Posted on 10/26/2008 5:34:19 AM PDT by 60Gunner
Okay, I know this is a bit of a chronological jump, considering I was last writing about my recent odyssey. I'll get back to that soon.
I am back at work now, and since returning I have encountered an unusually-long parade of ER patients who have displayed, shall we say, less-than-sound judgment with regard to the way they chose to conduct themselves in ER Triage.
I am a man of great forbearance and restraint. I have never told any patient that he/she was a slack-jawed, mouth-breathing idiot before- even when the patient's actions clearly proved such to be the case. But some people make it very difficult to restrain the urge. Happily, only a rare few have ever caused me to fervently wish that dope-slapping was approved as a therapeutic nursing intervention.
For the sake of brevity, I'll cut to the chase:
To all of the exasperation-inducing patients described in Paragraph Two of this entry, and to all potentially-exasperating patients, I offer the following pearls of advice. If you follow these maxims, I guarantee that your name and the word "idiot" will never be uttered in the same sentence when you are mentioned in verbal handoff report by your Triage Nurse.
1: Do not come into the ER with a chief complaint of "high blood sugar" and then sit, in full view of the Triage Nurse, gulping down a can of Coca Cola and eating a candy bar.
2: Do not use "I have (insert disease name here)," "Googled," and "My symptoms" in the same sentence.
3: Do not sprint full-tilt boogie into the ER from the parking lot (having been observed by the Triage Nurse for the entire 100 feet of your medal-winning dash), burst into the waiting area, and yell at the registration clerk in a full sentence that you are having a heart attack and need morphine.
4: Do not ask the Triage Nurse for any sample packets of Tylenol, Ibuprofen, antibiotics, the "Morning After Pill," Valium, Ativan, Zanax, Methodone, Oxycontin, Surgi-Lube, or medicinal marijuana.
5: Do not tell the Triage Nurse that you don't want to see a doctor but just want to have your blood pressure, blood glucose, lung sounds, or that "icky lump" in your bikini area (I am not kidding) checked by the Triage Nurse. You have to be registered before the Triage Nurse will listen to you say anything about that "icky lump" in your bikini area. Otherwise, go to the fire station or your clinic. And wash your "icky" frigging hands.
6: Do not get out of your car, walk ten feet to the wheelchair your relative provides for you, sit down in the wheelchair, and then go limp and pretend to be unconscious the remaining twenty feet to the Triage Desk. (Yes, I did see you peeking, you rascal!)
7: Do not ask for a five-gallon barf bag, be given one, pull your face out of it to spew all over the Triage Room, Triage Computer, Triage Floor, Triage Tech, and Triage Nurse- and then say, "Sorry, I missed."
8: Do not refuse to wear a mask if you are coughing or sneezing. If you do refuse, then do not take offense when you are thus held in that special regard reserved for all mindless, disease-carrying vermin.
9: Do not talk on your cell phone while being triaged and tell the Triage Nurse to "shush!" for interrupting when you are asked about your migraine. And do not get angry when you are ushered out of Triage to finish your phone call and the Triage Nurse moves on to the asthmatic 3-year-old who just came through the door.
10: Do not walk in and tell the Triage Nurse you were involved in a rollover motor vehicle crash an hour ago when all you are really looking for are narcotics. You will be slapped into a cervical collar and duct-taped onto a very uncomfortable backboard faster than you can say "I'm never using this frigging story again." Just tell the truth. Honesty serves two purposes: 1) We can deny your request for narcotics without you having to go through all that unnecessary discomfort, and 2) You can haul your drug-seeking carcass over to the neighboring ER without any telltale patches of tape-induced depiliation on your head.
11: Please be sure to leave the ID bracelet from the neighboring ER that you just left on your wrist when you arrive at our Triage. This enables us to contact that ER and find out why you were dissatisfied with the service they provided and which medication they refused to give you.
There you go. Have a safe Halloween, think before you drink, avoid anyone who says "Hey, watch this!," and stay inside any moving automobiles.
I had an experience like that. I took my then-six months pregnant wife into an ER with side pains. Seven hours in the ER later she was getting an “emergency” appendectomy.
For any of you that think this job is easy here is one. Lady comes into the E.R and complains of stomach pains. The E.R. Doc does a complete work up including a pelvic. Now mind you there are other people that need him in the E.R. But if he does not he get sued. Upon finding nothing out including the fact she is not pregnant he asks her, “Did you just come in here for a pregnancy test?” She says, “Well yes” He says, why didn’t you just buy a home kit and do it yourself?” She says, “Well this is FREE!” Of course you can NOT ask legal status either.
PING
Thanks for the bump. Interesting as always.
Ask your son to talk to me. I was really sick. But it was 36 hours before I got any pain and nausea meds. How could I have gotten better service?
