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The Real ER: A Nurse’s Insider Tips for Better Care

Going to the ER is never an enjoyable experience, but these tips from a real nurse can make the trip more bearable. 

There are plenty of jobs I’m pretty sure I couldn’t do and others I know I could never do. For example, I don’t think I could be an engineer, a mathematician, or a flight attendant, but I know I could never be a nurse. Nursing, in my opinion, is one of the most selfless, powerful—and difficult—career choices. From human excrement to overstressed family members, nurses deal with the dark underbelly of humanity on a daily basis. 

When patients and their families are heading to the hospital for emergency treatment or even checking in for routine surgery, manners and common sense sometimes escape them. I talked with Laura Johnson, a registered nurse in the state of California, to discuss what really goes on in a hospital, what advice she has for patients (and their families) to get optimum care, and what every American needs to know to get well soon. 

When You Should Go to the ER
According to Laura, two of the most common problems hospitals face are overcrowding and dealing with ailments that a general practitioner can (and should) manage. People with common colds, anxiety or panic attacks, and non-emergency ailments often head straight to the ER. The main reason to avoid rushing there every time your nose is running is financial; an unwarranted trip can cost you thousands of dollars and negatively affect your insurance plan. 

Laura says you should go to the ER in the following circumstances:

  • If you have a fever of more than 101º F that refuses to subside
  • If you are in uncontrollable pain
  • If you have persistent nausea and vomiting
  • If you have bloody vomit or stool
  • If you are experiencing chest pain or shortness of breath
  • If the patient is a baby or an individual who is unable to communicate what he or she is feeling

Laura also says that a plethora of patients flock to the hospital repeatedly for unwarranted care, and reveals that nurses call these patients “frequent fliers.” Frequent fliers are often alcohol and drug addicts, as well as elderly patients, and they all desire a level of care that they’re not getting at home.


How to Get into the ER
If you’ve ever been admitted to the ER, you know that the debacle of being let in can sometimes be more painful than the ailment itself. The last thing a patient wants to deal with when seeking emergency care is a dissertation’s worth of paperwork and hours of waiting. Laura says people who are experiencing the following conditions will be admitted to the ER immediately, so if you’re experiencing these symptoms, make sure to let the admitting staff know:

  • Chest pain
  • Shortness of breath

Name dropping also sometimes helps you get admitted faster. If you happen to know the name of the hospital’s president, CEO, or any other VIP, a casual, “What if I called John Jones?” might speed up the process for you.

If you feel your situation is more serious than the admitting staff recognizes, ask to speak to the emergency department director, the shift supervisor, or the nurse in charge and stress that you (or your loved one) has an emergency medical condition that must be evaluated straight away. If none of these people are available, ask if the on-duty triage nurse can conduct an examination to make sure the condition isn’t life-threatening.

Precautions to Take When Visiting a Loved One in the Hospital
Laura emphasizes that “hospitals are not as clean as you think.” She recommends using an antibacterial gel and washing your hands obsessively when visiting a hospital. When you return home, she advises washing your clothes immediately with hot water and soap. Laura doesn’t even wear her hospital shoes in her house—she leaves them outside on her porch and uses medical cleansing wipes to remove germs each night—so cleaning your footwear is another consideration when you get home.

Do not come to the hospital if you are sick, and do not bring your kids to the hospital if they are sick,” she adds. If a visitor’s immune system is already compromised by an existing illness, the visitor not only runs the risk of getting sicker but also may infect the patients.


How to Get the Best Treatment
The most foolproof way to ensure that you’ll get the best possible treatment during an extended stay in the hospital is to be nice to your nurse. After all, he or she will be the one to manage your care on an hourly basis and the first to treat you in an emergency situation. Just as important as the patient’s treatment of the nurse, though, is the way the patient’s family treats the nurse. A perfect example Laura cites is a recent case where a patient’s family member kept ringing the call button every twenty minutes for a can of soda for the patient. “There was a vending machine just down the hall,” Laura says. “It’s things like that that frustrate nurses. I wish patients and their families would be more considerate about knowing when to exercise the need for medical attention. Although I wouldn’t want my patients to know this, when they overuse their call button for non-emergency issues, we sometimes hide it or put it out of reach!” The last thing Laura wants patients to consider is that they should remember to call their nurse to take them to the bathroom before they go to the bathroom in their bed. “Happens every day,” she says.

Laura claims that nothing makes her and her fellow nurses happier than receiving acknowledgments of appreciation. “Although it doesn’t happen often, we love cards and notes. I keep every token of appreciation a patient has ever given me.”

The Ethical Issues
The toughest part of being a nurse—besides dealing with death, which Laura says “never gets easier”—is the ethical issues nurses face on a daily basis. “Doctors make misdiagnoses 24/7,” she says. “It’s hard to see the roller coaster of emotions families go through when this happens.” One patient of Laura’s is HIV-positive. He refuses to tell his wife and family about his diagnosis, and by law, Laura cannot inform them of his status. For patients and their families to realize how important it is to treat their nurses with respect, they need to develop a better understanding of these types of predicaments nurses deal with all the time.

“You never become immune to death, but you do get more accepting,” Laura says. “We have relationships with our patients, and it’s tough to say goodbye every single time. It makes you question why you do what you do.” So why does she do it? Without a moment’s pause, she answers, “The rewards outweigh everything. For every negative patient, there are five that truly appreciate the work we do.”

I know I, for one, am grateful for everything Laura and her fellow nurses do on a daily basis to keep us healthy, happy, and cared for.

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