You don't work in anER. Get over it.

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We all complain about ER abuse, frequent flyers, drug seekers, etc.

We have this idea that the ER is for emergencies. Get over it. The problem is with the name. ER evokes images of life saving, ameliorating pain, and all that good stuff. It really should be called "free and convenient medical clinic that is more likely to give you what you want then your own doctor, and is also set up to deal with the occasional emergency". It's not a cool name, and kind of a mouthful, but it's a hell of a lot mor accurate than ER.

While we may be right to complain, we are complaining about the wrong people- it is silly to expect the users of the system to change when we constantly re-enforce their behavior. This is a population not especially renowned for responsible use of their own money. Any reason to think they would be any more responsible with your money?

We are open 24/7.

Even a long wait n the ER is a hell of a lot shorter than the time it takes to get an appointment.

We are more likely to give what you believe is necessary than follow any evidence based guidelines.

We are more likely to:

Give narcs for a headache than any neurologist.

Give antibiotics for mildy symptomatic OM than any pediatrician.

Give antibiotics for a viral uri than any family practice doc.

The list goes on, but the bottom line is we frequently give people what they want, rather than what medical research indicates.

We do all our tests on the spot, and do a lot more of them than a PCP would. Does your doc have a CT machine? By the time you get an outpatient appointment, your problem might have resolved on its own. We can get a pt in to a specialist a hell of a lot faster than their own doc can.

In addition to the superior service we provide, we advertise, soliciting the business we complain about. The focus of ER advertising is convenience. Billboards on the side of the road boasting short waiting times. Ever see an ER advertisement that explained acuity based priorities?

And don't forget- It's free. Obviously it's actually expensive, but the ER users we complain about don't pay anything. While many have government insurance that prohibits non emergent use of the ER, this is not enforced.

So- we solicit the business, and reward the behavior. Kind of numb for us to complain about it. The ER you dreamed about doesn't exist. Get over it. With very few exceptions, if you want to do any emergency nursing, you are going to have to wade through a bunch of crap to do it.

The people we complain about aren't the problem, they are the symptom. The problem is the system. I bet half the complainers on this forum don't even vote. While venting is healthy, it doesn't change anything- except how you feel after work. Change the system.

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Specializes in Telemetry.

I myself have had to take my son to the ER for an earache when I didn't have the money to go to our primary care doctor. I was working as a nurse but getting called off all the time for low census and my husband had just started a new job after being laid off for 3 months. I come from a "well off" family and I have never known what it is like to not have money. I would rather die than ask for money from my family so we just did our best until things got better. Now I am debt free and I have a very nice life, but I will never forget how I felt during that time. Do people abuse the system? Absolutely. But are there good people out there that are just on temporary hard times? Absolutely. I love how people look at a group of people and refer to them as "those people". Be careful, you never know what lies ahead and you just may find yourself being one of "those people". Our country needs universal health care in my opinion. No one should have to choose between buying groceries and going to the doctor. Just my opinion.

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No one should have to choose between buying groceries and going to the doctor. Just my opinion.

Very true, but our problem stems from the issue that a lot of ER abusers define "groceries" as: cigarettes, alcohol, fast food, drugs, fancy clothes, jewelry, and needless car accessories.

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I'm somewhat divided here. I agree to what you are saying and I feel that exact way about a lot of different things. I think of that saying "stop ********, start a revolution". However, I also agree with PP. Being a single mom, I have found myself having to do A LOT of things that I would have never expected and things that I am absolutely embarassed about but have to do anyway. I would hope that you understand that there are exceptions to the people that annoy you. I always try to understand what the other person might be dealing with when it comes to treating people a certain way.

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I hear both sides, and I have sat in an ER quite a number of times with my kids. Could there be a clinic set up under the same roof as the ER, manned 24/7 to deal with patients who are not presenting with true emergencies? I don't mean fast-track. If there were 2 triage nurses, it would help matters a lot, too, because one nurse would not be tied up with non-emergency patient while truly ill people are waiting their turn. I can imagine the clinic would be overwhelmed with people seeking attention, but it's better than wasting the resources of the ER unnecessarily. Am I being naive?

I have also noticed that pediatricians are no longer taking care of kids who need stitches, glue on cuts, etc. and they immediately send them to the ER. Why can't they take care of the kids, why spend a bundle to get this taken care of in the ER, and why waste the valuable time and resources of ER staff?

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Specializes in Hospice, ER.

