I have taken care of so many people the last few days that were just plain sick! Vomiting for 12 hours or less, fever for less than a day, coughs, abdominal pain without N/V/D. I want to scream at them "you've got the the flu! go home, drink plenty of fluids and rest!"
In this day and age of instant gratification it seems like NO ONE wants to feel bad one minute longer than they feel they have to and ER doctors across the country carry magic wands that can cure all ails.
Sorry if I am ranting. I really love my job, but I just had too many people today that didn't need to be there. With insurance, without insurance, on medicaid.
I had one girl show up in my quad that had been in twice previously in less than a week! The triage nurse kindly chatised her about getting a family doctor like she had already been told twice and about how much more it was going to cost her than going to a doctor would have.
I am just so tired of people using the ER as their family doctor. I get so tired of people abusing the ER and EMS. I get so tired of people coming in with fevers that can't afford tylenol, but reek of cigarettes, or the patient that comes in hacking and coughing from COPD and still smokes. I get so tired of people moaning and groaning like they are going to die. (those are usually the ones that are the least sick) I wanted to tell one girl that even though she felt terrible, she wasn't going to die so get dressed and get out of my ER....I didn't though.
Again, sorry for the rant, but this has been a really long day and one of my patients kindly shared their flu with me so I feel horrible otherwise I probably wouldn't be as testy.
I'm going to bed now, please forgive my attitude. Just had to let off some steam.
Insurance or ability to pay has never been an issue in my books. Never will be.
Its the 20 y/o who has had a cold for a week and says he has chest pain thinking he needs to be immediately taken back for it
Its basically the ones with minor problems that try to aggrandize their situation with hysteria that I lose sympathy for.
Its the ones who say I was here last week for the same problem dont you have my record herem why dont you have my record here, why dont you know what meds Im on, etc.
Its the ones with elevated serum W titers, or decreased serum testosterone titers, increased porcelain titers etc.
aka the wimps.
Its the ones who are chemically challenged, who come in cursing at me or trying to bite or spit at me.
Its the ones that come in, that 3 and 4 years later I end up being called to testify for the DA about their behaviours, who the hell can remember. just this monday I was in court for almost 8 hours waiting to testify, Spent 13 minutes on the stand before I was released on a case from 1999.
You guys turned this into something I don't think it was ever meant to be. I've worked in the ED for 15 years and I don't care if you can pay or not, if you are black, white, green or orange. Everyone gets treated the same. I am working at a new place, been in my new job less than 2 months and already I know some of the patients by name. This has been a terrible week where I work too, everyone has the flu but they all think they are about to die. We have been packed. I am the only triage nurse for 3-11 shift and we have been seeing over 120 patients a day and we all know that 3-11 is the busiest shift. I am tired, we work 7 on 7 off and the girl that works opposite of me has the shingles so I have worked 9 days in a row, I'm off until Tuesday. My opinion is that the person that wrote this meant that often times people that are on public assistance use the ED as primary care when they DO have other options, at least they do here. There are public health offices allover here, it's just much more convenient to use the ED. I haveseen the same child come in 3 times in the past 2 weeks because of an ear infection that could be handled elsewhere. I can understand the people that are not on any kind of assistance and can't afford insurance either. I don't care if you have insurance or not, if you come in for something that doesn't need to be seen in the ED, something that doesn't need to be seen anywhere, you are wasting my time and EVERYONE'S resources.
I was warned before I read this thread that it was a rant. The poster clearly stated that on the subject title. I say let them blow off some steam. We all need to blow of some steam once in a while after a bad week. This BB allows us to do this and also to get support and hugs and humor from other nurses and members. The same poster who rants about the ED patients is also the person who dresses their wounds, administers medications, and helps educate them. So I really don't think this poster or the others who replied with their own vents meant any malice to their less privilaged patients. And for any person who has been without insurance or felt looked down on while in the ED- (been down and out myself) I am sorry for your experience and wish you the best of luck in the future. I mean that sincerely.
Specializes in LTC, assisted living, med-surg, psych.
I apologize if my post about what it's like to be on the other side of the counter offended anyone here. My intent was NOT to prevent anyone from ranting, just to provide a different perspective, because I was seeing a lot of hostility toward the less fortunate, and this attitude usually DOES come across to the patient, regardless of how hard one tries to hide it. Believe me, I've been on the receiving end of it more than once in my life.
