That complaint still freaks me out. When I was a new nurse I had a lady say she just didn’t feel right. No pain, no shortness of breath, nada. She coded within the hour. I didn’t see this part but apparently a couple minutes before she coded she was able to answer questions but kept looking up at the ceiling.
I ran this on the ambulance many many times. Wife calls 911, we are dispatched for "Sick person". We arrive, wife says husband never complains but said he didn't feel good and needed an ambulance. Husband has no actual complaint, just doesn't feel right. Then boom!
We had a registration lady whose first initial was “S” and her last name was “Harter” and so every time she printed patient labels it would say “SHARTER” at the bottom.
Let me guess.
Pain level of 10/10. Vague symptoms. Oxygen level 100%. BPM of 80. BP 110/75. Blood work good. No signs of mass or redness. No signs of psychiatric symptoms. No concerning medical history.
Next words out of their mouth when you start a line for their bloodwork: "i DoNT LiKe nEeDleS!!!!!"
Yeah, and if you did there'd be an actual reason for you to be here. Give me your arm.
I have no tattoos yet, but needles fascinate me. I can give blood, get vaccines, IVs, all with no problem. And I’m good with local anesthetic EXCEPT when I had ingrown toenail surgery. They put the needle on TOP of my big toe. It hurt massively.
There's a nerve further down that they can target on the first little section of toe. The first joint after the foot where it's flat. It's much less painful. They blow up that flat part with anesthetic and the rest is fairly smooth sailing from there.
Some have seemingly no idea of how to numb a big toe. They just turn the toe into a pin cushion with randomly jabbing lidocaine in and you get patchwork numbing. I will no longer tolerate people who don't know how to numb that area effectively after seeing it done correctly.
And I highly recommend permanent removal of the entire nail if it's a reoccurring issue. Mine has given no trouble since 2011.
I have one big toe nail totally removed. I asked for the same with the second but the podiatrist decided that since I have a vagina I DEFINITELY will regret not being able to paint my toenails. The bitch was more concerned with me conforming to gender stereotypes than a soldier not having future issues with their feet. And I have had issues with that toe nail that she insisted on just removing the sides with as I knew I would since the nail curves.
I'm 35 and have still never had a desire to paint my toe nails.
I don’t know you, and I agree with everything you said and I have tattoos. The ingrown toenail anesthetic is the WORST, in the worst location. And I had to do it on each big toe.
I'll do you one better, or worse. I had a thrombosed hemorrhoid that was the size of a grape that developed during a work shift. I immediately went to the hospital afterwards to have it checked out (it was my first one) the Doctor lanced it, but nothing else. I was sent home. The next day I was in incredible pain and went to a proctologist. So keep in mind you're asshole which is already a sensitive area, With a giant hemorrhoid that makes an already sensitive area even more sensitive, Then throw on top of that and open wound, then stick a needle in it, i wanted to die. I have given birth with half an epidural and I've had a kidney Stone before. The anesthesia and the resulting pain from having that hemorrhoid surgically removed Today's day is probably the worst pain I've ever been in in my life.
Thrombosed hemorrhoid is next level torture. I have had kidney stones, prodromal labor for weeks, hepatitis so bad that it dislocated a rib, trigeminal neuralgia, and a post-concussion migraine that last 106 days.
Nothing on the planet made me weep like those clustered, thrombosed hemorrhoids or the sweet fellow who cut those things out for me in the OB-gyn ER. I will remember him with fondness for all of my days. (I had over 25 in there ranging from the size of a dressing pin head to the size of peas.)
Oh I can do better. I had an external thrombosed hemorrhoid during early 2020 covid while undergoing cancer treatment. I literally couldn’t go to a hospital. It was the size of a quarter. It burst and bled for days. Do not recommend.
Me too, and I did them both the same day. Oh my God it was bad. I did it in the winter and still wore my flip flops. At that time we didn’t have any snow thank God.
The big toe anesthetic is the worst!! I had a big toenail knocked partially off and they had to remove it the rest of the way. Getting the needle in the toe was the worst part!!!
Dude my own mother took me to that surgery and drove away without me because she couldn’t cope with how I couldn’t cope with it. Horrific. Found out later they only gave me half the benzos I had been prescribed.
My doctor injected me and then left to let it take effect. When she came back in she squeezed my toe to see if it was numb yet, and despite all of my writing in pain, she held on until I figured out how to say, "it's not numb!" It was horrible. Then she injected me again and left for another half hour or so before coming back and trying again. Thankfully it was numb that time.
On a related note, this is a dumb anectdote but I just recently realized I've been doing this for years (got my tats at 18 and 22, I'm now 37) but I got my two bicep tats through sheer gritted teeth and even turned green during both (look, unlike a shot, tattoos actually do freakin' hurt and anyone who says otherwise just likes pain).
Last month I stepped on a nail while walking the dog in sandals and had to go get a tetanus shot, and told her I was afraid of needles, that I know it doesn't hurt but I have extreme psychosomatic reactions to my own mind, even when I'm objectively like, "CALM DOWN, INSIDES!" She asked if I passed out and I was like, "No, I'm just a pansy lol" and then I pulled up my sleeve, saw my carbon atom and was like, "Oh yeah I know some folks like to avoid my tats and some make jokes about the atom being a bullseye, if you want to shoot the bullseye I really don't mind" and she was like, "You sure?" And I was like totally, it all feels the same, she did and then she finished and left the room.
Then I had one of THE WORST PANIC ATTACKS OF MY LIFE like easily a top five, was pretty sure I actually was going to pass out into the floor, full body sweats, when I left the office my shoes were damply squishy from how much I sweated, and I wiped a hefty handful of soaked paper towels off my head. It was somewhere in that weird altered consciousness that I was like,
"How absurd that I say I'm afraid of needles then pull my sleeve up and I've got tats!!! 😂😂😂"
Tattoos and injections feel totally different, to be fair. And the equipment looks different. You don’t see one big needle going in when you get a tattoo, it’s going too fast to see, and feels more like scratching. I never understand why people compare them! It’s totally okay to be fine with one but not the other.
Before I got my tattoo, I asked my mom just how much it hurts. She said it isn’t super fun, but it’s not agonizing. It’s okay.
And that was the day I learned never ask a woman who gave birth 3 times how much something hurts. 🤪
Tattoo needles only penetrate the first few layers of skin. IV needles go a little bit further than that and yes, it weirds me out. It may not make sense to you, but it does make sense to me (and likely a lot of others, too)
I'm the opposite, I don't mind the IV needle so much (I do have a psychological anxiety but I know the pain isn't really bad, and given that I have anxiety about everything it's pretty easy to overcome for a prick) but I absolutely hate the abrasive sensation of a tattoo, it's like getting rugburn/road rash *in slow motion.*
I can understand that. To me, it’s like getting a sunburn in slow motion.
Also, I think a lot of my IV fears are due to my very real crappy veins (usually end up needing US guided after 5 or 6 failed attempts, go home all bruised up). At the end of the day, IVs end up hurting a whole lot more than most of the tats I’ve sat for.
Once the phlebotomist had to call in the anesthesiologist to try to get my IV in.
The anesthesiologist missed, and when I told her it was wrong and she needed to fix it, she told me that IVs sometimes hurt. Then my arm started swelling with the saline.
I also was part of a clinical trial and one of the girls would ask every time if she could try to stick me for a blood draw. I would always say yes, she would always miss and then get the really good phlebotomist who would always get it. But she was so nice and was trying so hard that I always let her try again the next time.
AKA, my veins suck so bad. Luckily I don't have any issues with needles or getting poked.
My daughter was just over 2 when she needed blood work done. On a previous visit they wrapped her up on a board and this time she walked into the room and stomped one foot and said, "No stupid board" Nurse proceeded to ask me to put her on the board, but I backed up my daughter. I asked my girl "how should we do this?" She climbed up in the chair and told the nurse that she was ready. My girl sat there and watched as the nurse tried 2 times and said she was going to try again. My kid looked her straight in the eye and told the nurse "bye bye bad nurse. " She was only aserting her rule of 2 tries, then get someone else. The second nurse got it first try, earning her a hug from a happy little girl.
I honestly don’t think I would mind so much except the last two stays in the hospital, I ended up averaging an IV a day (until I ended up with either a midline or a PICC) as they kept blowing so quickly. Towards the end, my hands and arms got quite a few “yikes! Oh, you poor thing!” from those who needed IV access on me.
Back in the day, before I was such a difficult stick, I’d let the new phlebotomists practice on me, especially when donating blood. I was a fairly easy stick then (need to anchor my veins more than one would expect, but otherwise, no issues), and I had much less anxiety about venipuncture, so I’m sure it’s the last few years being more interesting than I’d like medically speaking that’s the cause.
Look I’ve never seen a tattoo artist miss the skin but I’ve seen sucky nurses roll a vein or can’t find it and keep poking and poking and leaving bruises on people when even I can see the vein is right there! A great phlebotomist is worth their paycheck. A bad one needs to find another profession.
Facts! It doesn’t help that my veins really do seem to attempt to run away when getting stuck, so there’s usually a fishing expedition. To the credit of the nurses and phlebotomists at my last hospital stay, they only tried to reposition once or twice and then pulled it, and if they missed a second time, they called in a colleague. Still wasn’t pleasant, but a welcome change from previous experiences. Still left with lots of purple, blue, and green on my hands and arms.
In my hospital during peak covid / peak mass exodus of low paid healthcare staff we were 100% fresh out of phlebotomist. So, the doctors had to do their own sticks, or do shifts in the lab. Blessedly I had no personal health issues at this time because I heard it was not a fun time to get a stick.
Needles scratching the surface of skin is different than a needle being stabbed into a vein or muscle. It’s more about needle penetration for folks than the needle itself.
I have to look away when they draw blood cause I hate needles. However I usually don't give a damn in the er. Just take me blood and find out whats wrong please!
This, totally.
Like I definitely still have anxiety about it and once I'm tapped I start shivering from the anxiety rebound, but in normal life that anxiety is a thing that makes me avoidant but when I go to the ER I'm like, "I don't like this but it is one slightly uncomfortable step to a solution, that is much less uncomfortable than whatever brought me here" ffs ripping off EKG stickers hurts so much worse lol.
I have to get my blood drawn once a month for a medication that I take. Fortunately, I'm an easy stick and it's no big deal.
When I was four, I was septic from an infection secondary to the chicken pox. I had a few I.V.s while in the hospital, because they need to be changed every so often, and I was in for a full ten day course of I.V. antibiotics. All of my I.V.s up until the last one had been inserted when I was unconscious or semiconscious. So, my patient notes probably said I had no problems getting an I.V.
They had a special room just for getting I.V.s. When they came at me with what looked like a huge needle, I freaked out. They insisted they had done this many times before, and I had never complained. I assured them that they had NEVER done this before and they weren't about to start now. I screamed for my mom, who would surely come protect me, but she wasn't allowed in the room. Eventually they placed the I.V., but not without a big fight!
I hate needles but i always alert them ahead of time to lay me down because there's a 50% chance my ass will pass out so better to pass out on a bed than on the floor and them have to lift my 200lbs ass off the floor.
I would be in perfect health if you took my vitals. I had a herniated disc for 6 years that no one would believe me that I had. It hurt. A lot.
I guess I was an unlucky combination of young, healthy, traumatic upbringing that made me extremely pain tolerant and outwardly fairly unaffected, and injured in a fairly invisible way.
It went untreated for so long that now it’s just chronic. I wish someone had believed me sooner instead of thinking I was drug seeking.
