt look dry- would give you a script for immodium and phenergan supp and d/c you after the xrays come back. Did the meds alleviate your symptoms and pain? as far as the music and gum- whatever makes you get through the day I say- I hate being out there for 12 hours! thank god we have a few nurses that do it so we dont have to..

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Specializes in Nephrology, Cardiology, ER, ICU.

In the end, if you have care concerns, you DO need to address them. I would start with a letter to the nurse manager or patient relations folks at the hospital.

I too presume you mean "Zofran" versus "zoloft"? Right?

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Specializes in cardiology.
In the end, if you have care concerns, you DO need to address them. I would start with a letter to the nurse manager or patient relations folks at the hospital.

I too presume you mean "Zofran" versus "zoloft"? Right?

glad you cleared that up ... I was wondering why in the world someone would get Zoloft in the ER

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Specializes in 6 years of ER fun, med/surg, blah, blah.

You say you're a nurse. What department do you work in? Each area of a hospital has it's own "mission". The ED/ER is about rescue & stabilization. In-patient units have a more thorough assessment in place. In my ED we do "focused" assessments; what's the main problem & how can it be fixed for now. We don't usually do an head to toe assessment unless warranted by the patient's condition. You were given meds & I assume felt better & then went home to follow up with your regular Doctor. So, you received "good care". Sorry it didn't live up to your expectations.

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Specializes in ER, Peds, Charge RN.

I figure you should be really happy you "were not even given a gown." Those things are awful, butt hanging out and all... I think you're the first person in the world who has actually wanted one.

Other than that, care sounds pretty good to me. You're still alive, so that's a plus, right?

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I'm sorry you had the experience of a gum-smacking country-music-listening gal working in triage :uhoh21: . I'm sure that had to make you question the professionalism of the employees there straight from the start. I can completely understand that this triage nurse, who also seems to have been less than polite, would make you skeptical as to the professionalism of the care you were receiving. Its funny how we, as ER nurses, don't always realize the impact of that first impression - the triage nurse - on the patient's perception of care given.

You mentioned that this hospital is a Magnet designated facility. Magnet hospitals strive to follow Best Practices. In the ER it is Best Practice to divide patients based on Chief Complaint into different zones of the ER. In my ER you would have been triaged to Fast Track - the decision of which zone a patient is placed in is made by the triage nurse. The management of the ER must trust the triaging skills of your triage nurse to have her assigned to be in triage. Anyway, patients are assigned to zones based on Chief Complaint. In this instance, your Chief Complaint of n/v/d :barf01: does indeed sound to be more gastroenteritis (stomach bug) than pancreatitis or colitis. The doc probably read your chart, noted what zone you were in, made sure you weren't actively dying (laid eyes on you) or in danger of dying (labs). I would be upset if I had been in your place last night. You're probably thinking something like "what the heck am I paying all this money for if the doctor isn't even going to listen to me with his stethoscope." As comforting as it may be, a stethoscope is not a diagnostic tool. It is used to help decide differential diagnoses - differential diagnoses determine what tests, xrays, and labs need to be preformed. In your case the doctor was correct to form his differential diagnoses by knowing your Chief Complaint and talking to you. He was completely correct to go ahead and order diagnostic studies (labs and xrays).

I know that it is hard to change the way of thinking that a doctor should listen with a stethoscope etc; but, with today's technological innovations, that is no longer necessary. Maybe the doc was thinking, "Hey, she's a smart gal! I don't want to listen to her with my stethoscope and have her think I'm some old-fashioned, uneducated doc." You never know. I'm sure that your negative feelings of the doc not listening with his stethoscope were compounded by that first impression given by the triage nurse.

I am an ER nurse. I work in triage very frequently. I plan to share your experience with some of my coworkers because it helps to prove the point that the triage nurse should remain the epitome of professionalism at all times (and NEVER chew gum)!

I'm sorry you felt you had a bad experience. I hope this clears up some of your frustrations. But most of all I hope you are feeling well!!!!! :icon_hug:

Sally RN

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