We get parents calling for an appointment for their kid for vomiting. Of course, they can’t come in that day, and when they DO come in the next day, their puking child is sucking down a McDonald’s Happy Meal.
And I also love those drug seekers who come in wearing their sunglasses inside for their “migraine”, but take them off as soon as they get their Demoral and Phenergan; miraculously cured before the drugs have time to take effect.
I’d like to know this too.
I don’t go to the ER unless I’m worried about losing a body part or passing out.
This summer, I dropped a piano on my toe. It was the worst toe injury the attending had ever seen (when he finally saw me). Hurt myself at 7:30, was at the ER by 8:00. I finally got some pain meds at 1:00am and was admitted at 3:00am. Ended up with a fracture, serious laceration, and exposure of the bone requiring a podiatric surgeon (who was awesome). At one point, the discussion of amputation possibility certainly got my attention.
Part of the reason for the delay was that the nurses put me back into one of those little rooms in back instead of the waiting room. They would page Xray. Xray would go out to the waiting room and call for me. I wasn’t there. They figured I left.
Half an hour later, ER would page Xray. Xray would go to the waiting room. I still wasn’t there.
You get the picture. Four hours of this before a nurse had the presence of mind to figure out what was happening.
Truly, I can’t fault any of the nurses or doctors there. The problem was systemic, and made worse by the gaggle of illegals with no visible problems or symptoms mooching off this service that is supposed to be for those in real need.
From my observation, the biggest problem in ER is that there isn’t a single person who is responsible for a patient. Everything is handed off to other people/departments. If they fall short, nobody knows and you just drift. Its worse if you’re there long enough for a shift change.
BTW, I have insurance, and even though this hospital was out of network, they negotiated between themselves and I paid nothing, even though it should have cost me 10%, or about $1700.
Yep, the lady was spanish speaking with an interpreter. Every the time the nurse would look her way, she would start skaking. The nurse made the comment, the interpreter hesitated for a minute then repeated it in spanish. About a minute later she proceded to urinate in the waiting room.
And yes to the coitus, a very nasty looking couple. I felt like I needed to wash my eyes with isopropyl.
I thought I had the flu, and in fact, may have had. It started on a Friday, by Sunday night I was so dehydrated I was in agony. My daughter took me to the ER, we called my dr ahead of time. When I got there, they said 4-6 hours before I’d be seen. I joked, “What if I said I had chest pain?” Still 4-6 hours they said, ha-ha.
I checked out, and went to another ER after calling my dr again and telling her the situation. This time, I walked in, said I had chest pain, and nausea. I was on my way via ambulance in 15 minutes to the nearest big cardiac hospital (too fohgy to take a helicopter).
Upshot is, I had a lulu of a heart attack. Also, no chest pain. If I’d stayed in the first ER, I’d be dead.
I’m a nurse (retired). Did not have a clue I was having a heart attack. No chest pain. Just vomiting. I knew I was dehydrated, and that I needed an IV so bad I was nearly hallucinating.
10 days later, discharge ejection fraction was 50%, also found a little aortic aneurysm that I will likely get repaired later. Some dead heart tissue, but nothing serious apparently. I asked about a stent, cardio man said, all we’ll get with a stent is pink scar tissue, instead of white scar tissue, no need for that. Plus I’m allergic to the stent material he likes to use.
This is the only ER visit of my entire life.
I’m glad you are still with us.
Hmmmm...around here the wait can be so long that you can watch the anchor baby growing in the teenage girl across the waiting room.
I understand your frustration, I’ve had to go to the ER with family a few times. I don’t work in a hospital, but I am a medical professional and understand why it takes so long at an ER. They aren’t going to treat until they rule everything out. They need documentation so they order test, scans, etc. Everyone, including the doctors, wait for the various departments to have someone available to run the test, then they can properly diagnose.
One of the big problems is people without a family doctor use ER’s for general medicine.
BTW the one I love is the person that calls at 5:10 on Friday afternoon and thinks they may have xxxx. They’ve felt bad since noon on Wed, but just decided it might need attention.
Are you always an arse-whole?
The triage nurse at the first ER basically suggested it.
Good nurse. How are you feeling now?
Good stuff. Sent to my uncle who is finishing up nursing school right now, and worked in an ER over the Summer.
Tired. On the road to recovery. Enjoying the hospitality of my son, his dear wife, and the family.
Still no chest pain. :D
I mis-read that as:
Hmmmm...around here the wait can be so long that you can watch the anchor baby growing into a teenage girl across the waiting room.
And thought it should be:
Hmmmm...around here the wait can be so long that you can watch the anchor baby growing up into a pregnant teenage girl across the waiting room.
I’m glad to hear it. :)
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