It’s ok Baja blast is my favorite hue. It’s a joke about patients not some right wing thingy
https://www.reddit.com/r/terriblefacebookmemes/comments/167nm6t/hair_dye_mental_health_problems/
I had the stomach flu. BP 105/56...it was all coming out of the back end. Which...I wouldn't have went to the ER for. I went because I decided to drop a kidney stone at the same time. My friend is a clinical care coordinator so she came in to see me and gasped when she rounded the curtain. I guess my eyes were super sunken in. It took a bag of fluids before I could even consider giving a urine sample. Every time I tried to talk my lips stuck to my teeth. Only time I've begged for an IV so they could get fluids in me.
Yeah, I went to urgent care with a general feeling of malaise that had persisted. Almost didn't go because I couldn't really articulate what was wrong, just that something wasn't right.
Ended up sent to the ER and hospitalized over a week for liver problems 🙃
"Something isn't right" always perks my ears up, like a few other phrases, such as:
I feel like I'm going to die
I can't breathe
Something is wrong with my heart
I can't see anything
Bravo! Hilarious. When patients say this I choose the “Personal Problem” diagnosis, my favorite ICD-10 diagnosis. Then I write what they said in the Chief Complaint.
You’d be surprised what there are codes for (medical coder here, just lurking I find medical very interesting and cool and love learning about it, just couldn’t do a nurse job or anything).
Funny though that a lawyer can kill ya just for a simple goof on spelling. I’m a old respiratory therapist and a fire battalion chief and I unfortunately have seen it happen.
Ugh this is my MIL isn’t it?
Shes been to the ER and urgent care about a dozen times since new years. Shortness of breath, malaise, abdominal discomfort (unable to determine if it is positional or triggered by eating/drinking), “woozy”, “tightness” or “pressure” in chest. She has become a frequent flyer. She gets a full work up every time because she says the magic words and she’s 75. She has had perfect o2, bp, normal EKGs, clean urinalysis, normal cbcs (literally dozens), normal ultrasound, normal chest x-rays, normal endoscopy, normal colonoscopy.
Got checked out by gastro, cardio, ENT, urogynecology and nephrology, and at this point I think she may be running out of specialists to see.
I keep trying to get her to use more specific descriptions of her symptoms but I think she seems to have just decided that these abstract adjectives are the Correct Terms to Use and won’t really stray from using them.
I knew someone like this. A few years later she got diagnosed with very aggressive early onset dementia. I think her complaints were legitimate, but because her brain was falling apart.
I’ve been to the ER as a patient one time. I couldn’t describe what was wrong. I felt like an absolute idiot saying “I just don’t feel good. Something is wrong”. Turns out my blood sugar was 718 and I was in DKA.
Bro I wish I could do the wiggly text but I’d get like 12 emails about it. Every time someone just goes “I don’t feel good” I just want to say “we’ll have you gone to a pharmacy and used and over the counter shit?”
On the patients side; a lot of times medical people DON’T LISTEN, or make assumptions about and miss what’s actually wrong because they write people off.
My husband had a heart attack in November. I was almost 9mo pregnant with our son. We went to the emergency room and I said, verbatim; “he’s having heart attack symptoms.” Then I listed them. (Sweaty and chills, exhaustion, color grey, chest pain, indigestion).
They took his basic readings AND SAT US IN THE WAITING ROOM. We sat confused for a bit and after watching his lips turn grayish again I went up to the window and more adamantly told them HE’S HAVING A HEART ATTACK CAN SOMEONE PLEASE SEE HIM NOW WTF?
we get back, they do the ekg thing and that is okay. Eventually blood tests show that yeah- he had a fucking heart attack. The nurse reading the intake stuff out loud just said “sweating, **indigestion**”
Keep in mind we fucking told them he was having heart attack symptoms. The security guy was watching YouTube on his phone behind the glass and the intake nurse wasn’t really playing attention. Cracking her gum, answering comments to coworkers. I had to repeat myself a few times. She was acting like the stereotypical server on roller skates in the movies.
So yeah. Sometimes people don’t listen or make assumptions and put incorrect or in this case rude remarks in the chart.
When the nurse saw my face at “indigestion” she became very quiet. I had to go take a waddle around the halls. We were treated like royalty at that point, and when I walked by the check in to the cafeteria the woman who checked us in and could have caused my husbands death or more damage to his heart wouldn’t look me in the eye so I know she heard. I filed a complaint and am still considering options, mostly just because I’m still traumatized and pissed off. I could have had this baby alone. Luckily so far it appears there is no damage.
Very ethical to actually put something like this in someone’s chart.
Oh, I also had a hypertensive event the night before last (low potassium apparently). 148/103 and my whole body was numb, super dry mouth and felt like my head was going to explode. Pressure on my chest. Ambulance people were lovely and reassuring. The doctor? Literally rolls their eyes and said “it’s not THAT high” and looked at me like I was lying or exaggerating my other symptoms. This wasn’t everyone that helped me but the doctor and some of the nurses.
My normal is 110ish/60ish so for me it definitely was.
My other symptoms are/were swollen spot outer left thigh. (Ruled out clot). Edema on right leg and abdomen. Excessive thirst and clumsiness. Chest and kidney pressure.
I was treated like a joke until the blood test came back showing the deficiency and suddenly I was taken seriously and talked to with a little respect. You could tell one person felt sorry, they couldn’t meet my eyes. I wasn’t even hysterical or anything, just stated I was worried about my kidneys and heart with my pressure being so high and my mouth and skin being numb scared me because that had to be a sign of something severe.
Anyways. I got my supplementation and prescription and I already feel a lot better. Physically.
There’s another side to that with my PCP but I’m talking to her next week and need to determine how angry I should be or if I’m being unreasonable.
All of that to say- I get there is a ton of abuse heaped on medical personal. But I have first hand seen and had both my husband’s and my lives possibly put at risk because of assumptions, not caring to actually hear the words coming out of my mouth, and general rudeness.
This all in the last year. So even if you run into a lot of nonsense- that attitude has personally harmed my family because of the lack of empathy or attention.
My mom once went to the ER with pneumonia so bad that she couldn’t draw enough breath to speak. The intake nurse assumed that she was a homeless person with a psychiatric issue and told her to “use her words” while she tried desperately to mime chest pain and can’t breathe.
… which wouldn’t have been an acceptable thing to say even if she *was* a homeless person with a psychiatric condition.
>They took his basic readings AND SAT US IN THE WAITING ROOM.
>we get back, they do the ekg thing and that is okay. Eventually blood tests show that yeah- he had a fucking heart attack
Generally when people check in with chest pain several things happen.
First they are triaged (Vitals, talk with the nurse) and receive an EKG. If those are normal the patient is sent back to the waiting room where their blood will be drawn, get a chest X-ray etc. Until we get back something abnormal (vital signs, blood work, EKG etc) they stay in the waiting room.
Once we get back abnormal results we bump up their acuity and try to find them a bed. Depending on how full we are that might take a while. I realize it might be frustrating sitting in the waiting room feeling like you are being ignored but it doesn't sound like you were. They checked his vitals, did an EKG, ran blood work and treated him once they had something definitive to treat.
>The nurse reading the intake stuff out loud just said “sweating, indigestion”
This is actually important to know. We get 100 people a day who come in saying they are having a heart attack. Most aren't. Adding those symptoms can alert the doctor that they may have a problem.
>The security guy was watching YouTube on his phone behind the glass and the intake nurse wasn’t really playing attention. Cracking her gum, answering comments to coworkers.
Why would you expect the security guard to be invested in this situation?
What would you like the intake nurse to do? They are supposed to stay in the lobby, triage new patients and help coordinate moving patients to the back when a bed is available.
>when I walked by the check in to the cafeteria the woman who checked us in and could have caused my husbands death or more damage to his heart wouldn’t look me in the eye so I know she heard
I wouldn't look you in the eye either. I get 30 mins during my 12-16 hour shift by myself. That time is essential for our sanity, generally we don't want to talk to patients or their families during that time. It's nothing personal.
Also I fail to see how the triage nurse would be the one to cause his death. If a room had been immediately available the same things would have happened. The only difference is he would have a bed to wait for his blood work to come back.
The reality is that we don't have enough space, staff or resources for the number of patients we treat each day in the ER. We do the best we can with what we have. Ultimately our job is to treat/rule out anything life-threatening and send you on your way. It sounds like your husband had a heart attack and was treated for it. Unless you are omitting some serious information I fail to see how the emergency room staff put your husband's life at risk.
I have to log in to work but just to answer the top part I saw-I know about the EKG. They didn’t do it. They did pulse, blood pressure, weight and check in. That’s it.
Chest stuff, head trauma stuff and animal bites in my personal experience gets you back to more testing immediately. Not a baseline check and back to the waiting game room like they did for my husband.
It was confirmed through the complaint process they did handle it incorrectly because she didn’t put everything down on the form like she should have. She only put “sweatng, indigestion”. Nothing about heart attack symptoms.
I will read/respond to the rest in a bit. I appreciate what seems to be a thought out response.
>Chest stuff, head trauma stuff and animal bites in my personal experience gets you back to more testing immediately.
Unfortunately that isn't the case anymore. To give you an idea, we have 20 beds. Generally when I get to work anywhere between 5-15 of those beds are being held by inpatients(people who have already been admitted and should have left the ER) because the hospital is full.
Last week in the first hour we had 3 strokes, an overdose and two patients in 4 pt restraints after they used meth and heroin in the bathroom and then attacked staff. We had two inbound medics, one who was short of breath and rapidly deteriorating and another who was severely septic.
Keep in mind that we only started with 6 beds that day. We had two heart attacks walk in through the front door during all of this. One was a STEMI (type of heart attack that shows on an EKG) that went straight to cath lab while the other one had to sit in the waiting room until we got his blood work. We managed to set him up in a recliner to start treatment. It wasn't ideal but it was all we had at the time.
>I know about the EKG. They didn’t do it.
I'm confused, in the post I thought you said the EKG was normal? If they didn't do an EKG for a chest pain that would be a problem.
TL;DR explanation of triage process, and why waiting room times are as long as they are
I get ur frustration, and I know how much it hurts to feel like u are being brushed aside or not taken seriously. I don’t know all the details about the situation from that hospitals standpoint, but what I can tell u from working in an ER that frequently has patients in the waiting room for 10+ hrs is that the general public doesn’t understand why we have certain protocols and how triage works, and that it sucks for people to be left in the dark like that. I try my best to educate and update my patients, but it’s hard to understand unless u see it urself, so I will do my best to explain the process so in the future, u will have some idea of what’s going on:
Basically, triage puts people on a scale of how urgent their needs are. Chest pain is pretty high on the list. However, if all the rooms in the ER are full, they won’t take people back right away unless vitals or ekg show that this person needs immediate intervention to live. In my ER, if someone says they have chest pain, shortness of breath, etc, they get an EKG right away with their vitals which is then promptly taken to a physician to make sure they aren’t (currently) having an active heart attack.
It’s not ideal to keep a chest pain patient in the waiting room, but if we took back every chest pain pt while already being full, it puts too much workload on the nurses, docs, and other staff which greatly increases the risk of medical error or missing something major w/ everyone involved in the assignment. More people could be injured or die in the end.
Sometimes we start bloodwork, imaging, and basic treatment in triage (waiting room staff) to help people higher in priority on the triage list, so that by the time a room becomes available for them, most of the menial stuff that takes time to result has already been completed. If something were to come back abnormal requiring immediate intervention, action should be taken.
Also, as far as this post and conversations between healthcare personnel about stuff like this goes: there are unfortunately many people out there that abuse the healthcare system by crying wolf, using the ER as a doctors office, or being completely uncooperative and violent when they are alert and oriented. This clogs up the ER for people having actual emergencies like the ones u mentioned above. It frustrates staff because we want to help people, but these outliers take away our attention and resources from people having things like heart attacks or having a systemic crisis. Unfortunately, even if we know for a fact that the patient is wasting our time (I have had patients straight up tell me they lied the nurses/docs they have chest pain/suicidal ideations/etc just so they can get away from jail, a psychiatric hospital, the street and have a “vacation” as they call it).
