Monday, March 05, 2007

Helpful Hints

Just a few helpful hints if you are planning a trip to the ED.

1. Don't say "It's in the computer" when asked about your medications or history. It may be, but if the computers are down, or your medications have changed since the last time you were in the ED, or you have had your spleen, kidney, eye, testicle, and frontal lobe removed, your treatment options may be different now.

2. When asked why you are in the ED, don't say "Momma, you tell him". Second or third person medical histories are notoriously unreliable, and momma can't tell me how much pain you are in, although she will probably come out of the room 20 times and tell me "He's still hurtin, cain't you do somethin?" Also, as stated in a previous post, don't start with the bite from the tse tse fly you received in Burkina Faso in 1982. I only want you know why you are here TODAY.

3. If you are planning on bringing your 3 wk old with a slight amount of spit up or cradle cap that just won't go away, don't. Your child will be exposed to God knows what in the waiting room and will most likely be sick within 1 week of being in the ED. Please consult a baby rearing guide of which there is an entire row at your local Barnes and Noble.

4. If your 90 year old grand mother with a medical history that reads like War and Peace "just ain't gettin' better", please take her back to the same hospital she just got out of after a 35 day stay. If you say "she just wanted to try a new hospital" I will most likely loose control of bowel and bladder as all my body functions will shut down. Even in this computer age, it still takes 3-4 hours, especially at night, to get medical records from another facility, and another couple of hours sorting through them. And I can tell you the new internist is not going to be happy about assuming care or cleaning up a mess.

5. Finally, after triage, if you have a non urgent complaint and it is busy, expect to wait until all the sick patients are cared for. Each time you bitch and moan to the triage nurse, she becomes more passive aggressive, and your wait lengthens. It is especially bad when you ask why they brought the sweaty pulseless guy in ahead of you. That reflects badly on you and all the other hangnail/boil/rash/runny nose crew you run with.

I hope these pointers are helpful as you plan your visit.


  1. Also, when asked by the doctor "What seems to be the problem tonight sir?" Do not reply, "I don't know, you're the doctor." One day I will snap at this reply and end up in the pen as some big dude's bitch.

  2. Might I add: please bring with you a list of all the medications that you are currently taking. It doesn't matter if you generate this list on the computer and didn't have time to type the new ones in before the paramedics trundled you into the ambulance. Either write them in with a good old fashioned instrument of writing or bring the new bottles with you. Do not, DO NOT, tell me "Dr. So and So just started me on a new pill for something... it's small and (pick your color)." About 9.5 hours into a 12 hour shift this week when the umpteenth person tried play 'guess that pill' with me I said, "don't even start that. Do you have any idea how many little white pills there are in the world? What pharmacy do you use?"

  3. From a registration perspective - Don't say that all your info is in the computer and don't ask why you have to provide your INS/ID every time you come in. Also, if you read the signage you will see that it is hospital policy requesting that you provide your Ins/ID

    Do you really think I want to ask you unnecessary questions? Do you really think I want to create more work for myself? Do you really want me to leave or enter inaccurate info in your record that will cause YOU and others a problem later? How much time DO YOU want to waste discussing this instead of getting registered quickly and examined by the doc and out. Do you want the ambulance to come in and bypass you before we finish your registering? I am being paid for my time - are you? Do you really want to sign out AMA and drive to the other busier hospital that is a half hour away?

    Information changes often and I can't count the number of times there was wrong patient info in the system that needed to be corrected - when nothing had changed.

    In 20 years I never said these things, but instead I did patiently answer these questions and more. I always cared about their feelings etc., but, I would think - if I had just a dime for every time this or that question was asked. :)

  4. Why can't we have a modern ER like grocery stores?

    Self checkout? Have all the patients go to a screen and press buttons. After the machine does the diagnosis, put in the credit or debit card; out comes the pills, needle, thread and self help instructions.

    Ofcourse there would need to be a tazer robot to jumpstart any of the patients not moving or incapable of using the self checkout machines.

    It would save alot of money(no doctors), cut down on lawsuits(machines not responsible for incorrect responses etc.), and be more humane (severly ill people would not survive thus being euthanized and not suffering years of medical abuse)


  5. At my institution the provision of a Lortab gumball machine, automated work excuse generator, and prozac salt-lick in the waiting room has been discussed but has been nixed due to its reliance on sheer logic.

  6. 911doc if you institute the Lortab gumball machine etc. don't forget the pregnancy test machine next to the work excuse generator.

  7. Yeah, you and me we could make a bundle on the pregnancy test machine. Go to RiteAid, buy 100 home pregnancy tests for $3 a piece, then vend them from the machine for $500 a piece (which would be less than their bill for me to do the same thing in the ED). Of course the really smart ones demand the "blood test" because "last time my friend Jenny was pregnant they told her she wasn't and all they did was a urine test but three weeks later they did a blood test and she was"... but don't get me started.

  8. Ha!Ha! Pregnancy test machine! :)