Sunday, September 30, 2012

ER Wars Round 2

Winny Vs. The Management

Talked with the management of the BAD ER I saw a week ago.  This is how the conversation went:

ER Director: "My nurses didn't do anything wrong"
Winny: "They were TRIAGING in the order people presented"
ER Director: "That is what Triage is.  They WERE taking people in the order they presented."
Winny: "Don't give me that, I have worked a triage desk.  That is NOT traige. Triage is the worst first."
ER Director: "Well, maybe the person they took in WAS worse."
Winny: "I don't think so, and you JUST TOLD ME the criteria was the time people checked in."
ER Director: "Are you a nurse? Do YOU know the FIVE LEVELS of TRIAGE?"
Winny: "I don't have to know the FIVE LEVELS of TRIAGE to know you were not triaging properly. I have been at your ER before many times and have always been traiged properly before.  Something was badly wrong this time and that is why I am complaining."
ER Director: "Well the board said you had a 'headache',  I am sure the child they triaged was worse."
Winny: "I am sick of the prejudice people exhibit about headache pain.  I had "SEVERE PAIN".  I complained to the ER clerk 2x's my sister once.  Nothing was done.  Nor was I triaged."
ER Director: "I have heard this about this prejudice before, it does not exist.  People say the same thing about having Medicaid coverage."
Winny: "I work with medical, I know about being prejudged by a nurse that thinks I am drug seeking.  I have experienced the prejudice against headache patients up close and personal more than once so don't give me that!"
ER Director: "I checked your medical records. These were the same nurses you saw before the last time you were here"
Winny: "Oh, really?? Can you really say that the SAME EXACT nurses were on staff that were on staff the last time I was there?  Because I really don't think so."
ER Director: "I can't do that, so I guess they were not the same nurses"
Winny: "I thought so."
ER Director: "You need to complain to the head of registration.  The clerk should have notified the nurses"
Winny: "The clerk cannot make medical decisions.  Do you have the clerk making medical decisions there??"
ER Director: "No, the clerk cannot make medical decisions.  But the clerk should have notified nursing. He was new."
Winny: "I suspected as much, but that should NOT be my problem.  You coordinate with the head of admissions if the admission clerk is causing issues with your ER procedures.  Your nurses are in charge of the waiting room just as they are in charge of the triage room.  They need to keep aware of what is going on in the waiting room."
ER Director: "They had emergencies in the back, and were transferring a patient.  They were busy taking care of patients"
Winny:  "I don't have a problem with that, but they need to keep aware of what is going on in the waiting room, not rely on a clerk to let them know.  AND we let the clerk know what was going on.  The lack of communication again is NOT MY PROBLEM.  You need to make your nurses aware of what a person in extreme pain looks like.  I was not jonesing for a fix.  I was in EXTREME PAIN, which I communicated as clearly as I could.  Someone somewhere made a decision that my pain was less important than a child with the sniffles.  I have a problem with this big time.  I was not asking to be seen in front of a true life or death emergency.  I was asking to be triaged, properly triaged."
ER Director: "Well, there were ambulances coming in."
(I let this lie lay, but it is a teeny tiny waiting room, you can HEAR an ambulance come in. The ambulance bay is next to the door.  Duh!! )
Winny: "I don't need excuses, I need this not to happen the next time someone in extreme pain presents at your emergency room"
ER Director:  "You need to complain to the registration supervisor.  My nurses did nothing wrong.  They let me know that you had an issue."
Winny:  "If they had acute patients in the back, they certainly had no problem leaving them to come and gawk at me through the fishbowl the clerk sits in when I did a melt down.  If they are aware of what is happening THEN why was I ignored out there?"
ER Director: "These might have been radiology techs or lab techs that were there.  Those couldn't possibly have been my nurses"
Winny:  "These certainly looked like nurses to me.  I was insulted by this and the clerk certainly knew how to pick up a phone to call security when I blew up."
ER Director:  "Security isn't there that time of night and the police were not called"
Winny: "That's because the clerk hung up as my sister hustled me out the door while he sat there with his mouth open, and the rest of the crew stared at me, no one offering ANY ASSISTANCE."
ER Director: "Well, you need to follow up with the registration supervisor."
Winny:  "I'll tell you what I am going to do, I will follow up with the registration supervisor, but I am also going to follow this up with letters to your administration.  I also am requesting you educate you staff on what EXTREME PAIN looks like.  We don't sit still, we aren't quiet, and we aren't pleasant.  That's because we are in EXTREME PAIN.  I am also going to get with my physician to get injectible meds so I don't have this problem again and will not need to use your emergency room in the future."
ER Director: "That is good about the injectibles.  This is what I did when I had migraines."
Winny: HANGS UP (Thinking, yep the ER Director won't go to her OWN ER when she had migraines.  Figures!!).

