He did tell them he was diabetic. What else could he have done to “manage” his condition at that point?
True, no more than attending a Klan rally makes you a KKK member. But if you’re attending a Klan rally and your posting name is CrushAfrica then assumptions are made.
Pain is part of triage so if you run around screaming that you’re in agony that’s going to bump you up above the person who sits quietly enjoying the experience.
I work in an emergency department and at least once a week (often twice) I am stationed in triage for twelve hours as my shift assignment. Chief Pedant is right on the money regarding wait times and seriousness of injuries between laypersons and medical professionals. I also agree that the MD’s beside manner wasn’t really appropriate, if he has a problem with how long you’ve waited, that should be between him and whoever is up in triage or possibly the charge nurse. In fact, if a doctor where I worked seemed to imply that it was the patient’s responsibility to ensure they make it through the waiting room faster, I would probably have a word with him- that’s just going to make a packed waiting room packed full of squeaky wheels.
I would advise against adding symptoms or overstating pain, though. For every one patient we see that has 2/10 pain when it should really be 7/10, we easily see 20+ people who say they have 10/10 or “18/10” pain. We see so many people every day, our assessment ability for that pain is actually fairly accurate. If you are actually having the worst pain of your life, this is a partial list of things not to do if you want us to take you seriously: laughing, chatting with your friends, eating cheetos, texting during your triage, asking if we can change the TV channel, telling us you’re “going out for Wendy’s” and will be right back, etc. We have to be detectives up there, and it won’t help you get back any if your triage reads “Patient states 10/10 pain, but is noted to be eating quiznos and joking with friends while in triage area.” It just makes you look melodramatic or like a liar. I we ask is that you are reasonable, you don’t have to compare every injury to being slowing lowered into a vat of lava, but if your ankle pain is really 10/10, I’d better not see you getting up to walk outside and smoke every 30 minutes, even if you limp a little. Remember, I’ve not only seen dozens (if not hundreds) of true broken ankles, I’ve also broken my own a couple of times.
As for our options of treating that pain- not so many. We operate on preset guidelines or protocols for how to treat and address patient complaints, but no one is forced to wait to see a doctor. This means we can splint an arm or dress a wound, but it would be illegal for us to give medicines without a doctor’s oversight. So that means no pain meds until you are eval’d by an MD. Can you imagine what would happen to ERs if patients could simply come in, receive pain meds in triage and then wander away? Simply because you tell us you have ‘10/10’ pain.
Typically we have one ‘crash’ bed in the triage area, but we always try to keep it available for “grandma’s in the car and not breathing”-type patients, not just “i don’t want to wait with all of the sick people” patients. This is very often the last non-occupied bed in the ER, and we don’t have an assigned nurse to care for that patient, usually either the triage nurse or the paramedic up there work them with a doctor until we can find somewhere in the back to place them.
Once we get your chief complaint, meds, history and vital signs, we have a rubric that helps us place you in the list of patients, by giving you a number from 1-5 as your ‘triage acuity’. You never want to be a 1, because that means essentially you are dead or dying (so obviously we’ll find a spot for you- it might be the floor or the hallway or the triage crash bed-immediately). Most of the complaints come from the 4-5 level patients, but just know that a ‘4’ that has been waiting for 6 hours might still have to wait if we have a ‘3’ come in right when we get a room open. That’s just how emergency medicine works, sickest first, those that can survive the wait can wait. Trust us that we never make someone wait just out of spite, we want to get people out of the ER, either back to their homes or admitted or whatever needs to happen to them.
This is where being honest with your pain can help you (at least in my hospital). We have some overflow beds lining our hallways. Typically these beds lack privacy and add additional patients to a nurse’s load, but our medical director and the state allow us to use them for low acuity patients (4’s and 5’s). If you just sprained your ankle and just need an Xray, splint and crutches (a typical ‘4’) they might work fine for you and get you through the process faster. However if you inflated your pain to 10/10 and mentioned how the pain is causing you nausea and chest pain and dizzy spells in an attempt to seem more acute we’re going to have to assume that you’ll need an antiemetic, IV pain meds, ekg’s and so on, which makes you a ‘3’ (although a low-priority 3), so we’re going to have to wait for a real room to open up before we can get you back. From noon until 9pm we have an urgent care clinic, which operates similarly to our hallway beds.
Also, it depends on the hospital, but we are continuously recieving patients from many different sources- helicopter scene calls, local ambulances, wait and returns from outlying facilities, patients sent from their doctor’s office or answering service, plus everyone who just drives themselves in. Don’t assume that because there are only 4 people in the lobby that you won’t have to wait.
One other misconception is that just because your doctor sent you in, that you’ll be ushered directly back. Don’t count on it- we get phone calls alerting us to incoming patients only about half of the time, and irregardless if they call or not, you still have to be sorted and place on ‘the list’ like everyone else. Sorry-but if they really thought all you needed was a shot (or xray, or ekg) and they felt comfortable with that being the limit of your treatment, they could have done it without sending you to the ER. Since we don’t know you from Adam, we’ll have to work you up like anyone else who comes in.
My biggest advice for easy triage and fast rooming would be this: Show up prepared- have your medications and dosages listed, be specific and succinct with your complaint, be honest with your pain and symptoms and be patient with the staff in triage. Although we may be the first people you see, we don’t have the power to room patients wantonly. Understand that fractures, cuts, strains, bruises, abrasions and sprains are all painful, but rarely life or limb-threatening. Follow our directions, especially ice, pressure, elevation and not eating or drinking anything. I’ve never had a 12 hour wait when I was working, but we have frequent 4-6 hour waits and weekends can easily be 8 or 9 for minor patients, and in the 8 years I’ve been at this particular hospital, things have only gotten worse and worse (IRT wait times). Don’t expect a remedy anytime soon, healthcare reform or not…