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  1. #1

    • Angel Fan MC Man
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    Some "friendly" advice on the topic of your health

    My wife is an Emergency Room nurse. She saw this letter on the "best of craigslist" and thought you might get a chuckle and perhaps learn something. I've slightly edited the piece to make it a bit more"family friendly".

    From an anonymous RN...

    People, I am a triage nurse at a busy Emergency Room. I have a lot to say. . .

    Do NOT come up to the front desk of the Emergency Room, fling your health insurance card at me, tell me that your doctor told you to come in, stand there with a bored expression on your face and cross your arms over your chest. That is not helpful. When I ask what you are specifically here for do not repeat that the Doctor told you to come in. When I ask what SYMPTOMS caused you to come in; Do not say that it’s in the computer. Ahem;

    There are 16 people behind you all sicker than your whiney morbidly obese smoking arse. I’m not going to take the 8 minutes to log onto the computer, log my way in and through your medical record until I get to the part where your doctor’s phone nurse writes “This a**hole smoker called me because he’s got a cough” Just tell me that you’re here for the cough!

    If your spouse (usually the sensible one) drags you in for the stroke that you had 3 days ago and you still have facial droop, slurred speech, and one-sided paralysis do not state that “My wife made me come in” when I ask why you’re here. Just tell me what you’re here for. And after I put you in line to go back to the ER do not send your cringing hand-wringing co-dependant family members up to me every 15 minutes to ask if it’s your turn yet. IF IT WAS YOUR TURN WE WOULD BE CALLING YOUR G** D*** NAME. The window for stroke treatment was 3 hours. Now that you’re long past it you’re looking at a lengthy rehab. After 3 days another hour or four won’t make a lick of difference. Your anger, frustration, worry, and regret will not get you in any faster. As the slow truth of your stupidity sinks in do not glare at me.

    Do not ask to talk to my supervisor or the hospital supervisor when I talk to you in the same tone of voice that you talk to me. This is not Burger King, you do not get it ‘Your way right away.’ The squeaky wheel does not always get the grease. Do not excessively first name me just because I’m required to wear a hospital badge. Including my full name in every sentence is a shallow manipulation, an implied threat that unless you get your way another personally directed customer complaint is forthcoming. I am not stupid. Your threats annoy the s**t out of me. Making it personal does not change the 3 hour wait. Making it personal may result in the oft-used ‘Therapeutic wait’ (reserved for true a**holes). You do not want a therapeutic wait.

    Don’t cough in my face. Being in a hospital does not automatically excuse you from the social expectations that we as society have had of you since you were three. Do not be like the drunks who tell me that “If you didn’t want to be coughed (s**t, spat, vomited, bled, pissed) on you shoulda’ been a carpenter” If you continue this behavior do not be surprised when I throw a towel over your face while you are in mid-cough or mid-sentence.

    Do not tell me that you “Can’t breathe” in long rambling 20 word sentences. In the ghetto that may mean something different, Here in the ER we have different standards for what it really means to not be able to breathe. My bar of not breathing will be reset weekly by the people that are truly blue and/or about 30 seconds from coding from lack of Oxygen. There are people whose lungs are so diseased and scarred that they barely exchange oxygen on a good day with the help of their home oxygen tanks. These people come in and let their bodies do the speaking for them. They eloquently slump over their wheelchairs (or the ambulance gurneys) and are never so whiney about it as the 23 year old single smoking mom (of 4 kids by 4 fathers) who has been nursing an upper respiratory infection for a week or two.

