There has been quite a few times where pts complain over the waiting period due to a code. There was a pt just the other day who had been out in the WR for 3 hrs due to a code-and when I went out to call the pt back, the pt gave me such an attitude, stating "what in the h#ll took you so long! Dont you know I AM IN PAIN!" Pt c/o of ear pain times 2 weeks. As I explained to the pt, sorry it took so long, but we were in code situation, the pt interrupted me stating, "I dont care, What about my pain! My ear hurts!" The pt then had the nerve to demand a nursing supervisor to then tell her how rude I was to her, and how long she had to wait! And how she was "going to do something about this!" And how we didnt care about her pain!
Pts complain all the time about the waiting period, but seriously? We all know they can hear the code blue emergency room call. What is that about! How absolutely mind blowing someone would even THINK ear pain TRUMPS a CODE!
Then our VP came in just the other day, stating how our customer service scores were low, blah blah blah. Insane. There are so many clinics around, urgent cares, yet for some reason the ED is a clinic, and is getting customer service scores! Press Ganey, who thought of that anyway?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
sorry hon,
these days it's all about patient satisfaction.
there is no excuse for a pt. being kept waiting that long for a pain med---code or no code!!
are you saying that 100% of your staff was involved in the code situation????????????
when we have a code, there is always one rn who will kind of look after the other pt's.
after all, who knows, you could even have a second code---who would take care of that pt??
no, i really think that someone should have helped that patient.
the patient could have been more understanding, but so could the staff.
i beg to differ. although the op doesn't say exactly how long the patient had to wait for the pain med for her sore finger, a code trumps finger pain every time. and the 50% of staff (or so) who weren't involved in the code situation were responsible for the rest of the patients -- i'm sure they were doing the best they could but there are other priorities that trump finger pain besides a code. like the little old man climbing over his siderails, the little old lady whose blood pressure is 72/40, the young man with a blood pressure of 300/150 and the patient whose femoral sheaths were just pulled and who is bleeding all over the place. it's unfortunate that anyone has to wait for pain meds ever, but it's the reality these days that staffing is tight under the best circumstances and even tighter when there's an emergency going on somewhere on the floor.
besides, any patient who is cursing at the staff can darn well wait until "please" and "thank you" become a part of their vocabulary!
Specializes in Peds Cardiology,Peds Neuro,Pedi ER,PICU, IV Jedi.
To all ed pts: No one has every died from the discomfort of pain. People die from the medical condition causing the pain. Ergo, we don't care about your generic, non-life threatening pain. As long as there is a pt who has a complaint that is life threatening, your long term pain is not a priority. We see pts who are sickest first. Pain does not equal sick. Pain sucks. We know. Losing your license over delaying the care of someone dying to treat someone else's pain sucks more. You will wait. Triage works. It's there for a reason. It's not random. Get over yourself.
Your post is not entirely accurate. While people don't necessarily die from the discomfort of pain, they can and will die from the physiological prolonged effects of pain on their bodies. When a patient is in pain, physiologic systems are altered at many levels and pain can and does cause very serious side effects. Whether it's tachycardia and increased b/p, or other s/s that may be related. And while pain may not mean sick in one person, it can mean deadly in another - ever taken care of a kid with a perf'd bowel or appendix? You are correct, triage works (in most cases), and that those who are coding are priority one.
The OPs situation sucks for her, and this patient was not very understanding. It sucks and there was really no reason for the outburst from the patient. Some patients are like that though, the only people they give a damn about are the ones they see in the mirror every morning. If only we could ship them off to some deserted island in the South Pacific....
I was venting earlier needing to get out some frustration, but I do want to comment on this:
"Sorry Hon,
These days it's all about patient satisfaction.
There is NO excuse for a pt. being kept waiting that long for a pain med---CODE or NO CODE!!
Are you saying that 100% of your staff was involved in the code situation????????????
When we have a code, there is ALWAYS one RN who will kind of look after the other pt's.
After all, who knows, you could even have a second code---who would take care of that pt??
No, I really think that someone should have helped that patient.
The patient could have been more understanding, but so could the staff."
We are a small hospital, with 20 beds, got hit with about 50 pts in the WR, all types of screaming suicidal psych pts one who was very aggressive, 2 real CPs, took in 2 SOBs and 4 ambulance showed up within a minute of eachother, then the code happened. We had pts in the hallways, chairs, taking chairs outta rooms and making them a pt chair to be seen. The pts ear pain xs 2 weeks can wait. period. Did she get pain meds? nope. it was ear irrigation and discharge. 3 hrs for an ear irrigation, under those circumstances, I think the pt was lucky to have gotten our ENT room, and not sitting in one of the many chairs we had all over our hallways. Was every nurse on staff in the code????? get real. no, there are other pts with actual issues going on that needed to be addressed immediately by the other nurses that were working their a$$es off.
For any pt to become verbally or physically abusive to staff is intolerable in my book...pain or no pain. We were all taught manners, why should having pain make some ppl forget those manners?
Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
Absolutely that 2 weeks of ear pain with normal vitals is going to be waiting in my ER too and we are not that big. This patient is going to be CTAS 4 or 5 and is going to wait to see a doctor. To suggest that we are not being understanding or helpful because the patient has to wait for pain management is to suggest that I give that patient a priority over a patient in cardiac arrest .
