Etiquette Hell

Etiquette School is in session! => The Ehell Guide to Never Behaving Badly => Topic started by: kherbert05 on January 18, 2010, 12:13:03 PM

Title: ER Etiquette
Post by: kherbert05 on January 18, 2010, 12:13:03 PM
1) ER's are not first come first served. Staff Triag  people according to the severity of their issue.

2) Don't drive yourself if you are the one having a problem you could kill someone.

3) Try to avoid using the ER for minor things. If you have one check with your Doctor about going to the ER for things that could be handled in their office.

4) Don't make assumptions. Why someone is taken before you is not your business.

5) For those with chronic on going issues have documentation on you at all times. This can be med alert + a summary of issues and meds and contacts that you carry in your wallet. I have the same info on my emergency call list at work. My friends know the card is in my wallet. I update it every time my meds are changed and after each checkup. I just give it to the Triag person, makes communication much easier.

6) Be polite to the nurses and other staff members. But they understand you are scared, not feeling well, are in pain.

7) No the person in the waiting room doesn't have to let you watch their movie on their laptop. They don't have to change the movie to occupy your child.
Title: Re: ER Etiquette
Post by: ginlyn32 on January 18, 2010, 12:22:25 PM
8.) It is a bad idea to use the ER as a Doctor's office. If you have no insurance, check to see if your county/province has a low-cost clinic for uninsured patients. You can also call a Dr. and see if they offer assistance programs for those who are low-income or no insurance.

ginlyn

edited for spelling...because yes, I do know the difference between patient and patience. :P
Title: Re: ER Etiquette
Post by: FoxPaws on January 18, 2010, 12:44:05 PM
9) Use a Minor Emergency or Urgent Care center for things like food poisoning or sprained ankles. Not only will you not be taking up valuable time/space in a Major Emergency Room, but the service tends to be faster.

10) Limit your caregivers/drivers to two functional adults. There is no need for the whole family to tag along unless you are dying. Do not bring your children, elderly relatives, or anyone else who needs assistance or supervision. The only exception is if they are the closest of kin to the patient (e.g. Grandpa needs to be with Grandma). In that case, one family member/caregiver should be assigned solely to assist them while another looks after the patient.

11) Don't stay in the emergency parking zone any longer than necessary. If the patient is conscious, a family member should be able to leave them long enough to move the vehicle.

12) Don't snoop, pry, eavesdrop, gossip, or try to pump the staff for info on other patients.
Title: Re: ER Etiquette
Post by: Crazy Chicken Lady on January 18, 2010, 12:47:28 PM
ER staff don't have the time to run across the street to get McDonald's for patients while they wait (nor are they allowed to).

Don't get angry if the doctor won't prescribe you what you want. He or she takes into account your allergies, other medications, symptoms,etc to determine what will work best.

Please don't call 911 from the waiting area and demand to be taken to another hospital. Emergency dispatchers really hate this.

Also, please understand that more than likely you will have to wait longer than you would have to in a doctor's office. Most hospitals in this area are grossly understaffed and the doctors and nurses are doing the best they can.
Finally, please remember to fill out the surveys hospitals send out so that hospitals know what they need to improve on and it really makes staff members' days to hear something positive about how they do their jobs.



Title: Re: ER Etiquette
Post by: rashea on January 18, 2010, 03:50:46 PM
Try to keep conversations quiet. Other people are suffering, and noise can make that worse.

Be polite to the nurses (and everyone else, but espeically the nurses) they are the ones who do a lot of the taking care of you.

Tests take a while, do your best to wait patiently.

If cell phones are not allowed, respect this policy.

Try not to take up extra chairs in the waiting room, especially if the room is full.

Holidays are the worst time to visit ERs, so expect even longer than usual waits.

Don't try to judge the seriousness of someone else's problem. That's why they do triage.
Title: Re: ER Etiquette
Post by: Wavicle on January 18, 2010, 03:53:30 PM
Respect other people's privacy. If you see someone you know or overhear people's conversations, keep it to yourself unless you have spoken to them and you know it is OK to pass it on.
Title: Re: ER Etiquette
Post by: Kaylee on January 18, 2010, 04:19:11 PM
Yes.  Yes.  All of this, yes.

I'm mostly just here being the choir to be sung to.  But a few peds-specific rules:

Corollary to Rule #1 of All ERs Everywhere:  The Waiting Game!  Yes, there is a wait, even for children, though we do bring kids with certain problems directly into the ER even if they may not "look" sick (think asthmatics).  We really will see your child as soon as possible, but patience is the name of the game.  It also may take some time for assessment/treatment/consults with specialists once you're in here.  Please don't yell about how long you've been here; we'd like you to leave as soon as possible too. 

Corollary to #10:  We really do understand that it can be difficult or impossible in an emergency to find child care for the sick child's siblings.  That said, this is not a day care and it's a bad idea on a whole lot of levels to bring your kids in here.  If you really have to, you have to at least attempt to keep them corralled and under control.

If you are concerned with or disagree with what the doctor has or has not prescribed or ordered for your child, despite all the aforegoing frustrations, yelling/demanding/threatening the medical personnel is a really lousy way of getting what you want.

Title: Re: ER Etiquette
Post by: Pinky830 on January 18, 2010, 04:34:52 PM
A couple of veterinary-specific ones:

1. Yes, you will have to pay. Tonight. I know, I really do, it sucks for everyone to have a big vet bill-and at the ER it will probably be big-sprung on you. Please, please, don't yell at us that we're just in it for the money. Especially these days, the staff you're yelling at has likely had their hours cut, they live in fear of being laid off, and their employer had to scrape to pay their vendors last month.

2. Please try not to bring your pet in when you have been heavily indulging in mind-altering substances. Yes, OK, that's some people's idea of fun at 2 AM and I'm not here to judge you, but drunks and stoners have a hard time making decisions.

3. Don't call us first, describe your pet's symptoms, and argue with us about whether you really need to bring it in. You called me, dude. Unless it's something extremely simple, that's what I'm advising.

4. We are not Animal Control. Don't call us to come get a stray. And don't you dare abandon an unwanted pet here.

5. Knock it off with the prank calls. We're busy here.

6. Please don't make me explain everything to you, then call your spouse and hand me the phone and make me explain it all over again.

7. No, I'm sorry, you can't sit next to your pet's cage in the treatment area. I've tried it and it was a crippling distraction.

Title: Re: ER Etiquette
Post by: JonGirl on January 19, 2010, 05:02:16 AM



Try not to puke in the carpark outside the ER. It makes a mess and annoys the ambulance staff.






How do I know this?  :-X :-[
Title: Re: ER Etiquette
Post by: Larrabee on January 19, 2010, 05:08:46 AM

Don't try to strike up conversations with other patients in the waiting room.  Yes you may be bored but they could be very distracted by pain/nausea/concentrating on breathing and probably aren't looking to make a new friend but will feel rude if they don't respond to you.  It puts people in an awkward position. 

Don't downplay your symptoms/suffering.  If you aren't used to being ill and hate to complain its hard to break the habit and really open up about how bad you feel.  But the doctors need this information to treat you and there are no prizes for stoicism!
Title: Re: ER Etiquette
Post by: rashea on January 19, 2010, 08:09:33 AM
Try to contain your own germs. If you're sick, use tissues and your elbow when sneezing and coughing. Hand sanitizer is a good thing in hospitals.

Along with not downplaying your symptoms, don't try to make it out as though you are dying if you have a little cut. It won't get you in any faster.
Title: Re: ER Etiquette
Post by: BeagleMommy on January 19, 2010, 02:40:10 PM
Don't try to manufacture symptoms you think will get you helped faster.  I saw this once.  A man in the ER claimed to have been having chest pains.  After the ER staff rushed him into a treatment room he explained that he really only had a sprain, but didn't want to wait.  He then had to deal with some very unhappy police officers.
Title: Re: ER Etiquette
Post by: M-theory on January 19, 2010, 11:53:20 PM
Respect other people's privacy. If you see someone you know or overhear people's conversations, keep it to yourself unless you have spoken to them and you know it is OK to pass it on.

The world would be a better place if HIPAA applied to everyone.
Title: Re: ER Etiquette
Post by: JonGirl on January 20, 2010, 03:13:44 AM
Don't try to manufacture symptoms you think will get you helped faster.  I saw this once.  A man in the ER claimed to have been having chest pains.  After the ER staff rushed him into a treatment room he explained that he really only had a sprain, but didn't want to wait.  He then had to deal with some very unhappy police officers.


This can actually be a dangerous practice. What if someone really has chest pains?  :-\
That happened once a long time ago with the man pacing up and down, insisting he had pains and he actually keeled over and died.  :(
Title: Re: ER Etiquette
Post by: ccpb1214 on January 21, 2010, 07:01:04 PM
If there's a sign saying no cell phone use, it means no cell phone use.


It doesn't mean secretly using it and speaking quietly when the security guard isn't looking.
Title: Re: ER Etiquette
Post by: ccpb1214 on January 21, 2010, 07:04:53 PM
For visitors of friends/relatives: Be aware of the rules regarding flowers/gifts.

Some places (like the wards dealing with respiratory disorders) don't even allow flowers.

And if you are allowed to bring them, bring one low-maintenance bouquet. The nurses are not florists. They don't have time to regularly trim your Bonzai tree.
Title: Re: ER Etiquette
Post by: JoanOfArc on January 21, 2010, 07:28:49 PM
Good topic! 
For Staff: Please believe patients when they tell you their medical history.  For a patient in pain, having to swear that a fact is true over and over again is really annoying and it delays treatment.  Looks can be deceiving.  A 'young' person can have a disease normally seen in older folks. 

Tend to the privacy of your patients.  If all the rooms are full and you have to do care in the hall, have other staff hold up a sheet or block the view. 

On that note, if doing an intake in the hall, speak softly. Patients do not want their history publicized! 

If a patient is conscious and the situation doesn't require immediate action, consult your patients as to their wishes about treatment. 

Pain meds can be great, but sometimes a patient won't want them or, at least, not huge amounts.  Respect that refusal. 

If you are conducting a test and see something bad on the test, don't say "Oh deity" or something like that in front of the patient, then refuse to explain what is going on.  Seriously folks, that just makes the patient twice as anxious. 

Joan

Title: Re: ER Etiquette
Post by: kherbert05 on January 23, 2010, 10:29:38 AM
If there's a sign saying no cell phone use, it means no cell phone use.


It doesn't mean secretly using it and speaking quietly when the security guard isn't looking.

Even if the staff is using cellphones. One hospital sis worked for had these phones with bright yellow covers that were allowed to be used. These were tested to not interfere with the equipment.
Title: Re: ER Etiquette
Post by: flo on February 02, 2010, 06:59:56 AM
Don't jump ahead of other people in the line to sign in.  They are also there for an emergency.
Title: Re: ER Etiquette
Post by: loner on February 02, 2010, 02:06:51 PM
If you are visiting someone in the ER. Try not to hang out in the hallway outside the room they are in.  Patients need to be moved to other departments and beds are hard to maneuver around.  Plus patients usually feel uncomfortable when they are seen by others when they are sick/injured.
Title: Re: ER Etiquette
Post by: L.A. Lady on February 02, 2010, 02:31:15 PM
Please do not try to bribe anyone to get you seen faster. It rude and possibly illegal.

Do not make up phony ailments to get attention faster. If you are at the ER because of a rash, don't complain of chest pains.

Do not come to the ER for prescription refills or medications to make you high. Certain situations are exempt.

Speaking of medications. Please know what medication you are taking, along with the dosage. "Some sh*t for blood pressure." doesn't help the doctors. If you don't know, bring the bottle with you.   
Title: Re: ER Etiquette
Post by: Twik on February 04, 2010, 11:01:44 AM
On the other hand, the etiquette rule that the only polite response to "How are you feeling?" is "Oh, I'm fine, thank you very much! And you?" does not apply in ERs.
Title: Re: ER Etiquette
Post by: scap64 on March 12, 2010, 11:19:02 AM

Don't get angry if the doctor won't prescribe you what you want. He or she takes into account your allergies, other medications, symptoms,etc to determine what will work best.


