10/10-16 National ER Nurses Week

By Diane Forrest, RN

You might work in an ER if...

• You've ever had to contend with someone who thinks constipation for 4 hours is a medical emergency...
• You've ever entered a patient's chief complaint as "I'm drunk"...
• You refer to motorcyclists as "organ donors"...
• You've ever had a patient with a nose-ring tell you "I'm afraid of shots"...
• You stare at someone in utter disbelief when he or she actually covers his or her mouth when coughing...
• You've ever thought "as long as he's got a pulse, I won't worry about that rhythm."...
• You've ever referred to a body bag as a "To Go" bag...

• You think of chocolate, coffee, Coca-Cola® and the cafeteria's frozen yogurt when anyone mentions the 4 food groups...
• You think that the announcement of an impending arrival in 5 minutes of two adults in a serious MVA on backboards with sirens on and anxiety a level 10 would be a great opportunity to eat lunch...
• You have ever heard triage nurse first ask, "Is it urgent?" when interrupted from the first break in hours...
• You have four categories of patients...urgent, emergent, non-emergent, and S.I.O. (sleeping it off)...
• You automatically multiply by 3 the number of drinks they claim to have daily...
• You feel that you can diagnose passersby at the mall based on physical presentation...
• You don't have to ask "frequent flyers" any medical history questions because you can fill it out from memory...
• You can keep a straight face as the patient responds "Just two beers"...
• You give the local drunks tips on where to sleep so they (and you) won't be disturbed by a return visit

The other day I was telling you about Pediatric Nurses Week, and the important work these nurses do.  Well it is also Emergency Nurse's Week.  These nurses are amazing.  They never know what to expect from one minute to the next.  They see people who come in with colds, to patient having heart attacks, to accidents, gunshot wounds, or victims of other crimes.

There have been many security changes for the ER as well, patients come in wanting drugs pose a serious security risk.  Psychiatric patients can be harmful as well.  Each emergency room I have ever visited has their own security staff for these reasons.

Emergency room nurses have to be knowledgeable about every possible illness or injury be able to comfort and calm the patient and family member.  In the past year my husband was transported the ER on 4 occasions.   Luckily I knew and or worked with several of these nurses, so the process was fairly easy.  I was able to provide all the necessary information as well as take care of him while he was having tests run, freeing up the nurse to take care of other patients.  However most of the patients that enter the ER are not as prepared.

Emergency room nurses deserve this week of celebration and honor.  They could be the one to save your life

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Rules for the Emergency Room

• Here are some tips to those who may end up in an ER, be it yourself or a family member.
• If it requires the ambulance team and entire truck crew of firefighters to transport you and safely place you on a hospital stretcher, it is time to go on a diet.
• When you present to the triage nurse, do not tell him/her that your doctor called ahead. If you survey our waiting area, probably 50% of the people waiting said the same thing, and the other 50% use the ER as their regular doctor.
• Never start out by saying, "I was searching the Internet . . . "
• When asked how much you weigh, please do not give the "Deer-In-The-Headlights Look", and tell us you "really don't know". It's a simple question with a simple answer.
• Just because you have a phone and know how to call 911, we are not impressed by your arrival on an ambulance stretcher. You had better be sick.
• If you came escorted via EMS for multiple complaints that started more than one week ago and your entire family followed the ambulance to the hospital, you will be labeled a ninnie and treated like one, enjoy the waiting area with your family.
• One complaint/ailment per visit, please.
• Just because you came in on a ambulance, doesn't mean you're going home on one. You better start making arrangements, now. I am not driving you home, or figuring out how to get you home. Cab vouchers are not an option.
• If you have one of these four, go to your own doctor in the morning: A Migraine; the Flu; a stomach virus; or a stuffy nose.
• Do not ask us how long it will be. We don't know. I don't know what is coming through my door 30 seconds from now,so I sure as hell don't know when you're getting a room.
• We have priorities. We understand that you have been waiting for two hours in the waiting room. If you don't want to wait, make an appointment with a doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. That is why she goes first.
• If your mother is a patient and we ask her a question, let her answer it.
• If your child has a fever, you had damn well better give him Tylenol® before coming in. DO NOT let the fever remain high just so I will believe the child has a fever. Do you want your child to have a seizure? Do you?
• If you are well enough to complain about the wait, you are well enough to go home.
• Do not utter the words "it is in my chart", I don't have your chart, and I don't have the time to call and get it. Just tell me. It is faster.
• We know how many times you've been to an ER. We can usually tell if you are faking it during the first 5 seconds of talking to you. Do not lie to us. If you lie about one thing, we will have to assume you are lying about everything. You don't want that.
• If you have diabetes and do not control it, you are committing slow suicide.
•  If you are a female between 16 and 42 and your last period was between 28-35 days ago, please don't waste our time if you are here for Abdominal Pain & Vaginal bleeding. Guess what!!?? You got your period, again.
• Do not bring your entire posse with you. One person at the bedside is all you need. It is really difficult to move around seven people who are in the way if you are really sick.

• Every time I ask you a question, I learn more about what is wrong with you. I don't care if I asked you what day it is four different times. Each time I ask, it is for a reason. Just answer the questions, regardless whether you have answered them before.
• If you want something, be nice. I will go out of my way to piss off rude people.
• Our definition of sick is not your definition of sick. If a member of the ER staff says that someone is sick, it means that they are in the process of DYING. They have had a massive stroke, are bleeding out, having a heart attack, or have been shot. We don't consider a kidney stone, sick. Painful, yes. Sick, no.
• At any given time, one nurse has four patients. One doctor has up to 15.
• There is a law (similar to Murphy's) in the ER. If you have four patients: one of them will be sick (see above for definition); one of them will be whining constantly; one of them will be homeless; and one of them will a delightful patient. (don't be the whiner). Please.
• If you see someone pushing a big cart down the hall at full speed and you hear bells going off, do not ask for a cup of coffee. Someone is dying, you inconsiderate a*****e. In the ER, bells don't ring for nothing. Sit down, shut up, and let us work.
• If you can bi**h about the blood pressure cuff being too tight, or the IV hurting, you are not in that much pain.
• Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonald's®, and you very well may NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets, and the lights dimmed, go to the Ramada®.
• If you have any sort of stomach pain and you ask for something to eat, you are not sick.
• Do not talk s**t about the other members of staff I work with. The doctor that you hate? I work with him every day, and I know that he knows what he is doing. I trust him a lot more that I trust you. I am not here to be your friend, and neither is he. I will tell him what you said, and we will laugh about it. If you want a buddy, go somewhere else.
• If you are homeless, don't ask for a bus token or cab voucher to get home. It just confuses the staff.
• Please don't tell us how to do our job. Do we go to your place of business and tell you how to do your job?
• Please don't bring in a "show and tell". If you have to fish it out of the toilet, it's really not necessary to bring it in; we will take your word. If you did fish something out of the toilet, you may not use my pen.