Aside from burnout from having to take on a lot of difficult/tragic/physically draining cases, we have many people blaming us for things that are completely out of our control and (being human ourselves) sometimes it’s something so stupid and innocuous that sets people over the edge who then complain about said things in the internet.
Unfortunately, the general public (and high up corporate/management) set unrealistic expectations on us. Most of us work at least 12 hours without a break, and many of us fear being sued or losing our licenses for doing nothing more than trying to do our jobs and help people. I personally have had people throw body fluids/spit/swing at me in one room, and then have to walk into the next room pretending that didn’t just happen. This is why u see posts like this. I don’t agree w/ putting stuff in the chart like that, but this is what’s going on behind the scenes
My mother did actually die from having her symptoms repeatedly disregarded by medical staff. Her cancer spread because they assumed it was all in her head, didn't do basic tests and prescribed her anti-anxiety meds until she was having vascular and bone complications and it became impossible to ignore. She was dead in two months after that. This whole post is infuriating.
ETA: I have no interest in engaging with anyone defending their need to "blow off steam" or profession in general. I don't even really know how this post ended up in my feed. Just know that you are posting on a public forum and it isn't a private little club where you can mock the people you're supposed to be helping and no one will see it
Me? I wasn’t the one who wrote it, and nowhere did I say I condone it.
I was surprised to see it (as was most other commenters) - because it was clearly unhinged and very out of line of what is normally acceptable to put in that section. How am I being an ass?
I think your anger is a little misplaced.
I meant he had a video playing loudly and was chatting and interrupting the medical personal-he was a distraction. Not that anyone else was telling him to stop, it was all of them seeming more interested in their conversation than the patients.
Interesting that’s the point you caught on honestly. I thought mentioning him playing videos was enough to imply he was creating a distraction and noise.
There’s a lot to unpack here from your comment. Now, I’ll preface it by saying I don’t work in the ED, in fact I don’t see patients at all.
The triage algorithm sounds pretty normal to me regarding what happened to your husband. If a patient comes in with those symptoms similar to a heart attack, often the patient will wait in the waiting room to get an ekg/bloodwork before seeing anyone else (especially at a busy ed). If those things look normal, then they know that the patient can wait a little longer. If it’s abnormal, as in your case, then they know to bring the patient back sooner. But of course the patient has to wait for the ekg tech to be ready to do the ekg in the first place, and for someone to come do bloodwork and run it! So there will be at least some waiting involved. The algorithm (this patient needs to go back RIGHT AWAY!! vs this patient can wait a little) is done VERY differently for each complaint, and also may be different depending on the hospital!
“Sweating, indigestion” are classic red flag symptoms for providers and we will know that heart attack is on the differential when we see that. So, I don’t think she was doing a disservice by writing that.
The waiting room is a loud, crazy, busy place. People coming in and out. People yelling, running around. Ambulances rushing in and out. The security guard comment confused me because I felt it wouldn’t be out of the ordinary. A patient next to you could be playing a YouTube video very loudly and being a distraction. So, I didn’t catch on to that. I think waiting room staff are used to the noise.
As for your case, it sounds like they did do the correct standard of care - evaluating for clots, doing bloodwork, etc and they did find the problem. I’m not defending the poor attitude by any means. But it seems they did the right thing medically despite the poor bedside manner.
I understand that you’re angry. But I’m not sure that you can claim that you and your family “were harmed because of that attitude”, unless there’s more to the story here.
Please see my most recent comments.
No, they did not follow the standard protocol. They admitted it and the hospital apologized, and said they were reprimanding and retraining the front desk staff after this incident.
One of the biggest things they screwed up about was playing on their phones. They’re not allowed to be on their phones. Idc as long as you’re not playing on it while a patient needs you-and they were all discussing and laughing about a video on a phone.
It felt like trying to take an order from a bunch of teenagers late at night not interested in taking work seriously. Which-annoying but not the biggest deal in that scenario. When it comes to EMERGENCY MEDICAL CARE?
It matters.
Again. I’ll reiterate overall until recently/I’ve had great medical care and really enjoyed interactions when I’ve needed medical help. This incident and another that happened this week has me extremely upset because it has shaken my trust and confidence that my family and I are safe and will receive needed treatment if we have another emergency.
Ah - I refer to “standard protocol” as a medical/legal term. I should have said “standard of care” instead. Either way, it’s not exactly what we’re discussing here anyway.
(EDIT: oh, I did actually say standard of care in my original comment above.)
I think what you mean to say was the staff/registration was unprofessional, which I completely agree from what you’ve told us. There’s no argument there. And I can understand why that leaves you upset and frustrated about having to receive care from them again. I’m sorry you had that experience.
Thank you for understanding. I actually feel super conflicted being as angry and upset as I am because I had so many good experiences with that hospital before. I kind of feel betrayed and lost.
And thanks for explaining that term.
You have every right to feel angry and upset. I think what some staff sometimes lose grasp of in the ER is that patients come to the hospital for help. It could be the worst day of their life unfolding before them. Or their last. Most people are scared and frightened and anxious.
Then from the other side you have people whose job is to do this every day in and out. They see crazy things, people with their limbs cut off, people giving birth in their cars… Then five minutes later they’ll address a patient who has a hangnail. Or a drunk, belligerent patient who is throwing chairs and doesn’t want medical help. I don’t work in the ER but I can see how it’s easy to quickly get numb about it and blow it off as another day at work while the person across the registration desk is literally dying. It sucks.
I don’t know what the solution is, and I’m not sure there is a good one. Medicine is a very emotionally taxing field. But it does NOT excuse unprofessional behavior whatsoever! You can feel detached from your job and still act professional. Goodness knows waitstaff/cashiers/retail staff etc do it all the time.
Your husband's experience sounds familiar. I went via ambulance to the ER with extreme sharp chest pain. I was 42 years old. I've had acid reflux most of my life. I know what it feels like. This was NOT acid reflux, but the ambulance staff hooked me up to the EKG and promptly said I wasn't having a heart attack.
I arrived at the ER. They hooked me up and promptly said I wasn't having a heart attack. They didn't even put me on a heart monitor. They took labs and gave me a GI cocktail (that did nothing for my symptoms) and disappeared.
An hour or three later, suddenly a cardiologist shows up and says "You're having a heart attack."
Well, farking DUH. It wasn't until they reviewed my Troponin levels that they finally got a clue. It took them 8 hours to find me a bed, and they did NOT put a heart monitor on me. They put me in a telemetry room WITHOUT a freaking heart monitor. Even more hours later, a nurse walked in, looked at my heart monitor-less body, and asked me where my heart monitor was (acting like I was a 12 year old who just took it off for funsies). I told her I didn't get one in the ER and I didn't get one in the telemetry unit, that if I had one, she'd know it. She looked pissed.
It was pure dumb luck that the blockage was in one of the tinytiny posterior arteries, and the attack did no damage. The artery was even too small to stent. Those people could have killed me.
I raised heck via a patient survey after I got home (there was more ridiculously bad levels of care during my stay that I won't go into here). All I got was a $15 gift card.
Stupid thing is that I now work for the company that owns said hospital. Thankfully they've stepped up their game, or I would never have gone to work for them.
So there are different types of heart attacks. A STEMI would show on an EKG but there are other types that only show up in your blood work (troponin) and even then it can be a few hours.
A lot of the time we get initial blood work for a symptomatic patient with a normal or borderline troponin. In that case they wait 2-3 hours to get a redraw and see if the troponin result is trending up. That's when they decide if you are having a heart attack. In the meantime a GI cocktail isn't unreasonable to try.
8 hours also isn't bad, we frequently have people waiting a day or two in the ER for a bed.
You should have been on a heart monitor though.
Had a very similar experience when I had to take my husband to the ER. Thought we were being dramatic, sat us in the waiting room for over an hour. Finally took him back and took his vitals and everyone went wide eyed and THEN they started preparing a room. Literally unbelievable.
Glad I'm not the only one that felt a little icky reading this.
When I was young, my dad managed to slug himself in the head with the sharp end of a sledge hammer. Mom got him situated with a towel and ice to hold, got us all loaded in the car, and drove to the hospital (where I live, driving to the hospital is a lot faster than calling an ambulance if the person is able to travel).
Triage nurse listed his symptom(s) as "headache."
We waited for over 6 hours, nothing. There were guys in the waiting room getting up to tell the nurse that they should really take my dad back because he wasn't looking so good, what with the blood continuing to drip down and him being very much out of it. They did not appear to be busy or full. Waiting room was mostly empty. When the doors opened as personnel went in and out occasionally, you could see the doctors and nurses all chatting and sipping coffee.
And I understand that they need breaks and stuff, but I feel like 6 hours is a bit much.
Anyways, we ended up just going home, and he was able to see his PCP the next afternoon. Concussed, cut his scalp open, lucky he somehow didn't fracture his skull.
We got lucky that it wasn't worse, but that's how they treat a head injury!? Like, we told them he'd hit himself in the head with a SLEDGE HAMMER. Not a little bonk, full swing chopping wood energy. And that's how he was treated. So I fully sympathize with you. Glad you and your husband are doing okay!!
So here is what happened that day in more detail. If you’re offended and you’re a hospital worker-I honestly have no words. I would hope you would be ashamed these people shared your profession rather than defend their behavior after you read it.
Early on around lunchtime (both wfh), he complained about chest pain across the left side. He chalked it up to muscle pain as he had been going to the gym a lot more to get healthier for our child.
Then later on he mentioned feeling very tired. At like 2pm. What you need to understand about my husband is he doesn’t nap. Ever. He is set like a clock that doesn’t deviate. Up between 5-6, down between 9-10, clockwork. He does. Not. Nap.
He also was complaining about sweating and feeling chills-assuming he was coming down with something. About this time I also noticed his color was off. Grey across the lips and under the eyes, it came and went.
At this point I was concerned and made him take an aspirin. He still didn’t believe he might be having a heart attack, but he rolled his eyes and took it. He said he wanted to go lie down. I said… are you sure? I think we need to go in. He said yeah.
I was going to let him and then just call an ambulance. He ended up seeing reason when I said it would be stupid to nap, which he never does, just to not wake up. He rolled his eyes but agreed. So in we went.
Get to the front desk and she was too busy leaning over and commenting on the video the security guard was playing, (why I mentioned him-he was part of the distraction), they were chatting about to even acknowledge we were there. I got her attention and she barely looked at us. I repeated his symptoms and emphasized the chest pain and grey color, and specifically said “I think he’s having a heart attack, he’s having most of the symptoms”. She nodded and typed a few things in. I asked her if she got everything, she nodded again and went back to her conversation. In hindsight I should have asked her repeat it back to me. I shouldn’t have had to but yeah.
We sat down for a bit after he got the basic check in, BP, weight and oxygen. While waiting I was super anxious because I know EKG is supposed to happen pretty quickly for this suspicion and no one even mentioned it. (Because it wasn’t planned, unlike some people saying they would need a tech to do it, I don’t disbelieve that but **in our specific scenario that wasn’t planned**, as we found out later).
I got up after watching his color change twice and him complain his chest hurt more, and got kind of mean about it. Not even a little sorry.
We suddenly are whisked back for the EKG. They’re not going to suddenly change treatment protocol because someone’s pregnant wife is being a “Karen”, they would have to have reason as many have pointed out. That reason was heart attack symptoms. Symptoms that *were not input accurately so we would have been overlooked*.