At the triage desk we often hear complaints of waiting when a patient is having pain, but I am going to suggest that most patients are there with pain issues or some sort or another and I am a trained professional who is given the task of who has pain that needs immediate treatment (chest pain) and pain that can wait (ear pain)
Why make them wait if there's space?
I say get em in, get em out.
Puts me faster to 4 or 5 am when it dies down and I can put my feet up!!!
We are a small ER and if a code comes in then most of our staff is absorbed into that, no sense bringing in an earache to wait in a bay while the doctor is busy, that just gets them more agitated.
I can't administer anything for pain without the doctor giving the go ahead and I am not going to interrupt him to get it so ..... they can wait in the waiting room. If however, a chest pain comes in while the code is going on, I am going to bring them in, set them up on the monitor, start the O2, an IV etc. They triage higher than an ear ache and are going to be next for medical attention .... so again, the ear ache waits.
There has been quite a few times where pts complain over the waiting period due to a code. There was a pt just the other day who had been out in the WR for 3 hrs due to a code-and when I went out to call the pt back, the pt gave me such an attitude, stating "what in the h#ll took you so long! Dont you know I AM IN PAIN!" Pt c/o of ear pain times 2 weeks. As I explained to the pt, sorry it took so long, but we were in code situation, the pt interrupted me stating, "I dont care, What about my pain! My ear hurts!" The pt then had the nerve to demand a nursing supervisor to then tell her how rude I was to her, and how long she had to wait! And how she was "going to do something about this!" And how we didnt care about her pain!
Pts complain all the time about the waiting period, but seriously? We all know they can hear the code blue emergency room call. What is that about! How absolutely mind blowing someone would even THINK ear pain TRUMPS a CODE!
Then our VP came in just the other day, stating how our customer service scores were low, blah blah blah. Insane. There are so many clinics around, urgent cares, yet for some reason the ED is a clinic, and is getting customer service scores! Press Ganey, who thought of that anyway?
Anyone else get complaints like that?
Oh I so know where you are coming from in this vent...until my shift tonight. Patient arrives via EMS unresponsive. Husband has not arrived yet....We intubate...initiate a second IV....so on and so on. Once the hubby comes back I listen to the last few days prior to her unresponsiveness................Babysitting grandson, treating for an earache...she gets an ear ache the next day, the next day after that she vomits a few times......they go to bed that night and she is so restless she decides to sleep in the guestroom......Hubby lets her sleep in the next morning knowing she does not feel well. Noon rolls around and he goes to check on her and she is unresponsive...calls 911....
Tell EMD about c/o earache 2 days ago.......
Here she has bacterial meningitis.....poor lady.....not good........her temp is 104.7
An earache doesn't just seem to be an earache to me anymore...ya know:crying2:
But see, an unresponsive ear ache gets my attention, a ranting ear ache (if it is busy) gets my waiting room
We never knew of her earache until after she was intubated, ct scan, 2 large bore ivs, foley, LP etc, blah blah ...etc.
I know your frustration and deal with it every time I work.....65 bed level II trauma center. But I learned a lesson tonight.....an earache can be something more than just some patient being rude and bossy...it can be something so serious that they can die...and everyone who dealt with this patient is treated to prevent bacterial meningitis. Granted, most ear infections don't have this serious a complication and it was wrong for your patient to be so rude....but tonight, I was humbled with the barrier some of us that work ER carry on our shoulders with what is considered...ESI 4-5.
Oh I certainly hate the entitlement mentality as well.....I just had an experience that brings much thought post me leaving my shift......
Wow, what a lesson...I will definetly remember that! Thanks for sharing that.
I had a pt in Triage the other day, older lady in her 60s, presented with "not feeling well x 1 week" If u can believe it, no medical hx except for RH. So I listened to her lungs, heard fine crackles at the bases, stable vital signs...no cough, no fever, no sob, nothing. She just didnt "look right" to me...and I took a look at her feet, saw edema of bilat feet, and brought her back right away, where my charge was not all that happy...but neverless doc assessed her, breathing tx etc etc ordered, cxr came back, labs came back everything was high, abnormal EKG and...new dx of chf. Never know what ure going to find in Triage. You know what not that this makes any difference at all, but she was THE nicest lady I ever had the pleasure meeting and taking care of. She kept telling me not to fuss over her that she wasnt sick.
but we weren't talking about the unresponisive pt with meningitis-they get first priority, the post was not about missing strange diagnoses, it was about a whiny guy with ear pain who should have went to his pcp 2 weeks ago-it was about him suddenly thinking his problem was my problem and that he gets my undivided attention because he is loud and annoying. The lady with meningitis belongs in my er, the guy with ear pain needs to GOMER now!! he takes up space for the people who need it!
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Ruby Vee, BSN
17 Articles; 14,051 Posts
i beg to differ. although the op doesn't say exactly how long the patient had to wait for the pain med for her sore finger, a code trumps finger pain every time. and the 50% of staff (or so) who weren't involved in the code situation were responsible for the rest of the patients -- i'm sure they were doing the best they could but there are other priorities that trump finger pain besides a code. like the little old man climbing over his siderails, the little old lady whose blood pressure is 72/40, the young man with a blood pressure of 300/150 and the patient whose femoral sheaths were just pulled and who is bleeding all over the place. it's unfortunate that anyone has to wait for pain meds ever, but it's the reality these days that staffing is tight under the best circumstances and even tighter when there's an emergency going on somewhere on the floor.
besides, any patient who is cursing at the staff can darn well wait until "please" and "thank you" become a part of their vocabulary!