What Your Nurse Wants You to Know About the Emergency Department

It’s late on a Friday night. Your throat feels like you’ve been swallowing knives and your doctor’s office won’t be open again until Monday. You can’t stand it anymore so you head to your local emergency department (ED) to get some help. You check in and are asked to wait in a crowded waiting room. You’re uncomfortable, tired, and frustrated. After an hour you notice that someone who arrived AFTER you has just been called back. They weren’t bleeding or anything, they looked fine. What’s going on here? Half an hour later it happens again, someone comes through the doors and is immediately taken to a room. You decide it’s time to demand some answers. You ask the triage nurse how long you’ll have to wait, why she skipped over you. You’re sick, you’ve been waiting, you’re in pain.

You’re also not dying.

That is the priority in emergency medicine. Emergency departments are busy and the sickest patients need to be seen first. Nobody is in the back laughing at how long they made you wait. They are hurrying to get lab work and an EKG on the middle-aged man with chest pain to find out if he’s having a heart attack. They are working to get a doppler ultrasound on the leg of that “not sick” person who was called back before you, who might have a clot in their leg which could at any time dislodge and become a fatal emergency. They would love to swab your throat, diagnose your strep infection, and get you on some antibiotics and back home to bed. But first, an ambulance just arrived at the other door with someone who doesn’t currently have a pulse.

Spending long hours in the waiting room isn’t anyone’s idea of a good time. But maybe it can ease your mind a little to think of how lucky you are to be well enough to wait.

The waiting is even harder when you’re bringing in your sick kid, so I have some tips for you:

·         Try to stay calm. It’s scary to see your child in a medical emergency. You’re worried for them, you don’t know what’s going on, you feel very stressed. I get it. Try your best to stay calm on the outside. If you’re afraid of needles, don’t pass that fear on to your kids by getting worked up and talking about how much it’s going to hurt. Just reassure them that it will pinch for a second and then feel better. You will make every future doctor visit much easier.

·         If your child has a fever, medicate them at home before you come to the ED. Tylenol or Motrin will keep them more comfortable, especially if it takes a while for them to be seen. I’ve heard parents say they didn’t give their child any medication because they wanted us to see how high their temperature was. It’s ok, we’ll believe you. Just help your kid.

·         Kids throw up sometimes. It’s hard to see your child ill, but he does not need to be seen in the ED at midnight because he threw up once. Maybe he ate too much candy, maybe he has a stomach virus. We can’t do much in either case, so rest and fluids at home is the best course. This goes double for kids who are currently happily eating a bag of Cheetos. Now that you’re in the ED your kid will get blood drawn, maybe an IV for fluids, maybe an abdominal CT scan. This is only necessary if your kid has been sick for a while, can’t keep anything down, and is becoming dehydrated.

And some advice for everyone:

·         Don’t lie: We’ll figure it out anyway and in the meantime, you’re risking medication interactions, or extra tests while we try to diagnose you when you were holding the missing puzzle piece the whole time. If you just want a pregnancy test, for example, we’ll give you one. If you say you’re having abdominal pain you’re going to get a whole bunch of tests to find out the reason for the nonexistent pain. Even if you did something stupid and you’re embarrassed to own up to it, don’t lie. You probably aren’t the first person to have done that thing and we’ve probably heard worse. Tell the truth and we have the best shot at getting you fixed up.

·         Know your medications. Keep a list in your wallet, or on your phone. There are thousands of medications out there and I don’t know which little white oval or the round blue one you mean.

All that being said, never hesitate to visit the emergency room if you are concerned about your symptoms. It’s much better to get checked out and go home than it is to stay home and get worse. If you have difficulty breathing, chest pain, or any symptoms that make you worry, you need to go to the ED immediately. And feel thankful if you get to wait.