Head Tale

1.Don't tell me you have abdominal pain as you eat doritos in my triage
booth. Go home.

2. If you come 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.

3. 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.

4. “Butterfly” is not an IV size, this word signals me to put in a
larger bore needle.

5. 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, your butt
goes back to the waiting room.

6. 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?
Go home.

7. Don't ever say things like, “I usually get 4 mg 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.

8. If you are allergic to Tylenol, Toradol, and Motrin, I have already
assumed you are a drug seeker.

9. 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.

10. 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.

11. 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 ass, and
he's pawning you off.

12. The louder you moan/whine, the bigger size IV needle you get.

13. Foley catheters cure pseudo-seizures. They also cure intoxicated
persons.

14. If you are on more than 2 medicines at home, bring a list. Don't say, “you know, the little white pill”. I am not a pharmacist.
 
15. RN is not synonymous with waiter/waitress. This isn't MacDonald's, you can't have it your way. Similarly, if you want a pillow, two blankets,
and the lights dimmed, go to the Ramada, jackass!

16. Don't bitch about missing breakfast when I'm on the ninth hour of my
shift and haven't peed yet.

17. What gives you the right to complain about your sore throat for a
week while I have diarrhea from the antibiotics I've been taking for
pneumonia?

18. Broken toes are not an emergency. We'll make you feel stupid by
putting a little piece of tape down there and kicking you out. Again, go
home.

19. I am currently inventing a trapdoor system in triage to be triggered
when you say the word “toothache”.

20. Cover you 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.

21. If you tell me you have fibromyalgia or chronic fatigue syndrome,
know that I'm rolling my eyes and thinking you're a loser.

22. If you list Haldol, geodon, Xanax, and trazadone as allergies, don't
tell me you have no psych history.

23. 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 bumped you ahead of other people and I'll make your visit horrific.

24. Although you've been in the ER four times this week, you cannot list
the ER doc as your family physician.

25. Do not talk to me while I'm trying to listen to your lungs.

26. 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.

27. Gravida 7 at age 22 means you are a slut.

28. ONE complaint/ailment per visit, PLEASE!

29. 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 a week ago, and your entire family followed the ambulance to
the hospital, you will be labeled a pussy. Prepare to be treated like
one, and enjoy the waiting area with your family.

30. If you have one of the following 4 ailments, don't waste my time, see
your doctor in the morning: (1) a migraine (2) the flu (3) a stomach virus
(4) a stuffy nose.

31. Don't ask us how long it will be. We don't know. I don't know what's
coming through my door 30 seconds from now, so I sure as hell don't know
when you're getting a room. Plus, why are you now so happy to leave the
ER, when in the beginning you were just so happy to be here and were
begging for our help?!?!?!

32. If you are well enough to complain about the wait, then you are well
enough to go home.

33. We know how many times you've been to an ER. We can usually tell if
you are faking it in the first 5 seconds of talking to you. Do not lie to
us. If you lie about one thing, we will assume you are lying about
everything. You don't want that.

34. If you are a female between 16 and 42 and our last period was between
28-35 days ago, please don't waste our time if you are here for abdominal
pain and vaginal bleeding. Guess what?!?!?! You got your period, AGAIN!
By the way, pregnancy tests cost anywhere from 5-15 dollars at a
pharmacy. An ER visit costs at least a few hundred. If you haven't
gotten your period in 2 months, don't come in at 2 AM. Pharmacies are
now open 24 hours per day!

35. Do not bring your entire posse with you. One person at the bedside is
all that you need. It is really difficult to get around 7 people in the
event that you are really sick.
 
36. Every time I ask you a question, I learn more about what is wrong
with you. I don't care if I have asked you what day it is four different
times. Each time I ask, its for a reason. Just answer the question,
regardless of if you may have answered it before.

37. If you want something, be nice. I will go out of my way to piss off
rude people.

38. Keep the following numbers in mind. At any given time a nurse has 4
patients (some ERs its 5-8). One doctor may have up to 15.

39. There is a law about a nursing assignment in the ER. Of the four
patients, one of them will actually be sick, one of them will be whining
constantly, one of them will be homeless, or drunk, (or both), and one of
them will be the delightful patient who gets the warm blanket and
pillow. Please, don't be the whiner.
 
40. If you see someone pushing a large red cart down a hallway, and bells are going off, don't ask for a cup of coffee. Someone is dying, you
inconsiderate asshole. Sit down, shut up, and let us work.

41. If you can bitch about the blood pressure cuff squeezing too tight,
or the IV hurting, you are not in that much pain. Go home.

42. If you have any sort of stomach pain/ailment and you ask for
something to eat, you are not sick. Go home.

43. Related to Rule #42, just because you haven't eaten all day doesn't
mean I should have to run around to try and find you something to eat.
You got to the ER at 2 PM, what the hell did you do all morning, and at
lunch
time? You could have had something to eat, no one was stopping you! If
this is the case, I will not feel sorry for you, I will think you are
stupid for not eating something all day long, ESPECIALLY if you are
diabetic and prone to complaining about your “sugar” which is probably so
out of whack it wouldn't matter how much/little you've eaten…

44. Do not talk shit about the other members of the staff that I work
with. The doctor that you hate? I work with him everyday, and I know
that he knows what he is doing. I trust him a whole lot more than I
trust you. I am not here to be your friend, and neither is he/she. I
will tell him everything you said, and we will laugh about it. If you
want a buddy, go somewhere else.

45. If you are homeless, don't ask for a bus token or cab voucher to get
home, it just confuses us. You're homeless, remember?

46. 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?

47. Don't come to the hospital (apparently asking for help) and then
become pissed off with what we're doing. Ya, we may have to start an IV,
or draw
blood, yup, you may have to pee in a cup, you may have to go through a
nasty test. You're at the hospital, we have to try and find out what's
wrong with you. If nothing shows up on the tests, we send you home, done. If you refuse the tests, you'll just wait longer, and if you get violent
(and if we feel the tests are necessary) you'll be sedated until we can
get the necessary specimens/x-rays/CT scans, etc.
 
48. Related to Rule 47, don't pull at IV lines, monitor wires, your
wonderfully fashionable ER gown, or fight with the staff. You came to us,
remember? If you do these things, please keep in mind we have many ways
to restrain you.

49. 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'll take your word
for it. If you did fish something out of the toilet, you may not use my pen!

50. If you want to AMA, just go. Don't make a federal case out of it.
Don't shout expletives as you leave, don't throw things, spill things,
or attempt to hurt any staff. Just go. Again, if you can be that pissed
off, you must not be sick, so we don't really want to look after you anyways. Hope you enjoyed!!!

P.S. Here's a thought for the day… If you save one life, they call you a hero. If you
save hundreds of lives, they call you a nurse.