I've pushed more drugs than the local drug dealer. That being said, I've used the ER for emergencies. There is a difference between the working poor who just can't catch a break and dirtbags who have cigs, cell phone, gold, nails, etc. A clinic would be great, but a lot of people don't want to go and pay anything. We treat everybody.

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I volunteered at an ER that had two separate areas for the critical patients, and the other for the clinic type patients. The clinic type patients that were seen were back pain, ear aches, those that needed stitches or minor repairs, and those with flu like symptoms. It was also considered an overflow for the critical patients, if there was no room in the critical area. I don't know if that is what you are referring to. It was nice, because I felt like it was more organized and those that were critical could get the care that they needed.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

As I travel to and through various areas in the south and southeast U.S. lately (lately Texas and Georgia, with trips through Arkansas, Tennessee, and the Carolinas), I'm seeing more advertising for 24/7 urgent care places, which I think is a great idea. However, I'm sure a lot of people still go to the ER because we don't require them to pay before being seen, and I'm sure the urgent cares do.

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Specializes in ER.

I have no problem seeing earaches and sore toes, but I have a huge problem when they complain about heart attacks going in ahead of them. If you are willing to wait until there's a break in the critical care flow, I am willing to take care of you. But critical problems come first. Hey, if you are worried enough to wait hours I won't even care if you've come about a hangnail. Part of the job is reassuring and teaching about normal health and body functions. I really like doing it, and seeing understanding come across someone's face.

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As I travel to and through various areas in the south and southeast U.S. lately (lately Texas and Georgia, with trips through Arkansas, Tennessee, and the Carolinas), I'm seeing more advertising for 24/7 urgent care places, which I think is a great idea. However, I'm sure a lot of people still go to the ER because we don't require them to pay before being seen, and I'm sure the urgent cares do.

The urgent care I've been to required me to pay my co-pay upfront at the time of registration. Not a bad idea if you ask me, if I owned a private urgent care practice I'd want to be paid for the services I provide.

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I really don't mind seeing nonemergent patients most of the time, and I even like working the fast track zone every now and then because it's a nice break from the heavier care required in the regular zones. What I don't like is that it seems to me that the most demanding, rude, complaining patients are the ones who aren't very sick. They hover in the doorway, ask how long it's going to be, complain about the wait, want food, beverages, more warm blankets, etc. etc., meanwhile my really sick patient asks for nothing.

If you are going to come to the ED for a non-emergent complaint, do not complain about the wait. I didn't force you to drag your eight year old with a cold out of bed at ten o clock on a school night. Do not ask me repeatedly how long anything is going to be. I didn't know the last time you asked me five minutes ago, I still don't know now, and I do not have any control over it. Do not tell me you haven't eaten all day as if it is my problem. You made the choice to come here instead of calling a doctor and making an appointment. You could have stayed home and had dinner. Do not ask for five zillion warm blankets. You were the one who came here dressed in shorts and flip flops, and I know it sucks to be cold, but I've already given you three of them, and the little old lady next door needs my attention more than you need another blanket. And if you're thirsty, there's a paper cup and a sink five feet away from your stretcher. You walked in here, you can certainly get yourself a drink of water! Do not hover in the doorway glaring at me. That just makes me move slower. And for Pete's sake, do NOT send your child into the hallway to tell me that you need me. That should be forbidden!!! For one thing, you don't really need me, and another, there is a bloody, gruesome trauma coming in any second, and do you really want your kid to see that??? Don't "threaten" to go to "the other" Emergency room if the doctor doesn't come soon enough to suit you. I don't care. In fact, I think that sounds like a great idea!

Just stay in your room, wait your turn, and understand that when you chose to come to the Emergency room for something that is NOT an emergency, you will wait while the emergencies are treated first.

Otherwise, I have no problem with you.

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Very true, but our problem stems from the issue that a lot of ER abusers define "groceries" as: cigarettes, alcohol, fast food, drugs, fancy clothes, jewelry, and needless car accessories.

I'm curious as to how you came to this conclusion. You know all of these people personally? You know their financial circumstances, their spending habits, what car accessories they have? I doubt it. I think it's more likely that you are simply parroting the welfare queen fallacy. It's typically a very racist, classist point of view, and is unsupported by anything other than biased anecdata. I'm always surprised and disheartened to hear such things from people who have purportedly dedicated their professional lives to caring for others. I hope you can see past your own biases when you're taking care of your patients, and that they aren't shortchanged because of your personal views.

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