No, I haven't worked ER much, but I'm the one who deals with the people WITH insurance who are actually admitted to our hallowed halls......who then proceed to carp about the rooms being too hot or too cold (sometimes in the same breath), the pillows being too flat or too fluffy, the halls being too noisy, the nurses being too slow with the pain pills and too fast with the treatments, the aides being too lazy to bend their straws for them or take them to the bathroom for the fifth time in 20 minutes. Sometimes I wonder if the only difference between me and the average food server is about 20 bucks an hour, and of course I don't get tips for bringing the guy in 204 his eighth Pepsi of the night, or running down to the ICU for a warm blanket for the post-op in 220.
Now, I'm not really complaining......I couldn't care less if patients have insurance or not, if they're rich or poor, if they want a waitress, a shoulder to cry on, a counselor, or a technician. I'm paid the same for my 8 hours whether I'm running to a code 99 or running to the ice machine.
I can understand the frustration you all are dealing with when people decide that the sore throat they've had for a week suddenly is an emergency at 2 AM on a Sunday morning, but this behavior isn't limited to the "scum on total assistance". I'm sure we all have our frequent flyers, who come from ALL income brackets and take up valuable space complaining about runny noses and vomiting and other things that could easily be taken care of elsewhere, but who come to the hospital and get admitted, simply because their doctor doesn't know what else to do with them and they won't just go home and let whatever is ailing them run its course.
I'm sure we all have our frequent flyers, who come from ALL income brackets and take up valuable space complaining about runny noses and vomiting and other things that could easily be taken care of elsewhere, but who come to the hospital and get admitted, simply because their doctor doesn't know what else to do with them and they won't just go home and let whatever is ailing them run its course.
You're absolutely right. The people with minor compliants do come from all income brackets. The scales may tip though for the uninsured or those on welfare, because these folks have no where else to go.
Just today a gal came in for the third day in a row with the same complaint of vomiting! I took care of her the first day and she could have won an Emmy for the acting job she was putting on! PAHLEEZE!!!!!!! When I discharged her from ER two days ago, I really wanted to tell her that I knew she didn't feel good, but she wasn't dying, so get her clothes on and get out of the ER! I didn't though. I just had her sign her discharge paper and handed it to her and left the room. Thank goodenss she wasn't in one of my rooms today, I probably would have very sternly tried to educate her on the appropriateness of being in the ER for the third time.
I don't think it is wrong for ER nurses to try and educate the patients about the proper use of the ER, if it is done kindly and tactfully. Some people just don't realize that they can call their doctors at all hours of the day and night. Some people don't realize that a low grade fever is not life threatening. To paraphrase my micro instructor "fever is our friend, it is the body's response to infection."
I know that there are patients who try to do the right thing and call their doc only to be told to come to ER because the office is booked solid for the next week.
Thanks for all the responses. It's nice to know that I'm not alone in my frustrations. And thanks, Nightengale, I'm feeling a little better having spent the entire day Thursday in bed.:kiss
Pam;)
"I love my job. I love my job. I love my job!":chuckle
Specializes in LTC,Hospice/palliative care,acute care.
Any ED I have ever been in was a fun house...or horror show...It is all about your perspective...Luckily for the ED staff they see them come and go fast....The rest of us are stuck with them for days...weeks...and sometimes months.....In LTC it's years......Rant and vent all you like-that's what we are here for....
It's not the people who don't have a doctor coming in for healthcare that bother. Those people have nowhere else to access healthcare, and if we have and alternative, say free clinic or something you can't just send them there due to EMTALA.
No the ones that bother me are the ones that have a primary MD but couldn't be inconvenienced by the doctor's hours or scheduling practices.
"Dr Jones said he couldn't see me till 1:30 today (it's now 11:30) so I came here. How long is the wait because I have somewhere to be later."
I feel like saying, "Lady, you'd have made out alot better with Dr Jones cause you'll be lucky if we take you back by 1:30."
or the ones who bring their kids in after they've been sick for >1 wk - and then come in two more times for checkups - and return one last time w/ their cousin as well so we can write them school notes..... gotta love it...