On this one: doctors do sometimes prescribe what they are given incentives to prescribe (just google "clinical marketing" or go to this link:

http://news.blogs.nytimes.com/2007/05/09/doctors-getting-paid-to-prescribe-drugs/  )

Besides, heavy TV drug advertising/marketing also contributes to this problem.
It's a fine line between trusting medical advice and standing up for your patient/consumer rights.
Title: Re: ER Etiquette
Post by: Giggity on March 12, 2010, 11:29:11 AM
And one from the point of view of the customer:

When I'm ready to check out, you be ready with an invoice for me. If I have no insurance and am therefore a self-pay, and I have my checkbook out, that means - as per your sign on the check-in desk - I am ready to make payment at the time service is rendered.
Title: Re: ER Etiquette
Post by: kitty_ev on March 14, 2010, 10:12:35 AM

Don't get angry if the doctor won't prescribe you what you want. He or she takes into account your allergies, other medications, symptoms,etc to determine what will work best.


On this one: doctors do sometimes prescribe what they are given incentives to prescribe (just google "clinical marketing" or go to this link:

http://news.blogs.nytimes.com/2007/05/09/doctors-getting-paid-to-prescribe-drugs/  )

Besides, heavy TV drug advertising/marketing also contributes to this problem.
It's a fine line between trusting medical advice and standing up for your patient/consumer rights.

Depends on the country you're in whether or not this happens. In the UK we're put under lots of pressure to prescribe generic drugs rather than branded ones. The only instances we can prescribe branded drugs are if it's a medication for epilepsy or one or two other instances I can't remember at this particular moment.

This may be a more pre-ER rule, but please don't call for an ambulance if you just want a cup of tea making or the curtains pulling shut (it happens!).

Don't shout at staff. It won't make us see you any faster. We're already working to time targets.

The ER or hospital admissions are not the time to bring up all the little niggles that you've been putting off going to your regular doctor about. Go to your regular doctor once you've been discharged. Hospital doctors are usually specialists not generalists so your regular doctor will probably have a better idea about appropriate treatment for your non-specific foot pain.
Title: Re: ER Etiquette
Post by: kherbert05 on March 19, 2010, 01:54:18 AM
From the patient's side - please don't argue with me about my atypical reactions to medication and tell me they aren't possible. Really I can't take a OTC allergy med that people sometimes give kids on trips to make them sleep. It really makes me hyper - last time I decided I could fly off a 3rd floor balcony.

When I was given a sedative for surgery - I tried to punch out the RN and the Doc.

Pretty much every time I've been given a sedative I've at best spent hours crawling the ceiling at worst tried to hurt myself or others. Then several hours later I crash so hard people check to see if I'm still breathing.

On the flip side give me meds that have an upper effect - I'm crashed out asleep in no time flat.

(For some reason people are always telling me they want to see me drunk - No You Do Not)
Title: Re: ER Etiquette
Post by: Mopsy428 on May 15, 2010, 10:35:46 AM
8.) It is a bad idea to use the ER as a Doctor's office. If you have no insurance, check to see if your county/province has a low-cost clinic for uninsured patients. You can also call a Dr. and see if they offer assistance programs for those who are low-income or no insurance.

ginlyn

edited for spelling...because yes, I do know the difference between patient and patience. :P

I'd just like to add that in some situations, you have no choice. My sister has health issues. She was at college in a different state. She was hospitalized last fall, and then hospitalized a few weeks ago. She's under my parents' insurance, but her PCP is in this state. Loooong story short, my mother talked with the doctor at the hospital, and he said that college students from a different state who don't have a PCP in that state should use the ER for situations like hers (needing an antibiotic, etc., etc.)
Title: Re: ER Etiquette
Post by: vorbau on May 15, 2010, 07:13:49 PM
Please remember that the ER staff is there to save your behind, not kiss it. Or as Auntie Venom said in another thread, nurse =/= maid.

Do not swear at, spit, hit, slap, punch or kick any medical staff. This is assault and you *will* be arrested and charged. They have jail wards, you know.
Title: Re: ER Etiquette
Post by: Allie003 on June 27, 2010, 06:36:39 PM
From the patient's side - please don't argue with me about my atypical reactions to medication and tell me they aren't possible. Really I can't take a OTC allergy med that people sometimes give kids on trips to make them sleep. It really makes me hyper - last time I decided I could fly off a 3rd floor balcony.

When I was given a sedative for surgery - I tried to punch out the RN and the Doc.

Pretty much every time I've been given a sedative I've at best spent hours crawling the ceiling at worst tried to hurt myself or others. Then several hours later I crash so hard people check to see if I'm still breathing.

On the flip side give me meds that have an upper effect - I'm crashed out asleep in no time flat.

(For some reason people are always telling me they want to see me drunk - No You Do Not)

Absolutely. I've ended up in the ER a few times this pregnancy because of complications of severe morning sickness (there's a fancy Latin name I can never remember). Anyway, I've learned that one anti-nausea medicine makes me extremely paranoid and gives me panic attacks. So I always tell them I can't take it because of these reasons. My husband usually tells them. What happens last time I'm in the ER waiting on a room? The nurse gives me this med, although we both verbally told her and wrote on the admission paperwork. I spent two hours having a panic attack severe that the only thing that kept me from tearing out my IV and running out of the hospital was my husband holding me and telling me it was going to be alright. DH flipped out, and the nurse claimed it was standard procedure to give that med. I was livid, once I was convinced that no one was coming to kill me or my baby.

Also, that same OTC allergy drug turns me into a hyperactive three year old, so I'm feeling you there.
Title: Re: ER Etiquette
Post by: kitty_ev on June 27, 2010, 06:44:12 PM
From the patient's side - please don't argue with me about my atypical reactions to medication and tell me they aren't possible. Really I can't take a OTC allergy med that people sometimes give kids on trips to make them sleep. It really makes me hyper - last time I decided I could fly off a 3rd floor balcony.

When I was given a sedative for surgery - I tried to punch out the RN and the Doc.

Pretty much every time I've been given a sedative I've at best spent hours crawling the ceiling at worst tried to hurt myself or others. Then several hours later I crash so hard people check to see if I'm still breathing.

On the flip side give me meds that have an upper effect - I'm crashed out asleep in no time flat.

(For some reason people are always telling me they want to see me drunk - No You Do Not)

Absolutely. I've ended up in the ER a few times this pregnancy because of complications of severe morning sickness (there's a fancy Latin name I can never remember). Anyway, I've learned that one anti-nausea medicine makes me extremely paranoid and gives me panic attacks. So I always tell them I can't take it because of these reasons. My husband usually tells them. What happens last time I'm in the ER waiting on a room? The nurse gives me this med, although we both verbally told her and wrote on the admission paperwork. I spent two hours having a panic attack severe that the only thing that kept me from tearing out my IV and running out of the hospital was my husband holding me and telling me it was going to be alright. DH flipped out, and the nurse claimed it was standard procedure to give that med. I was livid, once I was convinced that no one was coming to kill me or my baby.

Also, that same OTC allergy drug turns me into a hyperactive three year old, so I'm feeling you there.

You're likely thinking of hyperemesis gravidarum.

If you have an allergy to a medication, please don't get cross if you're asked exactly what happens when you take it. Some people have been told that they have an allergy to certain antibiotics because they had a bit of a jippy tummy after taking it. This may be a recognised side effect. Allergies are more serious. Giving you a different medication may be inappropriate and give you poorer treatment.

If there are alcohol gel rubs around, please use them. Hospital cleanliness is everyone's business, not just hospital staff. Also, don't give staff dirty looks when they prompt you to use it- you'll be the first to complain if your loved one ends up with a preventable infection.
Title: Re: ER Etiquette
Post by: VorFemme on June 27, 2010, 07:33:45 PM
If someone tells you that they feel like they are going to throw up - get them a basin and don't "jerk" the elevator on the way up to the X-Ray department at 11 pm.  From the gleam in her eye, I'm pretty sure that DD made no effort to miss the guy's spit shined Army boots............and he took great care to run the elevator smoothly going down. 

If someone tells you that they have a history of penicillin allergies in the family and their mother calls later to report hives the size of a luncheon plate on their body in six places (they started out smaller and kind of joined up) - don't be shocked when she brings in photos "just in case" you think she was overreacting.

If your child is getting stuck for blood tests (suspected anemia due to being very pale skinned) - don't wait until the kid is over a year old to bring in their red headed pale skinned older sibling.  The doctor tore up the slip and decided that "pale" ran in the family.  (None of the tests showed anemia.)
Title: Re: ER Etiquette
Post by: kherbert05 on June 27, 2010, 08:22:40 PM


You're likely thinking of hyperemesis gravidarum.

If you have an allergy to a medication, please don't get cross if you're asked exactly what happens when you take it. Some people have been told that they have an allergy to certain antibiotics because they had a bit of a jippy tummy after taking it. This may be a recognised side effect. Allergies are more serious. Giving you a different medication may be inappropriate and give you poorer treatment.

If there are alcohol gel rubs around, please use them. Hospital cleanliness is everyone's business, not just hospital staff. Also, don't give staff dirty looks when they prompt you to use it- you'll be the first to complain if your loved one ends up with a preventable infection.

I have no problem telling medical people what I'm allergic to and how severe it is. Most of the time medical people listen to me, and I answer every question as fully as possible. For most I know the medical terms because I've lived with most of the medical condition since babyhood. It is only the sedative thing that gets questioned. I've been told flat-out that the OTC medicine can't have the effect on me that it does.

 I know it isn't an allergy, just a wierd side effect. If they have to give me a sedative say for surgery - I want them to be aware that I might become combative. That it isn't really me yelling at them or trying to escape. I'm trapped inside and a monster takes over my body. I can't stop it. That is the only way I can describe it. It is like a night terror, when you fighting for your life but in this corner the real you is trapped and you know the whole thing is an illusion. I've also tried to fly off a 3rd story balcony on the OTC medication.


Title: Re: ER Etiquette
Post by: penguinladi on June 27, 2010, 08:50:16 PM
As a patient, one thing you can do to lessen the possibility of getting a medication you have a reaction to, do not take anything or allow anyone to give you IV medication without asking to see the INTACT package or vial to see exactly what they are giving you.  You have the right to refuse any medication or treatment, even though you signed a consent-to-treat form.  If you have someone in the hospital with you, have them write down the time and what was done (medication, procedure, tests, etc) and exactly what you were told.  Ask for things to be explained in words you can understand--if someone uses a word you do not understand, ask for clarification.  Good medical professionals will see this as an opportunity to educate you on what is happening.  Just because the nurse has "standing orders" from the doctor, this does not substitute for good assessment skills and doing what is best for the patient.
Title: Re: ER Etiquette
Post by: Kimblee on June 28, 2010, 02:03:40 PM
From the patient's side - please don't argue with me about my atypical reactions to medication and tell me they aren't possible. Really I can't take a OTC allergy med that people sometimes give kids on trips to make them sleep. It really makes me hyper - last time I decided I could fly off a 3rd floor balcony.

When I was given a sedative for surgery - I tried to punch out the RN and the Doc.

Pretty much every time I've been given a sedative I've at best spent hours crawling the ceiling at worst tried to hurt myself or others. Then several hours later I crash so hard people check to see if I'm still breathing.

On the flip side give me meds that have an upper effect - I'm crashed out asleep in no time flat.

(For some reason people are always telling me they want to see me drunk - No You Do Not)

Absolutely. I've ended up in the ER a few times this pregnancy because of complications of severe morning sickness (there's a fancy Latin name I can never remember). Anyway, I've learned that one anti-nausea medicine makes me extremely paranoid and gives me panic attacks. So I always tell them I can't take it because of these reasons. My husband usually tells them. What happens last time I'm in the ER waiting on a room? The nurse gives me this med, although we both verbally told her and wrote on the admission paperwork. I spent two hours having a panic attack severe that the only thing that kept me from tearing out my IV and running out of the hospital was my husband holding me and telling me it was going to be alright. DH flipped out, and the nurse claimed it was standard procedure to give that med. I was livid, once I was convinced that no one was coming to kill me or my baby.

