Posted on 01/14/2007 1:55:28 AM PST by 60Gunner
I just love it when people get angry at me for telling them they can't circumvent the rules and that they must play fair. It makes going to school for all those years feel so worthwhile.
I had a whole family come in recently: two little destructive spawns of Satan, their unhygienic-looking parents, and the patient who was apparently the matriarch of the family. She had begun feeling poorly over the last two days. Small wonder; she had COPD, heart failure, renal insufficiency and diabetes.
The triage tech walked them all past the nursing desk in my section. I heard the two children roaring and bawling like a couple of sawed-off soccer hooligans all the way from Triage, and looked up from my charting in time to see the mom put her cell phone to her ear and start chattering.
"Ma'am, you can't use your cell phone in here. Turn it off, please." I said to her politely but firmly. She shot me a dirty look, rolled her eyes and kept talking as she passed by. Fortunately, our security guard saw the whole thing and blocked the woman's path. She snapped, "What?"
"You were asked politely to turn off your cell phone, Ma'am. Please do it now."
"What's the big deal?" snorted the woman.
I answered, "Other than the fact that it is posted plainly on the entrance to the ER, it interferes with our telemetry equipment. Please turn it off. Now."
"Just a minute." She turned away and continued to talk on the phone. The security guard faced her once again, deftly took the phone out of her hand, turned it off, and handed it to her. The woman, whose husband had now joined her, voiced her dismay in rather unladylike language. The husband asked me in a challenging tone, "What's the deal, man?"
The security guard (who was just shy of being as tall and solid as Mount McKinley) replied with a smile, "The deal is that if you do not obey the safety regulations of this hospital then you will have to leave... Man." The man (who had no business challenging a guy who could break him into kindling with his eyelids) took his wife by the elbow, shot the guard a sour look, and disappeared into one of my assigned rooms behind the wheelchair-bound, hunch-backed, hacking old woman and the two little hounds of hell snapping behind her.
Oh, this is just prime, I thought. The ER tech hurried out of the room a minute later, handed me the chart while guiltily averting her eyes, and flung the word "Sorry!" over her shoulder as she retreated toward Triage.
Under normal circumstances, I really don't mind having family in the same room as the patient; even a comparatively large family does not bother me if the room is large enough and if they are well-behaved. But I could already tell that this was not going to go well for me if these people continued as I suspected they would. And the closer I got to the entrance to the room, the more my suspicions were confirmed. Just before I knocked on the doorjamb, I heard the man say "Please don't touch that, Satchel. Please behave and come sit by Daddy."
Of course, Satchel ignored Daddy. He instead shouted "No!" and dumped what he was touching- the stainless steel Mayo stand- over with an almighty crash. The little girl screamed and Mommy scolded lil' Satch with a sarcastic "Do you feel better now?"
I decided that now was as good a time as any to make my appearance. Knocking on the jamb, I parted the curtain and introduced myself.
"Oh, it's you," the mom sneered.
"Yes. I am assigned to this section, and I am going to be the nurse for-"
"Where's the doctor?" the dad demanded, cutting me off.
"He's with another patient and will be in after I perform my assessment." As I turned to the patient, the mom said, "Since we are already here... our kids have been sick the last day or so and I'd appreciate it if you could check them out, too." These were the same kids, of course, who had been running and bellowing around the Triage area for an hour and making life miserable for everyone else in the room.
I turned to her and said "No, ma'am, I will not." The woman looked as if I had slapped her.
"Well, why not?!"
"If you want your children to be seen, you will have to take them out to triage and have them checked in, and wait for them to be seen."
"But we are already here!" She insisted. Why can't you just look at them?"
"Because, ma'am, that would be allowing them to go ahead of patients who are still waiting in the triage area to come back to a room. That's not fair. And except in an emergency, I won't see them before they are triaged."
"It's not my fault that they aren't back here. We're already in here, and so I don't understand why you can't just be nice about it and look at my sick kids. Just triage them here," she said, throwing her hands up in exasperation.
"I will not. You have to go through triage like everyone else. I can tell right now just by observing their, ah, activity, that they are actually doing quite well."
"You mean we have to go all the way back to triage and wait in line?"
"That is what I have been saying, ma'am, yes."
"You are such a selfish ass. If you're like this with your patients, God help them." the woman hissed. She stood up, grabbed her kids and dragged them out of the room. The dad stood, glared at me, and followed his wife.
I turned to the patient at last, and she looked up with tired eyes, her lids heavy, like tired water balloons, from fluid overload. She raised a hand to my cheek and patted me softly.
"Thank you."
Emergency Room Nursing Stories Ping.
Let me guess. Did they have insurance? Should they have been allowed in the door or just kicked out?
However, the Director of Emergency Services at my hospital did a survey last year and found out that nine of ten families who visited the ER seeking family care had insurance. Not welfare insurance, mind you - good insurance.
Some people treat the ER like a doctor's office. They come in with the rationale that if it is an Emergency Room, we must naturally assume that everyone who comes in has a real emergency. Then they get angry when we triage them and they have to wait.
