Patient Rules in the ER...

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erparamedic

Vampire Girl......er Dork
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Indianapolis, IN
I received this via email, and thought I'd share. There's plenty of people on SB that are in the medical field that will appreciate the humor (and truth!!).

Patient Rules in the ER

*Don’t tell me you have abdominal pain as you eat Doritos in my triage booth.
*If you came to the ER by ambulance, the first thing I will ask you is how you are getting home. No, we don’t have people on staff to drive you home, and don’t tell me you don’t want to “bother” one of your family members at this hour. You had no problem bothering 911 for the back pain you’ve had for 3 months.
*You don’t get to pick your own IV site. This will irritate me and I will probably miss your IV on purpose and start your site in the place I wanted to initially to prove a point.
*“Butterfly” is not and IV size, this word signals me to put in a large bore needle.
*Nausea is not a reason to come to the ER. If you are not in severe pain, are not vomiting or pooping your pants in front of me, you butt goes back to the waiting room.
*How can you have the worst migraine of your life, but be able to yell at me about the wait after you just put down a magazine you were reading?
*Don’t ever say things like, “I usually get 4mg of Dilaudid.” Requesting your med and dosage will prompt me to squirt out half of the med before I inject, then I lie about the dose.
*If you are allergic to Tylenol, toradol, and motrin, I have already assumed you are a drug seeker.
*If you came to the ER having a family doctor appointment that same day, I will make sure you are still in the department well past the time of your original appointment.
*I don’t care if you are neighbors with the GI specialist. Unless he drove you to the ER himself, you can’t be that friendly.
*Just because, “my doctor sent me here,” does not mean you get right back to a treatment room. This tells me you are a pain in the ***, and he’s pawning you off.
*The louder you moan/whine, the bigger size IV needle you get.
*Foley catheters cure pseudo-seizures. They also cure intoxicated persons.
*If you are on more than 2 medications at home, bring a list. Don’t say, “you know, the little white pill.” I am not a pharmacist or a mind reader.
*RN/ PST/LPN/SNE/or Medic is not synonymous with waiter/ waitress.
*Don’t ***** about missing breakfast when I’m on the ninth hour of my shift and haven’t peed yet.
*What give you the right to complain about you sore throat for a weeks while I have diarrhea from the antibiotics I’ve been taking for pneumonia?
*Broken toes are not an emergency. We’ll make you feel stupid by putting little piece of tape down there and kicking you out.
*I am currently inventing a trapdoor system in triage to be triggered when you say the word “toothache.”
*Cover your mouth when you cough/ belch. This is just common courtesy. When you neglect to do this, I am tempted to bust butt in your room, then close the door.
*If you tell me you have fibromyalgia or chronic fatigue syndrome, know that I’m rolling my eye and thinking you’re a loser.
*If you list Haldol, Geodon, Xanax, and Trazadone as medications, don’t tell me you have no psych history.
*Never sign in with chest pain because you were too embarrassed to write “penile sores” or “foul smelling discharge.” This will piss me off that I jumped you ahead of other people and I’ll make your visit horrific.
*Although you’ve been in the ER four times this week, you cannot list the doc as your family physician.
*Do not talk to me while I’m trying to listen to your lungs.
*Don’t tell me you have no money for medicine while you have a carton of cigarettes in your purse (next to your cell phone), and each of your seven children are playing their own PSP’s.
*Gravida 7 at age 22 means you are a sl**.
 
Having just finished two horrific night shifts, there is way too much truth in a bunch of these.

The woman who showed up at 11:30 last night to get her foot x-rayed because a car ran over it TWO WEEKS AGO redefined emergency, at least as I understand it.

And our admitting clerk spent about four hours trying to find a route home for a woman who came in the ambulance with her sister, and then her sister got transferred to another hospital and this gal didn't have a way home. No car, no money, no friends . . . And somehow it was our responsibility to find her a ride that wouldn't cost her anything, to a city 30 minutes away. Sigh. How do these people survive?

And writing prescriptions for Tylenol (so Medicaid will pay for it) for people who have a pack of cigarettes in their pocket that costs more than generical Tylenol does really frosts me. But I do it, because I'm afraid they won't treat their kid if I don't.

Ah, those would be funny if they were funny, those things on your list!
 
I'm not in the ER, but am in a health related profession and I have to go to the Dr. quite often with my clients....you hear a lot while sitting in the waiting room. Feel for all of you that have to put up with it.

