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Sunday, February 26, 2012

red flags in the ER

its like deja vu today...

Red flags in the ER:

1) You say you have "chemical sensitivities".
2) You have more than 2 allergies.
3) You have fibromyalgia, chronic fatigue syndrome, some kind of syndrome no one has ever heard of.
3) You bring your MRI or CT with you, usually of your back, stating you can't get into see the doctor for a "couple of weeks".
4) You say you just moved here from out of town.
5) You bring a suitcase with you.
6) You brought something in a bag that you want to show me.
7) You can't tolerate the "pain" of an automatic blood pressure cuff.
8) You're allergic to haldol or thorazine.
9) You are 40 and your mother is accompanying you
10) You say another emergency room "don't know what they're doin'".
11) Your medical problem started in 1930.
12) You say "yes ma'am a lot.
13) Your relative is taking notes.
14) The medics want me to come outside of your room to give me report.
15) You are taking more than 3 psych meds.
16) Your wife, daughter, husband, son, etc. speaks for you.
17) We have to bring a cart to get you out of the car but somehow you got yourself into it at home.
18) You are eating a big mac on arrival to the ER.
19) Your relative calls ahead to say you are coming.
20) Your first question at the triage desk is: How long is the wait?

17 comments:

Anonymous said...

#7 irks me to no end.
#9 too
#11 just makes me want to poke you in the eye with my pen to get to the point

Nurse and Hospital Stories said...

"You bring a suitcase with you."

haha. As if this patient is travelling to ER, eh. And I found #13 "Your relative is taking notes" amazing. Imagine, they are taking notes. For what? lol.

Cheers,
Peny@nursing shoes

Sean said...

I'm southern and therefore so Yes Ma'am and no Ma'am to everyone as a sign of respect. Why would that be a red flag?

EDNurseasauras said...

Sean, here up north southerner's get a pass on the Yes and No Ma'am unless it is the 15th ER visit this year for dental/migraine/backpain

Anonymous said...

Because numerous doctors visits without an answer becomes expensive and exhausting so they are being responsible with their money and their time taking notes keeping a journal for incase the they find themselves still with no answer if it's a long term issue that hasn't been addresses properly. I can't imagine why they wouldn't.

Anonymous said...

Who knows. Just seems to be coming from a lot of bitter cynical overworked ladys who are unfortunately called nurses and who have yet to figure out they are in the wrong field if you ask me.

Anonymous said...

I have an issue trying to figure out how anyone posting all this "bs" has became an RN and which part of their schooling told them to pass judgement on a patient. Stop complaining and move to a different field...

Julie said...

Dear anonymous, it appears to me that you are not a RN, therefore, you completely missed the purpose of the post. It is meant to make fellow ER and trauma nurses laugh about their crazy day to day experiences. Just because a nurse has these feeling doesn't make he/she a bad nurse. And I would like to know how taking notes means they "are being responsible with their money". Enlighten me. Please.

angelbear said...

Why are fibromyalgia and/or chronic fatigue a red flag? I am just curious because I am a nurse and I have fibromyalgia/lupus and the ER is the last place I would go unless I were near death. Mainly because the nurses around here would take 1 look @ my med list and ASSume I am drug seeking. I can generally understand there thinking I just wish they would investigate a bit before assuming. I really am interested though as to why those dx's are a red flag?

Melissa said...

Dear anonymous from march 2..... You probably think this bc you have fibromyalgia and are allergic to haldol

Jessann said...

Wow, the level of stupid on these comments makes my head hurt! If someone has an ongoing medical problem without an answer... The ED is the LAST place they need to be! Try your PCP so they can send you to a specialist! An ER visit, in this case, is wasting your time, my time, resources needed for the man down the hall with STEMI, and a lot of $! You obviously don't know how much it cost to actually treat a patient in the ED! Ongoing means chronic and an ED can't help you! If you have fibromyalgia... You need to see whoever dx you. In my 12 years as a ED/Trauma nurse, I have never once seen that dx cured in my ED (unless you count texting on your phone with a pain score of 10, a cure). Your med list doesn't cause red flags to us, unless you are out of all of your the narcs and need a refill because "your doctor is on vacation" without having a doctor covering his patients. Show me a ED nurse who is not cynical, sarcastic, and tired... And I can promise you they have less than 6 months experience and still think they can change the world while taking 30 minutes to look up how to give every medicine the MD just ordered. I can also promise that by the 1 year mark they will either quit or become cynical... It's called coping with all of the trauma we see, day in and day out! You see stuff happen on tv and say "how sad"... We work that "sad" everyday... Sometimes we win, sometimes we don't. So sit there and think we are mean or bad, need a career change or whatever... But remember, if your loved one is in my trauma bay... Do you want that new grad nurse who is sweet and worried about your pillow being fluffed, or someone like me, who knows how to do what needs to be done to save their life... You can't have both! My "schooling" to become an RN, is actually a BSN. Judging patients and their actions is actually a large part of our education. It's how patients get triaged and how we decide who is critical and who is not. So while you are so upset we judge patient's actions... Do yourself a favor and volunteer in an inner city level one trauma center for one day. When you finally quit having nightmares from what you saw, and remember we do this every day, then try to call us evil that we complain about all of the silly, stupid patient actions we have to deal with while we are having to actually save patients who need us! And to the one who is so sure we are in the wrong field, please, join the ranks, become an ED RN... We need someone to save the world!

