When is a situation considered an Emergency?

Nurses General Nursing

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:D Hi, I am not a nurse yet, so I would like to ask ya'll a question. This post is a little long, so just try to bare with me. What makes a situation an Emergency??? I will explain myself:

Yesterday, my husband had a slight stomach ache all day. He took some pepto thinking that would help, but at about 10:00 PM, he came wake me up and told me I needed to bring him to the hospital. Since we don't have any insurance, we drove about 30 minutes to the Charity Hospital. At this point he is in a good amount of pain. He is having trouble walking and every 2 minutes is seems like he needs to urinate but only a little comes out at a time. We get into the ER and they must have had about 100 people in their. He and I both knew their would be a bunch of people. Well he picks his # and goes sit down, and asks me to go talk to someone to see if they can give him some pain medication. So I went ask a lady (I'm assuming she was a nurse) and she asked if he went through triage yet (I think that is what it is called) and I told her no. She walked away and came back and said that there was nothing they could do, that he had to wait to be called and they would be starting to call #'s soon. :stone He was #9. I could tell she really sympathized for him, but there was nothing she could do.

We sit down for a few minutes and my husband asks me to take him to another hospital. We will just pay the bill, just get me to that hospital, (hoping it would be a little faster since it isn't charity) It is about 15 minutes away. So he gets in this ER and by this time he is obvious pain. :scrying: The lady at the desk looks like she is in NO hurry at all to try to help him. He went to the bathroom again, came out and basically begs the lady at the desk to let him talk to someone. So she says in the rudest, most hateful way, Sure, Go knock at that door. :flamesonb It was the way she said it, with a hateful smirk on her face like she knew the woman behind this door would make him feel like it didn't matter what he was feeling, and that is exactly what this lady did. He knocked on the door, knocked and knocked, and finally just opened the door to try to talk to her; she yells at him and tells him he needs to knock and this & that. He told her that he did knock and that he can't take the pain anymore, then she tells him he needs to wait like everyone else. He is almost in tears. :scrying:

So he tells me to bring him to the other hospital, about 25 minutes away. :confused: I didn't know what to do, I wanted him to just wait but he couldn't. So the whole way to the hospital (which is about 10 minutes from my house in the first place) he is yelling in agonizing pain. :sniff: I feel like crying, he is scaring me to death, & he is also scared to death because he had no idea what was going on, he's never felt pain like this before. I almost wanted to pull over and call 911 but I might have been at the hospital by the time they got their. We finally got to the hospital and I drop him at the door. The nurse looks at him and immediately takes him into triage and into a room. I was so HAPPY :roll .

We eventually found out it was a kidney stone and he did pass it before we left the hospital. So I ask... Do ya'll think this should have been considered an Emergency??? The whole time I kept thinking that he's having an Appendix attack and it is going to rupture or has ruptured and will poison his body while WAITING for someone to acknowledge that he is desperate need to some kind of comfort. Obviously this wasn't the case, but what if it was???

Am I overreacting? Should we have called an ambulance in the first place??? Is their any way that I can complain to someone that will really listen about the hospital's lack of urgency?

If you got this far, thanks for reading.

Maya

Specializes in Oncology/Haemetology/HIV.

Agree with many of the posters. Emergency is impending loss of life ora major limb. Pain is important but life threatening emergencies trump it every time.

Another thing to remember is most patients must be thoroughly assessed before safely being medicated. This cannot occur until after triage and being taken back. The other is that especially when abdominal/back/flank discomfort is present, many MDs WILL NOT MEDICATE FOR PAIN, until some tests are done and completed. Masking the pain can seriously impair ability to diagnose situations. And administeration of some pain meds can interfere with some tests.

That's too bad that happened. But, like other people on this thread said, it's the way most ER's are now day's. I remember the days that such pt's used to go back right a way, but now ER's are swamped with colds, back pain, STD and pregnency test on top of true emergencies. If you've been in ER a while you can pick a ks out of the crowd. But , you can also pick out the true chest pain, appy etc... The triage RN has to be the one to control the never ending flood gates of people. Everyone there feels they are in an emergency situation. Trieage is just what is says : Deciding what pt's go back first, who waits. Some times it's a no win situation for everyone involved. ER's could be more efficiant if they wern't used as doctors offices. I work in an inner city ER, there is never a distinction between insurance and non insurance pt's. If they need treated they need treated.

Pain is a subjective symptom not anything I have ever seen anyone actually die from(even tho many people think they are). Have you ever read an obituary where the patient died from pain?

Specializes in PCT.

I understand why he would be upset, especially in so much pain. People in pain do not react rationally. I work in an ED that is almost always full to the gills and somehow I always end up being the one to go out and explain why someone can't come back and lie down or get treated right now. It's useless to try and explain that while others are being treated for more life threatening conditions others will have to wait in the waiting room.