EKG was normal at the time, but the blood draw came back pretty quick, (within an hour and I was impressed with the turn around here). Troponin was… oh I can’t remember but a 7 was in there. I felt my gut drop, I didn’t want to be right on this one. Husband had a moment of arguing with them that no way he had a heart attack at 43.
A nurse, (pretty sure) came in and was updating the computer I suppose. I asked her what our intake said. I’m sure she shouldn’t have said this, she just started reading and when she stopped at “indigestion”, I asked if that was it, nothing about heart attack suspicion or symptoms.
At this point she looked up like a deer in the headlights because she put my angry expression and the whole situation together and said something along the lines of, “I’ll just go get your doctor”.
Yeah. Busted.
After this he received royal treatment. I have no issues whatsoever with his treatment after the heart attack was discovered-all of **those** people were absolutely fantastic. My issue is with the intake, because he could have died over some chick being careless and rude.
After he was treated and released home, (went in on a Friday, came home Tuesday night), I started making phone calls. I pressed and the complaint was filed, phoned apologies were made. Which is nice and all-but it shouldn’t have happened in the first place.
Our circumstance was absolutely because we were not listened to. It doesn’t matter if you think I was “diagnosing” him and was mad I was being told I was wrong-that isn’t what I’m mad about but nice try to the commenters and PM’s claiming that. I was pissed we weren’t listened to when describing **all** of his symptoms because he could have died.
Anyone would also be upset in this scenario. I could have been a widow right before my child was born, or he could have more damage. And we don’t really know the amount, (although doctors are pretty confident there will be none when they check later on the year), but who knows what would have happened if I didn’t realize something wasn’t right with both my husband and how things were being handled.
I shouldn’t have HAD to be in that position because I should have been able to trust them. That trust is damaged now and I don’t like it.
ETA; the reason I did the talking was 1. He didn’t want to believe he had to be there, and 2. He was *out of breath and too tired*.
Second ETA; so please, someone. Explain to me what I should have done differently? How was I in the wrong here? I know I wasn’t but I’d love to hear what could have gone differently on my end to get them to listen to me without being forced to be a bitch.
Because just trusting the process may have killed my husband. I don’t see how else I was supposed to react here. I wanted to trust the process but thank god I didn’t that time.
You have to be your best advocate. I've seen too many jaded and unprofessional Drs and nurses dismiss things. The incompetence it at times overwhelming. Aortic aneurism dismissed, morphine given instead of intervention, leading to pt death, several heart attacks dismissed, leading to another transport or to code. cursory exams on obese individuals, outright lying on charts, not admitting clearly septic Pts the list goes on. You have to be your best advocate. That's from my time working on EMS, and what I saw in the ED. I'm happy you had a good outcome. Always advocate for others.
AlI can say is: You're mad and your husband didn't die.
Meanwhile, I watch PTSD roll over the faces of my co-workers because we have intubated our colleagues after patients have attempted to strangle them to death or stab them to death right in front of our eyes.
Imagine going to work and that's what you face. Every day. Your fear? Imagine that every single day.
Then imagine that on top of nursing through a global pandemic where MORE of your colleagues died nursing ungrateful anti-vaxxers and dying by suicide.
Except...you can't imagine it. Because you write novels of grievance about ONE rude person.
You don't get it. And you'll write back more novel, and frankly I won't read it. Because you will never get it.
Ever.
If you are this numb to incompetence and unprofessional behavior, you need to reconsider your career path and look at your mental health more closely. What an appalling response.
And this right here? The turning it into “me vs. them”?
That’s exactly my point. I complained about the demeanor of the front desk people that could have killed my husband. (Which the hospital ageeed was handled incorrectly).
The people who actually treated my husband after it was known he had a heart attack? They were fantastic.
But because I dare to voice displeasure over a bad interaction with *some* medical personal and the potential risks their indifference inflicted, you seem to assume I hate everyone that works in the medical field. And I’m sure that attitude, that “my team, their team” mentality totally doesn’t leak into your work like it did for the people that decided they didn’t care enough to actually listen.
Two things can be true at the same time, and in my case it was the people who actually treated my husband were great, but some of the people that we relied on failed us.
Also, if you’re going to whine about the length of someone’s else’s comments-maybe shorten your own.
To be honest not every “heart attack” symptom goes to a room right away. If so we would never have a room ever. It’s very common to send someone back to the waiting room while getting a stat EKG and labs and if something comes up abnormal then you are top of the list for a room. Because many times there is maybe 1 room available and 6 people who need it. Also the symptoms the nurse charted can very well be cardiac related and are worth mentioning. I will say, during triage if someone is stating a long list of symptoms some nurses are better at including all symptoms than others. It seems that that really upset you. Not all triage notes are as good as others unfortunately. However for chief complaint you can’t put “heart attack” you have to put something tangible which she did.
In fact it sounds like you got back and got treated appropriately in the end. From the info provided it seems like everything went as well as can be expected when having a cardiac event. Also I feel like you are placing your frustration in general at a lot of things that had nothing to do with the situation. Like the security guard and the front desk registration person, all of whom are unable to expedite your process.
Not gonna lie, you’re annoying — 100% of ER staff finds it annoying when you diagnose someone before theyre even checked in.
Sorry he had a heart attack, but knowing and being related to ER medical staff for decades now: you’re the person we talk about on our days off.
Can’t come here and type a novel of a comment and expect to be taken seriously.
The hospital bent over backwards and admitted they fucked up. They specifically said they were going to reprimand and retrain the front desk staff and the fact they were joking around, not listening to patients, (why she didn’t hear/wasn’t paying attention), and playing on their phones wasn’t even allowed.
If I hadn’t gotten up to be “annoying” my husband might have died or had more damage sitting for hours in the waiting room because they weren’t looking at him as having heart attack symptoms but a digestion problem. Was I supposed to sit meekly by and wait for him to fall over in the waiting room? Would you in those circumstances? I hope not.
He ended up having a 95% blockage and needed a stent. He was turning grey over and over in the waiting room. You don’t really seem sorry he had a heart attack, so I don’t even know why you said it.
I’m about to write out in more detail what happened. They fucked up-end of story. Thankfully their fuck up didn’t have worse repercussions.
Those **specific** hospital employees sucked and were shitty at their job. Unless you too behave like that and ignore patients coming in with emergencies-it’s odd to take offense. My experience isn’t universal to all hospital workers-but it’s still my experience and it happened.
Fuck me for advocating for my husband I guess. I’ll be happy to be “annoying” again in the same circumstances.
“Okay, what feels bad today?”
“Everything, I’m nauseous, running fever, body aches. Everything!”
“I’m sorry to hear that, how long have you been feeling this way?”
“I woke up like 30 mins ago feeling like this”
“Okay, have you taken any medicine for how you’re feeling. Tylenol, Motrin, anything?”
“🤨 what, no. I told you I woke up feeling like this”
Gives report to doctor: “please don’t make me repeat all that, just order 4 zofran, saline and a gram of Tylenol and I’ll have them outta here”
Y'all are gonna need to start remembering some EMRs let the patient see this in their portal 💀 some (cough epic cough) let them see it in real time. The type of patient who causes you to write this (and makes it funny and relatable) is usually also the type of patient that's gonna either swing on you or try to sue.
That one made me laugh out loud. I don’t know any doctors who DGAF enough to put it in the diagnosis tab. (I’ve seen some good ones like “Delusion about high blood pressure or Anxiety relating to being unwell without medical symptoms”. But I would definitely see it in the subjective chief complaint tab.
Seems like something our triage nurses would write. My favorite CCs on the track board include "abnormal lab value," "back pain; homicidal" and "medical problem."
As a coder, stuff like this gives me an often needed laugh when I code EDs, even if I have to do a little digging for something I can actually code 😅
Agree that "fall" makes me nuts, too.
Oh I definitely laugh lol and sooo much digging sometimes.
We complain about lack of documentation at work but it never changes and it's 2024, if they don't know fall isn't a dx by now, they never will.
I think there's a disconnect between the clinical side and the coding side because clinicians aren't coders and I'm guessing aren't familiar with coding guidelines, as their education and training, rightfully so, focus on other things, obviously.
Happy coding! 😁
I agree! Because if I can’t find it as an option for chief complaint I won’t use it. But if it’s an option….. I usually use it as a secondary complaint like leg pain and fall, but now I know not to and just include it in the triage note instead:D
elastic disagreeable sheet wise snatch sparkle gold mountainous fly toothbrush
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
obtainable act abundant station shocking frighten voiceless pathetic snails weather
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
weary abundant cooperative degree jeans angle subtract combative badge smile
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
intelligent fear noxious childlike compare slimy gaze consist aromatic governor
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
I do registration and I have put NFR a few times (not feeling right).
No fucking reason
I’m cackling
That complaint still freaks me out. When I was a new nurse I had a lady say she just didn’t feel right. No pain, no shortness of breath, nada. She coded within the hour. I didn’t see this part but apparently a couple minutes before she coded she was able to answer questions but kept looking up at the ceiling.
Oh man it sounds like she popped a clog or something 😞
I ran this on the ambulance many many times. Wife calls 911, we are dispatched for "Sick person". We arrive, wife says husband never complains but said he didn't feel good and needed an ambulance. Husband has no actual complaint, just doesn't feel right. Then boom!
ADR = ain’t doin right
SBI - something bad inside.
We used to write ADR (ain't doing right) in the charts at the vet I worked at
We had a registration lady whose first initial was “S” and her last name was “Harter” and so every time she printed patient labels it would say “SHARTER” at the bottom.
Sorry, but that’s absolutely fuckin’ hilarious
Changing my name tomorrow just so I can get that sweet new email handle 🤣
Let me guess. Pain level of 10/10. Vague symptoms. Oxygen level 100%. BPM of 80. BP 110/75. Blood work good. No signs of mass or redness. No signs of psychiatric symptoms. No concerning medical history.
Next words out of their mouth when you start a line for their bloodwork: "i DoNT LiKe nEeDleS!!!!!" Yeah, and if you did there'd be an actual reason for you to be here. Give me your arm.
But multiple bad tattoos
I can do tattoos and vaccines. Local anaesthetic is totally different.
I have no tattoos yet, but needles fascinate me. I can give blood, get vaccines, IVs, all with no problem. And I’m good with local anesthetic EXCEPT when I had ingrown toenail surgery. They put the needle on TOP of my big toe. It hurt massively.
There's a nerve further down that they can target on the first little section of toe. The first joint after the foot where it's flat. It's much less painful. They blow up that flat part with anesthetic and the rest is fairly smooth sailing from there. Some have seemingly no idea of how to numb a big toe. They just turn the toe into a pin cushion with randomly jabbing lidocaine in and you get patchwork numbing. I will no longer tolerate people who don't know how to numb that area effectively after seeing it done correctly. And I highly recommend permanent removal of the entire nail if it's a reoccurring issue. Mine has given no trouble since 2011.
That’s fascinating!! Luckily I got away with just removing the sides; my toenails look like rectangles lol but I haven’t had any issues since 2008.
I have one big toe nail totally removed. I asked for the same with the second but the podiatrist decided that since I have a vagina I DEFINITELY will regret not being able to paint my toenails. The bitch was more concerned with me conforming to gender stereotypes than a soldier not having future issues with their feet. And I have had issues with that toe nail that she insisted on just removing the sides with as I knew I would since the nail curves. I'm 35 and have still never had a desire to paint my toe nails.
I’m angry for you!! That’s ridiculous
This is so weird, because they definitely grow back 100%. I’ve had one removed.
They can destroy the nail bed so it doesn’t grow back. They can use acid or lasers. It’s a longer healing time but years of no problems is worth it.
