Once upon a time, a more experienced emergency room nurse told me that doctors are bad with headache and backache patients because they can’t see the pain like they can see a broken arm or a heart attack. It is infinitely more rewarding for an ER doctor to put a cast on an arm or order the best medication to stop a heart attack in its tracks than to give a shot to a pain sufferer who will softly murmur a thank you, wrap herself in her blanket, and walk out the door with her head down and her husband carrying her discharge papers and her purse.
Just remember—when you are about fantasizing recreating Shirley MacLaine’s hospital scene, and screaming “GIVE HER THE SHOT!” at the nurse, your nurse is probably fantasizing about reenacting Jerry Maguire’s quitting scene.
Here are my thoughts to help you have a successful ER visit.
In a successful ER visit:
◆ You are treated in a timely manner with respect to circumstances
◆ You are treated with respect
⁃ Your privacy is respected
⁃ You are kept comfortable
⁃ All team members speak to with you as an equal participant in your care
⁃ Addresses your problem
⁃ Offers a correct and thorough diagnosis
⁃ Gives you appropriate treatment
⁃ Gives you enough treatment to get you through to your next doctor visit
Now, here are a few suggestions to help you get the best out of your ER visit:
◆ Expect to wait
⁃ The ER uses a system of priorities that is very similar to Mazlow’s Hierarchy with your ability to get air at the bottom platform of the pyramid. Next come your heart beat and circulation, and on and on…
◆ Make yourself personable
⁃ Be honest & don’t exaggerate. Triage nurses have seen a lot of people in pain and a lot of injuries and illnesses and have a natural instinct for dramatic behavior. If they cannot see your pain or injury, help them understand it. Try describing it with commonly understood details.
⁃ Ask for the help that you need. Explain why you are there and what you expect as an outcome of your visit. For example, say, “I have a plan to see my doctor in five days but I need pain medication to get me through until then.”
⁃ If you feel you are being demeaned or talked down to, turn it around without sarcasm and ask the doctor what he recommends you could do or what he might do in the same situation. If you are out and out mistreated, ask for another physician (or nurse).
⁃ If you have an expectation when you arrive that you will be mistreated, check it at the door. Don’t start by saying, “I have pelvic mesh and I am part of a lawsuit.” Those are toxic words to a team that is practicing defensive medicine— which is what all ER’s do.
I found another blogger, unnamed, who addressed the topic, “ER visits” for chronic pain sufferers. I’ve abbreviated a few of her suggestions:
◆ The emergency room is the last resort after trying every solution at home and calling your doctor or patient care team or going to an Urgent Care center.
◆ Make sure you have a regular physician or primary care doctor who manages your care.
⁃ Look at local and even national support groups for your condition(s). They will have lists of hospitals and even specific doctors in your area who have been a good match for others in your situation. If those doctors are not taking patients, ask their staff whom they would recommend.
◆ Be ready to show them that you tried to contact your regular doctor before going to the ER
⁃ The ER is more sympathetic to the patient who has been told to go the ER by his doctor or his team.
⁃ It makes it clear you are only using the ER as a last resort.
⁃ Bring a letter from your doctor or your most recent discharge papers from your doctor. Also, bring a copy of your pain plan if you have a pain management doctor.
◆ Bring a list of medications rather than rely on your own memory.
◆ Work cooperatively with the ER staff and don’t call negative attention to yourself. You may be in agonizing pain but the staff is first deciding whether you are exhibiting “drug seeking behavior,” so don’t give them any opportunity to decide wrong.
◆ If you have a rare condition or one that is frequently misunderstood or is thought not to cause pain, bring information about your condition. (I can’t tell you how many times people did that when I worked in the ER. We were grateful not to have to look it up.)
◆ Bring someone with you. This will help because it is hard to explain things when you are sick or in pain and they can help. They also can remember details for you.
◆ If possible, use the same ER as much as possible because doctors become suspicious when they discover visits to multiple hospitals (Hint: They call each other to say so!)
◆ Keep a folder handy with all your details written down so you don’t have to try to put it together in the midst of horrific pain.
Finally, if you feel you’ve been mistreated after your ER visit, please do at least three of these things:
◆ Write your story down.
◆ Contact the Medical Director of the ER during business hours.
◆ Contact the Medical Director of the hospital during business hours.
◆ Contact the Board of Medical Examiners or licensing bureau for your state.
◆ Send your description of your visit, by snail mail letter to each of the people above and include a letter to the offending doctor as well. Who knows? He may see the light.
◆ One final note, after you are treated well, drop a short note to the ER and you can be sure it will be given to your doctor!!
Have you been treated well or badly by an ER? What’s your take?
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