Also, that same OTC allergy drug turns me into a hyperactive three year old, so I'm feeling you there.

You're likely thinking of hyperemesis gravidarum.

If you have an allergy to a medication, please don't get cross if you're asked exactly what happens when you take it. Some people have been told that they have an allergy to certain antibiotics because they had a bit of a jippy tummy after taking it. This may be a recognised side effect. Allergies are more serious. Giving you a different medication may be inappropriate and give you poorer treatment.

If there are alcohol gel rubs around, please use them. Hospital cleanliness is everyone's business, not just hospital staff. Also, don't give staff dirty looks when they prompt you to use it- you'll be the first to complain if your loved one ends up with a preventable infection.

Heheh.

When my cousin was having World's Most Perfect Niece-baby Evah(tm) I was manic with the alcohol gel machines. i used them, and made Cousin's other daughter (who is simmilarly mperfect, and was my responsibility until WMPNBE(tm) got herself born) use it too... and got told two or three times by non-hospital staff that those were only for doctors.

I ignored them. It seemed like a tiny action to perform to keep germs ion the bathroom from getting to that teensy little pink blob that we were all so desprate to see. (That was a long pregnancy, four weeks almost past the due date and she was still under 8 pounds!)
Title: Re: ER Etiquette
Post by: Ambrosia Hino on June 29, 2010, 08:36:45 AM
If someone tells you that they feel like they are going to throw up - get them a basin and don't "jerk" the elevator on the way up to the X-Ray department at 11 pm.  From the gleam in her eye, I'm pretty sure that DD made no effort to miss the guy's spit shined Army boots............and he took great care to run the elevator smoothly going down.
 

I was not aiming for him. That really was accidental...I just didn't feel sorry that I did it either...

If someone tells you that they have a history of penicillin allergies in the family and their mother calls later to report hives the size of a luncheon plate on their body in six places (they started out smaller and kind of joined up) - don't be shocked when she brings in photos "just in case" you think she was overreacting.

and don't argue with the sick kid's older sibling when they insist that yes, he really has already had chicken pox, this is something else...I got blamed by Dad for him getting chicken pox, so I definately remember it happening!

If your child is getting stuck for blood tests (suspected anemia due to being very pale skinned) - don't wait until the kid is over a year old to bring in their red headed pale skinned older sibling.  The doctor tore up the slip and decided that "pale" ran in the family.  (None of the tests showed anemia.)

see, you really should have scheduled his appointments for after I got home from school...
Title: Re: ER Etiquette
Post by: Ambrosia Hino on June 29, 2010, 08:49:46 AM
For the hospital staff:

don't assume that someone curled up in a ball for pain is faking...I had surgery the day before and once the meds from the actual surgery wore off, I was in excrutiating pain...the meds the doctor had prescribed me worked about as well as popping a TicTac for pain. Yes, I know the med that I given in the ER that night was technically weaker, but it actually worked.

If a patient comes in (me) repeated vomiting please, for the sake of other patients, remove them to a more private room. And don't accuse them of faking for attention (see VorFemme's post about the spit-shined boots >:D )

oh, and if I come in, complaining of severe abdominal pain, and that I've been repeatedly puking my guts out, don't give me an IV of anti-nausea & pain meds, wait for me to pass out, then discharge me...without doing ANY tests to figure out what happened. Several months later, I got my gall bladder out - looking back on that particular night, I am 98% positive that I'd had a gall stone...one ultrasound could have saved me months of suffering with an earlier diagnosis
Title: Re: ER Etiquette
Post by: VorFemme on June 29, 2010, 08:59:36 PM
If someone tells you that they feel like they are going to throw up - get them a basin and don't "jerk" the elevator on the way up to the X-Ray department at 11 pm.  From the gleam in her eye, I'm pretty sure that DD made no effort to miss the guy's spit shined Army boots............and he took great care to run the elevator smoothly going down.
 

I was not aiming for him. That really was accidental...I just didn't feel sorry that I did it either...

I never thought that you AIMED for the boots - only that you made no effort/had no energy to turn your head away from those boots when his bumpy handling of the elevator (late night - he had to use a key to unlock it & was running it "manually" somehow).

Personally - I thought it might teach him to listen when someone told him that they were feeling woozy...........and believe it!
Title: Re: ER Etiquette
Post by: Ambrosia Hino on June 30, 2010, 07:29:58 AM
If someone tells you that they feel like they are going to throw up - get them a basin and don't "jerk" the elevator on the way up to the X-Ray department at 11 pm.  From the gleam in her eye, I'm pretty sure that DD made no effort to miss the guy's spit shined Army boots............and he took great care to run the elevator smoothly going down.
 

I was not aiming for him. That really was accidental...I just didn't feel sorry that I did it either...

I never thought that you AIMED for the boots - only that you made no effort/had no energy to turn your head away from those boots when his bumpy handling of the elevator (late night - he had to use a key to unlock it & was running it "manually" somehow).

Personally - I thought it might teach him to listen when someone told him that they were feeling woozy...........and believe it!

more like "no time"
Title: Re: ER Etiquette
Post by: VorFemme on June 30, 2010, 12:04:48 PM
If someone tells you that they feel like they are going to throw up - get them a basin and don't "jerk" the elevator on the way up to the X-Ray department at 11 pm.  From the gleam in her eye, I'm pretty sure that DD made no effort to miss the guy's spit shined Army boots............and he took great care to run the elevator smoothly going down.
 

I was not aiming for him. That really was accidental...I just didn't feel sorry that I did it either...

I never thought that you AIMED for the boots - only that you made no effort/had no energy to turn your head away from those boots when his bumpy handling of the elevator (late night - he had to use a key to unlock it & was running it "manually" somehow).

Personally - I thought it might teach him to listen when someone told him that they were feeling woozy...........and believe it!

more like "no time"

Then it was true poetic justice when he stood next to you and JERKED the elevator upstairs - because he did indeed "reap what he sowed" - in this case, he got to clean & polish his boots again.
Title: Re: ER Etiquette
Post by: kitty_ev on July 07, 2010, 09:23:56 PM
From the patient's side - please don't argue with me about my atypical reactions to medication and tell me they aren't possible. Really I can't take a OTC allergy med that people sometimes give kids on trips to make them sleep. It really makes me hyper - last time I decided I could fly off a 3rd floor balcony.

When I was given a sedative for surgery - I tried to punch out the RN and the Doc.

Pretty much every time I've been given a sedative I've at best spent hours crawling the ceiling at worst tried to hurt myself or others. Then several hours later I crash so hard people check to see if I'm still breathing.

On the flip side give me meds that have an upper effect - I'm crashed out asleep in no time flat.

(For some reason people are always telling me they want to see me drunk - No You Do Not)

Absolutely. I've ended up in the ER a few times this pregnancy because of complications of severe morning sickness (there's a fancy Latin name I can never remember). Anyway, I've learned that one anti-nausea medicine makes me extremely paranoid and gives me panic attacks. So I always tell them I can't take it because of these reasons. My husband usually tells them. What happens last time I'm in the ER waiting on a room? The nurse gives me this med, although we both verbally told her and wrote on the admission paperwork. I spent two hours having a panic attack severe that the only thing that kept me from tearing out my IV and running out of the hospital was my husband holding me and telling me it was going to be alright. DH flipped out, and the nurse claimed it was standard procedure to give that med. I was livid, once I was convinced that no one was coming to kill me or my baby.

Also, that same OTC allergy drug turns me into a hyperactive three year old, so I'm feeling you there.

You're likely thinking of hyperemesis gravidarum.

If you have an allergy to a medication, please don't get cross if you're asked exactly what happens when you take it. Some people have been told that they have an allergy to certain antibiotics because they had a bit of a jippy tummy after taking it. This may be a recognised side effect. Allergies are more serious. Giving you a different medication may be inappropriate and give you poorer treatment.

If there are alcohol gel rubs around, please use them. Hospital cleanliness is everyone's business, not just hospital staff. Also, don't give staff dirty looks when they prompt you to use it- you'll be the first to complain if your loved one ends up with a preventable infection.

Heheh.

When my cousin was having World's Most Perfect Niece-baby Evah(tm) I was manic with the alcohol gel machines. i used them, and made Cousin's other daughter (who is simmilarly mperfect, and was my responsibility until WMPNBE(tm) got herself born) use it too... and got told two or three times by non-hospital staff that those were only for doctors.

I ignored them. It seemed like a tiny action to perform to keep germs ion the bathroom from getting to that teensy little pink blob that we were all so desprate to see. (That was a long pregnancy, four weeks almost past the due date and she was still under 8 pounds!)

For real?! If you were in my hospital we'd be trying to squirt the stuff on you whenever you entered a door! It's cheap as chips (in comparison to treating infections) so it's mad to reserve it for only the doctors!
Title: Re: ER Etiquette
Post by: Kimblee on July 07, 2010, 09:37:03 PM
From the patient's side - please don't argue with me about my atypical reactions to medication and tell me they aren't possible. Really I can't take a OTC allergy med that people sometimes give kids on trips to make them sleep. It really makes me hyper - last time I decided I could fly off a 3rd floor balcony.

When I was given a sedative for surgery - I tried to punch out the RN and the Doc.

Pretty much every time I've been given a sedative I've at best spent hours crawling the ceiling at worst tried to hurt myself or others. Then several hours later I crash so hard people check to see if I'm still breathing.

On the flip side give me meds that have an upper effect - I'm crashed out asleep in no time flat.

(For some reason people are always telling me they want to see me drunk - No You Do Not)

Absolutely. I've ended up in the ER a few times this pregnancy because of complications of severe morning sickness (there's a fancy Latin name I can never remember). Anyway, I've learned that one anti-nausea medicine makes me extremely paranoid and gives me panic attacks. So I always tell them I can't take it because of these reasons. My husband usually tells them. What happens last time I'm in the ER waiting on a room? The nurse gives me this med, although we both verbally told her and wrote on the admission paperwork. I spent two hours having a panic attack severe that the only thing that kept me from tearing out my IV and running out of the hospital was my husband holding me and telling me it was going to be alright. DH flipped out, and the nurse claimed it was standard procedure to give that med. I was livid, once I was convinced that no one was coming to kill me or my baby.

Also, that same OTC allergy drug turns me into a hyperactive three year old, so I'm feeling you there.

You're likely thinking of hyperemesis gravidarum.

If you have an allergy to a medication, please don't get cross if you're asked exactly what happens when you take it. Some people have been told that they have an allergy to certain antibiotics because they had a bit of a jippy tummy after taking it. This may be a recognised side effect. Allergies are more serious. Giving you a different medication may be inappropriate and give you poorer treatment.

If there are alcohol gel rubs around, please use them. Hospital cleanliness is everyone's business, not just hospital staff. Also, don't give staff dirty looks when they prompt you to use it- you'll be the first to complain if your loved one ends up with a preventable infection.

Heheh.

When my cousin was having World's Most Perfect Niece-baby Evah(tm) I was manic with the alcohol gel machines. i used them, and made Cousin's other daughter (who is simmilarly perfect, and was my responsibility until WMPNBE(tm) got herself born) use it too... and got told two or three times by non-hospital staff that those were only for doctors.

I ignored them. It seemed like a tiny action to perform to keep germs ion the bathroom from getting to that teensy little pink blob that we were all so desprate to see. (That was a long pregnancy, four weeks almost past the due date and she was still under 8 pounds!)

For real?! If you were in my hospital we'd be trying to squirt the stuff on you whenever you entered a door! It's cheap as chips (in comparison to treating infections) so it's mad to reserve it for only the doctors!

Oh the nurses were very pleased, as was the doctor. It was other paitents complaining/
Title: Re: ER Etiquette
Post by: kitty_ev on July 12, 2010, 12:07:41 PM
Just returned from a trip to lovely Canada and while we were there we ended up making a trip to the ER for my brother. Silly twit had gotten himself a spider bite before we took off from the UK and it became infected resulting in a soft tissue infection causing his ankle to swell to the size of a melon and him being unable to put his weight on it. So off to the ER we went and unwillingly observed a few more things that should be in this thread.

