So I had a patient tonight with a sense of humor more inappropriate than most ER nurses. A patient that the whole staff was able to joke with and was truly grateful for his care. A patient who gave me a heartfelt handshake at discharge. Why is it that this is the exception rather than the norm? After the last 2 weeks of 4 point restraints, having to page security at discharge, urinals being thrown and f-bombs being dropped, it was a nice change.

When I end up having to go to the ER (try not to but sometimes you have no choice) no matter my problem I always try to be considerate of the ER personnel. I do try to joke around with them but sometimes you get a nurse with no sense of humor at all. I let them know I appreciate what they do to help me with my problem.

Wow, I was nothing but polite to the ER people the last time I visited one, and they to me.

 
The last time I went (2013), with what turned out to be a perforated colon, the ER nurse was a friend and fellow shooter at the local club, as well as being the town's mayor. Other than the reason I was there, it was an enjoyable experience.
 

Late last Fall I was in a hurry, had to teach an evening class, was in the shop, lost focus, the back of my finger just happened to touch the band saw blade.

Long story short, I went to the ER on the way to class, told them I had 30 students who would be waiting for me to show up (or hoping I wouldn't show up). The ER was very accommodating and professional. It did take 8 stitches, IIRC I was only 20 minutes late for class. But the ER did have to follow the procedure, asked me if I had thought of suicide.

Side note. There was a shooting in Salt Lake yesterday, we know one of the good samaritans in the middle of it and one on the ambulance team that responded. Oh s**t.

That was the way I approached my ER visit and subsequent hospital stay(s) a few years back. I think it started to drive my nurses on the floor nuts because I would apologize any time they had to come into the room. I had a blood clot in my kidney and was on a continuous bladder irrigation, so they had to come in quite frequently to change out the bags.
There was one awkward moment in the ER. The nurse was getting ready to put a catheter in to relieve the pressure in my bladder. He commented on my Gold Toe socks.....both my wife and I couldn't stop laughing after he was finished.

Working in the ER is definitely challenging. I find myself liking people less and less. It's the reason why the burn out rate is so high. Yesterday I was the PIT (Provider in Triage) person so that means that I saw every patient that walked through the doors after the nurses triaged them. I get a short history do a brief assessment then order labs and diagnostic tests so they are already done by the time they get to the back. 60 something patients later I was spent. As an ER provider you basically have to expect to be lied to constantly, be told incorrect information constantly, be treated like an asshole who owes everybody something constantly, etc... once in a while you get a good one but those are getting fewer and farther between.

If you were laughing after he inserted the catheter, I'd say he did an exceptionally good job!

Don

quote:

Why is it that this is the exception rather than the norm?

Any time my wife or I are guests of the hospital, we always go out of our way to reciprocate for the courtesies we are shown. I'll bring in fruit and/or pastries each morning or a pound of my favorite coffee if one of them is a coffee aficionado. I bought an 8-inch cast iron skillet and a few packages of my favorite corn bread mix for one nurse from "another part of the country" that had led an especially bland life. The small things really seem to be appreciated and it's a pleasure to be able to express in some small way our appreciation.
However, it's not quite that simple for the ER. The few times we've been there, the decision to admit or treat-and-dismiss is usually made in a very few hours, if that long. Then you're gone and that's it for probably a few more years. But, regardless of the reason for the visit or its brevity, there's just no justification for being a rude or abusive patient. None.

I have been on both sides of an ER gurney over the years. It is easy to burn out, especially as one gets older, and the overall ER population continues to change. I can say that I sure am glad that the ER is still open and available to me.

quote:

Originally posted by Dusty78:
Working in the ER is definitely challenging. I find myself liking people less and less. It's the reason why the burn out rate is so high. Yesterday I was the PIT (Provider in Triage) person so that means that I saw every patient that walked through the doors after the nurses triaged them. I get a short history do a brief assessment then order labs and diagnostic tests so they are already done by the time they get to the back. 60 something patients later I was spent. As an ER provider you basically have to expect to be lied to constantly, be told incorrect information constantly, be treated like an asshole who owes everybody something constantly, etc... once in a while you get a good one but those are getting fewer and farther between.

