What do people think the ER is?

Specialties Emergency

Published

I'm still laughing from last night.

Younger male adult. He's there with his woman, mom and grandma.. All hovering over top of him like he was on his death bed.

No prior health history. VSS. No pain, no nv, no loose stools. No cough.

Cc:weakness. Ok.

Trying to talk to him and he's looking all sad in the bed. Whispers to me as if actually speaking took too much energy.

Trying to get feedback, he keeps whispering. I let him know multiple times that I can not hear him. His ladies are answering for him. He's weak. Hasn't been eating or drinking. He lost almost 20lbs in a week they tell me.

Then he sees the iv and fluids. I get a response. He keeps chanting in this soft whisper 'get me out of here, I'm fine, I want to go'

I have the ladies leave the room. The tech comes in for the EKG. I told him he needs to speak louder an answer my questions. I need to do the little poke so we can run some tests and hydrate him.

He keeps telling me he wants to leave. He starts ripping everything off of himself, jumps out of bed and demands his shirt.

The doc walked in, walked out, went to talk to the ladies and I saw them all walk out. He kept saying I'm fine.

He didn't have the energy to talk to me, but that needle have him a boost of confidence to jump and practically run..

I really wish I could have gotten an answer from him as to what he felt was going to be the plan of care if he was going to refuse any and all testing.

Specializes in Emergency.
"I dont want any needles, meds, or tests done"

"Then WHY WASTE MY TIME/MONEY BY COMING HERE!!!!"

I cant do my voodoo magic to see whats wrong with you other than, oh yeah NOTHING!

Or when the ladies come in with gyne complaints and are shocked that they need to remove their undies. "Really??? Well I don't really want to do that!"

That reminds me of the young lady who came in by ambulance for a vag bleed, then was offended when the doc wanted to do a pelvic.

Specializes in Emergency Room.
My guess is 'in and out' as such alternatives as 'intraosseous' and 'intake and output' probably aren't what is meant.[/quote']

Ohhh yeah that makes sense! I never heard it referred to that way we call it a straight cath. The only use for IO I'm familiar with is intraosseous :)

Specializes in Gerontology, Med surg, Home Health.

If I thought I could get away with it, I'd make a comment about intraosseous and a cath....but the TOS police would arrest me.

I also love the drive thru service. I didn't touch pts today without orders.. Which I never do cuz I usually end up getting behind.. I'm glad.. I have 1 who called for a ride and it's my fault we weren't done with her. Sorry your ride is here, nobody told you to call a ride. That's not making me rush

Specializes in Emergency Room.

Had the female version of the OP's pt the other day - 25 yr old girl with vague complaints of dizziness, arm tingling, x2 months. Seen by PMD, told everything's ok but still doesn't feel right. She thinks her BP is low. BP is not low. Docs order labs, I send my orientee to go get them. Pt hands orientee lab results from a MONTH ago and says "please don't poke me I'm terrified of needles! I had bloodwork last month can you show it to the doctor!?" Needless to say, labs from a month ago are no good, we stick her for blood. She refuses an IV. All the while mom is going "it's ok honey, if you don't want it you don't have to have it" there are like 4 family members with her for moral support during this terrible life threatening situation.

Labs come back ok, the docs decide since she has vague neurological complaints not resolving she should have an MRI to r/o MS. They tell her they are willing to keep her in the observation unit overnight so she can have an MRI in the morning. She gets annoyed and asks "well what am I supposed to do all night?" Doc explains that she can leave and have outpatient MRI but it will take several weeks to get the test and results. She's annoyed.

Observation unit policy is every pt must have IV access. We explain that to her. Her response is "well if I have to have an IV I'm just gonna leave" Mom is right there with her going "you don't have to do anything you don't want to honey"

I guess these behaviors are not surprising when you see how they were raised...

Specializes in Hospice, corrections, psychiatry, rehab, LTC.
I had something similar. A young man with classic migraine sx.--HA, photophobia, nausea. No other neuro deficits. Girlfriend say that he "had" to have a CAT scan (the boyfriend is totally passive though the whole thing--I think he was used to her being overbearing/aggressive). Anyway, doctor very calmly explained why she was not going to order a CT scan. The girlfriend stated "then fine, if you don't order what I want, we are outta here and we will go to [insert name of a nearby 'competitor' hospital]." The pt never said anything during this entire exchange. I go in with the AMA form, give it to the patient to sign. Girlfriend says to him "you will not sign that. If you sign something it means you agree with it, we are leaving." She storms out...he gives me a looks that almost looked like "sorry for this" and then puts his head down and follows her. It can be frustrating at times, but this was more amusing that anything else.

Some people hear about a particular test and it sounds important, so they believe that it is the answer to any problem. I work in a prison setting and we constantly have inmates asking for MRIs, although it is clear from most of their requests that they have no idea what an MRI actually is or what it is useful in diagnosing.

Specializes in Emergency, Telemetry, Transplant.
Some people hear about a particular test and it sounds important, so they believe that it is the answer to any problem. I work in a prison setting and we constantly have inmates asking for MRIs, although it is clear from most of their requests that they have no idea what an MRI actually is or what it is useful in diagnosing.

I had a case where a pt's boyfriend (and he iss a premed student, so he know) asked "why are they doing a CAT [sic] scan? An MRI always shows everything that is going on."

Specializes in ED.

I had a guy the other night who told me that if someone didn't order a CT scan within 20 minutes, he was going to leave and call and ambulance to take him to another hospital. I told him that it certainly was within his rights to leave and go somewhere else. I also told him that if he called and ambulance to take him to another ER, the information that he left AMA would be told to the next ER he went to. I also told him that if he was well enough to go hospital surfing, no one is going to treat him as a true emergency and he would probably end up waiting longer to be seen.

I should also add, that this gentleman spent a considerable amount of time on the phone trying to get in touch with his doctor, thinking that would get him seen more quickly and get that almighty CT scan done immediately. He ended up leaving AMA when he found out that he would have to change into a hospital gown and be seen by the ER doc and have blood work and urines done prior to even being determined if a CT scan was necessary.

Specializes in Med/Surg, ICU, ER, Peds ER-CPEN.

We get that allot, and we're a Peds unit! Have had medical students bring their kids in because they suddenly are all geniuses and the pediatrician they saw that morning it's an idiot and that busy triage nurse asked way to many questions lol they usually calm down when the attending reminds then they haven't done an ER rotation yet so they best be nice to the people who actually know what they are doing and have a license lol

Specializes in Emergency Nursing.

I'm still shaking my head at the young guy who came in c/o chest pain after a speedball, was found to be in bigeminy but eloped because his girlfriend needed a ride to work and he was "fine." Did I mention he was driving.

Oh, and then he says to me, "how could the doctor tell me that if I walked out of here I could drop dead? That's f___d up." Wasn't really sure how to respond to that one... Sorry to hurt your feelings?

*face palm*

There's no phone in here and the TV only has 3 channels coming in, I'm so uncomfortable'

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