1) If you are in a large group of people (say, more than 3 including the patient) there's not much point in all of you being in the ER. Particularly late on a Friday night when it's busy anyway. You'll get in everyone's way and take up seats that people who are actually sick could benefit from.

2) If you are part of the aforementioned large group and decide not to go into the ER, it would be better if you didn't spend hours and hours hanging around outside shouting, screaming, playing with wheelchairs and getting in the way of vehicles ferrying patients to hospital.

3) Being a patient doesn't automatically entitle you to a wheelchair. If you are not a patient you certainly aren't entitled to a wheelchair. I observed some people in the aforementioned large group (I should mention that they were in their late teens/ early twenties) grabbing the hospital wheelchairs to play with outside. One of the group grabbed the last one as an elderly man went to fetch it for his elderly wife who was clearly unwell and holding on to the wall in the entrance. The young man who took the wheelchair saw the elderly man and the sick elderly woman and still ran off with the chair to play with his friends outside. Fortunately it wasn't long until security reclaimed the wheelchairs. They didn't move the group on though, they kept smoking and shouting loudly outside the building.
Title: Re: ER Etiquette
Post by: Eisa on July 19, 2010, 06:29:05 PM
When the wait is longer than you expected, don't scream at everyone in the waiting room [the last time I went to the ER with stomach pain and black stool, I was in the waiting room after they ask you what's wrong with you but don't have a room yet--and I could hear this person SCREAMING at everyone associated with the hospital about how they had to wait. Hello, everyone had to wait. Obviously, there's nothing really, really wrong with you that you get to go ahead of EVERYONE else. Sorry.]

When your patient comes up, throwing up blood, tells you that she's just had surgery that day and her pain medication is making her nauseated and that just sitting up/standing makes her throw up...PLEASE try to not then put her in a big dentist-like medical chair! [That also happened to me. I'd just had a tonsillectomy/adenoidectomy/septoplasty, and my pain meds were too strong. I was throwing up so much, I started throwing up blood. The ER people were nice, but they also put me in a chair for hours. It was horrible. Throwing up practically clots of blood was not pleasant. At least then I got a shot of Demerol. :P]

If your patient tells you that it's difficult to get blood from her as her veins disappear, don't ignore her. She's had to go through this a lot. She knows what she's talking about.  ::) [Had that happen a lot of times, where they just don't listen to me, stab me a bunch of times, and then "have to call in an expert." I told you my veins are hard to find!]
Title: Re: ER Etiquette
Post by: kitty_ev on July 20, 2010, 06:20:49 PM
If your patient tells you that it's difficult to get blood from her as her veins disappear, don't ignore her. She's had to go through this a lot. She knows what she's talking about.  ::) [Had that happen a lot of times, where they just don't listen to me, stab me a bunch of times, and then "have to call in an expert." I told you my veins are hard to find!]

I hear you! Happens to me all the time. I know I'm hard to bleed- I've had enough blood tests to prove it and I know where my relatively good veins are. I also know that while most people have veins accessible in certain places, I'm not one of them. Please don't "have a go" on the off-chance you'll hit something venous- it wastes your time and mine.
Title: Re: ER Etiquette
Post by: hyzenthlay on August 23, 2010, 06:39:52 PM
The ER is the last place you want to get medical care if you have a choice. They are busy, they are rushed, they are in the mindset to stop bleeding and restart hearts.

This is not a great environment in which to discuss chronic conditions, or determine long term treatment options for the nagging problem you never treated until it was too late. Nor is it where you want to be if your problem can in fact wait an hour or two and there is so much as a single Urgent Care facility open.

And yes in that rushed environment you may have to be pretty forceful, because sometimes they are running on auto-pilot so as to treat all the people that may be this close to death.
Title: Re: ER Etiquette
Post by: kitty_ev on May 31, 2011, 05:30:01 PM
I'm 100% certain that no-one on here is this crass, but unfortunately I've seen it several times now. If you're on a ward and someone's clearly desperately unwell- crash alarm has gone, doctors and nurses clearly busy, lots of new personnel on the ward assisting, this is not the time to call the one remaining healthcare assistant tasked with making sure no-one else is dying and ask why the evening drinks haven't come round yet. Please try and keep some perspective.

Don't shout at the nurses. Actually, don't shout at anyone- it's rude and incredibly disrespectful.
Title: Re: ER Etiquette
Post by: Calypso on June 02, 2011, 03:44:03 PM
When is it not rude to interrupt the ER doctor when he's talking?
When he's on the phone telling the cardiologist your Dad's BP, but he's reporting it upside down.... :-\
Title: Re: ER Etiquette
Post by: VorFemme on June 03, 2011, 12:31:04 PM
When is it not rude to throw up on the ER personnel?

Probably never - since you have a MEDICAL excuse - but if they are trying to tell you that you AREN'T sick, then at least you know that they needed the lesson in recognizing a sick person when they saw an atypical presentation (DD did not like the guy's attitude - I believe she was aiming for his spit shined boots [military hospital]).
Title: Re: ER Etiquette
Post by: Eisa on June 03, 2011, 04:01:56 PM
When is it not rude to throw up on the ER personnel?

Probably never - since you have a MEDICAL excuse - but if they are trying to tell you that you AREN'T sick, then at least you know that they needed the lesson in recognizing a sick person when they saw an atypical presentation (DD did not like the guy's attitude - I believe she was aiming for his spit shined boots [military hospital]).

I almost did once...I made it to the trash can, though. :P Barely!
Title: Re: ER Etiquette
Post by: kitty-cat on June 03, 2011, 07:10:37 PM
From my recent trip to the ER:

No one would tell me anything. Granted, I know I was kind of out of it, but in the age of digital x-rays, I'm pretty sure the x-ray techs could have told me "yes your leg is broken". That's all I wanted to know! I had a CAT scan (at least I think that's what it was...) and they wouldn't tell me that it looked okay.

I still haven't seen the x-rays from the ER. Every other time I've had a broken bone I've been allowed to see the x-rays. (and I was a kid then!)

At least the doctor who set my leg in the splint complimented me on my "creative cussing". He said it was the most creative he's heard in the ER for a while.
Title: Re: ER Etiquette
Post by: Wavicle on June 04, 2011, 12:33:07 PM
From my recent trip to the ER:

No one would tell me anything. Granted, I know I was kind of out of it, but in the age of digital x-rays, I'm pretty sure the x-ray techs could have told me "yes your leg is broken". That's all I wanted to know! I had a CAT scan (at least I think that's what it was...) and they wouldn't tell me that it looked okay.

I still haven't seen the x-rays from the ER. Every other time I've had a broken bone I've been allowed to see the x-rays. (and I was a kid then!)

At least the doctor who set my leg in the splint complimented me on my "creative cussing". He said it was the most creative he's heard in the ER for a while.

It is not within the scope of practice of the techs to evaluate the scans, and even if they are experienced enough to mostly be able to see it is still up to the doc to read them and the techs can get in HUGE trouble for telling you what they think they see. Please do not ask, if they are a good tech they will not tell you and it is a bad position to be in. For some things you may be able to request to talk to the radiologist, but they are usually busy. You need to go to the doc for results.

There are also certain protocols for getting your films. If you want them, you can probably call up the hospital and request copies on disk (few places use film but some still do).
Title: Re: ER Etiquette
Post by: Danismom on June 04, 2011, 12:49:34 PM
From my recent trip to the ER:

No one would tell me anything. Granted, I know I was kind of out of it, but in the age of digital x-rays, I'm pretty sure the x-ray techs could have told me "yes your leg is broken". That's all I wanted to know! I had a CAT scan (at least I think that's what it was...) and they wouldn't tell me that it looked okay.

I still haven't seen the x-rays from the ER. Every other time I've had a broken bone I've been allowed to see the x-rays. (and I was a kid then!)

At least the doctor who set my leg in the splint complimented me on my "creative cussing". He said it was the most creative he's heard in the ER for a while.

Yep, techs aren't allowed to tell you anything.  Also, in this digital age, they only rarely use actual film anymore.  Usually the images are computerized and the docs view them on the computer.  Therefore, unless the computer in your exam room had the program that allowed them to show you scans then they *couldn't* show you the images.  Usually they will show family members if asked to though since the family is able to come to the nurse's station or dictation area where the docs can pull the pictures up.
Title: Re: ER Etiquette
Post by: Piratelvr1121 on June 04, 2011, 01:18:10 PM
Oh I have a few myself.  This one is kind of an ER/Doctor issue because my usual dr I was seeing during my pregnancy saw me while I was in the ER.  And this was the only military dr I encountered who was such a flaming chauvinistic idiot, as everyone else was cool and respectful.

When a patient has a condition they've had for all their life, and that patient is nearing their mid-20's, it's a pretty safe bet to figure they have some understanding of how their body works because of it, and are pretty familiar with the blood tests and what they mean.  If not in medical terms, at least the general idea.   I was diagnosed with hypothyroidism when I was nine months old and by the time my second son was born, I'd had it for almost 24 years.   In addition to having my blood drawn once every 6 months or so to test my TSH for those 24 years and having taken some anatomy and physiology courses, I had a pretty good understanding of what it meant when my TSH was low or high.

Soooo...while I'm pregnant with the little pirate, my doctor of course has been keeping up with my thyroid levels, as well he should, but with one problem.  The man is convinced that a low TSH level means he needs to give me a higher dose of synthroid/levothyroxin.   (TSH=Thyroid stimulating hormone, which tries to stimulate the thyroid gland to produce more of its hormone so when I'm taking a higher dose than necessary it will be low.  Not high enough dose means I'll get high levels of TSH)  I tell him as politely as I can "That doesn't sound right, low TSH means I'm taking enough, or too much..."

"Nope, you're not taking enough and that's why you're getting sick."  (Mind you, for all the symptoms caused by a high TSH level, getting sick has never been one of them) Dude would NOT listen to me and prescribed me MORE synthroid and he admitted me for the night and when I realized he wasn't going to let me go home until my TSH levels went up to where he wanted them (and so long as he kept prescribing me higher doses, they would continue going down) I signed out AMA because he also didn't listen when I said "Um, but that will take at least 2 weeks for it to show up in a blood test, if not longer and I can't stay in the hospital that long!"   Nope, I was the stupid one because he knew EVERYTHING about hypothyroidism and the silly Marine Wife knew nothing.  ::)

I was so glad when I got transferred to another doc because he was transferred somewhere else.   Oh and he also wondered why I wasn't gaining weight when I was taking 300mg of synthroid.  As soon as I went to another doctor and had my dosage lowered to where it should be, I started gaining weight.

Later my mother tried to get me to get my dr's to put me on 300mg "Since you were so smart and thin when you were on that dose"  Thankfully NONE of the drs I went to after that would risk my health like that.
Title: Re: ER Etiquette
Post by: kitty_ev on June 06, 2011, 07:44:41 AM
From my recent trip to the ER:

No one would tell me anything. Granted, I know I was kind of out of it, but in the age of digital x-rays, I'm pretty sure the x-ray techs could have told me "yes your leg is broken". That's all I wanted to know! I had a CAT scan (at least I think that's what it was...) and they wouldn't tell me that it looked okay.

I still haven't seen the x-rays from the ER. Every other time I've had a broken bone I've been allowed to see the x-rays. (and I was a kid then!)

At least the doctor who set my leg in the splint complimented me on my "creative cussing". He said it was the most creative he's heard in the ER for a while.

Congrats on the "creative cussing"- I wish some of my patients would be more creative, my delicate ears are scorched sometimes!

Everyone who's commented above me is right- radiographers aren't allowed to tell you the results of a scan unless they're specifically trained to do so. It's the doctor's responsibility. I don't think most of us routinely show patients their X-rays, particularly as in our hospital it's all digital and the necessary software is only on certain machines, so you've got to get your patient to a suitable machine to let them see a scan. It takes a lot of time and isn't always practical.

We also don't necessarily give patients the results of all investigations that we perform. For example, if an inpatient is having daily bloods so we can monitor their liver function we won't usually go to them each day and say "well, today's test shows that your liver is improving/ worsening" unless we're intending to change the treatment the patient is on. If someone specifically asks, of course, that's a different matter and I'll tell them straight away, but if they don't ask I don't usually have the time to go and tell them if there's no news.

