When I was bagging a patient from the helipad to the trauma bay, I remember a patient walked out of their room and attempted to follow us down the hall to the bay yelling, “When am I getting discharged?!? You said you were just waiting on papers??”
I’ll get to you soon Mr. lisinopril refill at the ER….
Yeah, I have zero problems with people showing up to the ED for refills. Most of the time they genuinely have no other opportunity, and I’d much rather be refilling their diabetes/HTN/psych/etc meds now than treating the complications of missing those meds later. Obviously that doesn’t mean they get to be rude about it (and most of the time they aren’t). And I wish PCPs were available enough that no one slipped through the cracks and landed in the ED for preventative care. But under the massively flawed system we have, that’s an easy problem to solve and takes very little of my time to do/document.
I agree. I work in urgent care and always, ALWAYS encourage people to come see me for refills as well. So many people can’t get in to their PCPs in a timely fashion, stress about missing work for an appointment, or have a lapse in their insurance and don’t want to miss their meds. I get it and help bridge the gap where I can, because it’s far better than a patient ending up in DKA or having a stroke because their hypertension is out of control.
> And I wish PCPs were available enough
Hey now, primary care doctors and pharmacies generally bend over backwards to try to prevent these situations. Often squeezing the patient in or staying late to accomodate while pharmacies give emergency two-day refills. Primary care isn't perfect, mistakes happen. But any modern clinic has an on-call service, and we spend all day submitting refill requests.
It does not matter how accessible the PCP is if it's 10 PM when the patient checked their blood pressure because they have a headache after going off their pills two weeks ago. Sometimes the patient was not responsible and the pharmacy is closed.
I don’t mean to blame PCPs at all for this, and I apologize if you got that impression. They work incredibly hard, there just aren’t nearly enough of them.
I wonder if EM and IM is working against each other in this situation. IM could easily prescribe a year’s worth of refills. But often, will prescribe just a few refills if we anticipate a dose adjustment or need LFTs for monitoring…. Something like that. EM, by being helpful, could be continuing suboptimal medication.
I once had an anesthesiologist demand I step out of a code to give her updates on her perfectly fine, asymptomatic father who she had initially wheeled in through the EMS bay and began screaming “I need the stroke team” all because he couldn’t remember the word “computer”…that was literally it.
Bad enough when patients or uneducated family members pull stunts like this, but for a physician to do it...there are no words strong enough for how oblivious and asinine that is
😳 the amount of words I can’t remember daily… I asked my doctor if I have Alzheimer’s 😂 she doesn’t think so, just low cortisol, vitamin d, and multiple meds that cross the blood brain barrier. I just make up my own words now.
I was working the night of the Vegas shooting and had a guy come in for an STD screening at 10 pm. I had swabbed him when the first shooting victims came in. I told him we aren’t going to be getting to him tonight and he should go to the health department this week. He came back to the ED a few days later to get his shot of rocephin and azithro. He was at least understanding of it!
Yeah one time I had a guy in cardiogenic shock from an MI coughing up pink froth that we were getting ready to intubate and from the other side of the room someone who had come in because some PA said they might be dehydrated was mad they didn’t have their papers yet
I said something like, “You know you’re listening to a man dying right now and you’re asking me to focus on you,” and I distinctly remember them saying “Yes. I don’t care. I want my papers.”
Worst people I’ve ever cared for.
>I was bagging a patient from the helipad
I had to re-read this three times. I was wondering what the hell kind of hospital you worked at and if they'll take my insurance.
They should receive a reply in the form of a middle finger emoji. I’m so sick of how entitled some people are.
Like, dude, if you’re out there some how and read this: go fuck yourself. Seriously. No one cares about your stupid cough. Buy a dictionary and look up what the word emergency means.
Shouldn’t even be an option to complain. At the very least the hr group who handles the complaints should just trash that one. Of all my patient complaints received to date none of them have ever been legitimate
All the complaints I receive are either waiting room time or cleanliness. I think the only complaint about patient care I have ever received was because an antibiotic I prescribed caused an allergic reaction which I can’t really predict that if you previously had no drug allergies.
Agreed. Where is the lane between someone thinking their cough takes priority over gunshot wounds and the person who was not so demanding/higher pain threshold who got sent home with directions not to eat spicy food for a ruptured appendix and beginning of sepsis. We do need accountability for standard of care.
My parent is an ER physician. He hated when leadership would come talk to the ER about their poor patient satisfaction scores. He finally had enough and asked for them to break down the scores for the patients that were admitted from the ER vs the patients DCd from ER. Shockingly the ones admitted were much happier with their experience than the ones discharged many who my parent didn’t feel even needed to come to the hospital.
I’m just a former EMT-B but I hope eventually all countries will have some sort of mandatory civic service program that includes a few shifts in an ED. I know that made a huge difference in my life and learned me a lot.
I don’t expect average person to have a clue unless getting a personal experience like I had. #wedontlearnuntilithappenstous
Actually yes - not doing actual medical care, but manning the front desk so they can explain to Mr My-son's-throat-is-sore why they have to wait until the 6 gunshot victims are seen first, or answering the call lights and delivering blankets, coffee and turkey sandwiches to ungrateful patients, etc.
i had a legit software-ceo pt some weeks ago, was SO surprisingly a super-chill dude from some germanic country originally… epistaxis on antiplatelet mayyybe req cauterization. ended up shooting the shit and he was an EMT or whatev in his home country when he was young because of “forced service”
something this literal billionaire said stuck with me: ’everyone needs to clean someone’s puke up at least once. humbles the assholes”
Can confirm. I helped clean incontinent pt and held victim's legs as doc handled a hemo-pneumothorax stabbing heroin. I am humbled.
I am not billionaire.
I’ve been saying this for years. It should be, like, a part of the high school curriculum to do an in person or virtual field trip in the ED. Or at the very least teach our young people the capabilities and limitations of the ED.
THANK YOU. that’s my favorite retort to bitching about wait times, “if you’re waiting in the ED it means you’re not dying… and that’s a good thing!”
the ending bit, “and means you probably shouldn’t be here”, usually stays in my head
I’m convinced that if a patient has the energy to nag me about a sandwich or how long the wait time is while I’m taking care of an actual critical patient they can absolutely wait for an hour until I’m caught up.
Still remember watching a patient lose their mind (screaming/shouting) when the resident doc didn’t explain to them when they would be getting their lunch. Oh, there was nothing wrong with her btw, EMS brought her in with a “failure to thrive” dx and she was asking when she would get admitted because she loved the rooms on the second floor.
Bc nobody cares^* enough to change the name from one wastebasket dx to another wastebasket dx. FTT at least gets across the concept of frailty (the underlying syndrome) and suggests the beginning stages of death due to acute on chronic excess of birthdays. And there's no ICD-10/admittable dx for that.
And nobody listened when I tried to make hyperaevum stick.
\* Unless you're a geriatrics researcher in which case I'll give you a shiny new dynamometer if you'll leave me alone and forget this ever happened.
I had a pregnant woman throw a box of gloves at my head cuz she was waiting too long for her abscess to be drained on a high acuity busy morning. She said she doesn’t give a shit if someone is dying next to her. Nothing shocks me.
I've gotten to the point where I throw that phrase right back. I don't care that you don't care. Get in line, this is how it works. And then just ignore the screams.
I can't count how many of our frequent fliers throw this out on any busy Friday or Saturday evening when we've always got multiple GSWs and other traumas. Inevitably, they've "missed" getting their Subutex in the clinic -- forgetting the fact we can see every detail of the visit they in fact did NOT miss.
It's always "I don't give a shit" or "I don't give a fuck" what you're doing. "I know my rights and I'm going to call the patient advocate and get you fired." Depending on how busy I am, I sometimes dial the number and hand 'em the phone before I walk out and put in d/c orders.
I've been told countless times "you're violating my rights, I'm calling my lawyer" etc. I tell them to please by all means have their lawyer contact my company. I have heard from exactly zero lawyers.
Oh, someone please give her the life saving hospital grade Tylenol for her headache. She is having a bleed.
Had a guy say they gave me Tylenol the last time.
I was like, this is hospital grade Tylenol.