    Similarly, do not tell me that little Shantiqua is ‘bleeding bad’ with her 1cm cut, that your crummy pain is 10/10, that you are suicidal when you took 3 Tylenol instead of 2 (gasp!) after mommy grounded you, or that because your emergency is the worse that you’ve ever had, that it’s the worst that could possibly happen in the sum total of human experience. I’m supposed to act like your story is the saddest tale that I’ve ever heard. It’s not.
    Sad? Sad is when the drunk driver that killed the kids is unhurt. Sad is when someone is actively psychotic but still lucid enough to know that they have driven away everyone in their life and ruined everything with their madness. Sad is listening to the same beautiful young woman beg for some medicines that will stop the hallucinations while crying in frustration and screaming her angst. Sad is when people pull up to the front of the hospital with a dead relative in the passenger seat of their car. I mean this guy had been dead for 15 minutes and the family only then focused on driving to the hospital. Did they pull over and call 911 in an area where the average response time is 5 minutes? No. Did they do CPR? No. Did they expect me to single-handedly yard this 265 lb guy out of the car, into a wheelchair, back to the ER, do CPR, code him just like on TV, and make a miracle happen? Yes! Yes that’s exactly what they expected. I sat there with my fingers stuck in his throat where his pulse should have been and said “He’s dead, he’s been dead for 15 minutes. What is it that you expect us to do?” We argued over his blue/gray corpse for about a minute before I reluctantly took him back to the ER and started the rain dance. Guess what? After we abused his corpse for 20-30 minutes (not my decision) he was STILL DEAD. Who would have thought?

    Yes, I know what’s going on tonight. I’ve seen your exact symptoms hundreds of times. I order your X-rays, labs, ECG, and then read/interpret them (and you) before deciding where you’re sent. The whole model of my HMO’s emergency service (and the withholding of that service) is built on our clinical judgement. I am not (nor do I want to be) a doctor and I am not allowed to ‘diagnose’. Yet my job responsibilities and description require me to do exactly that in order to facilitate care. This arrives us at a legal fallacy where we (nurses) all pretend that we don’t know what’s going on and that “you’ll have to talk to the doctor” in order to keep our jobs and licenses. When we do tell people exactly what’s up, they use that to decide to leave (without seeing a doctor = legal mess), or argue ( = pain in my backside), or press for more medical advice, or complain, or ask for special treatment, or otherwise cause problems. Tired of not being told what’s up by the person with the knowledgeable smile? Tough. No, I’m not stupid. Telling you has only got me into trouble in the past. As I don’t know you, you’re not worth it.

    Do not believe that because your doctor told you to come right to the ER that you have a right to be seen right away. Let us discuss why he really said that; LIABILITY. Your doctor doesn’t give a rat’s arse about little Johnny’s sniffles as long as he’s out of the clinic before 5:00. Filling up his over-booked appointment calender could have an adverse affect on that, but sending them ‘right away’ to the ER won’t! AND no one can ever sue him for bad advice or irresponsible behavior because he TOLD them to go the ER ‘Right away’ for the ‘Highest level of care.’ Gotta keep those malpractice premiums down! There are only two things worse than a doctor that won’t see his own patients:

    1) The second worse thing is doctors that not only won’t see their own patients, but they send them into the ER with a wildly unrealistic set of expectations. “My doctor told me to come in right away and to go right back! He said I was too sick to wait in the lobby. He ordered you to do tests, they are (stop me if you’ve heard this one before) ON THE COMPUTER”. I’m not taking s**t for orders from some lazy, wart burning, boil lancing, sprained ankle rotating, sore throat examining general practitioner who has assessed you OVER THE PHONE and doesn’t even have ER privileges. Get outta my face! you can get an appointment at the clinic in three hours and you’ll be fine. Walk down to the lab yourself if you want those tests.

    2) Advice nurses are the bane of our existence. Sure they can’t tell everything over the phone, sure people are generally bad communicators, sure the clinics and doctors are over-booked, sure it’s 2-6 weeks out to even see a doctor, sure my cheap-arse HMO added another 90,000 new members last month but no infrastructure to deal with them, but the solution for this is not Not NOT to ‘go to the ER right away where they will fill the fantasies that our unscrupulous marketing department has instilled in you.’ I love getting advice nurses for patients. They must know because they are reluctant to mention it. We hate them all and feel no shame in railing against them while they suffer (off the clock) in their sick and/or injured misery.