And Piratelvr1121- eeep! Thank goodness you got a different physician!

Title: Re: ER Etiquette
Post by: kitty-cat on June 06, 2011, 08:16:05 AM
Well now I know! I was just so confused at the time I just wanted someone to confirm that yes my leg was broken. I had a feeling it was, I just wanted to know.
Title: Re: ER Etiquette
Post by: iridaceae on June 06, 2011, 08:21:00 AM
Do not go to the head of the check-in line and tell the person that "your mother just fell and it would be nice if someone went outside and got her" in a really sarcastic tone of voice. How are they supposed to know mom is sitting injured in a car with son-in-law?

DO pay attention to what the nurses say and ask.  When I was in the ER with a peritonsillar abcess if my stepmother (the doctor) and I hadn't paid attention to what the nurse was asking she would have given me an injection meant for a 25-year-old male. I was a 40+ female. ( I would guess my stepmother, who has rights at that hospital, had a word with someone about that later.)



Title: Re: ER Etiquette
Post by: Wonderflonium on June 06, 2011, 08:52:07 AM
Definitely understand that most of the time, you will get help as soon as possible and there is an order to things. However....

I went to the ER once with gall bladder pain. (I think we were just on the verge of verifying that's what it was.) I'd taken a Percocet and it didn't even take the edge off. I was between a 9 and a 10 on the pain scale and had been for an hour and a half by the time I got to the hospital and got put in a bed. And then I waited. And waited. And waited. It got to the point where I was begging the friend who drove me to find something heavy and knock me unconscious, and I was completely serious. It was excrutiating. After an hour and a half (I think; she had to tell me because I was in so much pain), she went to the nurse's station where some nurses and doctors were hanging about chatting. She explained the situation and said, "You need to give her something NOW." Within minutes, they came in, gave me some IV drugs, and all was well. It took less than 5 minutes; they couldn't have done that just a wee bit earlier?

So I guess what I'm saying is don't be afraid to advocate for yourself. Three hours at a 9 to 10 on the pain chart had nearly out of my mind, and it really irritates me that it could have ended a lot sooner.  >:(
Title: Re: ER Etiquette
Post by: dawbs on June 06, 2011, 09:08:09 AM
Speaking of creative cussing, it's good for everyone to try to exercise patience.

People in pain/on meds/etc don't always have full control of their 'filter' or their bodies or anything else. 
People should do their darndest to keep control.  People who are subjected to them should try to have a bit of understanding and patience.

I think Mr. Dawbs (then the pre-Mr. Dawbs)has STILL not forgiven the nurse/tech/whomever who gave him a hard time for saying "it hurts like hell".  He was using INCREDIBLY mild language, considering...he had broken a his radius.  The last 2 inches of it had, when he fell, moved out of place and was now residing up in his wrist, close to his thumb.  He was trying to be polite, that sort of nitpicking did not help his filter.

On the flip side, our local urgent care bumped me to the head of the line when I dived past a nurse to steal her trashcan to be sick--she told me how much she appreciated the effort. (it was a kidney stone.  I didn't know that yet though, I was still thinking I might die)
Title: Re: ER Etiquette
Post by: Larrabee on June 06, 2011, 09:12:56 AM


So I guess what I'm saying is don't be afraid to advocate for yourself. Three hours at a 9 to 10 on the pain chart had nearly out of my mind, and it really irritates me that it could have ended a lot sooner.  >:(

Didn't you have a call button by the bed?  I'm sorry you went through that but nurses aren't mind readers, why didn't you tell them you were in pain and ask for relief?

My rule of ER etiquette, if you see nurses stood in a group together, don't assume they are chatting and ignoring patients, they may well be discussing your care or trying to organise something which will require several staff.
Title: Re: ER Etiquette
Post by: Wonderflonium on June 06, 2011, 09:19:49 AM
So I guess what I'm saying is don't be afraid to advocate for yourself. Three hours at a 9 to 10 on the pain chart had nearly out of my mind, and it really irritates me that it could have ended a lot sooner.  >:(

Didn't you have a call button by the bed?  I'm sorry you went through that but nurses aren't mind readers, why didn't you tell them you were in pain and ask for relief?

My rule of ER etiquette, if you see nurses stood in a group together, don't assume they are chatting and ignoring patients, they may well be discussing your care or trying to organise something which will require several staff.

At that point, I couldn't even be sure I had feet, but I think there was a call button. IIRC, we used it, and just got a cursory visit from the nurse that didn't do anything.

I was in excrutiating pain when I was admitted, so they didn't have to be mind readers to know I needed relief. I was admitted BECAUSE I was in so much pain.
Title: Re: ER Etiquette
Post by: Larrabee on June 06, 2011, 09:51:55 AM
So I guess what I'm saying is don't be afraid to advocate for yourself. Three hours at a 9 to 10 on the pain chart had nearly out of my mind, and it really irritates me that it could have ended a lot sooner.  >:(

Didn't you have a call button by the bed?  I'm sorry you went through that but nurses aren't mind readers, why didn't you tell them you were in pain and ask for relief?

My rule of ER etiquette, if you see nurses stood in a group together, don't assume they are chatting and ignoring patients, they may well be discussing your care or trying to organise something which will require several staff.

At that point, I couldn't even be sure I had feet, but I think there was a call button. IIRC, we used it, and just got a cursory visit from the nurse that didn't do anything.

I was in excrutiating pain when I was admitted, so they didn't have to be mind readers to know I needed relief. I was admitted BECAUSE I was in so much pain.

Fair enough, if you asked for pain relief and didn't get it that's bad. 

Title: Re: ER Etiquette
Post by: kitty_ev on June 07, 2011, 09:25:53 AM
Speaking of creative cussing, it's good for everyone to try to exercise patience.

People in pain/on meds/etc don't always have full control of their 'filter' or their bodies or anything else. 
People should do their darndest to keep control.  People who are subjected to them should try to have a bit of understanding and patience.

I think Mr. Dawbs (then the pre-Mr. Dawbs)has STILL not forgiven the nurse/tech/whomever who gave him a hard time for saying "it hurts like hell".  He was using INCREDIBLY mild language, considering...he had broken a his radius.  The last 2 inches of it had, when he fell, moved out of place and was now residing up in his wrist, close to his thumb.  He was trying to be polite, that sort of nitpicking did not help his filter.

On the flip side, our local urgent care bumped me to the head of the line when I dived past a nurse to steal her trashcan to be sick--she told me how much she appreciated the effort. (it was a kidney stone.  I didn't know that yet though, I was still thinking I might die)

I always give people a free pass for swearing about their pain e.g. "this hurts like *!?*$". I also don't mind swearing just because it's hurting, though I really dislike hearing the f-word thrown about. I only really and truly object to swearing when it's actually directed at me e.g. "oy you fat ******* ******* *****" which got thrown at me once (by a child! with parents present! who said nothing! Egads!) because personal comments and insults are really unnecessary. Swears as an adjective for severe pain I can let slide.
Title: Re: ER Etiquette
Post by: Twik on June 14, 2011, 11:35:29 AM
When is it not rude to throw up on the ER personnel?

Probably never - since you have a MEDICAL excuse - but if they are trying to tell you that you AREN'T sick, then at least you know that they needed the lesson in recognizing a sick person when they saw an atypical presentation (DD did not like the guy's attitude - I believe she was aiming for his spit shined boots [military hospital]).

Conversely, if they are debating whether you are DEAD (when actually it's their BP machine that has passed to the great beyond), throwing up on them settles the matter nicely.  >:D
Title: Re: ER Etiquette
Post by: NotTheNarcissist on July 05, 2011, 04:51:02 PM
Is this an ER etiquette list? Here's one.

Do not rummage through the trash of a family member who declined to add you on the HIPAA list to try to figure out what medicine the injured family member has been given.

(My SIL did this to her sister, rummaged through the trash in the ER room to glean any details possible, esp. medicine, since her injured sister was not comfortable opening up to her with the details.)
Title: Re: ER Etiquette
Post by: heathert on October 14, 2011, 01:35:00 PM
Definitely understand that most of the time, you will get help as soon as possible and there is an order to things. However....

I went to the ER once with gall bladder pain. (I think we were just on the verge of verifying that's what it was.) I'd taken a Percocet and it didn't even take the edge off. I was between a 9 and a 10 on the pain scale and had been for an hour and a half by the time I got to the hospital and got put in a bed. And then I waited. And waited. And waited. It got to the point where I was begging the friend who drove me to find something heavy and knock me unconscious, and I was completely serious. It was excrutiating. After an hour and a half (I think; she had to tell me because I was in so much pain), she went to the nurse's station where some nurses and doctors were hanging about chatting. She explained the situation and said, "You need to give her something NOW." Within minutes, they came in, gave me some IV drugs, and all was well. It took less than 5 minutes; they couldn't have done that just a wee bit earlier?

So I guess what I'm saying is don't be afraid to advocate for yourself. Three hours at a 9 to 10 on the pain chart had nearly out of my mind, and it really irritates me that it could have ended a lot sooner.  >:(

This is what frankly miffs me quite a bit about ERs. If it's packed and busy, I understand waiting waiting for a while but when they are obviously gossiping and chatting about the staff goings-on, that seems unconscionable.  The question is, why?
Title: Re: ER Etiquette
Post by: Ruelz on October 14, 2011, 01:42:54 PM
This is more hospital/doctor's office related than the ER in particular...

But I was rather irked, to find posters all over the reception area in our hospital, that requested that the clients be polite and kind and not to call names, etc.

Ex. "Rudeness will not be tolerated!"

Yet the staff were chit-chatting about their weekend, munching on cookies, and otherwise taking it easy while clients were waiting and the line-up was getting longer.  And no, it wasn't break time...I know they are supposed to break in the coffee room or elsewhere...not in the work area.
 
Why can the staff be rude if the clients can't?
Title: Re: ER Etiquette
Post by: Larrabee on October 14, 2011, 01:52:37 PM
Generalisations and stereotypes about healthcare staff aren't really appropriate for this particular thread surely?
Title: Re: ER Etiquette
Post by: Ruelz on October 14, 2011, 01:53:38 PM
Are you asking or telling?
Title: Re: ER Etiquette
Post by: Larrabee on October 14, 2011, 01:59:29 PM
Are you asking or telling?

Stating my opinion, hoping others agree.
Title: Re: ER Etiquette
Post by: Wonderflonium on October 14, 2011, 02:00:44 PM
I didn't notice any generalizations; I just saw people pointing out specific instances in which they were bothered.
Title: Re: ER Etiquette
Post by: Ruelz on October 14, 2011, 02:01:59 PM
Thank you.  It was an observation.
Title: Re: ER Etiquette
Post by: kherbert05 on October 14, 2011, 05:37:16 PM
I'm forever thankful to the triage nurse that told off a doctor. I had come into skin contact with peanut butter. Per standing instructions from every doctor I've had - I went directly to the ER. I was already having some symptoms.


Triage nurse took my information - fast tracked me to a bed and an O2 monitor. Doctor calls me a hypochondriac and implies I'm drug seeking. Nurse hears and practically  drags him out by his ear. She asks him if he even looked at my O2 levels which were dropping. My throat was starting to close. She must have called for another doctor - because  one came in told the other doc to wait in the office. Gave me epi watched me for a while. Then he went into the office and lit into the other doctor.


One question that I never got answered. Do people really drug seek for Epinephrine? I mean I like the I can breathe and my skin condition improving (that might be the follow up steroids) - the other effects not so pleasant in my book. 
Title: Re: ER Etiquette
Post by: Wonderflonium on October 14, 2011, 06:26:26 PM
One question that I never got answered. Do people really drug seek for Epinephrine?

Reading your post, I was wondering the same thing. I've never heard of anyone trying to scam epi.
Title: Re: ER Etiquette
Post by: Black Delphinium on October 14, 2011, 10:01:29 PM
One question that I never got answered. Do people really drug seek for Epinephrine?