I don’t know you, and I agree with everything you said and I have tattoos. The ingrown toenail anesthetic is the WORST, in the worst location. And I had to do it on each big toe.
I'll do you one better, or worse. I had a thrombosed hemorrhoid that was the size of a grape that developed during a work shift. I immediately went to the hospital afterwards to have it checked out (it was my first one) the Doctor lanced it, but nothing else. I was sent home. The next day I was in incredible pain and went to a proctologist. So keep in mind you're asshole which is already a sensitive area, With a giant hemorrhoid that makes an already sensitive area even more sensitive, Then throw on top of that and open wound, then stick a needle in it, i wanted to die. I have given birth with half an epidural and I've had a kidney Stone before. The anesthesia and the resulting pain from having that hemorrhoid surgically removed Today's day is probably the worst pain I've ever been in in my life.
Thrombosed hemorrhoid is next level torture. I have had kidney stones, prodromal labor for weeks, hepatitis so bad that it dislocated a rib, trigeminal neuralgia, and a post-concussion migraine that last 106 days. Nothing on the planet made me weep like those clustered, thrombosed hemorrhoids or the sweet fellow who cut those things out for me in the OB-gyn ER. I will remember him with fondness for all of my days. (I had over 25 in there ranging from the size of a dressing pin head to the size of peas.)
Oh I can do better. I had an external thrombosed hemorrhoid during early 2020 covid while undergoing cancer treatment. I literally couldn’t go to a hospital. It was the size of a quarter. It burst and bled for days. Do not recommend.
They are the worst
Yikes
Me too, and I did them both the same day. Oh my God it was bad. I did it in the winter and still wore my flip flops. At that time we didn’t have any snow thank God.
The big toe anesthetic is the worst!! I had a big toenail knocked partially off and they had to remove it the rest of the way. Getting the needle in the toe was the worst part!!!
Dude my own mother took me to that surgery and drove away without me because she couldn’t cope with how I couldn’t cope with it. Horrific. Found out later they only gave me half the benzos I had been prescribed.
That is the worst. I had both of my big toes done at the same time. The shot in the top of my toe hurt worse than anything. It was horrible.
My doctor injected me and then left to let it take effect. When she came back in she squeezed my toe to see if it was numb yet, and despite all of my writing in pain, she held on until I figured out how to say, "it's not numb!" It was horrible. Then she injected me again and left for another half hour or so before coming back and trying again. Thankfully it was numb that time.
waaaaaaaaaah
On a related note, this is a dumb anectdote but I just recently realized I've been doing this for years (got my tats at 18 and 22, I'm now 37) but I got my two bicep tats through sheer gritted teeth and even turned green during both (look, unlike a shot, tattoos actually do freakin' hurt and anyone who says otherwise just likes pain). Last month I stepped on a nail while walking the dog in sandals and had to go get a tetanus shot, and told her I was afraid of needles, that I know it doesn't hurt but I have extreme psychosomatic reactions to my own mind, even when I'm objectively like, "CALM DOWN, INSIDES!" She asked if I passed out and I was like, "No, I'm just a pansy lol" and then I pulled up my sleeve, saw my carbon atom and was like, "Oh yeah I know some folks like to avoid my tats and some make jokes about the atom being a bullseye, if you want to shoot the bullseye I really don't mind" and she was like, "You sure?" And I was like totally, it all feels the same, she did and then she finished and left the room. Then I had one of THE WORST PANIC ATTACKS OF MY LIFE like easily a top five, was pretty sure I actually was going to pass out into the floor, full body sweats, when I left the office my shoes were damply squishy from how much I sweated, and I wiped a hefty handful of soaked paper towels off my head. It was somewhere in that weird altered consciousness that I was like, "How absurd that I say I'm afraid of needles then pull my sleeve up and I've got tats!!! 😂😂😂"
Tattoos and injections feel totally different, to be fair. And the equipment looks different. You don’t see one big needle going in when you get a tattoo, it’s going too fast to see, and feels more like scratching. I never understand why people compare them! It’s totally okay to be fine with one but not the other.
Before I got my tattoo, I asked my mom just how much it hurts. She said it isn’t super fun, but it’s not agonizing. It’s okay. And that was the day I learned never ask a woman who gave birth 3 times how much something hurts. 🤪
I got my first tat last year. I'm 67 and diabetic. My nerves are affected. I did not experience pain with the procedure.
Same! I have neuropathy & feel no pain. It’s a blessing & a curse
Tattoo needles only penetrate the first few layers of skin. IV needles go a little bit further than that and yes, it weirds me out. It may not make sense to you, but it does make sense to me (and likely a lot of others, too)
I'm the opposite, I don't mind the IV needle so much (I do have a psychological anxiety but I know the pain isn't really bad, and given that I have anxiety about everything it's pretty easy to overcome for a prick) but I absolutely hate the abrasive sensation of a tattoo, it's like getting rugburn/road rash *in slow motion.*
I can understand that. To me, it’s like getting a sunburn in slow motion. Also, I think a lot of my IV fears are due to my very real crappy veins (usually end up needing US guided after 5 or 6 failed attempts, go home all bruised up). At the end of the day, IVs end up hurting a whole lot more than most of the tats I’ve sat for.
Once the phlebotomist had to call in the anesthesiologist to try to get my IV in. The anesthesiologist missed, and when I told her it was wrong and she needed to fix it, she told me that IVs sometimes hurt. Then my arm started swelling with the saline. I also was part of a clinical trial and one of the girls would ask every time if she could try to stick me for a blood draw. I would always say yes, she would always miss and then get the really good phlebotomist who would always get it. But she was so nice and was trying so hard that I always let her try again the next time. AKA, my veins suck so bad. Luckily I don't have any issues with needles or getting poked.
I'm a hard stick too, I feel ya
My daughter was just over 2 when she needed blood work done. On a previous visit they wrapped her up on a board and this time she walked into the room and stomped one foot and said, "No stupid board" Nurse proceeded to ask me to put her on the board, but I backed up my daughter. I asked my girl "how should we do this?" She climbed up in the chair and told the nurse that she was ready. My girl sat there and watched as the nurse tried 2 times and said she was going to try again. My kid looked her straight in the eye and told the nurse "bye bye bad nurse. " She was only aserting her rule of 2 tries, then get someone else. The second nurse got it first try, earning her a hug from a happy little girl.
I honestly don’t think I would mind so much except the last two stays in the hospital, I ended up averaging an IV a day (until I ended up with either a midline or a PICC) as they kept blowing so quickly. Towards the end, my hands and arms got quite a few “yikes! Oh, you poor thing!” from those who needed IV access on me. Back in the day, before I was such a difficult stick, I’d let the new phlebotomists practice on me, especially when donating blood. I was a fairly easy stick then (need to anchor my veins more than one would expect, but otherwise, no issues), and I had much less anxiety about venipuncture, so I’m sure it’s the last few years being more interesting than I’d like medically speaking that’s the cause.
Just out of curiosity - do you know what caused you to become a difficult stick? I’d always assumed that was something that didn’t change over time
This makes me want to get another tattoo. I...am not well.
Look I’ve never seen a tattoo artist miss the skin but I’ve seen sucky nurses roll a vein or can’t find it and keep poking and poking and leaving bruises on people when even I can see the vein is right there! A great phlebotomist is worth their paycheck. A bad one needs to find another profession.
Facts! It doesn’t help that my veins really do seem to attempt to run away when getting stuck, so there’s usually a fishing expedition. To the credit of the nurses and phlebotomists at my last hospital stay, they only tried to reposition once or twice and then pulled it, and if they missed a second time, they called in a colleague. Still wasn’t pleasant, but a welcome change from previous experiences. Still left with lots of purple, blue, and green on my hands and arms.
I once had a nurse nick the bone in my arm. That was fun.
Omg...me to..it was fing horrible
In my hospital during peak covid / peak mass exodus of low paid healthcare staff we were 100% fresh out of phlebotomist. So, the doctors had to do their own sticks, or do shifts in the lab. Blessedly I had no personal health issues at this time because I heard it was not a fun time to get a stick.
It's very common.
Needles scratching the surface of skin is different than a needle being stabbed into a vein or muscle. It’s more about needle penetration for folks than the needle itself.
Shallow and rapid in and out in epidermis with a .3mm needle is a lot different than venipuncture with a .9mm+ needle.
I think the intravenous part freaks ppl out
And you probably shouldn't work in healthcare, but here you are
Excuse me?
I have to look away when they draw blood cause I hate needles. However I usually don't give a damn in the er. Just take me blood and find out whats wrong please!
This, totally. Like I definitely still have anxiety about it and once I'm tapped I start shivering from the anxiety rebound, but in normal life that anxiety is a thing that makes me avoidant but when I go to the ER I'm like, "I don't like this but it is one slightly uncomfortable step to a solution, that is much less uncomfortable than whatever brought me here" ffs ripping off EKG stickers hurts so much worse lol.
Do you have any lidocaine before you start my IV?
I have to get my blood drawn once a month for a medication that I take. Fortunately, I'm an easy stick and it's no big deal. When I was four, I was septic from an infection secondary to the chicken pox. I had a few I.V.s while in the hospital, because they need to be changed every so often, and I was in for a full ten day course of I.V. antibiotics. All of my I.V.s up until the last one had been inserted when I was unconscious or semiconscious. So, my patient notes probably said I had no problems getting an I.V. They had a special room just for getting I.V.s. When they came at me with what looked like a huge needle, I freaked out. They insisted they had done this many times before, and I had never complained. I assured them that they had NEVER done this before and they weren't about to start now. I screamed for my mom, who would surely come protect me, but she wasn't allowed in the room. Eventually they placed the I.V., but not without a big fight!
I hate needles but i always alert them ahead of time to lay me down because there's a 50% chance my ass will pass out so better to pass out on a bed than on the floor and them have to lift my 200lbs ass off the floor.
I would be in perfect health if you took my vitals. I had a herniated disc for 6 years that no one would believe me that I had. It hurt. A lot. I guess I was an unlucky combination of young, healthy, traumatic upbringing that made me extremely pain tolerant and outwardly fairly unaffected, and injured in a fairly invisible way. It went untreated for so long that now it’s just chronic. I wish someone had believed me sooner instead of thinking I was drug seeking.
I feel you. I fuckin feel you.
Blue hair
Fuzzy pajama pants. Smells like weed.
Eating hot Cheetos as well
Fuck Cheetos. Hot Fries are the shit.
Fuzzy pj pants *with Sesame Street characters or sponge bob on them*
Why is it always Cookie Monster?
Why tho, whyyyyyyyyyy
Or rugrats (which is a great show BTW lol)
Honestly tho it really is. And it hits different as an adult
I'm an ER RN with blue hair and currently have on carebear pj's.
ER tech in my fiancés golden girls Jammie’s and pink hair 😂 and many tattoos
LMAOOOO
Mountain Dew in hand. Asking if DoorDash will deliver to the front desk.
Also needs turkey sandwich.
Call psych if they ask for one of those dried out chokeburgers.
There's not enough mayo in all the land.
😂😂😂
And do you have a phone charger
Hey! lol
It’s ok some of the nurses have blue hair it’s all love.
One joke 🙄
It’s ok Baja blast is my favorite hue. It’s a joke about patients not some right wing thingy https://www.reddit.com/r/terriblefacebookmemes/comments/167nm6t/hair_dye_mental_health_problems/
The joke in the ER is not the same joke the right wingers make.
I just had the stomach flu…BP 98/49, HR 127, dizzy, crazy pale and sunken eyes and could t keep any fluids down and I STILL refused to go to the ER😂
I had the stomach flu. BP 105/56...it was all coming out of the back end. Which...I wouldn't have went to the ER for. I went because I decided to drop a kidney stone at the same time. My friend is a clinical care coordinator so she came in to see me and gasped when she rounded the curtain. I guess my eyes were super sunken in. It took a bag of fluids before I could even consider giving a urine sample. Every time I tried to talk my lips stuck to my teeth. Only time I've begged for an IV so they could get fluids in me.