    People! I could go on for pages. Think about every miserable customer service job that you’ve ever had and multiply that by tenfold with whiney patients. It’s not that I hate people; I just hate peoples’ sense of entitlement and instant gratification. Folks might as well say “I have abused my body for decades and I’m here for you to fix me.” Sheesh,

    To review:

    1) Don’t be a jerk
    2) Lose the weight, stop smoking, take your damn psych meds, and take care of yourself!
    3) Its not our fault or responsibility that you’re sick/injured. In fact, it’s probably yours.
    4) Folks that arrive dead usually stay dead
    5) It’s not like on TV
    6) Years of patient abuse have (clearly) left us all a bit burnt out and jaded, so. . .
    7) Don’t forget your manners when you come to my ER : )

    -another RN
    Words to live by. Any thoughts?

    --Barry
    God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

  2. #2

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    Re: Some "friendly" advice on the topic of your health

    So true! But if you get super glue in your eye, they'll see you right away in front of everybody else and tell you that you should have read the back of the label before using it.

  3. #3

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    Re: Some "friendly" advice on the topic of your health

    he he he


    i can add to take

    i work in food and people, your not helping yourself by ordering "a double bacon cheeseburger(2/3 lbs of meat plus bacon) extra mayo, seasoning and supersize the ff, extra seasoning...."

    "is that all?"

    "no, i'll,take a small dt. coke" OR "a bottled water"

    what do they think they are doing by drinking dt? counteractiong the 80 grams of fat they are about to consume?


  4. #4

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    Re: Some "friendly" advice on the topic of your health

    Well, remind me to never visit that nurse.

    Thanks for sharing.

  5. #5

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    Re: Some "friendly" advice on the topic of your health

    Wow that's one crabby nurse. My fiance works as an ER nurse once in a while (normally he's in the NICU) and he's not that jaded.. yet.

  6. #6

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    Re: Some "friendly" advice on the topic of your health

    But Dr., I really was gardening in the nude when I accidently fell on that.

  7. #7

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    Re: Some "friendly" advice on the topic of your health

    Quote Originally Posted by krystledm View Post
    he he he


    i can add to take

    i work in food and people, your not helping yourself by ordering "a double bacon cheeseburger(2/3 lbs of meat plus bacon) extra mayo, seasoning and supersize the ff, extra seasoning...."

    "is that all?"

    "no, i'll,take a small dt. coke" OR "a bottled water"

    what do they think they are doing by drinking dt? counteractiong the 80 grams of fat they are about to consume?
    yep i worked at the olive garden a few years back, but it always amused me when the ordered a diet coke, salad with lemons on the side - no dressing, bread sticks with alfredo and fettechini alfredo with extra alfredo on the side...yeah..ok?

  8. #8

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    Re: Some "friendly" advice on the topic of your health

    First, if anyone actually read that entire article, it is really time for you to get a hobby.

    I think a list of bullets would have made for easier reading, but I know RB didn't write it, only posted it.

    Every one of us could write a similar letter depending on our careers. We all have crap to deal with which is lame and sucks, etc. etc.

    The irony is that MANY health care professionals do not practice what they preach. I can't even tell you how many respiratory therapists smoke like crazy, how many nurses are obese, drink and drive etc. I guess regardless of your career, you're a person first.




  9. #9

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    Re: Some "friendly" advice on the topic of your health

    Wow, I feel so sad for that nurse. It must be awful to choose a career and train for it and then find out that it makes you miserable.

  10. #10

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    Re: Some "friendly" advice on the topic of your health

    Quote Originally Posted by RetroMousie View Post
    Wow, I feel so sad for that nurse. It must be awful to choose a career and train for it and then find out that it makes you miserable.
    Do the words "tongue in cheek" ring a bell here? This nurse was trying to make a point, about things they have to face every day, and do so, at least I thought, in a somewhat humorous way.

    --Barry
    God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

  11. #11

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    Re: Some "friendly" advice on the topic of your health

    Gosh, Barry, thanks for clarifying that it was 'tongue in cheek'. My thought was that it was way too bitter to be 'tongue in cheek' but I am glad that I no longer need to feel badly for this person being stuck in a job she clearly loves.

