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?


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.

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.

Anonymous said...

FUCK this bitch and anyone else who thinks fibro is just a coverup for drug seeking. I have Fibro, I went from being exstreamly active 18 yr old girl to having to be almost wheelchair bound due to the pain. There have been nights where i am screaming and withering in pain, vomiting when i probbaly should have gone to the ER and its nurses like you who keep me from going. Do i want to take pain pills FUCK NO. I want to be able to function like a normal human agian. You have no idea how horrible this condition is.
Honestly i have never been so pissed in my life. People like you are the reason people say Fibro is all in your head and not real. WHO WOULD FAKE THIS?
Who would willing give up normal life to be bound to one room 90% of there life? FUCK YOU. You dont deserve to be in the medical field. Grow the fuck up do some research. Take shit seriously or be the idiot you are.

Anonymous said...

Because all ER nurses know fibro and chronic fatigue are bs diagnosis and code for overweight, depressed, middle aged woman- go train for a triathlon or something and your symptoms would disappear!

Keri Evans said...

Wow, I'm 21, a dancer have a pretty good life, supervisor at one of the biggest telecom company's in America graduating next year with a degree in dermatology going to get married in 7 months and was diagnosed with fibro when I was 20. My doctor at first never gave me pain pills.I been to the ER one time and it wasn't seeking medication at all it was to treat my sudden fibro flare up of a huge amount of pain. After reading this I thought nurses were supposed to be here to help and take care of people not complain about fibro patients that's actually really sad I don't need anyone's drugs and when my blood pressure was 149|90 because the amount of pain I was in they didn't consider me whinny as a matter of fact I didn't whine at all I was very quiet and waited for them to get me. But anyways good to know how some nurses feel about people

Anonymous said...

The first three "red flags" are actual medical conditions. And you're a nurse.

I have spent the last three days sobbing, vomiting, and passing out because of my pain. I am so stressed out and alone in dealing with this that I again am wishing I'd die.

For three days I've wondered if I should go to the ER. I've asked all my friends what they thought and of course they've all implored me to go. But then I made the mistake of going online.

First, I read countless patients state that they will never go to ER for their pain because of the way they are treated. This I already know, I've experienced it myself, I do almost every month when I see the doctor who is supposed to be treating it. Then I read this. On a list of things an ER RN absolutely hates about her job, fibro patients are #3. I was apprehensive. Now I'm terrified.

Like everyone defending their illness, I had two jobs before flare ups became more frequent. I was a cook at night and an accountant during the day. People think this is a depressive disease? No. The depression comes when you lose everything. Being home everyday and being alone, it makes me want to die.

I know they deal with drug abusers, I see them every month at pain management. And I hate those people because they make people like me live a life of hell. But for a nurse to not give a patient even the benefit of a doubt,that makes you a shitty person.

I guess I'm going to keep on crying and passing out because if there's one more thing that would push me over the edge, it would be going to the ER and being treated like garbage.

Fuck the person who wrote this, fuck anyone who agrees with her, and fuck you all for laughing in our faces after we have lost everything that made us want to live. Fuck this disgusting careless world. And fuck fibromyalgia.

Anonymous said...

I am so sorry. But maybe its time you leave the profession. I am so tired of ignorant uncaring medical staff trying to kill me. First I come in bleeding tell the Dr I have a blood disorder that I can't pronouce (Methylene tetrahydrofolate reductase finally got someone to tell me its called MTHFR the mother fucker gene) but I do have high platelettes. So he gives me birth control a month later back in the ER can't breathe and leg pain. I sit for 2 hours then walk to exam, xray, cat scam then back to exam to be told I can't get out of bed. I have a pulmonary emblosim. The 2 months later hemeroage I must get a blood transfusion. Then I go to ER feeling like crap wait around and I am in renal failure. When I say I feel like I'm dying I mean it. A year later its a massive stroke. This past summer I was diagnosed with RA with a blood factor over 500 plus fibromyalgia. I ended up in the ER again with hand pain a 9 on the pain scale...I was ready to cut it off if it would help. Thank God I had an ER staff that took me seriously and took care of the pain. It is not fair to treat us all like we are drug seeking ....Please look at each of us as you would like to be treated.

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