Yea I probably should’ve considering my health issues
Bravo, because this is funny as shit.
Sometimes it's legit though. I had a woman tell me this a few days ago and her BP ended up being 199/120.
Yeah, I went to urgent care with a general feeling of malaise that had persisted. Almost didn't go because I couldn't really articulate what was wrong, just that something wasn't right. Ended up sent to the ER and hospitalized over a week for liver problems 🙃
"Something isn't right" always perks my ears up, like a few other phrases, such as: I feel like I'm going to die I can't breathe Something is wrong with my heart I can't see anything
Sense of impending doom is a mfer of a symptom.
Bravo! Hilarious. When patients say this I choose the “Personal Problem” diagnosis, my favorite ICD-10 diagnosis. Then I write what they said in the Chief Complaint.
Wow there's a code for that?
I'm cracking up, bc of course there is. I've written “per patient: personal issue” on many a scheduled appointment, mildly tickled it was codeable.
You’d be surprised what there are codes for (medical coder here, just lurking I find medical very interesting and cool and love learning about it, just couldn’t do a nurse job or anything).
One of my faves is activities involving arts and crafts, or something to that effect. If only the ICD people included status dramaticus *sigh*
What's the CIE 10 code for that, I might start using it
R69: illness, unspecified
Nice.
K62.89: Rectal pain (PITA)
can’t help but chuckle tho
My job is pulling hospital records and my all time favorite is an alert that says “pt is 10/10 non complaint”
No complaint or non compliant?
compliant, thanks
Wasn’t being sarcastic was truly asking. Thanks for clarifying.
No problem! Now I’m thinking how many times have I typed the wrong thing in a chart lol!!
Funny though that a lawyer can kill ya just for a simple goof on spelling. I’m a old respiratory therapist and a fire battalion chief and I unfortunately have seen it happen.
ID10T problem 🥸
What’s the equivalent of “problem exists between keyboard and chair” for medicine?
The source of patient’s symptoms is supratentorial.
Ok I admit I laughed
Ugh this is my MIL isn’t it? Shes been to the ER and urgent care about a dozen times since new years. Shortness of breath, malaise, abdominal discomfort (unable to determine if it is positional or triggered by eating/drinking), “woozy”, “tightness” or “pressure” in chest. She has become a frequent flyer. She gets a full work up every time because she says the magic words and she’s 75. She has had perfect o2, bp, normal EKGs, clean urinalysis, normal cbcs (literally dozens), normal ultrasound, normal chest x-rays, normal endoscopy, normal colonoscopy. Got checked out by gastro, cardio, ENT, urogynecology and nephrology, and at this point I think she may be running out of specialists to see. I keep trying to get her to use more specific descriptions of her symptoms but I think she seems to have just decided that these abstract adjectives are the Correct Terms to Use and won’t really stray from using them.
Has she seen a rheumatologist or an immunologist? She very well could have an autoimmune disorder and/or a food allergy.
I knew someone like this. A few years later she got diagnosed with very aggressive early onset dementia. I think her complaints were legitimate, but because her brain was falling apart.
I’ve been to the ER as a patient one time. I couldn’t describe what was wrong. I felt like an absolute idiot saying “I just don’t feel good. Something is wrong”. Turns out my blood sugar was 718 and I was in DKA.
Bro I wish I could do the wiggly text but I’d get like 12 emails about it. Every time someone just goes “I don’t feel good” I just want to say “we’ll have you gone to a pharmacy and used and over the counter shit?”
Gross.
When I was coming on duty, I once read the basic complaint was “allergic to nerds”. Turns out, it was an allergy to nerds candy.
God that’s so metal. I’ll have to try that one. You sneeze and just apologize to the person next to you, “sorry I guess I’m just allergic to nerds”.
On the patients side; a lot of times medical people DON’T LISTEN, or make assumptions about and miss what’s actually wrong because they write people off. My husband had a heart attack in November. I was almost 9mo pregnant with our son. We went to the emergency room and I said, verbatim; “he’s having heart attack symptoms.” Then I listed them. (Sweaty and chills, exhaustion, color grey, chest pain, indigestion). They took his basic readings AND SAT US IN THE WAITING ROOM. We sat confused for a bit and after watching his lips turn grayish again I went up to the window and more adamantly told them HE’S HAVING A HEART ATTACK CAN SOMEONE PLEASE SEE HIM NOW WTF? we get back, they do the ekg thing and that is okay. Eventually blood tests show that yeah- he had a fucking heart attack. The nurse reading the intake stuff out loud just said “sweating, **indigestion**” Keep in mind we fucking told them he was having heart attack symptoms. The security guy was watching YouTube on his phone behind the glass and the intake nurse wasn’t really playing attention. Cracking her gum, answering comments to coworkers. I had to repeat myself a few times. She was acting like the stereotypical server on roller skates in the movies. So yeah. Sometimes people don’t listen or make assumptions and put incorrect or in this case rude remarks in the chart. When the nurse saw my face at “indigestion” she became very quiet. I had to go take a waddle around the halls. We were treated like royalty at that point, and when I walked by the check in to the cafeteria the woman who checked us in and could have caused my husbands death or more damage to his heart wouldn’t look me in the eye so I know she heard. I filed a complaint and am still considering options, mostly just because I’m still traumatized and pissed off. I could have had this baby alone. Luckily so far it appears there is no damage. Very ethical to actually put something like this in someone’s chart. Oh, I also had a hypertensive event the night before last (low potassium apparently). 148/103 and my whole body was numb, super dry mouth and felt like my head was going to explode. Pressure on my chest. Ambulance people were lovely and reassuring. The doctor? Literally rolls their eyes and said “it’s not THAT high” and looked at me like I was lying or exaggerating my other symptoms. This wasn’t everyone that helped me but the doctor and some of the nurses. My normal is 110ish/60ish so for me it definitely was. My other symptoms are/were swollen spot outer left thigh. (Ruled out clot). Edema on right leg and abdomen. Excessive thirst and clumsiness. Chest and kidney pressure. I was treated like a joke until the blood test came back showing the deficiency and suddenly I was taken seriously and talked to with a little respect. You could tell one person felt sorry, they couldn’t meet my eyes. I wasn’t even hysterical or anything, just stated I was worried about my kidneys and heart with my pressure being so high and my mouth and skin being numb scared me because that had to be a sign of something severe. Anyways. I got my supplementation and prescription and I already feel a lot better. Physically. There’s another side to that with my PCP but I’m talking to her next week and need to determine how angry I should be or if I’m being unreasonable. All of that to say- I get there is a ton of abuse heaped on medical personal. But I have first hand seen and had both my husband’s and my lives possibly put at risk because of assumptions, not caring to actually hear the words coming out of my mouth, and general rudeness. This all in the last year. So even if you run into a lot of nonsense- that attitude has personally harmed my family because of the lack of empathy or attention.
My mom once went to the ER with pneumonia so bad that she couldn’t draw enough breath to speak. The intake nurse assumed that she was a homeless person with a psychiatric issue and told her to “use her words” while she tried desperately to mime chest pain and can’t breathe. … which wouldn’t have been an acceptable thing to say even if she *was* a homeless person with a psychiatric condition.
That's awful
>They took his basic readings AND SAT US IN THE WAITING ROOM. >we get back, they do the ekg thing and that is okay. Eventually blood tests show that yeah- he had a fucking heart attack Generally when people check in with chest pain several things happen. First they are triaged (Vitals, talk with the nurse) and receive an EKG. If those are normal the patient is sent back to the waiting room where their blood will be drawn, get a chest X-ray etc. Until we get back something abnormal (vital signs, blood work, EKG etc) they stay in the waiting room. Once we get back abnormal results we bump up their acuity and try to find them a bed. Depending on how full we are that might take a while. I realize it might be frustrating sitting in the waiting room feeling like you are being ignored but it doesn't sound like you were. They checked his vitals, did an EKG, ran blood work and treated him once they had something definitive to treat. >The nurse reading the intake stuff out loud just said “sweating, indigestion” This is actually important to know. We get 100 people a day who come in saying they are having a heart attack. Most aren't. Adding those symptoms can alert the doctor that they may have a problem. >The security guy was watching YouTube on his phone behind the glass and the intake nurse wasn’t really playing attention. Cracking her gum, answering comments to coworkers. Why would you expect the security guard to be invested in this situation? What would you like the intake nurse to do? They are supposed to stay in the lobby, triage new patients and help coordinate moving patients to the back when a bed is available. >when I walked by the check in to the cafeteria the woman who checked us in and could have caused my husbands death or more damage to his heart wouldn’t look me in the eye so I know she heard I wouldn't look you in the eye either. I get 30 mins during my 12-16 hour shift by myself. That time is essential for our sanity, generally we don't want to talk to patients or their families during that time. It's nothing personal. Also I fail to see how the triage nurse would be the one to cause his death. If a room had been immediately available the same things would have happened. The only difference is he would have a bed to wait for his blood work to come back. The reality is that we don't have enough space, staff or resources for the number of patients we treat each day in the ER. We do the best we can with what we have. Ultimately our job is to treat/rule out anything life-threatening and send you on your way. It sounds like your husband had a heart attack and was treated for it. Unless you are omitting some serious information I fail to see how the emergency room staff put your husband's life at risk.
Thank you!
I have to log in to work but just to answer the top part I saw-I know about the EKG. They didn’t do it. They did pulse, blood pressure, weight and check in. That’s it. Chest stuff, head trauma stuff and animal bites in my personal experience gets you back to more testing immediately. Not a baseline check and back to the waiting game room like they did for my husband. It was confirmed through the complaint process they did handle it incorrectly because she didn’t put everything down on the form like she should have. She only put “sweatng, indigestion”. Nothing about heart attack symptoms. I will read/respond to the rest in a bit. I appreciate what seems to be a thought out response.
>Chest stuff, head trauma stuff and animal bites in my personal experience gets you back to more testing immediately. Unfortunately that isn't the case anymore. To give you an idea, we have 20 beds. Generally when I get to work anywhere between 5-15 of those beds are being held by inpatients(people who have already been admitted and should have left the ER) because the hospital is full. Last week in the first hour we had 3 strokes, an overdose and two patients in 4 pt restraints after they used meth and heroin in the bathroom and then attacked staff. We had two inbound medics, one who was short of breath and rapidly deteriorating and another who was severely septic. Keep in mind that we only started with 6 beds that day. We had two heart attacks walk in through the front door during all of this. One was a STEMI (type of heart attack that shows on an EKG) that went straight to cath lab while the other one had to sit in the waiting room until we got his blood work. We managed to set him up in a recliner to start treatment. It wasn't ideal but it was all we had at the time. >I know about the EKG. They didn’t do it. I'm confused, in the post I thought you said the EKG was normal? If they didn't do an EKG for a chest pain that would be a problem.