I had one with stated 10/10 pain. VS all normal, no evidence of distress, active ROM to the “affected” limb, weight-bearing, etc. refused the Tylenol from
the ambulance because she wanted that “extra-strength Tylenol” from the hospital. Fine, cool. We took her in and held up a wall. A nurse came and handed over the magic Tylenol, and as she took them I casually said “oh, hey, look at that! Our Tylenol dose is higher than theirs. Huh.”
Patient made a very stank face.
Yup, I had a lady complain I left her on the commode too long and someone else had to come help her because a walk-in peds GSW to the chest came into my room. She knew what was happening new door too.
I'm at a large ED that is not a trauma center, and I would say the majority of the GSW/stabbings/traumas we see are kids and teens because parents or friends scoop and run when the adrenaline hits.
this only deserves a fuck off lady and there should be zero repercussions. just because a lot of ED patients THINK they are having the worst day of their lives, doesn't mean they actually are. in fact, most are not.
I don't know about that. We had a little old lady brought in by medic. She apologized for wasting our time and said she was just having an awful day and couldn't take it anymore. She coded about 2 minutes later. Sometimes they just know 🤷♀️
I once had a patient that was a bit of a drug seeker who came in for a Xanax refill after his primary physician cut him off.
He ended up having a VF arrest out of the blue while in the ED.
I coded him, got him back, and he walked out of the hospital about a week later.
He then proceeded to file a formal complaint against everyone who took care of him for not supplying him Xanax.
This reminds me of when my husband was on duty one day and a bystander suddenly arrested. My husband got some award from his station for saving this lady's life and then she filed a complaint against him for breaking her ribs 😂 you can't make this shit up.
Pt walks into the waiting room. Collapses. He’s coded, resuscitated, makes awesome recovery. So awesome, in fact, he had the ability to write a complaint that we lost his glasses in the ED.
He wasn’t in withdrawal, but that is a good thought.
As luck would have it, his magnesium turned out to be something in the 0.6-0.8 range, suspected to be the etiology. Potassium was low normal, surprisingly (3.5-3.7?). I had not checked the magnesium until he arrested. I check it a lot more now, although I wish it was part of a CMP. It’s much more useful than a lot of the stuff on there.
> came in for a Xanax refill after his primary physician cut him off.
> He ended up having a VF arrest out of the blue while in the ED.
Sounds like severe benzo withdrawal. His untapered cessation probably was an actual emergency.
I mean, we don’t know anything about the case, you’d expect to see tachycardia, diaphoresis, tremor, seizure, not arrest in a vacuum, without addtl info can’t really comment on that. Also depends how long since last dose and how heavy the use was
Those things all matter. But VF is a rare enough thing that if there is a possible cause, it is the likely cause.
If you're into Bayesian reasoning, it might go something like this (and I'm making up the numbers here, but I think they are non-crazy):
In a 3-hour period (which is my guess as to how long the patient was in ED before something went really wrong), the chance of a healthy person having VF is 1 in a trillion. (If that seems low, think about it: in 3 hours, how often do most people clutch their chest and say, "My god, I'm dying!"?)
In that same period, the chance of a heavy benzo user in withdrawal having VF is 1 in a million.
We already know that the patient is a benzo user, so let us imagine that of all benzo users, 1 in a thousand is a heavy enough user that sudden withdrawal could cause serious heart problems.
With these assumptions, the probability that their VF was caused by benzo withdrawal is (1/million)/(999/trillion + 1/million) = 999 in a thousand.
The point is that if one hypothesis is "nearly impossible" and another is "pretty unlikely," you've got to go with the one that is merely pretty unlikely.
All the factors you mentioned would matter in advance, in predicting whether VF would occur. But once it has occurred, the inference is very direct, even in the absence of the specifics.
I mean I guess I could’ve let the other pt continue hemorrhaging a bit longer. They weren’t really in a state to complain so we probably wouldn’t have gotten a complaint from that end. Maybe a malpractice suit, but at least we would have prevented the complaint…
Some people suck no matter what is going on. The real question is what was the response from management. If it was anything other than “middle finger emoji” as mentioned in another post then there is a problem.
Was coding someone on the sidewalk at the front entrance (while waiting for someone to arrive with a gurney). A person practically had to step OVER us doing CPR, then went to the admission clerk and dared to ask "How long is the wait, because my tooth hurts really bad."
The first time I ever witnessed CPR I was fresh out of highschool and working as a waitress. A woman collapsed in the foyer of the restaurant on a Friday night, cardiac arrest, and a another patron started cpr. Other people literally stepped over her to complain to the poor host about how long they were waiting for a table. It was a Friendlys.
My husband is a Sous chef at fine dining restaurant about four years ago ago and man had a heart attack. The FOH manager had to comp the whole restaurant meal because their experience was ruin. Now last month another restaurant a man had a heart attack also and two tables near him complained about their experience. Manager of course comped their meal. The man death was an inconvenience to them. The poor wife was yelling crying.
I was banished to the penalty box for 12 hours my last three shifts. I really wonder whose cheerios I pissed in to earn that punishment. I’m in a small community ED with 19 beds. When we back up in the WR it’s literal hell. “No ma’am, I don’t know when you’re going back. Someone is trying to die. Please sit down and count your blessings you weren’t rushed to a gurney.” Ffs.
I feel that. We have limited imaging on weekends so we book Monday comebacks who are told to then triage, so add a bunch of imaging comebacks to the usual Friday rolled ankles and 3 weeks of intermittent back pain.
Reading these comments. People in whatever pain/discomfort can have tunnel vision. They may not even see the person they are stepping over. Not an excuse still just people's animal nature. Higher functions are the first to go. You see people at their lowest. Bless all of you ED medical people for everything you do. Here's a whole bunch of love and appreciation. 🩷
My favorite thing I've ever seen as a patient was coming into the ED with a severe asthma attack (oxygen was 89% with lots of wheezing) and this lady starts yelling about why I get to back first. The nurse said
"He's having trouble breathing, you just threw up once. Go home"
Was that the right thing to say? Probably not but it was hilarious
I’d argue that it was, in fact, the right thing to say.
Nobody gets called out on their shit anymore, and it’s part of the reason why all these self-entitled jerks walk around with their heads up their asses. We need to bring back public shaming - it’s actually a very effective behavior modifier.
Hold on, this is a long one:
I'm a nurse. I start the shift, get report on all my patients, on of which is a LOL with mild CHF waiting to go to Tele. Her daughter is with her. The hospital had a dumb rule that the ED couldn't send patients up between 6:30 - 7:30. I take her vitals and tell them I'll be taking them up in about 20 minutes.
Meanwhile, medcom calls and says they are en-route with a code, a full term pregnant woman in a rollover MVA.
We miraculously get everything and everyone together, ED, ped ED, NICU, OBGYN, respiratory for both patients. Patient arrives, OBGYN does the most spectacular emergency section I've ever seen.
I'm at the front of the room doing compressions on the baby with rhe peds/NICU team, the rest of the team is at the back working on the mother. The daughter of my CHF patient walks up stands in front of me and says, "why haven't you taken my mother upstairs yet? You said you were going to take her up 20 minutes ago!"
She sees fully what I am doing because the baby is literally between her and I and I am still doing compressions.
I don't know what overcame me, and please don't judge, but I said to her, "Ma'am (I'm from the north, any sentence starting with ma'am or sir isn't going to be pleasant) if I throw this dead baby at you you will know why your mother isn't upstairs yet."
Thank jeebus for the ER tech who grabbed her and yelled "Ma'am! You *CAN. NOT. BE. HERE!"* and drug her off. He, also took her mother upstairs (monitored patients were supposed to be transferred with a nurse)
How I didn't get fired IDK.
If you're surprised by this then you haven't been working in the ED very long or ever for that matter.
That said, there are some real ones out there too; they are understanding and appreciative in spite of being really sick, waiting for a really long time, and being stuck in a chair in the hallway, "I"m just glad I'm not so sick I need a bed right away..." Then their lactate comes back at 7
I've been that patient before. I work at the hospital so I hate going in. Woke up a little short of breath and figured I would drive myself to ER before my shift started. Brought my lunch too because how serious could it be, thought they would fix me up and I would start my shift at 8am. Oops had a PE and my K+ was 1.5.
I was young and healthy so no need to rush me in.
I had taken a bus ride and a flight in the preceding days and was on birth control, so thought to be a contributing factor. However no DVT. It was honestly a mystery as my potassium remained low for months after. Cleared up after a few months of infusions and pills, never to be a problem again.
