Fix Me Now

A lady came in and yells a me, “Where’s your wheelchairs?” I look up from my computer and point to the corner by the televisions where they are kept and she runs over, grabs one and rushes out the door. A few moments later she wheels in her husband in no apparent distress and yells at the registration lady, ” He needs to go back now!”

“Alright calm down,” the registration clerk says and puts him in the computer system and has him sign forms. As he is signing his wife starts yelling, “We don’t have time for this. He is a diabetic and needs medicine and his leg is infected. He could die you know and you are making him sign papers. You need to hurry up.” “I’m trying, but there is a process to this,” the clerk replies. I listen to all this fuss and move things around my triage room to make way for the wheelchair to get his vitals.

A minute or two later the clerk tells me I can grab him. As I start my triage his wife comes up behind me and stands over my shoulder as I’m getting vital signs. “He needs to go straight to the back. Why are we stopping here?” his wife complains. “Its part of the process miss,” I state. In triage I write their main reason for coming, medical history ( diseases, medications, allergies, surgeries etc) and vital signs (blood pressure, heart rate, temperature and oxygen level)  so the doctor knows what he needs to focus on when he comes in. “Oh so if he dies right here, that’s just part of you doing your job?” she states. ”

As a general rule make no promises. I always under promise and over deliver, but she was mad annoying so I made an exception. “Madam, he is not going to die. Please go sit in the corner and the sooner you let me do my job the faster I can get him to the back.” I turn my back to her and start asking him questions about why he came. Immediately she interjects and talks over him, ” He is here for his foot.  His right ankle is severely infected. I brought him here last year for the same problem and they had to open it up and they didn’t even let it numb all the way before they cut him and he felt everything. Also, he is a diabetic and needs medicine for his diabetes.” I turn to the man to confirm and he just grunts,  “Yeah, what she said.” For those reading who are not medically trained she is referring to him having an abscess that you have to cut open and drain. We give patients lidocaine which numbs the area up first then wait about 20 minutes for it too kick in and then we cut open the infected area. I have been a nurse for 10 years and it works every time.

I ask him about his primary care doctor and she states that he does not have one. As I type I stress the importance of having one so he can get prescriptions for his diabetes. “Well he cannot get one so we came here. The hospital needs to write him for the prescriptions he needs,” his wife states. Well ERs don’t functions for your convince and we are not your primary care provider even though many people treat us like we are.

“So why cannot he get a primary care provider madam,” I ask. “He lost his ID and cannot get into a primary care doctor without his ID,” she states. Not taking care of your health because you don’t have an ID is a sorry excuse so I ask her why she has not taken him to get a new one. She tells that they moved here 2 years from the Indian reservation in North Dakota and he has to get his tribal ID from there. I don’t profess to know anything about Native Americans and the reservation rules but it has been 2 years. Not a month or two but 2 whole years. For something that important to your life, you put it off for 2 years and you want to run in here trying to boss us around because you feels his health is priority now. Sorry but we don’t operate at your connivence.

I look at his ankle and its swollen, but not infected and check his blood sugar which turns out to be fine. I make him a level 4 which is basic care and send him to the back to get seen. The doctor assesses him, given him pain meds and antibiotics, writes prescriptions for more and puts him up for discharge. Later on I go back there to help make room for some real emergencies coming in and his wife is standing at the door tapping her feet and looking irritated. “We are ready to go now so we are just going to leave,” she comes over and tells me. Well I don’t care what your do, your grown, the ER is not a prison and we didn’t ask you to come here. I’m nice to her instead of saying what I really feel and I tell her hold on a moment.

I grab the chart out the rack and go over the prescriptions with him which are Percocet for pain and Bactrim for his infection. She immediately states fussing, “You all never do anything for him. He is a diabetic and needs medication and you all need to write it for him.” I stop her and tell her that’s not the way we diagnosis and treat diabetes. I inform her of the proper way which is get a primary and have him order the necessary tests to confirm the  diagnosis and write for medicine to control it. After I help the man into the wheelchair she brushes me to the side, “I don’t need you to tell me the procedure for diabetes. I know the procedures. I went to school for that.”

She pushes him past me cursing several times about how bad we treated him on the way out. Well why waste my time since you know so much. There seems to be an epidemic of internet trained medical professionals.  WebMD and Google trains tells you a lot of general information but not how to apply it. One day you know I just may lose my job to these self-taught internet know it all but today is not that day.

I feel like more and more people treat the ER like it’s a primary care provider and not reserved for actual medical emergencies. Have you ever been to the ER for something minor that you felt was pressing? How did you feel about how they treated you? Post your experience or comment on how your feel about this experience below.

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