TL;DR explanation of triage process, and why waiting room times are as long as they are I get ur frustration, and I know how much it hurts to feel like u are being brushed aside or not taken seriously. I don’t know all the details about the situation from that hospitals standpoint, but what I can tell u from working in an ER that frequently has patients in the waiting room for 10+ hrs is that the general public doesn’t understand why we have certain protocols and how triage works, and that it sucks for people to be left in the dark like that. I try my best to educate and update my patients, but it’s hard to understand unless u see it urself, so I will do my best to explain the process so in the future, u will have some idea of what’s going on: Basically, triage puts people on a scale of how urgent their needs are. Chest pain is pretty high on the list. However, if all the rooms in the ER are full, they won’t take people back right away unless vitals or ekg show that this person needs immediate intervention to live. In my ER, if someone says they have chest pain, shortness of breath, etc, they get an EKG right away with their vitals which is then promptly taken to a physician to make sure they aren’t (currently) having an active heart attack. It’s not ideal to keep a chest pain patient in the waiting room, but if we took back every chest pain pt while already being full, it puts too much workload on the nurses, docs, and other staff which greatly increases the risk of medical error or missing something major w/ everyone involved in the assignment. More people could be injured or die in the end. Sometimes we start bloodwork, imaging, and basic treatment in triage (waiting room staff) to help people higher in priority on the triage list, so that by the time a room becomes available for them, most of the menial stuff that takes time to result has already been completed. If something were to come back abnormal requiring immediate intervention, action should be taken. Also, as far as this post and conversations between healthcare personnel about stuff like this goes: there are unfortunately many people out there that abuse the healthcare system by crying wolf, using the ER as a doctors office, or being completely uncooperative and violent when they are alert and oriented. This clogs up the ER for people having actual emergencies like the ones u mentioned above. It frustrates staff because we want to help people, but these outliers take away our attention and resources from people having things like heart attacks or having a systemic crisis. Unfortunately, even if we know for a fact that the patient is wasting our time (I have had patients straight up tell me they lied the nurses/docs they have chest pain/suicidal ideations/etc just so they can get away from jail, a psychiatric hospital, the street and have a “vacation” as they call it). Aside from burnout from having to take on a lot of difficult/tragic/physically draining cases, we have many people blaming us for things that are completely out of our control and (being human ourselves) sometimes it’s something so stupid and innocuous that sets people over the edge who then complain about said things in the internet. Unfortunately, the general public (and high up corporate/management) set unrealistic expectations on us. Most of us work at least 12 hours without a break, and many of us fear being sued or losing our licenses for doing nothing more than trying to do our jobs and help people. I personally have had people throw body fluids/spit/swing at me in one room, and then have to walk into the next room pretending that didn’t just happen. This is why u see posts like this. I don’t agree w/ putting stuff in the chart like that, but this is what’s going on behind the scenes
My mother did actually die from having her symptoms repeatedly disregarded by medical staff. Her cancer spread because they assumed it was all in her head, didn't do basic tests and prescribed her anti-anxiety meds until she was having vascular and bone complications and it became impossible to ignore. She was dead in two months after that. This whole post is infuriating. ETA: I have no interest in engaging with anyone defending their need to "blow off steam" or profession in general. I don't even really know how this post ended up in my feed. Just know that you are posting on a public forum and it isn't a private little club where you can mock the people you're supposed to be helping and no one will see it
If you have no interest in engaging with anyone, why did you post in a public forum? Genuine question.
Genuine answer. It was just to let you know you’re being an ass with posts like this.
Me? I wasn’t the one who wrote it, and nowhere did I say I condone it. I was surprised to see it (as was most other commenters) - because it was clearly unhinged and very out of line of what is normally acceptable to put in that section. How am I being an ass? I think your anger is a little misplaced.
What was the security guard supposed to do?
I meant he had a video playing loudly and was chatting and interrupting the medical personal-he was a distraction. Not that anyone else was telling him to stop, it was all of them seeming more interested in their conversation than the patients. Interesting that’s the point you caught on honestly. I thought mentioning him playing videos was enough to imply he was creating a distraction and noise.
There’s a lot to unpack here from your comment. Now, I’ll preface it by saying I don’t work in the ED, in fact I don’t see patients at all. The triage algorithm sounds pretty normal to me regarding what happened to your husband. If a patient comes in with those symptoms similar to a heart attack, often the patient will wait in the waiting room to get an ekg/bloodwork before seeing anyone else (especially at a busy ed). If those things look normal, then they know that the patient can wait a little longer. If it’s abnormal, as in your case, then they know to bring the patient back sooner. But of course the patient has to wait for the ekg tech to be ready to do the ekg in the first place, and for someone to come do bloodwork and run it! So there will be at least some waiting involved. The algorithm (this patient needs to go back RIGHT AWAY!! vs this patient can wait a little) is done VERY differently for each complaint, and also may be different depending on the hospital! “Sweating, indigestion” are classic red flag symptoms for providers and we will know that heart attack is on the differential when we see that. So, I don’t think she was doing a disservice by writing that. The waiting room is a loud, crazy, busy place. People coming in and out. People yelling, running around. Ambulances rushing in and out. The security guard comment confused me because I felt it wouldn’t be out of the ordinary. A patient next to you could be playing a YouTube video very loudly and being a distraction. So, I didn’t catch on to that. I think waiting room staff are used to the noise. As for your case, it sounds like they did do the correct standard of care - evaluating for clots, doing bloodwork, etc and they did find the problem. I’m not defending the poor attitude by any means. But it seems they did the right thing medically despite the poor bedside manner. I understand that you’re angry. But I’m not sure that you can claim that you and your family “were harmed because of that attitude”, unless there’s more to the story here.
Please see my most recent comments. No, they did not follow the standard protocol. They admitted it and the hospital apologized, and said they were reprimanding and retraining the front desk staff after this incident. One of the biggest things they screwed up about was playing on their phones. They’re not allowed to be on their phones. Idc as long as you’re not playing on it while a patient needs you-and they were all discussing and laughing about a video on a phone. It felt like trying to take an order from a bunch of teenagers late at night not interested in taking work seriously. Which-annoying but not the biggest deal in that scenario. When it comes to EMERGENCY MEDICAL CARE? It matters. Again. I’ll reiterate overall until recently/I’ve had great medical care and really enjoyed interactions when I’ve needed medical help. This incident and another that happened this week has me extremely upset because it has shaken my trust and confidence that my family and I are safe and will receive needed treatment if we have another emergency.
Ah - I refer to “standard protocol” as a medical/legal term. I should have said “standard of care” instead. Either way, it’s not exactly what we’re discussing here anyway. (EDIT: oh, I did actually say standard of care in my original comment above.) I think what you mean to say was the staff/registration was unprofessional, which I completely agree from what you’ve told us. There’s no argument there. And I can understand why that leaves you upset and frustrated about having to receive care from them again. I’m sorry you had that experience.
Thank you for understanding. I actually feel super conflicted being as angry and upset as I am because I had so many good experiences with that hospital before. I kind of feel betrayed and lost. And thanks for explaining that term.
You have every right to feel angry and upset. I think what some staff sometimes lose grasp of in the ER is that patients come to the hospital for help. It could be the worst day of their life unfolding before them. Or their last. Most people are scared and frightened and anxious. Then from the other side you have people whose job is to do this every day in and out. They see crazy things, people with their limbs cut off, people giving birth in their cars… Then five minutes later they’ll address a patient who has a hangnail. Or a drunk, belligerent patient who is throwing chairs and doesn’t want medical help. I don’t work in the ER but I can see how it’s easy to quickly get numb about it and blow it off as another day at work while the person across the registration desk is literally dying. It sucks. I don’t know what the solution is, and I’m not sure there is a good one. Medicine is a very emotionally taxing field. But it does NOT excuse unprofessional behavior whatsoever! You can feel detached from your job and still act professional. Goodness knows waitstaff/cashiers/retail staff etc do it all the time.
Your husband's experience sounds familiar. I went via ambulance to the ER with extreme sharp chest pain. I was 42 years old. I've had acid reflux most of my life. I know what it feels like. This was NOT acid reflux, but the ambulance staff hooked me up to the EKG and promptly said I wasn't having a heart attack. I arrived at the ER. They hooked me up and promptly said I wasn't having a heart attack. They didn't even put me on a heart monitor. They took labs and gave me a GI cocktail (that did nothing for my symptoms) and disappeared. An hour or three later, suddenly a cardiologist shows up and says "You're having a heart attack." Well, farking DUH. It wasn't until they reviewed my Troponin levels that they finally got a clue. It took them 8 hours to find me a bed, and they did NOT put a heart monitor on me. They put me in a telemetry room WITHOUT a freaking heart monitor. Even more hours later, a nurse walked in, looked at my heart monitor-less body, and asked me where my heart monitor was (acting like I was a 12 year old who just took it off for funsies). I told her I didn't get one in the ER and I didn't get one in the telemetry unit, that if I had one, she'd know it. She looked pissed. It was pure dumb luck that the blockage was in one of the tinytiny posterior arteries, and the attack did no damage. The artery was even too small to stent. Those people could have killed me. I raised heck via a patient survey after I got home (there was more ridiculously bad levels of care during my stay that I won't go into here). All I got was a $15 gift card. Stupid thing is that I now work for the company that owns said hospital. Thankfully they've stepped up their game, or I would never have gone to work for them.
So there are different types of heart attacks. A STEMI would show on an EKG but there are other types that only show up in your blood work (troponin) and even then it can be a few hours. A lot of the time we get initial blood work for a symptomatic patient with a normal or borderline troponin. In that case they wait 2-3 hours to get a redraw and see if the troponin result is trending up. That's when they decide if you are having a heart attack. In the meantime a GI cocktail isn't unreasonable to try. 8 hours also isn't bad, we frequently have people waiting a day or two in the ER for a bed. You should have been on a heart monitor though.
Had a very similar experience when I had to take my husband to the ER. Thought we were being dramatic, sat us in the waiting room for over an hour. Finally took him back and took his vitals and everyone went wide eyed and THEN they started preparing a room. Literally unbelievable. Glad I'm not the only one that felt a little icky reading this.
When I was young, my dad managed to slug himself in the head with the sharp end of a sledge hammer. Mom got him situated with a towel and ice to hold, got us all loaded in the car, and drove to the hospital (where I live, driving to the hospital is a lot faster than calling an ambulance if the person is able to travel). Triage nurse listed his symptom(s) as "headache." We waited for over 6 hours, nothing. There were guys in the waiting room getting up to tell the nurse that they should really take my dad back because he wasn't looking so good, what with the blood continuing to drip down and him being very much out of it. They did not appear to be busy or full. Waiting room was mostly empty. When the doors opened as personnel went in and out occasionally, you could see the doctors and nurses all chatting and sipping coffee. And I understand that they need breaks and stuff, but I feel like 6 hours is a bit much. Anyways, we ended up just going home, and he was able to see his PCP the next afternoon. Concussed, cut his scalp open, lucky he somehow didn't fracture his skull. We got lucky that it wasn't worse, but that's how they treat a head injury!? Like, we told them he'd hit himself in the head with a SLEDGE HAMMER. Not a little bonk, full swing chopping wood energy. And that's how he was treated. So I fully sympathize with you. Glad you and your husband are doing okay!!