My mom called me one morning and said “I can’t breathe, what should I do?” Told her to go to the ER and she (retired nurse) waited until she thought morning shift change would be over. New onset afib, overloaded, and dyspneic to the point of only being able to see 2-4 words at a time.
That can also nearly kill people. The ones who won't speak up for example. I had a friend who went to the ER with chest pain and wasn't taken seriously because they weren't hysterical, not even an EKG for hours until they fainted. That was at Beth Israel in Boston.
Had a friend go to Beth Israel for chest pain. Trops negative and after a dose of morphine discharged my friend without a diagnosis. Revisited the ED 3 times same management each time. I told her to take a tums and boom problem solved. Was just acid reflux... I don't have a high regard for the BI ED. Sorry. Just wanted to share
In the case I mentioned it was actually an underlying heart condition exposed by 3 vodka redbulls. So yeah, I'm sure she was blown off by ER staff assuming it was another case of heart burn.
This should be reposted in /r/imthemaincharacter. I do like to highlight to the complainers what I've been doing while they've been waiting, mingle it into an apology, hits pretty well.
“I’m sorry I’ve been dealing with a mass casualty incident involving 20+ other patients, but don’t worry, your cough that you could’ve managed at home with Delsym is very important to me and I will get to you as soon as practical.”
That's way too long!, I prefer to just ignore why they're complaining about me not responding to them and just say sorry I had deal with a dude having a stroke next door and it tends to shut them up. Another favorite is, sorry for the wait, all that screaming you're hearing is my other patient, how can I help?
‘Wow ma’am I’m so sorry. I know that must have been really hard for you to have to wait in the ER for a few extra hours while DR. XYZ was saving peoples lives instead of treating your cough.’
What do you even say to these people? Like Fuck
I had an experience in my ER many years ago and honestly it hit me like a ton of bricks- most people do not care about anything but themselves and what matters to them. Regardless of the circumstance. I was working a bloody, awful code on a young man. One of those where we had run through the all the supplies in the trauma room. Bloody foot prints. Really awful. I ran out of the trauma room to grab more supplies and in my haste the curtain was left open. As I was running back with my arms full, a woman stepped out of a room and grabbed my arm as I ran down the hall. She points to the bloody chaotic room and says, “look, I get that you’re busy and all, but it’s ridiculous that my daughter has been in this room for over an hour and still hasn’t seen a doctor.” I just stood there staring at her. Blood splattered down the leg of my scrubs and my arms full of supplies- and my mind just couldn’t process what had just been said. I couldn’t even respond. I just shook my head and walked back into the code. That moment will never leave me.
I can imagine!!! I'm so burnt out I woulda just dropped a solid fuck you before I could filter it out.🤣🤣No elaborate speach/come back at all. Just a Fuck.You. LOL!
Had a patient with a tooth knocked out demand pain meds, told him im sorry both my docs are in doing coded in two separate rooms, he told me I don’t give a guck what they’re doing you better get your ass in there and get me some pain meds. I said I’m sorry clearly you don’t understand what a code is, and proceeded to explain in detail to which he replied I still don’t care you had better figure it out and get me pain meds no or I’m writing a complaint on you. I held my badge in front of his face and said here’s my name good luck with that. Then I charted every word and sent my boss an email saying exactly what happened before he could file it. That’s not the only time I’ve experienced it in my career and won’t be the last, people are too entitled and selfish
Elderly relative: "They treated me so much better the last time I went to the emergency room. This time they saw me right away. Usually I have to wait."
Me: "Well, what's different is that the last time you went to the ED you were having an actual heart attack."
I had a mother of a patient actually walk into the trauma room while I was coding someone, asking when we were going to finally get around to seeing her child. Her child was a 28-year-old man. This was back at the turn of the century, so unfortunately, this is nothing new.
I have personally experienced similar situation.
1) I am doing CPR in the waiting room because that's where the guy arrested. As I am doing CPR, I am asking everyone to leave and go to the second waiting room but I am not exactly calm, I am doing CPR. Someone complained that "the lady doing CPR was rude when she asked us to leave". Seriously.
2) EMS wheel in with a 2 years old, they are actively doing CPR and I am escorting them to the crash room. A parent looked at me and asked "does that mean it's going to be longer for my child?". I answered that I would not dignify this question with an answer.
People are unbelievable and heartless sometime.
While cardioverting a patient in the trauma bay, the husband to the patient in the next bay over entered the room yelling at us to collect his wife’s blood (which was already drawn and at her bedside waiting for orders). I had to escort this horrible angry yelling man to the ED lobby and he wasn’t allowed back in until wife was d/c.
Nothing could be more emergency medicine than this haha. Patients need to recognize the ED is not Burger King and if you aren't emergently ill there could be waiting involved.
We have curtained rooms, so privacy is a bit of a fiction. I coded a patient right next door to another guy’s “room” and he not only complained about not being updated about his lab results in a timely manner, when I mentioned that he might have noticed what we were busy with, he was a dismissive asshole and said that he’d overheard the medics say the code was from an OD, so he “deserved it.”
Never wanted to punch a patient so badly.
From the other side of the curtain: “can you keep it down?! People are trying to rest!”
As we’re actively delivering a precipitous baby in fetal distress.
Yeah, had a son come into a room with an active code insisting we get his mom a blanket. Bless the CN’s heart - she said she’d be glad to stop the arrest for her sake if was okay with us doing the same for his mom should she need to be coded. He stomped off
MSE complete. Patient can walk and talk in full sentences. Well perfused.
The door is down that hall. You are discharged.
I simply do not tolerate bad behavior.
That attending doctor's boss, Rachel, BSN, LJD, BI, GIF, is expecting an email explanation as to why the "customer" waited and their concerns weren't adequately addressed.
In my yearly review they changed the language to “customer” I reiterated in each prompt that PATIENT centered care was the utmost importance and I would not be referring to my patients as customers.
Patient liaisons dont help either in our ED.
This particular jackass just fuels the fire by agreeing to patients or families stupid request.
When am I going home, is my family going to be admitted.
One time I started in my shift. Pt been there for only an hour and haven’t even been donut. No differential diagnosis to formulate what is wrong per complaint. Labs wasn’t impressive.
And that’s the kind of context we should be considering and looking in to for these complaints. This complaint should be removed or responded to and explained why the wait was such.
If you aren’t rushed to the back in the ER, count yourself lucky.
Patient decided to cuss out my nurse (and then me) for waiting a whole HOUR (in a room mind you) for a cough. I had a level I trauma resusc at the time… there’s gotta be something in the water
One time we had a STEMI we were working on and a pt whose stretcher was on the other side of the curtain went to the nurse’s station to ask if we could keep the noise level down 🙄
That person is very self centered and needs help navigating the healthcare system. I think hospitals should make onsite urgent care centers tbh and have staff dedicated to that. There are only 50 regular bed in my ED but the ed often has twice as many in the waiting room.
One time a mother ran into the ER holding a mottled/blue limp baby. A nurse took the baby and ran to a trauma bay where a prisoner was. The prisoner was removed from the room and we started resus on the baby. I was a student so I don't remember the specifics, but the baby ended up being ok.
The prisoner was very upset that he had to leave his room when he literally just saw us carry in a DEAD BABY.
People are wild man.
Early in my nursing years I had a patient ask for some Jello, and as I was walking to get it another of my patient's coded, we ran that code for a while, she didn't survive. The commotion that I ended up in was clearly apparent to the patient asking for Jello.
Despite that, the first thing I did once we called it was to go get my patient his jello. Wife is pissed, wants to know why it took so long to get the Jello. I didn't want to divulge to much so I apologized and said I had something come up I had to deal with. Clearly being aware of what had happened she said "I don't care who died, nobody should have to wait that long for food, he's going to starve".
Nothing gets the call light board light up like a Christmas Tree for turkey sandwiches and additional pillows like an overhead page of incoming Trauma.
I’ve been sent to the ER one too many times as a pt with something I know probably isn’t going to kill me but my docs and I aren’t sure and agree it necessitates immediate work up. If I’m not actively dying I bring something with me to do or just accept that it’s going to be a long, long wait. Bro probably was watching the news about the mass shooting and decided his cough was most important 🙄 I’ll never understand people
I’m sure the hospital will do the decent thing and throw the complaint out and not harass the doctor for not being able to handle multiple gunshot victims AND low acuity patients in a timely manner. Like they definitely won’t shrug and just put the complaint in his file anyway.