You'd think that being ill would at least make them less animated. Apparently not.
The kind of vulgar behavior you describe is becoming more commonplace by the day. Too many people can't manage themselves or their children in public. They seem to feel "entitled".
The minute you described the family, I recognized them. I've been treating them for years! I can't believe you were able to refuse to see the little darlings before they were properly triaged, in line. At the ER I used to work, every pt was sent a survey, and any bad results from those surveys would get the nurse written up immediately. It didn't have to be right, or fair, or even make sense. It just had to be a bad survey with your signature on the ER form. I've gotten in trouble before for following protocol just like this, because the family (it doesn't have to be the pt) filled out the survey and said that I was rude, or made them wait too long, etc. When the real stuff comes in, like a medflight trauma, or a real time-is-muscle MI, the petty stuff waits, and that generates even MORE negative surveys. Needless to say, I don't work there anymore. I left after turning down their 2.5% raise, to accept a 14.00/hour raise, working in a CVICU.
Two days ago the nurse came out of one of our rooms shaking her head. The patients two kids were SWINGING from the curtain. Lucky the whole thing including the bar holding it up didn't come crashing down. Mom just sat there like a lump, never said boo to the little hellions.
I think that there should be a means test.
A friend of mine sells insurance. He said he often gets calls from people who are pregnant and want insurance.
Why didn't the people pay for insurance earlier? Could it be because they are irresponsible?
Our medical system is in real financial trouble because of the mindset that no matter how irresponsible everyone deserves medical care. I want people to pay for what they get, or be forced to pay as much as they can afford.
I also do not believe that a person who is homosexual and enganges in butt perversions or who shares dirty needles has any right to free medical care. The people who have AIDs are taking up billions of dollars of research and medical care. (Yes there is a small percentage of people who were born to an AIDs person, they should get medical care.) But, the people who have Multiple Sclerosis, Lupus, Diabetes, Cancer, and dozens of other diseases largely did not engage in risky behavior and should not have their medical care and research dollars siphoned off to the benefit of people who engage in irresponsible and risky behaviors.
In other words if you give medical care away without really trying to get back some or all of the money to people who expect it for free, then you are breaking the back of our medical system.
Did I answer your question?
Quite succinctly, thank you.
I don't have the luxury of being able to stand off at a distance and consider the social and ethical causality for the single mother of three who is lying blue and pulseless on my table. She's blue and she's pulseless, and according to my nursing ethos, that's the Big Deal of the Day.
Should people who get into trouble secondary to irresponsibility somehow be made to pay for their care? If so, how? Should we turn people away when we determine that their stupidity caused them to come to us in the first place? Who determines the threshold? Insurance companies? Perish the thought.
Who would you rather have taking care of you when you slip on that bar of soap you absent-mindedly left on the shower floor, causing you to break your hip? A nurse who does not determine the standard of practice as a function of her patient's intelligence, or an insurance claims adjuster?
Exactly!...... I had a boy who would attack my 2 younger sons whenever the 2 older ones weren't around. This kid would hit my boys with sticks or whatever he had handy. I would call the mother and she would hang up on me. I would call the police and they would stop the fight and tell me there wasn't much they could do but take a report until one of my sons was really hurt.... One day my elderly neighbor took a broom and she beat the boy for hitting my sons. No police ever came, the boy never hit them again or even came back into the neighborhood..... And to this day whenever it snows my boys shovel her out and make sure her garbage cans go to the street. She told me that was how she dealt with bullies. She is usually a very sweet old lady but she just got tired of this bully.
It's people like that, that make going to the ER truly unpleasant.
I've been to an ER twice in the past 4 years. Once with a broken toe and once with severe bruising on my shin.
The toe was on a Sunday afternoon during a blizzard, and I barely made it home again. That didn't stop the noisy, unruly children from finding the place.
The shin was a Friday night. I had slipped on a train platform and caught my leg between the platform and the train, and I was a bit concerned about the damage. No children this time, just some people acting like they were at a party.
lolol.. good one
Did I say, thanks for your hard work?
I can relate, as I've heard lots of stories. Most of my extended family are in the medical field. We have RN's, LPN's, imaging techs, ER techs, an OR nurse (male), one hospital administrator, one physicians assistant, and I'm sure a few specialties I can't remember.
Out of a generational spread of about ten years, there are about 25 people in my extended family. Only three of us did not choose a medical profession. One is a Postmaster, one is a bank VP, and there is me. We're the black sheep of the family.
That single mother (even if her color is blue) should get immediate medical care.
But I would go after her and make her accountable for her medical care. If her behavior caused her medical problems then some pretty tough treatment to correct her behavior would be part of her medical care. I am not part of her village.
I really thing we are talking about two issues which are related but different.
1. In your world of the ER, care should not be withheld. 2. In my world where people are suffering from life threatening diseases (that they did not cause)I see huge medical resources being siphoned off to people whose behavior caused their own problems.
60Gunner -
Thanks. I really like your stories. Publish 'em.
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