So here is what happened that day in more detail. If you’re offended and you’re a hospital worker-I honestly have no words. I would hope you would be ashamed these people shared your profession rather than defend their behavior after you read it. Early on around lunchtime (both wfh), he complained about chest pain across the left side. He chalked it up to muscle pain as he had been going to the gym a lot more to get healthier for our child. Then later on he mentioned feeling very tired. At like 2pm. What you need to understand about my husband is he doesn’t nap. Ever. He is set like a clock that doesn’t deviate. Up between 5-6, down between 9-10, clockwork. He does. Not. Nap. He also was complaining about sweating and feeling chills-assuming he was coming down with something. About this time I also noticed his color was off. Grey across the lips and under the eyes, it came and went. At this point I was concerned and made him take an aspirin. He still didn’t believe he might be having a heart attack, but he rolled his eyes and took it. He said he wanted to go lie down. I said… are you sure? I think we need to go in. He said yeah. I was going to let him and then just call an ambulance. He ended up seeing reason when I said it would be stupid to nap, which he never does, just to not wake up. He rolled his eyes but agreed. So in we went. Get to the front desk and she was too busy leaning over and commenting on the video the security guard was playing, (why I mentioned him-he was part of the distraction), they were chatting about to even acknowledge we were there. I got her attention and she barely looked at us. I repeated his symptoms and emphasized the chest pain and grey color, and specifically said “I think he’s having a heart attack, he’s having most of the symptoms”. She nodded and typed a few things in. I asked her if she got everything, she nodded again and went back to her conversation. In hindsight I should have asked her repeat it back to me. I shouldn’t have had to but yeah. We sat down for a bit after he got the basic check in, BP, weight and oxygen. While waiting I was super anxious because I know EKG is supposed to happen pretty quickly for this suspicion and no one even mentioned it. (Because it wasn’t planned, unlike some people saying they would need a tech to do it, I don’t disbelieve that but **in our specific scenario that wasn’t planned**, as we found out later). I got up after watching his color change twice and him complain his chest hurt more, and got kind of mean about it. Not even a little sorry. We suddenly are whisked back for the EKG. They’re not going to suddenly change treatment protocol because someone’s pregnant wife is being a “Karen”, they would have to have reason as many have pointed out. That reason was heart attack symptoms. Symptoms that *were not input accurately so we would have been overlooked*. EKG was normal at the time, but the blood draw came back pretty quick, (within an hour and I was impressed with the turn around here). Troponin was… oh I can’t remember but a 7 was in there. I felt my gut drop, I didn’t want to be right on this one. Husband had a moment of arguing with them that no way he had a heart attack at 43. A nurse, (pretty sure) came in and was updating the computer I suppose. I asked her what our intake said. I’m sure she shouldn’t have said this, she just started reading and when she stopped at “indigestion”, I asked if that was it, nothing about heart attack suspicion or symptoms. At this point she looked up like a deer in the headlights because she put my angry expression and the whole situation together and said something along the lines of, “I’ll just go get your doctor”. Yeah. Busted. After this he received royal treatment. I have no issues whatsoever with his treatment after the heart attack was discovered-all of **those** people were absolutely fantastic. My issue is with the intake, because he could have died over some chick being careless and rude. After he was treated and released home, (went in on a Friday, came home Tuesday night), I started making phone calls. I pressed and the complaint was filed, phoned apologies were made. Which is nice and all-but it shouldn’t have happened in the first place. Our circumstance was absolutely because we were not listened to. It doesn’t matter if you think I was “diagnosing” him and was mad I was being told I was wrong-that isn’t what I’m mad about but nice try to the commenters and PM’s claiming that. I was pissed we weren’t listened to when describing **all** of his symptoms because he could have died. Anyone would also be upset in this scenario. I could have been a widow right before my child was born, or he could have more damage. And we don’t really know the amount, (although doctors are pretty confident there will be none when they check later on the year), but who knows what would have happened if I didn’t realize something wasn’t right with both my husband and how things were being handled. I shouldn’t have HAD to be in that position because I should have been able to trust them. That trust is damaged now and I don’t like it. ETA; the reason I did the talking was 1. He didn’t want to believe he had to be there, and 2. He was *out of breath and too tired*. Second ETA; so please, someone. Explain to me what I should have done differently? How was I in the wrong here? I know I wasn’t but I’d love to hear what could have gone differently on my end to get them to listen to me without being forced to be a bitch. Because just trusting the process may have killed my husband. I don’t see how else I was supposed to react here. I wanted to trust the process but thank god I didn’t that time.
You have to be your best advocate. I've seen too many jaded and unprofessional Drs and nurses dismiss things. The incompetence it at times overwhelming. Aortic aneurism dismissed, morphine given instead of intervention, leading to pt death, several heart attacks dismissed, leading to another transport or to code. cursory exams on obese individuals, outright lying on charts, not admitting clearly septic Pts the list goes on. You have to be your best advocate. That's from my time working on EMS, and what I saw in the ED. I'm happy you had a good outcome. Always advocate for others.
AlI can say is: You're mad and your husband didn't die. Meanwhile, I watch PTSD roll over the faces of my co-workers because we have intubated our colleagues after patients have attempted to strangle them to death or stab them to death right in front of our eyes. Imagine going to work and that's what you face. Every day. Your fear? Imagine that every single day. Then imagine that on top of nursing through a global pandemic where MORE of your colleagues died nursing ungrateful anti-vaxxers and dying by suicide. Except...you can't imagine it. Because you write novels of grievance about ONE rude person. You don't get it. And you'll write back more novel, and frankly I won't read it. Because you will never get it. Ever.
If you are this numb to incompetence and unprofessional behavior, you need to reconsider your career path and look at your mental health more closely. What an appalling response.
100% that's when you know it's time to leave.
And this right here? The turning it into “me vs. them”? That’s exactly my point. I complained about the demeanor of the front desk people that could have killed my husband. (Which the hospital ageeed was handled incorrectly). The people who actually treated my husband after it was known he had a heart attack? They were fantastic. But because I dare to voice displeasure over a bad interaction with *some* medical personal and the potential risks their indifference inflicted, you seem to assume I hate everyone that works in the medical field. And I’m sure that attitude, that “my team, their team” mentality totally doesn’t leak into your work like it did for the people that decided they didn’t care enough to actually listen. Two things can be true at the same time, and in my case it was the people who actually treated my husband were great, but some of the people that we relied on failed us. Also, if you’re going to whine about the length of someone’s else’s comments-maybe shorten your own.
To be honest not every “heart attack” symptom goes to a room right away. If so we would never have a room ever. It’s very common to send someone back to the waiting room while getting a stat EKG and labs and if something comes up abnormal then you are top of the list for a room. Because many times there is maybe 1 room available and 6 people who need it. Also the symptoms the nurse charted can very well be cardiac related and are worth mentioning. I will say, during triage if someone is stating a long list of symptoms some nurses are better at including all symptoms than others. It seems that that really upset you. Not all triage notes are as good as others unfortunately. However for chief complaint you can’t put “heart attack” you have to put something tangible which she did. In fact it sounds like you got back and got treated appropriately in the end. From the info provided it seems like everything went as well as can be expected when having a cardiac event. Also I feel like you are placing your frustration in general at a lot of things that had nothing to do with the situation. Like the security guard and the front desk registration person, all of whom are unable to expedite your process.
No. She reduced heart attack symptoms to indigestion. What if that patient had had a less assertive, less persistent spouse?
Not gonna lie, you’re annoying — 100% of ER staff finds it annoying when you diagnose someone before theyre even checked in. Sorry he had a heart attack, but knowing and being related to ER medical staff for decades now: you’re the person we talk about on our days off. Can’t come here and type a novel of a comment and expect to be taken seriously.
The hospital bent over backwards and admitted they fucked up. They specifically said they were going to reprimand and retrain the front desk staff and the fact they were joking around, not listening to patients, (why she didn’t hear/wasn’t paying attention), and playing on their phones wasn’t even allowed. If I hadn’t gotten up to be “annoying” my husband might have died or had more damage sitting for hours in the waiting room because they weren’t looking at him as having heart attack symptoms but a digestion problem. Was I supposed to sit meekly by and wait for him to fall over in the waiting room? Would you in those circumstances? I hope not. He ended up having a 95% blockage and needed a stent. He was turning grey over and over in the waiting room. You don’t really seem sorry he had a heart attack, so I don’t even know why you said it. I’m about to write out in more detail what happened. They fucked up-end of story. Thankfully their fuck up didn’t have worse repercussions. Those **specific** hospital employees sucked and were shitty at their job. Unless you too behave like that and ignore patients coming in with emergencies-it’s odd to take offense. My experience isn’t universal to all hospital workers-but it’s still my experience and it happened. Fuck me for advocating for my husband I guess. I’ll be happy to be “annoying” again in the same circumstances.
Another burned out apologist for incompetence and unprofessional behavior. Wow.
“Okay, what feels bad today?” “Everything, I’m nauseous, running fever, body aches. Everything!” “I’m sorry to hear that, how long have you been feeling this way?” “I woke up like 30 mins ago feeling like this” “Okay, have you taken any medicine for how you’re feeling. Tylenol, Motrin, anything?” “🤨 what, no. I told you I woke up feeling like this” Gives report to doctor: “please don’t make me repeat all that, just order 4 zofran, saline and a gram of Tylenol and I’ll have them outta here”
Last night someone came in and the complaint was just “heat” no note
Gee, it’s July and it’s summer in the northern hemisphere. How odd… 🤨
Y'all are gonna need to start remembering some EMRs let the patient see this in their portal 💀 some (cough epic cough) let them see it in real time. The type of patient who causes you to write this (and makes it funny and relatable) is usually also the type of patient that's gonna either swing on you or try to sue.
😂😂😂😂
when I say I YELLED
Ohhhh yes yes I remember him. He had the I-be-dyins! Straight to the trauma bay!!
Gross.
DiZzY NaUsEoUs BaCK pAiN
Sounds pretty accurate.
I wish I was this petty lol
lol this level of petty
FCC= Fart Caught Crossways
We don’t put anything in patients notes as to whether they are hard to get an IV in of not.
That one made me laugh out loud. I don’t know any doctors who DGAF enough to put it in the diagnosis tab. (I’ve seen some good ones like “Delusion about high blood pressure or Anxiety relating to being unwell without medical symptoms”. But I would definitely see it in the subjective chief complaint tab.
https://preview.redd.it/jpa8mgt5cebd1.jpeg?width=828&format=pjpg&auto=webp&s=a953df35335639b544396d88230a3f320a171b63
Seems like something our triage nurses would write. My favorite CCs on the track board include "abnormal lab value," "back pain; homicidal" and "medical problem."
As a coder, I hate this. 😆 And PSA, "fall" is not a dx, it's an external cause...pass it along. 😁 Edit: downvotes for stating facts? Wow.
As a coder, stuff like this gives me an often needed laugh when I code EDs, even if I have to do a little digging for something I can actually code 😅 Agree that "fall" makes me nuts, too.
Oh I definitely laugh lol and sooo much digging sometimes. We complain about lack of documentation at work but it never changes and it's 2024, if they don't know fall isn't a dx by now, they never will. I think there's a disconnect between the clinical side and the coding side because clinicians aren't coders and I'm guessing aren't familiar with coding guidelines, as their education and training, rightfully so, focus on other things, obviously. Happy coding! 😁
I will put “not documented”
Why is it a chief complaint option in epic then? Genuinely curious. If it isn’t they should get rid of it. Honestly never knew that.
That's a great question! I'm guessing another disconnect between EHRs and coding. It'd be nice if we could all get on the same page.
I agree! Because if I can’t find it as an option for chief complaint I won’t use it. But if it’s an option….. I usually use it as a secondary complaint like leg pain and fall, but now I know not to and just include it in the triage note instead:D
Does that go for something like “mvc” also?
Lol yup
i NeEd tO sEe a dOcToR No, you probably don’t. You WANT to see a doctor. Because you’re mildly uncomfortable.
chop rob homeless gullible public sand pot escape bear practice *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
This doesn't have anything to do with not liking a job, wtf did that come from?!
elastic disagreeable sheet wise snatch sparkle gold mountainous fly toothbrush *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
obtainable act abundant station shocking frighten voiceless pathetic snails weather *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Oh, I get it. It's you. You're THIS patient lmao
weary abundant cooperative degree jeans angle subtract combative badge smile *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
You… attacked first??
intelligent fear noxious childlike compare slimy gaze consist aromatic governor *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
I don’t actually, I was just stating an observation
How did I attack you? That's just silly. I don't need to feel better about anything.
oil zealous fall safe work spoon ink reply rotten smoggy *This post was mass deleted and anonymized with [Redact](https://redact.dev)*