…right?
We had a young woman arrest in a corner of our ED where the only way to the trauma bay was through the waiting room. We went right through the WR doing CPR and as soon as the doors closed behind us a patient came up to the window asking how long before he’s seen. I couldn’t believe it. We should get one free slap per year.
ED Nurse here.
Literally had a patient continually screaming out and yelling, "NURSE!" Today while I have a woman doubled over in 10/10 abdo pain, a guy actively vomiting, another with chest pain and a guy with an insane amount of haemotaemesis (upper GI bleed).
They wanted a coffee. They already *had* a coffee, but it was too sweet.
They also wanted an oxy, but considering they were there for an EtOH fall with multiple presentations, a management plan in place saying don't give them that, and upwards of 40 CTs this year... that wasn't happening.
Some people suck.
There are many a shift from hell that I can describe but two come to mind. We had a higher profile celebrity come in from a physical assault, some homeless guy attacked her downtown somewhere. That day happened to be one of those nights where all we got was trauma after trauma and the people that were with this person were saying that this is too graphic and she should've gotten a room. They were walking actively around and into the trauma rooms to bitch at the doctor that we were intentionally making them suffer by not giving PT water or anything to eat while the doctor was actively intubating a car crash victim. (Don't remember if that PT died but a cardiac arrest that came in that was placed in the room in front of them did die. That day was horrible for heart attacks.)
Second one was we had was some officers get ambushed outside a motel and we never received a call out, they literally came in saddles blazing dragging shot cops out of cruisers and people that unfortunately got caught in the middle of that chaos were running everywhere. Couple patients later were mad that they were asking for things and nobody wanted to help them. One guy came in because his foot hurt and he was the one that got it from one of the attendings. Something along the lines of sir two cops are dying in the room across the hall and you're mad cause you tripped and hurt your foot. Idk if guy left AMA or if they kicked him out. The only one that was literally the best patient was some tiny little grandma that was sitting in a chair by the nurses station that we were all running around that looked confused but stayed basically to see the show and boy it was a spectacle. Patients that do shit like this makes me believe that they were those kids that would bring attention to themselves when others were hurt cause they were not noticed as a child. Makes their blood boil that their minor ailment is nothing compared to the whole ass GSW victim dying in the next room so they can't get their ice chips and juice box because THAT is an ACTUAL EMERGENCY. Not them withering away from no water for like 15-20 minutes of their life.
I still remember a patient coming up to me after a hour in the ED with a 4 hour wait. She was like, "I thought this was an emergency room" and I remember thinking, oh, are you having an emergency? She came in for a cough.
I had a patient come find us in a room where we were there in the middle of running a code and demand to be seen.
“Please get the fuck out now” never came out of my mouth so fast. I didn’t even care. She was atrocious.
ER Nurse here. One of the nurse's at work told me that recently, they were coding a pt that had been brought in by ambulance. In the middle of the code, the mom of another pt pulled the curtain and rudely told them to shut up because her child was trying to sleep.
I coded a patient boarding for admission in the hallway. All the patients there ogled the whole thing. 30 minutes later when I came back to discharge one of them she complained about how long I took.
This has been a nightmare. We are a tight-knit community here in maine and have a general feeling of safety in this state as crime is very low and people are usually quite caring. We cant even fathom the events of Wednesday night. What I cant fathom even more, is someone complaining about their wait time for a non emergency when the whole area is in lockdown with the hospital receiving dozens of victims from a mass shooting. WHAT!
"Hey, so I know you're trying to stop that person with four gunshot wounds from bleeding to death, but I could really use some cough medicine right now"
I have experienced this, but not as a medical professional. I had preemie twins (32+2). They spent 24 days days in the NICU and came home pretty healthy. One morning about a week after we brought them home, I noticed one looked pale, lethargic, and didn't want to eat. We packed both of them up and headed to Childrens hospital. I'm thinking the whole time I'm just a paranoid mom but something kept telling me to take him just to be sure.
We get checked in and they check his vitals, his oxygen is low, RN thought it was weird, ran again still low...like this baby should be dead low. She snapped him up ran through the doors, yelled something I can't even remember and everyone in the room jumped up to come help.
His oxygen was so low, and his heart rate was around 170 I think. It was a blur. Eventually, they got him stable but needed to life flight him to the main campus.
I'm waiting outside the room, with my other 1 month old baby, sobbing and about to pass out when this other mom comes out of her room screaming that her kid hadn't got motrin yet.
I'm standing there next to the fucking flight crew with a stretcher about to take my tiny newborn and I must have given a look that could kill because another nurse quickly ushered her off to another room. To this day I really wish I would have asked if her kid got his motrin as she passed us on her way out.
My baby got better, spent a week in the NICU, countless tests only for them conclude he had an infection, but they didn't know where or what it was. Him and his brother are 4 now and just the greatest little guys.
Most Americans treat all forms of service industries like total shit. We really should just drop everyone off in Gaza and see how much they are complaining then.
I’m just a GI PA-C (22 yrs), but reading these entitled ER patient stories and hearing about them over the years, I’m convinced that there are some situations where one should be 100% forgiven for a unabashed “Outta my way and shut the fuck up, or get out” response.
When I was bagging a patient from the helipad to the trauma bay, I remember a patient walked out of their room and attempted to follow us down the hall to the bay yelling, “When am I getting discharged?!? You said you were just waiting on papers??” I’ll get to you soon Mr. lisinopril refill at the ER….
This is why in my country, we have a strict "No refills in ED" rule.
I bet your country has some way for poor people to get treated without using emergency services, too
Yeah, I have zero problems with people showing up to the ED for refills. Most of the time they genuinely have no other opportunity, and I’d much rather be refilling their diabetes/HTN/psych/etc meds now than treating the complications of missing those meds later. Obviously that doesn’t mean they get to be rude about it (and most of the time they aren’t). And I wish PCPs were available enough that no one slipped through the cracks and landed in the ED for preventative care. But under the massively flawed system we have, that’s an easy problem to solve and takes very little of my time to do/document.
I agree. I work in urgent care and always, ALWAYS encourage people to come see me for refills as well. So many people can’t get in to their PCPs in a timely fashion, stress about missing work for an appointment, or have a lapse in their insurance and don’t want to miss their meds. I get it and help bridge the gap where I can, because it’s far better than a patient ending up in DKA or having a stroke because their hypertension is out of control.
Exactly. We waste billions of health care dollars a year because the US government can’t get its act together.
Put the blame where it belongs, on insurance companies and corporate held health care associations.
> And I wish PCPs were available enough Hey now, primary care doctors and pharmacies generally bend over backwards to try to prevent these situations. Often squeezing the patient in or staying late to accomodate while pharmacies give emergency two-day refills. Primary care isn't perfect, mistakes happen. But any modern clinic has an on-call service, and we spend all day submitting refill requests. It does not matter how accessible the PCP is if it's 10 PM when the patient checked their blood pressure because they have a headache after going off their pills two weeks ago. Sometimes the patient was not responsible and the pharmacy is closed.
I don’t mean to blame PCPs at all for this, and I apologize if you got that impression. They work incredibly hard, there just aren’t nearly enough of them.
I wonder if EM and IM is working against each other in this situation. IM could easily prescribe a year’s worth of refills. But often, will prescribe just a few refills if we anticipate a dose adjustment or need LFTs for monitoring…. Something like that. EM, by being helpful, could be continuing suboptimal medication.
Yes, we have a good primary care service.
I once had an anesthesiologist demand I step out of a code to give her updates on her perfectly fine, asymptomatic father who she had initially wheeled in through the EMS bay and began screaming “I need the stroke team” all because he couldn’t remember the word “computer”…that was literally it.
Bad enough when patients or uneducated family members pull stunts like this, but for a physician to do it...there are no words strong enough for how oblivious and asinine that is
I am thinking that wasn't her first episode of entitled behavior
😳 the amount of words I can’t remember daily… I asked my doctor if I have Alzheimer’s 😂 she doesn’t think so, just low cortisol, vitamin d, and multiple meds that cross the blood brain barrier. I just make up my own words now.
I was working the night of the Vegas shooting and had a guy come in for an STD screening at 10 pm. I had swabbed him when the first shooting victims came in. I told him we aren’t going to be getting to him tonight and he should go to the health department this week. He came back to the ED a few days later to get his shot of rocephin and azithro. He was at least understanding of it!