Reading your post, I was wondering the same thing. I've never heard of anyone trying to scam epi.
Well, the wiki page mentions so-called "adrenaline junkies", maybe people do it for that fight-or-flight high?
Title: Re: ER Etiquette
Post by: heathert on October 17, 2011, 10:15:47 AM
Personally, I wasn't posting to upset hospital staff, I really wanted to see if they might have answer to the question as to why they would chat in the ER that we may not realize. 
Title: Re: ER Etiquette
Post by: Jules1980 on October 17, 2011, 10:59:16 AM
Because sometimes they are waiting for things beyond their control.  They may be waiting for a code to come in that will take everyone to attend to or it maybe that they can't go any further with treatments until they get lab results, x-rays, etc. back, so they are chatting while they wait. 
Title: Re: ER Etiquette
Post by: Wonderflonium on October 17, 2011, 11:16:10 AM
Because sometimes they are waiting for things beyond their control.  They may be waiting for a code to come in that will take everyone to attend to or it maybe that they can't go any further with treatments until they get lab results, x-rays, etc. back, so they are chatting while they wait.

I understand that, but when I'm lying in a bed thinking about how if God truly loved me, he'd kill me then and there to take away the pain, it's hard to see them chatting, especially when I've felt like dying for 3 hours and it took less than 5 minutes for them to make it better.
Title: Re: ER Etiquette
Post by: Phoebelion on October 17, 2011, 11:30:29 AM
1.  Please do take the time to explain what's going on to the wife standing there staring at her husband in anaphylactic shock.  She's terrified.  He looks like he's dead even tho the machine is beeping.

2.  Please do THROW out the hysterical woman (wife of DH's best friend) who has nothing whatsoever to do with the man in anaphylatic shock.  If you don't, I - his wife - will. 
Title: Re: ER Etiquette
Post by: Wonderflonium on October 17, 2011, 01:21:25 PM
I still think in this case, it was just bad practice. Luckily, my friend finally took it upon herself to advocate for me; I was in too much pain to do it on my own. I was at the hospital that was connected (literally) with my doctor's office and they had access to all medical records, so they knew what the problem was. And once my friend went over and demanded that they do something, they did and the problem resolved rather quickly.

(Side note: I know there are probably procedures in place, but I wish they'd given me forms to sign BEFORE they gave me the drugs. I could barely write and didn't remember how to spell my own name.  :P)
Title: Re: ER Etiquette
Post by: Danismom on October 19, 2011, 09:06:03 PM
1.  Please do take the time to explain what's going on to the wife standing there staring at her husband in anaphylactic shock.  She's terrified.  He looks like he's dead even tho the machine is beeping.

2.  Please do THROW out the hysterical woman (wife of DH's best friend) who has nothing whatsoever to do with the man in anaphylatic shock.  If you don't, I - his wife - will.

The hospital staff will generally take their cues from the identified closest family member.  If you want someone removed, you have to speak up.  Otherwise, we will think you want them there, even if they are acting out.  We generally try to allow them to remain present unless they begin to hinder the care we are giving.  At some point though, we may have to explain they need to either quiet down or remove themselves.  However this conversation rarely goes well and usually the entire family ends up angry. 

I'm sorry her behavior was disturbing to you.  All you need to to do is tell staff and we will get her out.  Or at least that's how it *should* work.
Title: Re: ER Etiquette
Post by: Twik on October 20, 2011, 09:51:38 AM
I still think in this case, it was just bad practice. Luckily, my friend finally took it upon herself to advocate for me; I was in too much pain to do it on my own. I was at the hospital that was connected (literally) with my doctor's office and they had access to all medical records, so they knew what the problem was. And once my friend went over and demanded that they do something, they did and the problem resolved rather quickly.

I agree that sometimes you (or your friends) have to advocate. I recall once visiting a friend who'd had emergency surgery the day before. She was in *serious* pain, and asked for a shot. The nurse went away, and never came back. I finally went out to see what the hold-up was, to find that the shift had ended, and she'd left without telling the new nurses anything about my friend needing pain relief. They were quite willing to do it, but they had no idea it had been called for. If we'd just been patient and compliant, she'd not have received anything for hours, perhaps.
Title: Re: ER Etiquette
Post by: Miriam on October 20, 2011, 10:48:17 AM
I went to the ER when I was 19 because I woke up with a headache and couldn't move my left arm. It was weird, like I slept on it for so long it became permanent. The local ER nurse looked at me and said "Well she's too young to have anything neurologically wrong with her, she's fine, take some tylenol and go home."

The next morning I was unresponsive, so my mother drove me to another doctor. I had 3 seizures in that parking lot and didn't wake up for days due to a stroke. Yes, local ER nurse, I understand 19 years is a young age but you could have done better than that. I'm not attention seeking or after drugs but now I'm 22 and I still can't use my left arm and leg properly. All I needed was a head scan where you could see that 4-inch blood clot in the right frontal lobe so you could see I needed something more than tylenol.

I'm sure it has nothing to do with manners or etiquette but the response and turning me away could have left me permanantly disabled or hemorraged. Last year I was able to hold a soda can in my left hand for more than a minute and that's medically amazing. Simple things are medically amazing now!
Title: Re: ER Etiquette
Post by: LadyStormwing on November 19, 2011, 10:30:41 PM
Love this. If I had a dollar for ever ER visit I've had in my life...what can I say? I'm a clutz with no immune system.  ;D

1. Don't go at it alone. Bring a responsible adult with you - friend, spouse, parent, adult child, who can listen to the staff's instructions, make sure all the paperwork is complete, advocate for you when you're doped up on painkillers, and make sure all your duckies are in a line during the entire process.

2. I can't stress PATIENCE enough. No one else feels well either, you are going to be miserable, so you might as well make the most of it. When I was in for appendicitis, I wasn't sure what was causing more pain - my near-bursting appendix, the IV drip that wouldn't stop beeping because the fluid had run out, or the poor-yet-hilarious woman in the cubical next to me whose migraine treatment sent her out to left field somewhere. She wanted to go shopping, and thought the store was on my side of the room. Man, she wanted to go shopping! At one point she yelled at her husband, "You're not my keeper!" to which he hissed back, "You need a keeper!" (It was 2am, the poor man had had it.) I just couldn't stop laughing.

To health!
Title: Re: ER Etiquette
Post by: kherbert05 on November 20, 2011, 08:50:55 AM
Love this. If I had a dollar for ever ER visit I've had in my life...what can I say? I'm a clutz with no immune system.  ;D

1. Don't go at it alone. Bring a responsible adult with you - friend, spouse, parent, adult child, who can listen to the staff's instructions, make sure all the paperwork is complete, advocate for you when you're doped up on painkillers, and make sure all your duckies are in a line during the entire process.

2. I can't stress PATIENCE enough. No one else feels well either, you are going to be miserable, so you might as well make the most of it. When I was in for appendicitis, I wasn't sure what was causing more pain - my near-bursting appendix, the IV drip that wouldn't stop beeping because the fluid had run out, or the poor-yet-hilarious woman in the cubical next to me whose migraine treatment sent her out to left field somewhere. She wanted to go shopping, and thought the store was on my side of the room. Man, she wanted to go shopping! At one point she yelled at her husband, "You're not my keeper!" to which he hissed back, "You need a keeper!" (It was 2am, the poor man had had it.) I just couldn't stop laughing.

To health!

I agree that having someone with you is optimal, but not always possible. I was driving home from our farm and started having trouble breathing. I was right by Memorial City ER - so pulled off the freeway and into the ER parking lot. (Cousin's MIL stumbled and grabbed my arm at the farm. I'm 99% sure she must have been eating some food with peanuts in it. I had a mark on my arm and was having an allergic reaction to something.)

The ER people were a bit put out with me because they had to hold me longer than normal - because I had no one to take me home. Sis and BIL were at a movie (I didn't know this and left a message) and my cousins live in another town. I was about to call Cousin CC, when sis returned my call.
Title: Re: ER Etiquette
Post by: Garden Goblin on December 01, 2011, 11:20:32 AM
I love the local hospital.  I spend entirely to much time there due to various family members. 

Because I've been so often, I know the routines, know what info they need, and have what I can't recite from memory packed neatly into a manila envelope to hand over.  The nurses know me by sight and we have a good working relationship where their job is to make my family member healthy and my job is to keep my family member from being a cranky, uncooperative pain in the behind.  Since we work together, both jobs get done well and everyone gets to go home reasonably happy.

Recently a new nurse had to be taken aside by the supervisor and given the 'if you take 30 seconds to talk to the family member present and answer their question, they can make your life a lot easier.  If you brush them off and otherwise treat them like they are just there to annoy you, they can make your life a lot harder.' 

My family members have reactions to medications, which means that if I am present, you will be asked what you are giving them and unless you can give me a satisfactory answer (note - something to help them sleep is not an answer, I need drug/dosage and have myriad forms filled out that state I have the right to know), you will not be administering it.  I've discovered, unfortunately the hard way, that the nurses who won't give a proper answer to the question are much more likely to not have read all the way through the chart and be about to administer something for which the patient has documented unpleasant side effects, including full on allergies or complications with other conditions.   

I tried to tell her what my mother-in-law was going to need and kept getting brushed aside.  It was like a complete shock to that nurse to learn the elderly woman who fell also had MS and Sundowners, like a broken shoulder and MS were mutually exclusive conditions  ::) .  So, yes, while a broken shoulder doesn't ordinarily prevent someone from being able to stand, it's helpful to know if someone's legs don't work before answering a concern of 'I have to use the bathroom' with 'it's down the hall'.  Fortunately, I knew where the wheely commodes were kept and fetched one myself while summoning decent assistance.

There are a few nurses out there who need to get it through their heads that a patient who asks questions is not being difficult, and the five seconds it takes to give a decent answer is not a hardship.  Fortunately, given the environment at this hospital, new nurse is either going to have to shape up or ship out.
Title: Re: ER Etiquette
Post by: blue2000 on December 01, 2011, 12:15:45 PM
I love the local hospital.  I spend entirely to much time there due to various family members. 

Because I've been so often, I know the routines, know what info they need, and have what I can't recite from memory packed neatly into a manila envelope to hand over.  The nurses know me by sight and we have a good working relationship where their job is to make my family member healthy and my job is to keep my family member from being a cranky, uncooperative pain in the behind.  Since we work together, both jobs get done well and everyone gets to go home reasonably happy.

Recently a new nurse had to be taken aside by the supervisor and given the 'if you take 30 seconds to talk to the family member present and answer their question, they can make your life a lot easier.  If you brush them off and otherwise treat them like they are just there to annoy you, they can make your life a lot harder.' 

My family members have reactions to medications, which means that if I am present, you will be asked what you are giving them and unless you can give me a satisfactory answer (note - something to help them sleep is not an answer, I need drug/dosage and have myriad forms filled out that state I have the right to know), you will not be administering it.  I've discovered, unfortunately the hard way, that the nurses who won't give a proper answer to the question are much more likely to not have read all the way through the chart and be about to administer something for which the patient has documented unpleasant side effects, including full on allergies or complications with other conditions.   

I tried to tell her what my mother-in-law was going to need and kept getting brushed aside.  It was like a complete shock to that nurse to learn the elderly woman who fell also had MS and Sundowners, like a broken shoulder and MS were mutually exclusive conditions  ::) .  So, yes, while a broken shoulder doesn't ordinarily prevent someone from being able to stand, it's helpful to know if someone's legs don't work before answering a concern of 'I have to use the bathroom' with 'it's down the hall'.  Fortunately, I knew where the wheely commodes were kept and fetched one myself while summoning decent assistance.

There are a few nurses out there who need to get it through their heads that a patient who asks questions is not being difficult, and the five seconds it takes to give a decent answer is not a hardship.  Fortunately, given the environment at this hospital, new nurse is either going to have to shape up or ship out.

Can I borrow you sometime??

I get brushed off a lot by medical personnel, possibly because I look younger than I am. I have massive health problems at the moment, and the last time I went to the ER, the doctor shrugged it off as nothing major. It makes me want to smack them. Sadly, it is hard to aim a clue-by-four when you can't see straight. :P
Title: Re: ER Etiquette
Post by: Ambrosia Hino on December 01, 2011, 12:35:11 PM
I love the local hospital.  I spend entirely to much time there due to various family members. 