Ellybabs said...

As a former ED RN for 18yrs, amen to your comments Jessann!! These comments will only sound harsh to someone who has never been in our shoes. When you have decide between who gets CPR and someone who wants a free pregnancy test, you can get cynical. It comes with the job, thanks for still doing it by the way. I would entrust a nurse like you over a new grad any day!

Anonymous said...

You know, I do have fibromyalgia (apparently induced by cancer treatment stress) and I DO have a lot of pain from the blood pressure cuff (for some reason my upper arm is very very sensitive after I had bilateral mastectomy). And on my list of medication I do have Percocet. I have side effects from a botched LD flap breast reconstruction, I have osteoarthritis and inflammatory arthritis and I'm taking aromatase inhibitors that among others give really bad joint pains.

When I went to our local ER because I had a really bad arthritis flare in my hand - I did so after thinking it over and over because I thought it was ridiculous to go to the ER for that, I only decided to go when I realized it took me 15 minutes to pull a pair of pants on (I'm severely right handed and the right hand had the flare). And I drove myself with one hand as any small move of the right was making me scream.

And the medical staff there did not consider me raising any flags. They got me a thumb/wrist splint, a 6-day steroid pack, a steroid shot and also gave me extra Percocet to take until I could go in to see my pain management specialist (this happened a Saturday morning). And guess what? they also told me I was the first "valid" patient of the day.

So don't generalize. Sometimes things are not exactly what they seem.

Anonymous said...

I worked 80 hour weeks after I became a lawyer at 22 until I had a hysterectomy at 47 and 6 weeks later began experiencing agonizing pain. Agonizing. i gave up a job paying me six figures that I loved dearly to live on a small disability pension just because I'm a lazy sob who enjoys sitting around the house instead of in a suit teaching students or arguing cases and being respected professionally and loving every second of it. Right?

I hate my life and can only hope that it ends soon because chronic agonizing pain is wearing me down every day. I'm up at 4 AM because I can't sleep because of the pain.

I really hate it when medical practitioners assume that I'm a lazy drug seeking bum. Honestly, the only reason that I was able to obtain drugs that make it possible to struggle through another day is because I have excellent health insurance, am extremely articulate, had an impeccable record of employment (as a matter of fact I worked through the pain for two years and was fired because my division at work was clearing out the older people who earned large salaries...

Fibromyalgia is a real disease and causes real, terrible pain. I'm sorry there are no tests to convince you it's real. Soon I hope there will be and I will gladly volunteer for any possible study, test, etc. Because it's real.

I can show you my birth certificate and then the Juris Doctor degree I earned in December and turned 23 that February and my BA magna cum laude at 20 from a good university if you think that I am just lazy. I hate sitting around the house.

Anonymous said...

Because it's a smoke screen and they are really drug seekers looking for Dilaudid.

Anonymous said...

Because we have become jaded from being lied to, cussed at, called a "f*%&$# bi&*%", spit on, hit, scratched, and exposed on a daily basis to the dregs of society. All of which have a sense of entitlement, demanding pain medicine, food, and a cab voucher - all while they are either texting in their IPhone or trolling the internet on their IPad. All of this after they've slapped down their Medicaid gold card demanding to know how long its gonna be. Sorry, but you tend to see the human race in a different light. Doesn't mean they get inferior care, we just don't like them.

Anonymous said...

I agree with you. Fibromyalgia is a red flag? This is why so many other conditions that can accompany the disease ho unnoticed, untreated, and eventually cause death to it's inhabitants. You may be a nurse but you certainly don't seem to live by or take your oath to heart.

And yes, I have fibromyalgia.