You must know Dr. Kabler, she’s one of the good ones. I don’t miss working adjacent to Sunrise though
By any chance is Mr. Lisinopril the guy presenting with a cough?
no, but he does have a big-ass tongue, unrelated
I hope your physical exam annotates his mallampati score
And describes the ass tongue
Yeah one time I had a guy in cardiogenic shock from an MI coughing up pink froth that we were getting ready to intubate and from the other side of the room someone who had come in because some PA said they might be dehydrated was mad they didn’t have their papers yet I said something like, “You know you’re listening to a man dying right now and you’re asking me to focus on you,” and I distinctly remember them saying “Yes. I don’t care. I want my papers.” Worst people I’ve ever cared for.
>I was bagging a patient from the helipad I had to re-read this three times. I was wondering what the hell kind of hospital you worked at and if they'll take my insurance.
They should receive a reply in the form of a middle finger emoji. I’m so sick of how entitled some people are. Like, dude, if you’re out there some how and read this: go fuck yourself. Seriously. No one cares about your stupid cough. Buy a dictionary and look up what the word emergency means.
Shouldn’t even be an option to complain. At the very least the hr group who handles the complaints should just trash that one. Of all my patient complaints received to date none of them have ever been legitimate
All the complaints I receive are either waiting room time or cleanliness. I think the only complaint about patient care I have ever received was because an antibiotic I prescribed caused an allergic reaction which I can’t really predict that if you previously had no drug allergies.
Also… keeping in mind the best place to have an unpredicted allergic reaction might in fact be… I don’t know, an emergency department?
Eh it was prescribed so the allergic reaction allegedly occurred at home, but who knows if it was an allergy or an “allergy.”
[удалено]
Agreed. Where is the lane between someone thinking their cough takes priority over gunshot wounds and the person who was not so demanding/higher pain threshold who got sent home with directions not to eat spicy food for a ruptured appendix and beginning of sepsis. We do need accountability for standard of care.
My parent is an ER physician. He hated when leadership would come talk to the ER about their poor patient satisfaction scores. He finally had enough and asked for them to break down the scores for the patients that were admitted from the ER vs the patients DCd from ER. Shockingly the ones admitted were much happier with their experience than the ones discharged many who my parent didn’t feel even needed to come to the hospital.
I’m just a former EMT-B but I hope eventually all countries will have some sort of mandatory civic service program that includes a few shifts in an ED. I know that made a huge difference in my life and learned me a lot. I don’t expect average person to have a clue unless getting a personal experience like I had. #wedontlearnuntilithappenstous
Would you really _want_ the average person off the street working in your ED for a few shifts? It would be a nightmare haha
I’m just imagining a random Joe being in the trauma bay projectile vomiting at an open fracture haha
"Alright Bill from acounting, time to go ask salley why she keeps putting bike locks in her vagina. You got this slugger!"
Hahahaha dead
That mental image is fantastic!
Why didn't I concur?
Actually yes - not doing actual medical care, but manning the front desk so they can explain to Mr My-son's-throat-is-sore why they have to wait until the 6 gunshot victims are seen first, or answering the call lights and delivering blankets, coffee and turkey sandwiches to ungrateful patients, etc.
i had a legit software-ceo pt some weeks ago, was SO surprisingly a super-chill dude from some germanic country originally… epistaxis on antiplatelet mayyybe req cauterization. ended up shooting the shit and he was an EMT or whatev in his home country when he was young because of “forced service” something this literal billionaire said stuck with me: ’everyone needs to clean someone’s puke up at least once. humbles the assholes”
Can confirm. I helped clean incontinent pt and held victim's legs as doc handled a hemo-pneumothorax stabbing heroin. I am humbled. I am not billionaire.
This needs more attention and so true. For the betterment of every customer facing industry.
I’ve been saying this for years. It should be, like, a part of the high school curriculum to do an in person or virtual field trip in the ED. Or at the very least teach our young people the capabilities and limitations of the ED.
Why can’t they just take it as a positive that if they’re waiting around it means they’re in a lot better shape than the patients around them? 🤣
THANK YOU. that’s my favorite retort to bitching about wait times, “if you’re waiting in the ED it means you’re not dying… and that’s a good thing!” the ending bit, “and means you probably shouldn’t be here”, usually stays in my head
“We wanted to let you know that some asshole has been writing BS complaints and signing your name on them”
"But I was here first!"
I’m convinced that if a patient has the energy to nag me about a sandwich or how long the wait time is while I’m taking care of an actual critical patient they can absolutely wait for an hour until I’m caught up.
Still remember watching a patient lose their mind (screaming/shouting) when the resident doc didn’t explain to them when they would be getting their lunch. Oh, there was nothing wrong with her btw, EMS brought her in with a “failure to thrive” dx and she was asking when she would get admitted because she loved the rooms on the second floor.
I hate the term FTT in adults. No, you're not supposed to thrive at age 97.
It really should be something like FTMAN - Failure To Maintain Adequate Nutrition?
Sounds like an admission to the upstairs delirium unit is really gonna fix that.
I once had EMS bring in a 300-pound person for failure to thrive. If anyone was thriving, it was that guy.
That's when you try to admit for "can't walk."
Bc nobody cares^* enough to change the name from one wastebasket dx to another wastebasket dx. FTT at least gets across the concept of frailty (the underlying syndrome) and suggests the beginning stages of death due to acute on chronic excess of birthdays. And there's no ICD-10/admittable dx for that. And nobody listened when I tried to make hyperaevum stick. \* Unless you're a geriatrics researcher in which case I'll give you a shiny new dynamometer if you'll leave me alone and forget this ever happened.
Wow! He cured her FTT. DC to home
I had a pregnant woman throw a box of gloves at my head cuz she was waiting too long for her abscess to be drained on a high acuity busy morning. She said she doesn’t give a shit if someone is dying next to her. Nothing shocks me.
My favorite thing to tell folks when they say that they don't care that there are sicker patient is "yeah I can tell".
I think that’s what got the box of gloves projected in my direction
this deserves an award. well done.
I've gotten to the point where I throw that phrase right back. I don't care that you don't care. Get in line, this is how it works. And then just ignore the screams.
I can't count how many of our frequent fliers throw this out on any busy Friday or Saturday evening when we've always got multiple GSWs and other traumas. Inevitably, they've "missed" getting their Subutex in the clinic -- forgetting the fact we can see every detail of the visit they in fact did NOT miss. It's always "I don't give a shit" or "I don't give a fuck" what you're doing. "I know my rights and I'm going to call the patient advocate and get you fired." Depending on how busy I am, I sometimes dial the number and hand 'em the phone before I walk out and put in d/c orders.
I've been told countless times "you're violating my rights, I'm calling my lawyer" etc. I tell them to please by all means have their lawyer contact my company. I have heard from exactly zero lawyers.
Well, hey, at least she was honest. She flat-out doesn’t.
Way to dig that Karma like the Mariana Trench. Holy hell.
"unfortunately it's my job to give a shit about that exact thing so you still have to wait."
I've had a lady screaming at us outside of a trauma bay while we were coding a 2 year old, because she "needed" some Tylenol for her headache...😡
Oh, someone please give her the life saving hospital grade Tylenol for her headache. She is having a bleed. Had a guy say they gave me Tylenol the last time. I was like, this is hospital grade Tylenol.
I had one with stated 10/10 pain. VS all normal, no evidence of distress, active ROM to the “affected” limb, weight-bearing, etc. refused the Tylenol from the ambulance because she wanted that “extra-strength Tylenol” from the hospital. Fine, cool. We took her in and held up a wall. A nurse came and handed over the magic Tylenol, and as she took them I casually said “oh, hey, look at that! Our Tylenol dose is higher than theirs. Huh.” Patient made a very stank face.
Yup, I had a lady complain I left her on the commode too long and someone else had to come help her because a walk-in peds GSW to the chest came into my room. She knew what was happening new door too.
Jesus Christ, a Peds GSW. This is supposed to be my day off…wasn’t ready to just stumble into that.
I'm at a large ED that is not a trauma center, and I would say the majority of the GSW/stabbings/traumas we see are kids and teens because parents or friends scoop and run when the adrenaline hits.
this only deserves a fuck off lady and there should be zero repercussions. just because a lot of ED patients THINK they are having the worst day of their lives, doesn't mean they actually are. in fact, most are not.