  12. #12

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    Re: Some "friendly" advice on the topic of your health

    What a Grinch (only, I didn't say Grinch)

  13. #13

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    Re: Some "friendly" advice on the topic of your health

    Barry - All I can say is that I am VERY happy that we didn't meet that nurse in one of the 6 or so trips to the ER that we made last year because of my wife. When you're scared to death about the health of a loved one, the last thing you need is some nurse with a tree up her butt telling you she doesn't give a rat's a** about your situation.

    And yeah...I did read the whole thing because I spent HOURS there last year. Our usual wait time to get a room was between 8 to 12 hours or longer each time. And MOST of the time, we found incredbile, compassionate people who were working their butts off and who really wanted to help my wife.

    The lady in that letter has been at it a bit too long. "In the ghetto that might mean something different." What the heck is that? The common denominator that I found in the ER was....people are SCARED. Yes they might ramble. Yes...God forbid, they don't realize that their loved one has died before they made it to the hospital. Yes, they want their loved one to be seen right away. And I'm sure it takes amazing patience (no pun) to deal with these near hysterical people in the middle of the night. I know, because I've been one of them. You want anxiety? How about when you're making the fourth trip in to the same hospital and there's no orders when you arrive on the floor, so they can't give your wife any pain meds? How about when the young know-it-all intern says your wife can't have the Morphine drip and she'll just have to deal with the pain, when she's been on four times that amount at home? And her pain is a 50 on a scale of 1 to 10! Yes...I raised my voice on more than one occasion, and the floor administrator got to know me on a first name basis.

    But our ER techs and doctors were always the best. We had people whose names need to be sent to the pope. People who took my wife's hand and brushed back her hair, and looked her in the eye and told her everything is going to be ok. She's deathly afraid of NG tubes, and she had to have about six of those last year. She was scared. I was scared. And the sun comes out when the right doctor or nurse reassures you that they will do everything that they can to make her comfortable.

    So, IMO, if your "gift" is not talking people down, the ER is really not the place for you.

    This lady seems to have a "Don't waste my time with your miserable story" attitude. She says that this isn't Burger King. Fine. But it's not Walmart either. The last thing I need is for this lady to get in my face when I'm really not sure if my wife is going to make it through the night.

    How about this line:

    And after I put you in line to go back to the ER do not send your cringing hand-wringing co-dependant family members up to me every 15 minutes to ask if itís your turn yet. IF IT WAS YOUR TURN WE WOULD BE CALLING YOUR G** D*** NAME.
    It's human nature, RB. They see their loved one suffering and there's not one fricking thing in the world they can do about it. Except trying to make sure that someone cares.

    This lady obviously doesn't. Hopefully she'll find another vocation soon. Like maybe driving a cab in Manhattan. I'm sure your wife has seen and heard it all, and I'm sure she's a wonderful person. I'm sure she can identity with most of what that other ER nurse posted. I just hope she doesn't let her job turn her into that other nurse. Because what your wife does is a gift, and she is, in a very real sense, a hero to hundreds of people just like me every year. God bless your wife and every other ER nurse who has to deal with all of that every day. My wife and I haven't been back lately, and we hope to stay away for a long, long time. But when we do go back, I hope we get some of the same wonderful people again and not the ER nurse from hell.

  14. #14

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    Re: Some "friendly" advice on the topic of your health

    I have to say that I truly appreciate the nurse's I come across and realize that I am not the only patient in the world that they have to attend to. Plus, I do acknowledge them when the go beyond what they need to do.


  15. #15

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    Re: Some "friendly" advice on the topic of your health

    Quote Originally Posted by localdisnyfan View Post
    Barry - All I can say is that I am VERY happy that we didn't meet that nurse in one of the 6 or so trips to the ER that we made last year because of my wife. When you're scared to death about the health of a loved one, the last thing you need is some nurse with a tree up her butt telling you she doesn't give a rat's a** about your situation.
    This was something that was posted originally on a nursing forum website, and it was something that people working in the same biz would share with each other...frustrations, yes but something they could share a laugh about between themselves. This is not how this or any other nurse would actually deal with a patient. There are some cogent points, however, for us to consider.

    I've seen other things worse than this posted here, and they were thought to be hilarious by some. I thought that some might get a kick out of this. Guess I miscalculated here.

    --Barry
    God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

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