Sometimes people seem to think that we're just trying to be vindictive and make them suffer. We don't want you to be in pain anymore than you would like to be in pain. Unfortulately when every bed is full, each nurse has 5-6 patients and the doctors have yet to see 12 patients that are in the rooms and beds in the hallways helping you is just not possible at the moment. I assure you that I have never seen anyone taken straight back because they said they were in to much pain to wait any longer. There is just nothing we can do to make it go any faster. Everyone will be seen it's just a matter of when we have the resources available.

Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.

I agree with the above posters. Look at it this way- you now know what the "kidney stone dance" looks like, and will probably never forget it.

I agree with the above posters. Look at it this way- you now know what the "kidney stone dance" looks like, and will probably never forget it.

My husband's had kidney stones in the past (before we met) and he thought he had another one when we went to the ER. It turned out his colon had ruptured. The DH is just unlucky!

Specializes in ER, ICU, Infusion, peds, informatics.
a year or two ago my mil suffered a cat bite, which segued into cat bite cellulitis. i took her to the er at midnight because she couldn't take the pain anymore. waited in the wr for about an hour, waited in the back for about an hour and a half.......and she complained the whole time. after trying to soothe and explain and cajole, i'd had enough. i stood up beside her gurney and yelled "do you think you are the only one who is miserable here??? these people are not here at 2 in the morning because they have nothing better to do!!!"

not another peep...........

oh, i don't know......sometimes it sure does seem like that is why they come in......:clown:

Pain is a subjective symptom not anything I have ever seen anyone actually die from(even tho many people think they are). Have you ever read an obituary where the patient died from pain?

No, I have not ever heard of anyone dying of pain. But he didn't know it was just pain. He didn't know what was going on. He was scared that something was seriously going wrong in side of him. Isn't excrutiating pain sometimes an indicator that something serious is going on????

Thanks everyone for responding. I totally understand that other emergencies have to take precedence over others. It is just the way it works. There was just nothing I could tell him, and seeing him like that, I guess I just got upset about it also.

Thanks again for taking the time to respond.

Actually, yes , you can die from pain. Pain causes the body to loose blood to non vital organs, to shunt blood to the place of pain. Pain also causes stress to the body, can have an MI etc. Not to say that ks pain is that kind of pain, but, ks's are worth getting back to ER asap if possible. Ever see a ks pt come in pale , diaphoretic , low bp. It happens. If they can't get back they are most certainly a pt that is worth keeping an eye on and evaluating as much as possible in triage. Ks can cause pylo, that can lead to sepsis.:nono:

Specializes in Nurses who are mentally sicked.

I have never been working in the ED or ER before....

But I know ER nurses always pay great attention to patients who have airway problems...think about it...patient die very quickly without oxygen.

In the case of your husband, he showed the ER nurse that his airway had no problem...and he was walking around...

I hope this will help you understand better how the ER/ED nurses function in the ER/ED. I felt sorry for what you had gone through...it must have been a very scary experience.

Actually, yes , you can die from pain. Pain causes the body to loose blood to non vital organs, to shunt blood to the place of pain. Pain also causes stress to the body, can have an MI etc. Not to say that ks pain is that kind of pain, but, ks's are worth getting back to ER asap if possible. Ever see a ks pt come in pale , diaphoretic , low bp. It happens. If they can't get back they are most certainly a pt that is worth keeping an eye on and evaluating as much as possible in triage. Ks can cause pylo, that can lead to sepsis.:nono:

This still does not make the pt emergent. A death from pain R/T a stone would not happen in one evening. And if a pt in pain was diaphoretic with low BP, he would have been brought back, I guarantee it. Most stone pts do not come in with low BP, however. And there is no indication the OP's husband wasn't being eyeballed by the triage nurse while in the WR.

Where I work I am sometimes still fortunate enough to be able to bring kidney stone pains right back to a room. Although once in the room there is little I can do to speed the physician eval up. But more there are been many times I have had to tell a kidney stone pt that they have to wait. I really have sympathy, but as already stated, we get swamped, have no beds, ambulances coming in up the wazzoo. Sometimes people are misled by the lobby being empty, but that is not always an indicator of the rooms in back. I understnad one of the main issues here is the way the staff communicated that to the OP and her husband. I can't excuse or defend them, I was not there, and I do think there are nice ways of explaining the situation. However, I also understand two things 1. sometimes no matter how good an explanation, and how nice/appropriately it was stated people in distress do not hear the same message that was said--understandably. 2. The big picture is the important issue, and it is the triage nurses job to keep track of that. Knowing the big picture some nurses can be blunt, or appear to loose sympathy in explaining to the 30th pt of the morning that although the pt feels thier emergecny is most urgent someone else is having even more of an emergency and there are no beds.

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