Sometimes I even hear stuff like this from people I've worked with. My favorite (a little off topic, but I'll share anyway)...a woman who is supposed to work the night shift, from 11P-7A calls in at 10:30PM...."Sorry, but I cannot come to work tonight." When asked if everything is all right she responds "It is my Birthday tomorrow, I do not want to work."...Hello? you just remembered at 10:30PM that it's your birthday tomorrow? Stuff like this happens aaaaallll the time...I wish our company wasn't so hard up for staff..:shakehead:
 
Then there was the night that the bus load of hemophiliacs overturned on the nearby freeway as a result of colliding with a bus load of osteoclasts.
 
i always worry when haldol is on the allergy list.

it was the first med i ever gave back in nursing school. i spent all day spying on that lady (in for a hys as i recall) waiting for the tardive dyskinesia.
 
Some of my old favorite truisms(for paramedics) are:

The most obese patients will always be the furthest possible distance from the ground. Anyone that has ever used a stair chair for more than 2 flisghts of stairs feels my pain here.

Air goes in and out, blood goes round and round.... anytime that changes its a bad thing.

And(I swear to the Gods that brought me Helium I was told this by my first partner) If its wet, sticky and not yours don't touch it!!!!!
 
Just yesterday I had a guy in the ED demanding an emergency psychiatric evaluation because he had a disability form that he wanted filled out. This was after having been fired from a job he'd only held for 3 weeks that included disability insurance as a benefit. He'd been able to coordinate transportation (in an area with no public services at all), selected our ED instead of the one nearer to his home (since they're served by the community mental health center instead of a private psychiatrist), previously contacted my office about an appointment (and lied on our standard intake question about whether he was seeking disability) but didn't want to wait 2 weeks, enlisted the services of a "disability specialist" to come in with him, navigated the registration process with aplomb, and had no difficulty in the crowded waiting area for a prolonged duration. He was flabbergasted at my assertion that there's no such thing as a psychiatric paperwork emergency. I certainly did do an evaluation for any emergency psychiatric conditions, but not a disability exam. His only real psychiatric disability appeared to be an inability to understand that my main purpose in life wasn't to ensure he had an uninterrupted income.

When I got back to my office, I saw a patient who'd patiently waited 2 hours beyond the end of her scheduled appointment. Despite working full-time, she often doesn't know where her next meal is coming from since her mother's and kids' needs get met first. She's embarrassed that we arrange for free medications for her, and once tried to give me her only Christmas present (a coffee mug) because we don't charge her for visits. This lady tends to assume she is a nuisance. ER-disability-guy probably is incapable of seeing that erparamedic's list is about people like him.
 
Not only true from ED but also true from a EMS point of view. Too many patients at 3am that either hurt themselves days/weeks ago, or there is the chest pain that started a 10 the previous morning. Not to mention the drunk that totaled there car, and only had 2 beers, it it amazing how many people in the world that only drink 2. But what gets me the most is the person that tells you there is no medical history but the give you a shoebox full of Rx medications or a list that fills a piece of paper front and back.
 
I'm LMAO! I have seen most of those people, I swear.

I was in the ER lobby, after my mom broke her wrist last year. There was a woman (accompanied by her husband/boyfriend/whatever) wandering around the room, coughing loudly (and wetly). Her male partner quietly told her to cover her mouth and she yelled at him, "I feel sick so everybody else is gonna suffer, too."

Being in law enforcement for over half my life, I can feel your pain.
 
LOL!!

I just got home from work, and it never ceases to amaze me why people come to the ER!!

Today:

A 31 year old lady came to the ER and her chief complaint was: "I think I'm pregnant." No pain, no bleeding, no "problem" of any kind... she just wanted a pregnancy test! ARRRGGHH!
I had a patient that was a very rude, crotchety, mean old man.... he made gouging my eyeballs out look appealing! (That story it waaaay too long to write about!)
There was a "code brown" that was enough to make me puke my dinner from last night! (None are good... but some are just plain.... well, there's not a word for it!)
A 22 year old came in for a "cut" that he received at a bar last night (it had been about 14 hours prior to coming to the ER)... this "cut" could not be sutured cause it had been too long, and now he has a nice wide hole in his head that will take forever to heal... oh, yeah... and he didn't wear any shoes! He says they got stolen when he got his butt kicked.... 14 hours ago!!!

Also... I spent 10 years on a fire department; first as an EMT, then Paramedic... and for the medics that have posted.... I can 100%, completely agree with your posts. It is very true for EMS! One "rule" was forgotten though... Not only will the most obese person be as far as possible from the ground floor... but they will also be in the smallest car made, and require full extrication! (Nothing against the obese... just observations)

What happened to common sense? Where/when did people lose it? Every time I think I've seen it all... I see something new and even more mind boggling!
 
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