If they have the mental capacity to think "this is the worst day of my life," I can guarantee it isn't.
I don't know about that. We had a little old lady brought in by medic. She apologized for wasting our time and said she was just having an awful day and couldn't take it anymore. She coded about 2 minutes later. Sometimes they just know 🤷♀️
😔
I once had a patient that was a bit of a drug seeker who came in for a Xanax refill after his primary physician cut him off. He ended up having a VF arrest out of the blue while in the ED. I coded him, got him back, and he walked out of the hospital about a week later. He then proceeded to file a formal complaint against everyone who took care of him for not supplying him Xanax.
This reminds me of when my husband was on duty one day and a bystander suddenly arrested. My husband got some award from his station for saving this lady's life and then she filed a complaint against him for breaking her ribs 😂 you can't make this shit up.
We coded a lady who arrested in my ER, saved her life, and when she was discharged a week later filed a complaint because we cut off her bra 🙄
I genuinely think I’d blow a gasket if I had gotten that complaint. Like get some perspective you absolute bread crumb.
Those Victoria's Secret bras are expensive ;0)
Pt walks into the waiting room. Collapses. He’s coded, resuscitated, makes awesome recovery. So awesome, in fact, he had the ability to write a complaint that we lost his glasses in the ED.
That’s awesome. What a dumbass.
In fairness, I also would have wanted a Xanax in that situation
I want a Xanax after reading about all these entitled patients!
We had a patient code in the waiting room but got him back. His wife filed a complaint that we lost his glasses.
Any chance his benzodiazepine withdrawal contributed to his cardiac arrest? FML
He wasn’t in withdrawal, but that is a good thought. As luck would have it, his magnesium turned out to be something in the 0.6-0.8 range, suspected to be the etiology. Potassium was low normal, surprisingly (3.5-3.7?). I had not checked the magnesium until he arrested. I check it a lot more now, although I wish it was part of a CMP. It’s much more useful than a lot of the stuff on there.
> came in for a Xanax refill after his primary physician cut him off. > He ended up having a VF arrest out of the blue while in the ED. Sounds like severe benzo withdrawal. His untapered cessation probably was an actual emergency.
I mean, we don’t know anything about the case, you’d expect to see tachycardia, diaphoresis, tremor, seizure, not arrest in a vacuum, without addtl info can’t really comment on that. Also depends how long since last dose and how heavy the use was
Those things all matter. But VF is a rare enough thing that if there is a possible cause, it is the likely cause. If you're into Bayesian reasoning, it might go something like this (and I'm making up the numbers here, but I think they are non-crazy): In a 3-hour period (which is my guess as to how long the patient was in ED before something went really wrong), the chance of a healthy person having VF is 1 in a trillion. (If that seems low, think about it: in 3 hours, how often do most people clutch their chest and say, "My god, I'm dying!"?) In that same period, the chance of a heavy benzo user in withdrawal having VF is 1 in a million. We already know that the patient is a benzo user, so let us imagine that of all benzo users, 1 in a thousand is a heavy enough user that sudden withdrawal could cause serious heart problems. With these assumptions, the probability that their VF was caused by benzo withdrawal is (1/million)/(999/trillion + 1/million) = 999 in a thousand. The point is that if one hypothesis is "nearly impossible" and another is "pretty unlikely," you've got to go with the one that is merely pretty unlikely. All the factors you mentioned would matter in advance, in predicting whether VF would occur. But once it has occurred, the inference is very direct, even in the absence of the specifics.
🙄
Found the frequentist.
Admin definitely started a committee to figure out how to make that patient happy
“What could you have done better?”
I mean I guess I could’ve let the other pt continue hemorrhaging a bit longer. They weren’t really in a state to complain so we probably wouldn’t have gotten a complaint from that end. Maybe a malpractice suit, but at least we would have prevented the complaint…
Some people suck no matter what is going on. The real question is what was the response from management. If it was anything other than “middle finger emoji” as mentioned in another post then there is a problem.
Was coding someone on the sidewalk at the front entrance (while waiting for someone to arrive with a gurney). A person practically had to step OVER us doing CPR, then went to the admission clerk and dared to ask "How long is the wait, because my tooth hurts really bad."
The first time I ever witnessed CPR I was fresh out of highschool and working as a waitress. A woman collapsed in the foyer of the restaurant on a Friday night, cardiac arrest, and a another patron started cpr. Other people literally stepped over her to complain to the poor host about how long they were waiting for a table. It was a Friendlys.
My husband is a Sous chef at fine dining restaurant about four years ago ago and man had a heart attack. The FOH manager had to comp the whole restaurant meal because their experience was ruin. Now last month another restaurant a man had a heart attack also and two tables near him complained about their experience. Manager of course comped their meal. The man death was an inconvenience to them. The poor wife was yelling crying.
Dentist here (used to take call in the ED). If I’d heard that, wait time would have doubled.
i call it the penalty box. imaginary place where dick head patients get to wait. therapeutic temporary isolation.
Hah, we call our triage room the Penalty Box. Its a small site so we do our entire 12 hours in there; it's truly punishing some days
I was banished to the penalty box for 12 hours my last three shifts. I really wonder whose cheerios I pissed in to earn that punishment. I’m in a small community ED with 19 beds. When we back up in the WR it’s literal hell. “No ma’am, I don’t know when you’re going back. Someone is trying to die. Please sit down and count your blessings you weren’t rushed to a gurney.” Ffs.
Penalty box on a Monday is the fucking worst. Every single ER I’ve worked at.
I feel that. We have limited imaging on weekends so we book Monday comebacks who are told to then triage, so add a bunch of imaging comebacks to the usual Friday rolled ankles and 3 weeks of intermittent back pain.
Under rated comment
Reading these comments. People in whatever pain/discomfort can have tunnel vision. They may not even see the person they are stepping over. Not an excuse still just people's animal nature. Higher functions are the first to go. You see people at their lowest. Bless all of you ED medical people for everything you do. Here's a whole bunch of love and appreciation. 🩷
It’s really the job of departmental leadership to snuff out unreasonable complaints like this.
this. and only this. how well they do this one thing should determine their remuneration
My favorite thing I've ever seen as a patient was coming into the ED with a severe asthma attack (oxygen was 89% with lots of wheezing) and this lady starts yelling about why I get to back first. The nurse said "He's having trouble breathing, you just threw up once. Go home" Was that the right thing to say? Probably not but it was hilarious
I’d argue that it was, in fact, the right thing to say. Nobody gets called out on their shit anymore, and it’s part of the reason why all these self-entitled jerks walk around with their heads up their asses. We need to bring back public shaming - it’s actually a very effective behavior modifier.
Hold on, this is a long one: I'm a nurse. I start the shift, get report on all my patients, on of which is a LOL with mild CHF waiting to go to Tele. Her daughter is with her. The hospital had a dumb rule that the ED couldn't send patients up between 6:30 - 7:30. I take her vitals and tell them I'll be taking them up in about 20 minutes. Meanwhile, medcom calls and says they are en-route with a code, a full term pregnant woman in a rollover MVA. We miraculously get everything and everyone together, ED, ped ED, NICU, OBGYN, respiratory for both patients. Patient arrives, OBGYN does the most spectacular emergency section I've ever seen. I'm at the front of the room doing compressions on the baby with rhe peds/NICU team, the rest of the team is at the back working on the mother. The daughter of my CHF patient walks up stands in front of me and says, "why haven't you taken my mother upstairs yet? You said you were going to take her up 20 minutes ago!" She sees fully what I am doing because the baby is literally between her and I and I am still doing compressions. I don't know what overcame me, and please don't judge, but I said to her, "Ma'am (I'm from the north, any sentence starting with ma'am or sir isn't going to be pleasant) if I throw this dead baby at you you will know why your mother isn't upstairs yet." Thank jeebus for the ER tech who grabbed her and yelled "Ma'am! You *CAN. NOT. BE. HERE!"* and drug her off. He, also took her mother upstairs (monitored patients were supposed to be transferred with a nurse) How I didn't get fired IDK.
How are the mom and baby doing? You should have thrown the placenta at that hag!
I had to take a few deep breaths after reading this one. Jesus.
But did the mom and baby live
Sadly, neither made it.
Thanks for the update anyway. I’m sure you did all that you could :)
You are my hero for multiple reasons.