Because I've been so often, I know the routines, know what info they need, and have what I can't recite from memory packed neatly into a manila envelope to hand over.  The nurses know me by sight and we have a good working relationship where their job is to make my family member healthy and my job is to keep my family member from being a cranky, uncooperative pain in the behind.  Since we work together, both jobs get done well and everyone gets to go home reasonably happy.

Recently a new nurse had to be taken aside by the supervisor and given the 'if you take 30 seconds to talk to the family member present and answer their question, they can make your life a lot easier.  If you brush them off and otherwise treat them like they are just there to annoy you, they can make your life a lot harder.' 

My family members have reactions to medications, which means that if I am present, you will be asked what you are giving them and unless you can give me a satisfactory answer (note - something to help them sleep is not an answer, I need drug/dosage and have myriad forms filled out that state I have the right to know), you will not be administering it.  I've discovered, unfortunately the hard way, that the nurses who won't give a proper answer to the question are much more likely to not have read all the way through the chart and be about to administer something for which the patient has documented unpleasant side effects, including full on allergies or complications with other conditions.   

I tried to tell her what my mother-in-law was going to need and kept getting brushed aside.  It was like a complete shock to that nurse to learn the elderly woman who fell also had MS and Sundowners, like a broken shoulder and MS were mutually exclusive conditions  ::) .  So, yes, while a broken shoulder doesn't ordinarily prevent someone from being able to stand, it's helpful to know if someone's legs don't work before answering a concern of 'I have to use the bathroom' with 'it's down the hall'.  Fortunately, I knew where the wheely commodes were kept and fetched one myself while summoning decent assistance.

There are a few nurses out there who need to get it through their heads that a patient who asks questions is not being difficult, and the five seconds it takes to give a decent answer is not a hardship.  Fortunately, given the environment at this hospital, new nurse is either going to have to shape up or ship out.

Can I borrow you sometime??

I get brushed off a lot by medical personnel, possibly because I look younger than I am. I have massive health problems at the moment, and the last time I went to the ER, the doctor shrugged it off as nothing major. It makes me want to smack them. Sadly, it is hard to aim a clue-by-four when you can't see straight. :P

I agree, can we start borrowing you for ER trips? ;D
Title: Re: ER Etiquette
Post by: Larrabee on December 01, 2011, 01:23:01 PM
(note - something to help them sleep is not an answer, I need drug/dosage and have myriad forms filled out that state I have the right to know)

It was a great post, but can I ask you one favour?

Please forgive the nurses for saying 'something to help them sleep' the first time and ask for more details politely.

We're under a fair amount of pressure to get the balance right between not patronising the knowledgeable patients/relatives and not upsetting/confusing the less knowledgeable ones by using technical terms and jargon.

Title: Re: ER Etiquette
Post by: Garden Goblin on December 01, 2011, 06:38:20 PM
Please forgive the nurses for saying 'something to help them sleep' the first time and ask for more details politely.

'Please tell me what drug you are giving her/him/me' is my usual request, which I don't think can really be answered by 'something to make her/him/you sleep' if the nurse is actually paying attention to what is being said.  And if they aren't actually paying attention, they are more likely to be on autopilot and thus make this type of error and will respond with a quick and grateful 'oops' and a closer look at the chart.  Or they are inattentive and crummy nurses to start with and are just ignoring me and get angry if I get insistent.

With one nurse I had to go as far as to physically block her access to the IV in order to get her to answer, and her response was to try to summon security instead of just answering the question.  Sure enough, she was trying to give my sister something on the 'absolutely not' list.  My sister ended up just saying screw this and walking out AMA.  Terrible, terrible hospital with many horror stories.  When my cousin broke his leg and it was the nearest hospital, he told the ambulance to go away and had me drive him to a different city.  We got chewed out by the lady who admitted him at the ER until we told her why we'd come by car rather than ambulance, then she just sighed and nodded.  I had to threaten to pull the IV out of my arm to get an answer from one nurse at an otherwise good hospital.  Fortunately, that time the drug in question wouldn't have been an issue, but this was shortly after I'd been given codeine and had an...interesting...reaction.   While I know now that codeine isn't an IV thing, I didn't then.  Five seconds to answer the question instead of arguing with me, and the nurse could have made both our lives much less stressful.

It's sad, but being too polite in this instance to often results in me being talked over/ignored.  Fortunately, like I said, the current hospital is awesome and they all know me well enough at this point to give the right answer the first time (or start telling me what it is before I even ask). 

This thread just has me mentally counting up incidences and coming to the conclusion that I spend entirely too much time in hospitals for a healthy person.  And that I know entirely to many people in the '.01% of patients may experience X reaction' category.
Title: Re: ER Etiquette
Post by: heathert on December 05, 2011, 08:07:55 PM
Garden, 

I have to ask, because I'm going to be moving to a rural part of a state with a reputation of having notoriously bad hospitals,  how do you reccomend people advocate for others and themselves when they don't know anything about medical conditions?  I'm trying to prepare myself in advance.  :-\
Title: Re: ER Etiquette
Post by: kareng57 on December 05, 2011, 08:23:39 PM
(note - something to help them sleep is not an answer, I need drug/dosage and have myriad forms filled out that state I have the right to know)

It was a great post, but can I ask you one favour?

Please forgive the nurses for saying 'something to help them sleep' the first time and ask for more details politely.

We're under a fair amount of pressure to get the balance right between not patronising the knowledgeable patients/relatives and not upsetting/confusing the less knowledgeable ones by using technical terms and jargon.


I have to agree.  While I do have a medical background, it's pretty dated, and I don't automatically recognise the names/purposes of current drugs.

I see nothing wrong with firstly giving the purpose of the drug, and then the name, if the family member wants it.  Otherwise:  "what's the name of that drug you are giving Dad?"  "Promoxucillin" (I'm making it up).  "What's that?"  "It's an antibiotic, Dad has a mild pneumonia and we want to be sure that it does not progress".

The same with "something to help him sleep" - just because a nurse/doctor says this doesn't meant that he/she is being terribly patronising.  The relative who is asking could even be a retired pharmacist and not know the name of a new drug.
Title: Re: ER Etiquette
Post by: Garden Goblin on December 05, 2011, 08:41:41 PM
Garden, 

I have to ask, because I'm going to be moving to a rural part of a state with a reputation of having notoriously bad hospitals,  how do you reccomend people advocate for others and themselves when they don't know anything about medical conditions?  I'm trying to prepare myself in advance.  :-\

Get things in writing and have a witness.  If you don't think that will be possible, invest in a digital tape recorder and keep records that way.  (Do make sure the doctor knows that conversations are recorded).  Make the doctor put all diagnoses and instructions in writing and if at all possible, have them signed. 

Keep asking questions until you feel you understand the answer to your satisfaction.  Get copies of all your records (preferably electronically) and keep them in case you need a second opinion without delay.  Insist test results be explained to you.  Be a nuisance if necessary, abet a polite one.  Don't get shrill (you'll be dismissed as hysterical no matter the situation or how reasonable your concerns  ::)) but keep your tone firm.  If you want something done, phrase it as an instruction rather than a request.  "Excuse me, I need X" rather than "Please can I have some X". 

Go to the computer.  WebMD and the like can be a real asset.  It might not give you all the answers, but it can tell you what questions you should be asking.  Print things out and take them with you.  Get yourself a notebook if necessary to keep everything together, with some scratch paper for taking notes.  Keep in mind though, you can easily shoot yourself in the foot here.  Remember the adage 'If you hear hoofbeats, think of horses, not zebras'.  It's more likely you have the flu presenting in an uncommon way than it is for you to be suffering whatever you saw on House last week.

Be polite to nurses and admins.  In some ways, they know more than the doctors.

I have to agree.  While I do have a medical background, it's pretty dated, and I don't automatically recognise the names/purposes of current drugs.

I don't have a medical background, but I do know the commonly given drugs that members of my family have reactions to and enough to know what to ask in addition to ensure they are being given the right dosage.  If it doesn't sound familiar, I can then make the quick comment, 'will that react with the ____ the patient is on or with the _____ condition the patient suffers from?'  Then my concerns can either be quickly alleviated or the nurse can do a check, which at least 1 in 10 times results in the nurse either giving something else or having a discussion with the doctor.

Or I can give the nurse the quick warning of, 'you can give her Demerol if you like, but she won't be able to respond coherently at that point' and let the nurse determine if it's a good idea or if it's better to give Tylenol and wait an hour until the rest of the tests get performed.

They gave her Demerol in the hospital on Black Friday.  Yesterday she called me from the rehab center to ask how she'd got there, as she didn't remember anything between Thanksgiving dinner and waking up that morning.
Title: Re: ER Etiquette
Post by: kherbert05 on December 05, 2011, 09:42:21 PM
Garden, 

I have to ask, because I'm going to be moving to a rural part of a state with a reputation of having notoriously bad hospitals,  how do you reccomend people advocate for others and themselves when they don't know anything about medical conditions?  I'm trying to prepare myself in advance.  :-\
I have a basic medical history that I keep in my wallet, and another one is attached to my emergency contact card at work. My sister knows my history (was taught to recite it at a young age and I know her's)

A few years back they actually admitted me for an allergy/asthma attack because of chest pain and an irregular heart beat. They gave me something that nauseated me. Then they were going to give me something for the nausea that "would help me sleep". I told them no it would probably have me tap dancing on the ceiling. Sis showed up about that time. She confirmed to the nurse that I react badly to sedatives. She told them they needed to be prepared to restrain me if they gave it to me because I have tried to deck people and escape before surgery. I've also tried to fly off a third story balcony after taking something that is usually a sedative. They called the doctor and got orders for something that would stop the nausea but keep me up - I slept for 6 hours straight. 
Title: Re: ER Etiquette
Post by: kitty_ev on June 06, 2012, 04:43:11 PM
Garden, 

I have to ask, because I'm going to be moving to a rural part of a state with a reputation of having notoriously bad hospitals,  how do you reccomend people advocate for others and themselves when they don't know anything about medical conditions?  I'm trying to prepare myself in advance.  :-\

Also, don't forget that bad hospitals does not equate to bad clinicians. Hospitals are a lot about protocols and procedures- if these are bad even an excellent clinician will seem like a quack.


A current bugbear of mine- if you're going to A&E/ the ER I know it's a stressful and difficult time and you often are hanging around a while waiting to be seen. Staff know it's boring and that you need to keep people updated. We get that. However, our lives are made more difficult and your care gets delayed if you wander away from the department frequently or for long periods (or both). It delays your care and everyone else's care if clinicians have to spend half their time hunting for patients who've gone out "for a quick cigarette" and are gone for 30 mins or more. Popping out for 5 mins is fine, just don't make it much longer. Actually, this rule applies when you're admitted as well. Staff can't treat patients who aren't present.
Title: Re: ER Etiquette
Post by: RooRoo on October 09, 2012, 03:53:51 PM
Re: all those questions they ask

My memory is unreliable, so I keep an emergency medical information sheet with me at all times. It lists my emergency contacts, my allergies, my medications (including OTC), my doctors' phone numbers, my chronic conditions, and history (a list of my surgeries & childhood diseases). In other words, the answers to the questions they always ask!

It has "Emergency medical information" in big letters, and a red cross. I keep one copy in my cell phone case, which dangles off my purse. (Some EMTs are not allowed to look in your purse.) It has a clear window, and I fold the sheet so the "Emergency medical information" and red cross show. I also keep a couple of spare copies in my purse, to hand to the nurses who interrogate me.

I just made 4 extra copies, because I'm having minor surgery on Thursday. It saves both them and me time. And I have been thanked many times for handing it over, and even complimented for being foresighted.
Title: Re: ER Etiquette
Post by: rashea on October 09, 2012, 04:00:25 PM
Re: all those questions they ask

My memory is unreliable, so I keep an emergency medical information sheet with me at all times.