I suppose top of my list is the attention seeker and the Drama Mamma. The attention seeker who comes in with the worst explanation of abdo pain - its 10/10 - no tenderness or rather the Ouch comes as a time delay after the prod - NO physiological signs of pain - joking and laughing and moving with ease and then becomes abuse if they are not seen within 30 seconds of presentation and why haven't you got me a glass of water and while you are there I want something to eat and what do you mean by "nil by mouth"???
Or the ultimate time waster - the person who pretends to take panadol just to make another person feel bad or to use suicide threats as blackmail.
Then there are the "Drama Mamma's" don't speak English except when they want some water etc - moan and groan and yet are non-compliant - "No No No Nurse No pills - choke my throat" Well then - an injection "No no no Nurse - too sore - no like" What can you say? "Sorry but my magic wand broke and we are now all out of options"
Yes, I know what many of you are feeling when you say there are those that abuse the emergency rooms. I was an admitting clerk for an ER for three years, and was on the "front lines" when they rushed in the door with every symptom and story imaginable.
However, I don't think we can completely know what these people must face.
1st - they do not have near the medical training that many of us do. When a mother, well educated in a non-healthcare field and employed with wonderful insurance, comes rushing in the ER because her 2 year old child has flu-like symptoms, (this after hearing of 11 children dying in the US from the flu so far this year) I think we need to be more understanding. Why should we expect them to know they should give the child tylenol and plenty of fluids? I can imagine they're there because the mother fears the child's problems may be worse than she thinks. Or perhaps she's unable to provide relief on her own and reaches out to those at the ER for help.
2nd - My husband is an active duty Marine. In one of our previous duty stations (late 90's), we were in the middle of the Champus/Tricare change over. Our region was the last to get "fixed". During our two years in our remote duty station, 10 of the 11 staff members were in collections because their medical bills were not getting paid by Tricare. Families were following Tricare's directions (training was provided for the families, and 11 Congressmen were involved by the time it was finally fixed) After several months of this confusion, NOT ONE SINGLE doctor would take our military insurance. They were as frustrated as us, because they weren't getting paid for their work. Our families had no choice but to go to the ER.... even if it was for monthly cramps or a splinter.
More than I blame the people going to the ER for the simplest of problems, I blame our goverment. It's incredible that people living in the richest and most prosperous nation in the entire world.... and in the entire history of the world.... cannot not have easier access to health care. I can't understand why it's so unobtainable for so many. We have so many resources to fix this problem. It's a shame.
I think that those who have posted "the other side of the coin" are not the abusers of the system that the ER nurses are talking about but I think you are the ones who would go in with a broken leg and appologise for taking up time.:kiss You are the good guys - rest easy - this is not about you. Nor about any genuine case that comes in - and the mother worried to death about her child and who does not have the background to realise that it is not serious is not one of the time wasters. Niether is the person in real distress or the recent immigrant ( two weeks ago) from Africa who had an unknown community aquired pneumonia coughed right into my face without covering her mouth (TB anyone?) but who ended up being admitted NONE of these are time wasters but the one seeking panadol/tylenol for a hangover or the person on the phone wanting to talk to a doctor because the condom broke or the guy who rang up wanting to know what would happen if you tied a rubber band around your testicles............................
teeituptom, BSN, RN
4,283 Posts
Hi There
Insurance or ability to pay has never been an issue in my books. Never will be.
Its the 20 y/o who has had a cold for a week and says he has chest pain thinking he needs to be immediately taken back for it
Its basically the ones with minor problems that try to aggrandize their situation with hysteria that I lose sympathy for.
Its the ones who say I was here last week for the same problem dont you have my record herem why dont you have my record here, why dont you know what meds Im on, etc.
Its the ones with elevated serum W titers, or decreased serum testosterone titers, increased porcelain titers etc.
aka the wimps.
Its the ones who are chemically challenged, who come in cursing at me or trying to bite or spit at me.
Its the ones that come in, that 3 and 4 years later I end up being called to testify for the DA about their behaviours, who the hell can remember. just this monday I was in court for almost 8 hours waiting to testify, Spent 13 minutes on the stand before I was released on a case from 1999.