ER Etiquette

[Jules1980]

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. 

[Wonderflonium]

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.

[Phoebelion]

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. 

[Rohanna]

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.

Unfortunately sometimes you do need to be your own advocate. Whether or not the staff was at fault, I would still be buzzing/sending family to ask if I was left for that long. It's one of those things- yes, maybe the should be more on top of it, but what do you want, to be right or to get help?

A LOT of people come to the ER claiming pain who really aren't feeling as badly as they claim. If you aren't a squeaky wheel, they may try the "wait and see" to see if you are really telegraphing pain or just looking for meds. You may have been waiting for bloodwork to see if giving you pains meds was appropriate, or for the doctor to review your chart and order it (nurses can't just "give" you meds- it needs for your attending physician to review you, then order tests, then decide what the nurse can administer). So your nurse may be chatting while you wait- but she may be chatting, while at the desk waiting for the doc to make his way around to you. That is where asking comes in - has something been ordered or are we waiting? What's happening with me. A bad nurse will snap at you, a good one will say - your chart is with the doctor/we're waiting on the lab/etc. I don't mean ask every 30 seconds, but after hours of waiting I would be asking what my care plan was.

[Wonderflonium]

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.  )

[Danismom]

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.

[Twik]

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.

[Miriam]

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!

[LadyStormwing]

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. 

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!

[kherbert05]

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. 

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.

[Garden Goblin]

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.

[blue2000]

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.

[Ambrosia Hino]

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.

I agree, can we start borrowing you for ER trips?

[Larrabee]

(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.

[Garden Goblin]

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.