ER Etiquette

[kitty_ev]

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.

[Calypso]

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....

[VorFemme]

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]).

[Eisa]

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. Barely!

[kitty-cat]

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.

[Wavicle]

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).

[Danismom]

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.

[Piratelvr1121]

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.

[kitty_ev]

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!

[kitty-cat]

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.

[iridaceae]

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.)

[Wonderflonium]

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. 

[dawbs]

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)

[Larrabee]

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.

[Wonderflonium]

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.