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An Open Letter

2010 November 13
Posted by Nurse Me

Dear Patient/Family Member:

Experiencing a cardiac arrest IS A RELEVANT PIECE OF INFORMATION TO REVEAL DURING YOUR TRIAGE ASSESSMENT. Yes, I know you were referred from a clinic for elevated potassium (7.4), but when we ask you about past or present medical problems, CARDIAC ARREST IS WHAT WE MEAN. We were even specific, “Do you have any heart problems?”, “Are you having or ever had chest pain? Nausea? Vomiting? Sweating? Dizziness? Passing out?”*

CARDIAC ARREST IS A HEART PROBLEM!

Also of note, you should always bring any referral paperwork, test results, discharge instructions from previous doctor, clinic, ER visits, etc. Always.

That way when you ask to go to the bathroom, a frantic, frightened waiting room patient won’t come running to the nurses’ desk screaming that “someone is on the floor and shaking violently.” That way we won’t have to code you on the bathroom floor.

Now for the wife. Please don’t begin your story with “We were making tortilla soup when the lab called and said he should probably come to the ER to have his blood tests repeated and……”

NO, NO, NO, NO, NO! Your story should start with “The same thing happened 2 months ago….” And when we ask you “what was done in the hospital, what did the doctors tell you?”, please don’t say “everything is better now because they did CPR and fixed his heart.”

NO, NO, NO, NO, NO.

PS – I’m sorry your husband is dead.

Sincerely,
Nurse Me

*For all you medical professionals out there, this patient received an EKG and repeat K+ (5.4) via VBG immediately after triage.

6 Responses
  1. November 14, 2010

    In my line of work, I often have to hear the entire life history of the caller before I can get to the problem. If I have not had 7,265 previous callers do the same thing, I MAY just wait out the story and sift what I need. If I have 3 other lines on hold, I may very well be short with the caller and ask pertinent, pointed questions. I have been known to interrupt them also, repeatedly….to get the information I need.

  2. November 15, 2010

    Frig. Was he a renal patient? Hate to say it, but they can drop like a hat.

  3. Texas REader permalink
    November 16, 2010

    Serious question – did the husband and wife come across as not very bright generally, or only in regards to the fact that you are never just “fixed” after having a heart attack? If the latter, maybe it’s denial. Or maybe they both have (er, HAD) low IQs.

  4. Nurse Me permalink
    November 16, 2010

    Tex-

    I wouldn’t call them not bright so much as ignorant. Isn’t it always our hope that patients and families educate themselves about the diseases they have and the medications they take? “Oh, I don’t know. I take 4 pills. 2 white ones, a blue one and a yellow one. I take the one white and the yellow in the morning……”

    The land of denial is a fabulous place for (some) to live.

  5. November 20, 2010

    Do you get many who refer to pills strictly by color? Are you sure they’re just ignorant?

    I’m in a non-emergency field, and maybe that makes a difference, but I find that the clients who only know the colors despite being educated at every appointment really are MR/DD and not just ignorant. Those who don’t even know the colors tend to be the symptomatic paranoid schizophrenics. They tend to need adjustments in medication before any education will take.

  6. Nurse Me permalink
    November 22, 2010

    Yes, many patients refer to pills strictly by color because when pressed to name their meeds, they can’t. BUT patients are becoming smarter, whether by repetition via our frequent flyer program or a Pavlovian response, they now just bring their meds to the ER.

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