Wednesday, August 24, 2011

On the Various Definitions of a Real Emergency

Hood Hospital triage, where else-
Hood Nurse-Hi there ma'am! My name is Hood Nurse, and right now I'm just going to check out your vitals signs and collect some medical information. What's going on today?
Patient- Well, you see, I've had this boil for about 5 days now on my butt, and the pain is just really becoming unbearable. I tried to deal with it at home, but it just keeps getting worse, so I decided to come in.
Hood Nurse- I see. How would you rate the pain right now?
Patient- A ten.
Hood Nurse-Okay, well, we'd be happy to get that checked out for you. I'm afraid all the rooms in back are full at the moment, so I'll need you to wait in the waiting room for a bit and another nurse will call you when a room is available.
Patient- So, am I gonna have to wait a long time to be seen for this? I mean, don't you guys have an area for like, sore throats and stuff, and then another area for real emergencies like mine?

We sure do. Next.


  1. I try and readjust a patient's perspective on pain when they say "10" for something obviously not a ten. I will give an example such as someone taking a baseball bat to their body or a gunshot wound.

    Unbelievably (or maybe not so much) they still say "10"


  2. Ugh working in fast track gives me the heebie jeebies. If it isn't a boil, it's a rash, and if it isn't a rash, it's some sort of foul genital discharge, and if it isn't discharge, it's scabies. Ick ick ick. I always feel so itchy when I'm done.

  3. The pain scale is so stupid. How the hell is anyone to know what an actual 10 is? I'm also vaguely recalling having read somewhere that humans have no memory of actual pain, just the emotions surrounding pain. A 10 has to be the worst thing imaginable and my idea of a 10 would be something out of a Saw movie.

  4. I was recoveringcradling guy in PACU one day and working hard on pain control. Fentanyl, morphine, dilaudid, toradol... Good iv, multiple doses of all narcs, rr10, hr 56, 110/50, no guarding or grimacing, denied hx of IVDA and didn't see any signs of it.. Wtf? We wanted him comfy but 10 10 10 10 10. No progress at all. A sweet little RN buddy o mine finally said "so if I jumped on that leg it wouldn't hurt ANY more than it does now?". Patient "ok. 9.". Aaaarrggghhhh! Turned out pt had been told by his buddies to say 10 or we wouldn't give him anything. I convinced him we were better nurses than his buddies would ever be, I believed him, and voila- 2/10. What a fiasco.

  5. Damn autocorrect. Recovering. Im a pillow fluffing RN but not a cradler.

    Wonder where boily-butt thought the STEMIs and MVAs should go?

  6. At least said patient didn't come in complaining of chest pain and then "oh by the way, I have some butt puss going on." I've seen that.
    I've also seen a nurse explain the pain scale to a patient as suppose a 10 is getting kicked in the nuts so hard you have to part your hair to pee, so what do you rate your current pain now.

  7. We reserve the right to "correct" obviously ridiculous pain ratings by subtracting the number of psych dx's the patient reports in their Hx, and dividing by the number of chronic pain and psych meds. In both cases, Fibromyalgia counts double.

  8. Shit 8/30 Anon, I hope that you only correct the ridiculous pain ratings. As a nurse with ADHD, anxiety, depression and chronic pain with a total of 4 meds for these conditions, the highest possible pain score that I can achieve under your system is a '2' even if I come in with my leg cut off.

    Of course I do not come into the ED for my chronic pain condition, and on the last three times that I have come in for injuries (yes I am a complete and utter klutz), I have refused the offered scripts for pain meds because I have meds at home and feel no need to stock up.

  9. Chronic pain patient zeroDecember 14, 2011 at 6:15 AM

    Who goes to the ER for a known chronic pain condition anyway? There is nothing they can do about chronic conditions in the ER. All they can do is keep you waiting, in pain, in cold and uncomfortable surroundings, for hours, check you out, and tell you to see your pain management specialist.
    Stay home, take your prescribed meds, and be miserable in comfort til you can get in to your regular doctor.