In the meantime, my very nice PCP drove over to the pharmacy and hand delivered my prescriptions for injectible meds, including dilaudid.  He had extensive instructions and wanted the pharmicist to receive them in person.  How many doctors are left that would do this?  A bright point in my week!!!

Hoping all of you have pain free weeks ahead, and never have to put up with what I did at this ER.  After I am through with this ER I hope they will never treat a person in pain or a person with a headache the same way.  I am ready for Round 3!!! Ding!!


  1. Where do you live? I want YOUR doctor! Glad you have it worked out to get pain relief now without an ER visit. If I had the energy I would write out what we just went through with my husband's cardiologist. He's having another CHF attack (short of breath, gained 4 pounds in 3 days) and last visit I handled it by increasing the Lasix. Dr. had a cow, wanted to know what caused it and did an echo. So this time we called to tell him it was happening again so he could see him/test/admit and he calls back and basically says, "Just carry on."

  2. I hate that sick people have to fight to get adequate care and you feel like you have to be your own physician. I wish sometimes they would just cosign on the prescription pad what we write!!

    My PCP is a young guy, just in his sixth year of practice. It has been a pleasure to see him grow his practice and not lost the caring part! What a small town doc used to be when I grew up!!! His entire practice (nurses etc) are like him.

    The ironic part Ness, enough meds to probably keep me out of an er for 6 months - the cost (my insurance did not cover it at all because it is injectible) $51.00 including needles.

    My copay for an ER visit? $150.00 to $250.00 depending on the insurance over the years. You know what they charge for 15 minutes of time and 3 injections and hours of painful waiting and agony? (Oh and sometimes an IV?) and ME telling them what my diagnosis is and what the treatment should be?? Between $400 and $700 dollars a whack. The frequency? With the stimulator between 1 to 2 times a MONTH. If I go through a bad cycle with the stomach & pancreas or have infections, my copays were more than I made if I had not met my out of pocket. Something is drastically wrong with our healthcare.

    Glad your husband has YOU to help, but who watches out for those who don't have a Ness to go with them!!!?? The doctor probably forgot he had a cow by the time another episode hit. sigh.

  3. Wow, sorry you have had such an awful time dealing with the ER. I quit going to mine because all they would give me is Imitrex, which I told them before they gave me it did not work for me. I just end up taking something to make me go to sleep as long as my husband is home to take care of my daughter. Otherwise I am stuck waiting and suffering.

  4. Tara: The weird thing,aslong as I have had this headache (and it was misdiagnosed as a migraine for quite awhile) not ONE ER DOC ever offered a triptan, which would be logical even tho it does not work well for HC. I have had one doc who insisted he could cure any headache give me haladol and compazine as a chemical straight jacket that did nothing, and some that gave me steroids and nothing else but never a triptan. Maybe you could get some injectables like I did. I am tired of hours of being in pain (and also taking up ER resources that would be better used on someone with trauma or stroke or heart attach) just for a treatment that I know by heart by now!!! My go-to isgoing to be benedryl and phenergan to control nuasea & pain, and to make me sleepy along with a little bit of dilaudid to knock down the pain.Not due for another episode until the end of this month beginning of the next so will let you all know how it goes. It sucks big time to have bad headaches. and people ARE prejudiced in emergency settings. I'm getting militant about it. No more Ms. Nice Winny anymore if I am poorly treated. I don't know how you can take this without medication. I know its possible becauseI did it too,but OH MY Tara, hoping you get a better solution you can do at home.

  5. Oh it is so good to see you when you come out of the woodwork!!! So very sorry for your ER visits and bad times. Gentle Hugs.

  6. Good for you for standing up for yourself. My DH was in the ER last year (almost a year now actually) and we had to do the same. I've dumped several PCPs over the years because they were so arrogant and would not listen to anything I had to say. I love my current doc and the one before her (I changed cause one retired). I'm glad I found your blog (I was visiting Shauna's blog and saw your comments).

  7. Nitewriter, its a shame that the sick have to fight to be heard when they are at their most vulnerable. Love Shauna's blog! there is a definite lack of understanding what pain actually looks like. I have my letters written, just waiting (what for I don't know!!) to mail them out!