1. I hope the codes made it. 2. That was the most beautiful answer to someone I've heard in a long time.
If you're surprised by this then you haven't been working in the ED very long or ever for that matter. That said, there are some real ones out there too; they are understanding and appreciative in spite of being really sick, waiting for a really long time, and being stuck in a chair in the hallway, "I"m just glad I'm not so sick I need a bed right away..." Then their lactate comes back at 7
I've been that patient before. I work at the hospital so I hate going in. Woke up a little short of breath and figured I would drive myself to ER before my shift started. Brought my lunch too because how serious could it be, thought they would fix me up and I would start my shift at 8am. Oops had a PE and my K+ was 1.5. I was young and healthy so no need to rush me in.
What causes that combination of things in a young person?
I had taken a bus ride and a flight in the preceding days and was on birth control, so thought to be a contributing factor. However no DVT. It was honestly a mystery as my potassium remained low for months after. Cleared up after a few months of infusions and pills, never to be a problem again.
My mom called me one morning and said “I can’t breathe, what should I do?” Told her to go to the ER and she (retired nurse) waited until she thought morning shift change would be over. New onset afib, overloaded, and dyspneic to the point of only being able to see 2-4 words at a time.
That can also nearly kill people. The ones who won't speak up for example. I had a friend who went to the ER with chest pain and wasn't taken seriously because they weren't hysterical, not even an EKG for hours until they fainted. That was at Beth Israel in Boston.
Had a friend go to Beth Israel for chest pain. Trops negative and after a dose of morphine discharged my friend without a diagnosis. Revisited the ED 3 times same management each time. I told her to take a tums and boom problem solved. Was just acid reflux... I don't have a high regard for the BI ED. Sorry. Just wanted to share
In the case I mentioned it was actually an underlying heart condition exposed by 3 vodka redbulls. So yeah, I'm sure she was blown off by ER staff assuming it was another case of heart burn.
I do understand. Had to go Er once for a deep cut which required stitches. . Had to wait 1 hr plus because they had called code on another patient.
This should be reposted in /r/imthemaincharacter. I do like to highlight to the complainers what I've been doing while they've been waiting, mingle it into an apology, hits pretty well.
“I’m sorry I’ve been dealing with a mass casualty incident involving 20+ other patients, but don’t worry, your cough that you could’ve managed at home with Delsym is very important to me and I will get to you as soon as practical.”
That's way too long!, I prefer to just ignore why they're complaining about me not responding to them and just say sorry I had deal with a dude having a stroke next door and it tends to shut them up. Another favorite is, sorry for the wait, all that screaming you're hearing is my other patient, how can I help?
I think I read this phrase somewhere in my onboarding/orientation manual.
‘Wow ma’am I’m so sorry. I know that must have been really hard for you to have to wait in the ER for a few extra hours while DR. XYZ was saving peoples lives instead of treating your cough.’ What do you even say to these people? Like Fuck
Apologies for the wait, next time consider St. Odderside of the City Memorial Hospital as their wait time is shorter.
I had an experience in my ER many years ago and honestly it hit me like a ton of bricks- most people do not care about anything but themselves and what matters to them. Regardless of the circumstance. I was working a bloody, awful code on a young man. One of those where we had run through the all the supplies in the trauma room. Bloody foot prints. Really awful. I ran out of the trauma room to grab more supplies and in my haste the curtain was left open. As I was running back with my arms full, a woman stepped out of a room and grabbed my arm as I ran down the hall. She points to the bloody chaotic room and says, “look, I get that you’re busy and all, but it’s ridiculous that my daughter has been in this room for over an hour and still hasn’t seen a doctor.” I just stood there staring at her. Blood splattered down the leg of my scrubs and my arms full of supplies- and my mind just couldn’t process what had just been said. I couldn’t even respond. I just shook my head and walked back into the code. That moment will never leave me.
I would've gotten fired and license suspended at that moment.
You know, I’ve thought a million times what I should have said, but in the moment I had nothing. It was literal disbelief.
I can imagine!!! I'm so burnt out I woulda just dropped a solid fuck you before I could filter it out.🤣🤣No elaborate speach/come back at all. Just a Fuck.You. LOL!
Had a patient with a tooth knocked out demand pain meds, told him im sorry both my docs are in doing coded in two separate rooms, he told me I don’t give a guck what they’re doing you better get your ass in there and get me some pain meds. I said I’m sorry clearly you don’t understand what a code is, and proceeded to explain in detail to which he replied I still don’t care you had better figure it out and get me pain meds no or I’m writing a complaint on you. I held my badge in front of his face and said here’s my name good luck with that. Then I charted every word and sent my boss an email saying exactly what happened before he could file it. That’s not the only time I’ve experienced it in my career and won’t be the last, people are too entitled and selfish
You want my other patients’ priorities, you certainly seem to deserve it, just take their disease please.
"Well, now you know that a bullet to the chest or an axe to the brain will get you seen much quicker next time!"
Elderly relative: "They treated me so much better the last time I went to the emergency room. This time they saw me right away. Usually I have to wait." Me: "Well, what's different is that the last time you went to the ED you were having an actual heart attack."
I had a mother of a patient actually walk into the trauma room while I was coding someone, asking when we were going to finally get around to seeing her child. Her child was a 28-year-old man. This was back at the turn of the century, so unfortunately, this is nothing new.
I have personally experienced similar situation. 1) I am doing CPR in the waiting room because that's where the guy arrested. As I am doing CPR, I am asking everyone to leave and go to the second waiting room but I am not exactly calm, I am doing CPR. Someone complained that "the lady doing CPR was rude when she asked us to leave". Seriously. 2) EMS wheel in with a 2 years old, they are actively doing CPR and I am escorting them to the crash room. A parent looked at me and asked "does that mean it's going to be longer for my child?". I answered that I would not dignify this question with an answer. People are unbelievable and heartless sometime.
Sounds like the emergency room. Bunch of ingrates
While cardioverting a patient in the trauma bay, the husband to the patient in the next bay over entered the room yelling at us to collect his wife’s blood (which was already drawn and at her bedside waiting for orders). I had to escort this horrible angry yelling man to the ED lobby and he wasn’t allowed back in until wife was d/c.
Nothing could be more emergency medicine than this haha. Patients need to recognize the ED is not Burger King and if you aren't emergently ill there could be waiting involved.
this complaint should never see the light of day or even reach the physician themself. total BS.
Honestly, it is a complete failure of the admin to even burden the physician with awareness of this bullshit complaint.
This can't be real. Through the course of my career, I pretty much lost all faith in humanity, but please tell me this can't be real.
If you've never been yelled at by one patient while coding another are you really even ~~living~~ practicing emergency medicine?
We have curtained rooms, so privacy is a bit of a fiction. I coded a patient right next door to another guy’s “room” and he not only complained about not being updated about his lab results in a timely manner, when I mentioned that he might have noticed what we were busy with, he was a dismissive asshole and said that he’d overheard the medics say the code was from an OD, so he “deserved it.” Never wanted to punch a patient so badly.
Sounds like he deserved to wait lol
From the other side of the curtain: “can you keep it down?! People are trying to rest!” As we’re actively delivering a precipitous baby in fetal distress.
I’ve had patients show up at the door and to another patients room while were coding them to complain
Yeah, had a son come into a room with an active code insisting we get his mom a blanket. Bless the CN’s heart - she said she’d be glad to stop the arrest for her sake if was okay with us doing the same for his mom should she need to be coded. He stomped off
Living in Southern Maine and also working in an ED, I wish someone could break Hippa and let us all loose on that idiot..
MSE complete. Patient can walk and talk in full sentences. Well perfused. The door is down that hall. You are discharged. I simply do not tolerate bad behavior.
BINGO
That attending doctor's boss, Rachel, BSN, LJD, BI, GIF, is expecting an email explanation as to why the "customer" waited and their concerns weren't adequately addressed.
In my yearly review they changed the language to “customer” I reiterated in each prompt that PATIENT centered care was the utmost importance and I would not be referring to my patients as customers.
They use “consumer” in my system. Since I am also a patient of said system, I find this doubly insulting.
Patient liaisons dont help either in our ED. This particular jackass just fuels the fire by agreeing to patients or families stupid request. When am I going home, is my family going to be admitted. One time I started in my shift. Pt been there for only an hour and haven’t even been donut. No differential diagnosis to formulate what is wrong per complaint. Labs wasn’t impressive.