God How i hate triage. It really wants to make me channel my inner Sam Kinison and start screaming.

"Why are you here?! SAY IT! SAY IT! SAY IT! I don't give a shit what happened 2 years ago, why are you here TONIGHT! Did your mother not hug you enough as a child and that's why you continue to do stupid shit like this to get attention?! What's this bullshit, you're allergic to all NSAIDS? Well isn't that convenient..."

Always be nice to those with big needles and catheters......

I'll never understand being rude/angry/mean to people responsible for your care or service.

When I went to the ER a couple years ago for a large kidney stone, there were 2 other guys in for the same thing. One was yelling/cursing at the nurses, and the other was having a tantrum and throwing things. Now, my pain was off the "smiley face" chart, but I kept it together and was polite. Guess who got their drugs first??

I lasted in emergency medicine for 13 years. I got fried and my wife encouraged me to go in a different direction did orthopedic surgery for a few years and am now working in a new state in an urgent care center with very little of the drama I used to see in the Dr. I say it is not the trauma that gets to you but the drama

quote:

Originally posted by dsmack:
If you were laughing after he inserted the catheter, I'd say he did an exceptionally good job!

Don

Oh no. The laughing came much much later. That was the first of 5 caths over a 3 day time frame.

quote:

Originally posted by Dusty78:
As an ER provider you basically have to expect to be lied to constantly, be told incorrect information constantly, be treated like

I am not a Dr., but I do not understand why patients would do this. When I've gone to the ER it has been because I or a family member had a genuine emergency that could not be treated elsewhere. How can one hope for the best solution to the problem yet give false information to the Dr.? Beyond that to be unkind makes no sense at all.

quote:

Originally posted by deepocean:

quote:

Originally posted by Dusty78:
As an ER provider you basically have to expect to be lied to constantly, be told incorrect information constantly, be treated like

I am not a Dr., but I do not understand why patients would do this. When I've gone to the ER it has been because I or a family member had a genuine emergency that could not be treated elsewhere. How can one hope for the best solution to the problem yet give false information to the Dr.? Beyond that to be unkind makes no sense at all.

Yeah people come to the ER all the time for no good reason. Some want narcotics. Some will subject themselves to a $20k cardiac work up just so they can get a work note. They aren't paying the bill so they don't care. A lot of young women come in. I'm plaining of abdominal pain and the first thing we do is a pregnancy test. When we tell them they aren't pregnant they say "oh thank god ok I'm good" and they leave. Literally they just wasted everyone's time and money because they have this incorrect notion that the urine pregnancy test they buy in the store is some how inferior to ours in the ER...its not. Sometimes you even get the "I had chest pain last week and I want to be checked out!" So no chest pain now? "No!" *facepalm*

quote:

Originally posted by deepocean:

quote:

Originally posted by Dusty78:
As an ER provider you basically have to expect to be lied to constantly, be told incorrect information constantly, be treated like

I am not a Dr., but I do not understand why patients would do this. When I've gone to the ER it has been because I or a family member had a genuine emergency that could not be treated elsewhere. How can one hope for the best solution to the problem yet give false information to the Dr.? Beyond that to be unkind makes no sense at all.

Yes, but you're a responsible adult, and you're assuming genuine emergency. My friends in the medical community shared with me that the ER does gets its share of attention seekers (e.g. gal I went to church with who had a "seizure" any time she wasn't getting enough attention and took a ride in an ambulance at tax payers dime. My friends and I estimated her ambulance and ER bill to be about $300k) and narcotic painkiller seekers.

Thanks for being there 2000Z-71...

Sorry for your experiences; especially in light of the critical work you do and the stress that must exist for all the staff in that type of work.

My son when he was about 3 or 4 split his nose. I took him to the er. My son sat on the table with a stoic look as the dr stitched him up. When he finished my son hopped down and said "Thank you." I remember the suprised look on the dr's face, now I know why.

Silent