I love having one of those. I hate that it isn't big enough for all my surgeries.
Title: Re: ER Etiquette
Post by: Jules1980 on October 09, 2012, 05:11:55 PM
As a hospital worker, I love those lists.  It save so much time when I can just write 'see list' and attach it to the file rather than having to write it all down time after time.
Title: Re: ER Etiquette
Post by: JeseC on January 13, 2013, 07:53:12 PM
Be sensitive to patients with mental health problems.  This includes people presenting with self-inflicted damage resulting from mental illness.  A good referral to a mental health practitioner will do a lot more than fussing over how much of a bad idea that was.

My particular incident was a regular doctor rather than an ER, but I've heard many similar stories about problems in the ER, people being accused of "wasting time" or "being stupid," and the like.  Judging a mentally ill person for their symptoms does little more than encourage them to not seek help next time.
Title: Re: ER Etiquette
Post by: Garden Goblin on January 14, 2013, 08:40:52 AM
Re: mental conditions (along with a few other things)

Quick note to certain members of a particular hospital's staff - depressed does not equal stupid or deaf.  Bipolar does not equal hard of hearing or come with an inability to understand words larger than two syllables.  Hard of hearing does not mean blind.  Blind does not mean deaf and/or stupid.  Mildly retarded does not automatically equate to unable to dress or feed oneself, nor does it mean diapers.  Schizophrenic does not automatically equate to violent or suicidal.  And for the love of little green frogs, anxiety disorders DO mean don't keep a person in suspense or keep reminding them that whatever problem they had could be/get a lot worse.
Title: Re: ER Etiquette
Post by: PurpleFrog on January 14, 2013, 08:58:56 AM
Please don't shout at me when I tell you that it's only been 20 minutes since your last dose of pain meds and I can't give you more yet. I'm legally not allowed to kill you.

Please don't tell me you have a pain score of 9 or 10 while lieing serenely and reading a magazine, I will have to note that you are showing no signs of serious pain and query drug seeking behaviour.

Do not enter other patients rooms/cubicles

Please, if a frail older patient is in a room alone and staff have left the door open so we can see her at all times, do not take it upon yourself to close the door becuse 'you don't like seeing sick people'.

Finally: when there has been a widley publicised major incident, with mulitiple injurys and casualties think twice about calling an ambulance for somthing minor. If  you do call an abulance and are sent to a peripheral hospital as the major hospital is closed due to said incident do not shout at staff because you are a long way from home. Once you have been discharged and you have to wait for an ambulance home (due to mobility issues) it will take a while, you going out of area and most of the ambulances are still tied up with said major incident. Asking every 15 minutes will not make it come quicker.

During a major incident all hospitals in the area will be busier, we can't help it.

Finally: when the poilce & other emergency responders who have completed their shifts, despite their own injurys and distress at this major incident, drag themselves 20 miles to us so as not to put extra strain on the already streached major hospital, you can bet we're jumping them to the front of the Que, before the earache/fell over drunk/random non urgent illness, yes its favoritism, but you know what tough.

Title: Re: ER Etiquette
Post by: snowdragon on January 15, 2013, 05:07:25 PM
Just because you can't see the problem does not mean it's not more serious than your problem - they will be jumped to the top of the list,  be thankful you are not that bad.

Just because you are X age does not mean you  go first, old or young.  again be thankful you are not at the head of the line.
Title: Re: ER Etiquette
Post by: ladyknight1 on January 15, 2013, 05:54:08 PM
This applies to hospitals as well as the ER.

The vast majority of hospitals are now no-smoking for the entire property. My uncle had a tantrum over that rule when he was visiting my great-uncle.
Title: Re: ER Etiquette
Post by: mmswm on January 15, 2013, 07:37:37 PM


Please don't tell me you have a pain score of 9 or 10 while lieing serenely and reading a magazine, I will have to note that you are showing no signs of serious pain and query drug seeking behaviour.



On the other hand, a person with major, chronic pain issues can quite legitimately be quietly reading a magazine and still have a pain level of 9 or 10.  When you're 10 or 13 years old and quite literally have never known a  pain free moment in your entire life, you learn to deal with even major pain in ways that make no sense to "normal" people.  Please believe the parent or other person accompanying the patient when they tell you this. 

This is a bit of a bad spot with me.  My youngest son suffered unimaginable pain for months because I couldn't find a doctor that would believe him.  When I finally drove him 4 hours to the nearest major city's children's ER, I finally met a doctor who did the appropriate diagnostics and figured out what the critical problem was. This is the same child that did two weeks of PT after major hip surgery, relearning how to walk, on an undiagnosed broken foot, and never complained about foot pain.  This kid is one tough cookie.  I firmly believe that his "6 or 7" on the 1-10 pain scale would probably kill us puny mortals.
Title: Re: ER Etiquette
Post by: blue2000 on January 15, 2013, 09:28:26 PM


Please don't tell me you have a pain score of 9 or 10 while lieing serenely and reading a magazine, I will have to note that you are showing no signs of serious pain and query drug seeking behaviour.



On the other hand, a person with major, chronic pain issues can quite legitimately be quietly reading a magazine and still have a pain level of 9 or 10.  When you're 10 or 13 years old and quite literally have never known a  pain free moment in your entire life, you learn to deal with even major pain in ways that make no sense to "normal" people.  Please believe the parent or other person accompanying the patient when they tell you this. 

This is a bit of a bad spot with me.  My youngest son suffered unimaginable pain for months because I couldn't find a doctor that would believe him.  When I finally drove him 4 hours to the nearest major city's children's ER, I finally met a doctor who did the appropriate diagnostics and figured out what the critical problem was. This is the same child that did two weeks of PT after major hip surgery, relearning how to walk, on an undiagnosed broken foot, and never complained about foot pain.  This kid is one tough cookie.  I firmly believe that his "6 or 7" on the 1-10 pain scale would probably kill us puny mortals.

I can believe it. I have dealt with pain that I half-jokingly qualified as '85' on a scale of 1 to 10. My default response to pain is to kind of curl up and shut down. A magazine would have been nice to take my mind off things.

However, I wasn't asking for painkillers at the time, so drug-seeking wouldn't be an issue.
Title: Re: ER Etiquette
Post by: PurpleFrog on January 16, 2013, 03:24:18 AM


Please don't tell me you have a pain score of 9 or 10 while lieing serenely and reading a magazine, I will have to note that you are showing no signs of serious pain and query drug seeking behaviour.



On the other hand, a person with major, chronic pain issues can quite legitimately be quietly reading a magazine and still have a pain level of 9 or 10.  When you're 10 or 13 years old and quite literally have never known a  pain free moment in your entire life, you learn to deal with even major pain in ways that make no sense to "normal" people.  Please believe the parent or other person accompanying the patient when they tell you this. 

This is a bit of a bad spot with me.  My youngest son suffered unimaginable pain for months because I couldn't find a doctor that would believe him.  When I finally drove him 4 hours to the nearest major city's children's ER, I finally met a doctor who did the appropriate diagnostics and figured out what the critical problem was. This is the same child that did two weeks of PT after major hip surgery, relearning how to walk, on an undiagnosed broken foot, and never complained about foot pain.  This kid is one tough cookie.  I firmly believe that his "6 or 7" on the 1-10 pain scale would probably kill us puny mortals.

We do take this into account, and past medical history will be considered, in cases with no past medical history in a&e we can't jump straight to morphine etc for someone with no medical history who appears a-symptomatic. Even gas and air is addictive, so we ha e to be cautious with undiagnosed pains.
Title: Re: ER Etiquette
Post by: RebeccainGA on January 16, 2013, 09:13:21 AM
Having been through all I've been through with DP, I so agree with the medical history information - I can rattle it off, thankfully, and have two versions, the 'nurse doing intake' short version and the 'doctor that really needs to know' long form. If you can't rattle it off, or fear you may be unconscious, then get it down and put it somewhere it can be found. Most phones can have an ICE program added to them, which can contain medical information, contacts, etc. for emergencies. DP's entry on her phone is MASSIVE. Mine is short. Both of us have it, though.

Advocating for yourself/someone else - I had to get the medical director of the hospital involved with DP's care once. I'm actually writing a 'how to' kind of book for families of long term hospital patients because of the things I had to learn the hard way - there just aren't any resources out there for families. Dr. Google can actually be useful IF you are using it the right way - as a way to learn what the terms the doctor uses mean, to learn about the side effects of  medications (and why they may be given), and as a 'are we looking for this condition with this test?' check. You can't (or shouldn't) diagnose yourself or someone else with a Google search, but you certainly can use it to get some background and understand what's going on better.
Title: Re: ER Etiquette
Post by: mmswm on January 16, 2013, 09:59:03 AM


Please don't tell me you have a pain score of 9 or 10 while lieing serenely and reading a magazine, I will have to note that you are showing no signs of serious pain and query drug seeking behaviour.



On the other hand, a person with major, chronic pain issues can quite legitimately be quietly reading a magazine and still have a pain level of 9 or 10.  When you're 10 or 13 years old and quite literally have never known a  pain free moment in your entire life, you learn to deal with even major pain in ways that make no sense to "normal" people.  Please believe the parent or other person accompanying the patient when they tell you this. 

This is a bit of a bad spot with me.  My youngest son suffered unimaginable pain for months because I couldn't find a doctor that would believe him.  When I finally drove him 4 hours to the nearest major city's children's ER, I finally met a doctor who did the appropriate diagnostics and figured out what the critical problem was. This is the same child that did two weeks of PT after major hip surgery, relearning how to walk, on an undiagnosed broken foot, and never complained about foot pain.  This kid is one tough cookie.  I firmly believe that his "6 or 7" on the 1-10 pain scale would probably kill us puny mortals.

We do take this into account, and past medical history will be considered, in cases with no past medical history in a&e we can't jump straight to morphine etc for someone with no medical history who appears a-symptomatic. Even gas and air is addictive, so we ha e to be cautious with undiagnosed pains.

Unfortunately, based on my admittedly unscientific study of "all the ER's I've ever had to deal with", you guys would be the anomaly, not the rule.  I wish all ER's were run like you've described yours. *sigh*
Title: Re: ER Etiquette
Post by: Piratelvr1121 on January 16, 2013, 07:29:01 PM
I've had good and bad experiences with ERs.  We actually have a good hospital near us but in our previous county it was wretched.  DH once went to the ER for some gallstone pain. He knew it was gallstones because his usual doctor had diagnosed it.   But the jerk in the ER looked at him and said "Oh it's just from hyperventilating, it's something you kids do."  ???  DH insisted he hadn't been hyperventilating and the guy insisted he was and sent him home.   The hospital itself wasn't bad, as DH ended up having his gallbladder surgery there and it went well.

The good ER experience we had there though was when Pirateboy2 was 2 years old and had a febrile seizure.   The daycare called me to let me know that he was running a high fever and could I come get him?  I called DH, and he said "Don't worry about it, I'm home so I'll pick him up.   Well then I got a call from DH not long after telling me to meet him and Pirateboy2 at the ER because the little guy had a seizure.   My supervisor thankfully had no problem at all with me leaving right there and then. 

I was already pretty darn shaken when I got there and they were very good about blocking me from being able to see his little body shaking uncontrollably.  Whereas some kids just have one seizure then it's over, he kept having them until they were able to give him something to stop the seizing.  Then one of the nurses came out and told me they were going to do a spinal tap, and explained how it was done without being condescending.

I think DH was even more terrified than I was since I understood what a febrile seizure was, as I had one at that age too, but DH had never heard of them before, so when he put PB2 in his car seat to take him home from the daycare, and the child's eyes rolled back in his head and he started to shake, it really scared him.  Thankfully he had his cellphone in his pocket so he was able to call the day care directors for help so they came out, called 911 for him and I think one or two stayed with him until the ambulance came.   The ER staff on call were great with PB2 in helping him to stop seizing and they were a great support for us too.
Title: Re: ER Etiquette
Post by: Doll Fiend on April 06, 2013, 10:05:49 PM
Just last weekend I was in the ER. I had horrible pain but didn't expect anything more than some pills a little stronger than OTC pain pills. Got morphine. Was waiting and had some one come in and start to quiz me in my altered state. Guy wanted what I was getting. (3 IV's) I did thank the nurse who got rid of him for me.

Please, please, stay out of other people's areas. I don't remember everything but I was scared by it all.