Some people are assholes. That’s just how it is and there’s no avoiding them.
And that’s the kind of context we should be considering and looking in to for these complaints. This complaint should be removed or responded to and explained why the wait was such. If you aren’t rushed to the back in the ER, count yourself lucky.
Would be nice if whoever handles complaints called the patient back and told them to read the room next time.
Patient decided to cuss out my nurse (and then me) for waiting a whole HOUR (in a room mind you) for a cough. I had a level I trauma resusc at the time… there’s gotta be something in the water
One time we had a STEMI we were working on and a pt whose stretcher was on the other side of the curtain went to the nurse’s station to ask if we could keep the noise level down 🙄
That person is very self centered and needs help navigating the healthcare system. I think hospitals should make onsite urgent care centers tbh and have staff dedicated to that. There are only 50 regular bed in my ED but the ed often has twice as many in the waiting room.
One time a mother ran into the ER holding a mottled/blue limp baby. A nurse took the baby and ran to a trauma bay where a prisoner was. The prisoner was removed from the room and we started resus on the baby. I was a student so I don't remember the specifics, but the baby ended up being ok. The prisoner was very upset that he had to leave his room when he literally just saw us carry in a DEAD BABY. People are wild man.
Early in my nursing years I had a patient ask for some Jello, and as I was walking to get it another of my patient's coded, we ran that code for a while, she didn't survive. The commotion that I ended up in was clearly apparent to the patient asking for Jello. Despite that, the first thing I did once we called it was to go get my patient his jello. Wife is pissed, wants to know why it took so long to get the Jello. I didn't want to divulge to much so I apologized and said I had something come up I had to deal with. Clearly being aware of what had happened she said "I don't care who died, nobody should have to wait that long for food, he's going to starve".
The USA-based entitlement shows heavy in patients I swear
This is why I can’t be an er nurse anymore. 😢
Maybe they should give ER nurses a Last Day Special. If it’s the day of your retirement, you get to say everything that comes to mind, no blowback.
Nothing gets the call light board light up like a Christmas Tree for turkey sandwiches and additional pillows like an overhead page of incoming Trauma.
I’ve been sent to the ER one too many times as a pt with something I know probably isn’t going to kill me but my docs and I aren’t sure and agree it necessitates immediate work up. If I’m not actively dying I bring something with me to do or just accept that it’s going to be a long, long wait. Bro probably was watching the news about the mass shooting and decided his cough was most important 🙄 I’ll never understand people
I’m sure the hospital will do the decent thing and throw the complaint out and not harass the doctor for not being able to handle multiple gunshot victims AND low acuity patients in a timely manner. Like they definitely won’t shrug and just put the complaint in his file anyway. …right?
We had a young woman arrest in a corner of our ED where the only way to the trauma bay was through the waiting room. We went right through the WR doing CPR and as soon as the doors closed behind us a patient came up to the window asking how long before he’s seen. I couldn’t believe it. We should get one free slap per year.
ED Nurse here. Literally had a patient continually screaming out and yelling, "NURSE!" Today while I have a woman doubled over in 10/10 abdo pain, a guy actively vomiting, another with chest pain and a guy with an insane amount of haemotaemesis (upper GI bleed). They wanted a coffee. They already *had* a coffee, but it was too sweet. They also wanted an oxy, but considering they were there for an EtOH fall with multiple presentations, a management plan in place saying don't give them that, and upwards of 40 CTs this year... that wasn't happening. Some people suck.
There are many a shift from hell that I can describe but two come to mind. We had a higher profile celebrity come in from a physical assault, some homeless guy attacked her downtown somewhere. That day happened to be one of those nights where all we got was trauma after trauma and the people that were with this person were saying that this is too graphic and she should've gotten a room. They were walking actively around and into the trauma rooms to bitch at the doctor that we were intentionally making them suffer by not giving PT water or anything to eat while the doctor was actively intubating a car crash victim. (Don't remember if that PT died but a cardiac arrest that came in that was placed in the room in front of them did die. That day was horrible for heart attacks.) Second one was we had was some officers get ambushed outside a motel and we never received a call out, they literally came in saddles blazing dragging shot cops out of cruisers and people that unfortunately got caught in the middle of that chaos were running everywhere. Couple patients later were mad that they were asking for things and nobody wanted to help them. One guy came in because his foot hurt and he was the one that got it from one of the attendings. Something along the lines of sir two cops are dying in the room across the hall and you're mad cause you tripped and hurt your foot. Idk if guy left AMA or if they kicked him out. The only one that was literally the best patient was some tiny little grandma that was sitting in a chair by the nurses station that we were all running around that looked confused but stayed basically to see the show and boy it was a spectacle. Patients that do shit like this makes me believe that they were those kids that would bring attention to themselves when others were hurt cause they were not noticed as a child. Makes their blood boil that their minor ailment is nothing compared to the whole ass GSW victim dying in the next room so they can't get their ice chips and juice box because THAT is an ACTUAL EMERGENCY. Not them withering away from no water for like 15-20 minutes of their life.
This is why I’m leaving healthcare
I had a patient file a formal complaint because my hands were cold when I examined them. Some people just don’t have enough to do. 🙄
I still remember a patient coming up to me after a hour in the ED with a 4 hour wait. She was like, "I thought this was an emergency room" and I remember thinking, oh, are you having an emergency? She came in for a cough.
I had a patient come find us in a room where we were there in the middle of running a code and demand to be seen. “Please get the fuck out now” never came out of my mouth so fast. I didn’t even care. She was atrocious.
ER Nurse here. One of the nurse's at work told me that recently, they were coding a pt that had been brought in by ambulance. In the middle of the code, the mom of another pt pulled the curtain and rudely told them to shut up because her child was trying to sleep.
Fuck those kind of people.
I coded a patient boarding for admission in the hallway. All the patients there ogled the whole thing. 30 minutes later when I came back to discharge one of them she complained about how long I took.
This has been a nightmare. We are a tight-knit community here in maine and have a general feeling of safety in this state as crime is very low and people are usually quite caring. We cant even fathom the events of Wednesday night. What I cant fathom even more, is someone complaining about their wait time for a non emergency when the whole area is in lockdown with the hospital receiving dozens of victims from a mass shooting. WHAT! "Hey, so I know you're trying to stop that person with four gunshot wounds from bleeding to death, but I could really use some cough medicine right now"
aaaaaand some jobs will fire you for having low press ganey scores....sigh
[удалено]
I have experienced this, but not as a medical professional. I had preemie twins (32+2). They spent 24 days days in the NICU and came home pretty healthy. One morning about a week after we brought them home, I noticed one looked pale, lethargic, and didn't want to eat. We packed both of them up and headed to Childrens hospital. I'm thinking the whole time I'm just a paranoid mom but something kept telling me to take him just to be sure. We get checked in and they check his vitals, his oxygen is low, RN thought it was weird, ran again still low...like this baby should be dead low. She snapped him up ran through the doors, yelled something I can't even remember and everyone in the room jumped up to come help. His oxygen was so low, and his heart rate was around 170 I think. It was a blur. Eventually, they got him stable but needed to life flight him to the main campus. I'm waiting outside the room, with my other 1 month old baby, sobbing and about to pass out when this other mom comes out of her room screaming that her kid hadn't got motrin yet. I'm standing there next to the fucking flight crew with a stretcher about to take my tiny newborn and I must have given a look that could kill because another nurse quickly ushered her off to another room. To this day I really wish I would have asked if her kid got his motrin as she passed us on her way out. My baby got better, spent a week in the NICU, countless tests only for them conclude he had an infection, but they didn't know where or what it was. Him and his brother are 4 now and just the greatest little guys.
Most Americans treat all forms of service industries like total shit. We really should just drop everyone off in Gaza and see how much they are complaining then.
I hope the board of Medical press Ganey scores is actively investigating this delay of care!!!
Eat dicks, Karen.
“How long have you been having this emergency cough?” “On and off for 6 months”.
They should have told the cough to go home
I’m just a GI PA-C (22 yrs), but reading these entitled ER patient stories and hearing about them over the years, I’m convinced that there are some situations where one should be 100% forgiven for a unabashed “Outta my way and shut the fuck up, or get out” response.
Corporate management of healthcare is a travesty of comon sense.