November 6, 2007, 2:09 am

ER on Jeopardy, Baby!

pepsier

This photo would never pass muster in today’s hospital world!

Look at that fan precariously balanced on a platform with the cord hanging down – safety hazard!

The nurse on the right is discussing a case in the waiting room – HIPAA violation!

I actually worked in an ER that had a full bank of vending machines right outside the waiting room – when waits get over six hours, I guess people feel the need to have something. So much for NPO.

********************

Ladies and Gentlemen, it’s time for….Jeopardy!

First category: “I’m Really Sick, You Know” for $200

  • The answer: “I always run low so that is a fever for me!”
  • The question: “What does a patient always say when you tell them their temperature is normal?”

***

Second category: “Doctor, It Hurts When I do ‘This’!” for $400

  • The answer: “I have a high tolerance for pain, so this is really bad.”
  • The question: “What does every single patient say when describing their pain?”

Same category, for $600:

  • The answer: “I don’t want to get addicted.”
  • The question: “Who is unclear on the concept of pain medication?”

Same category, for $800:

  • The answer: “I’m allergic to Morphine, Stadol, Toradol, Dilaudid, Percocet, Percodan, Vicodin, Norco, Fentanyl, Oxycontin, Compazine, Zofran, Tigan, Protonix, Pepcid, Tagamet, Zantac, Reglan, Prilosec, Maalox, Donnatal, Bentyl and viscous xylocaine.”
  • The question: “Who wants Demerol and Phenergan?”

***
Third category: “Forewarned is Forearmed”, for $1000

  • The answer: “I want to know if Dr. Generous is working right now.”
  • The question: “Who wants to know the chances of getting a pain shot before coming to the ER?”

***
Fourth category: “Where’s Cherry?”, for $400

  • The answer: “I need to speak to a nurse now!”
  • The question: “What part of ‘we don’t have advice nurses’ didn’t they understand?”

***

Final Jeopardy Category: “Believe it….or Not

  • The answer: “My wife had surgery two days ago and can’t sleep. I want you to call her primary doctor and have a couple of sleeping pills waiting for her at the front desk for me to pick up in fifteen minutes.”
  • The question: “What is an actual request/demand made of ER personnel by telephone?”

***

Thanks for playing along!

I hope you wagered all your money on the final category because it really, honestly did happen.

The doctor says my jaw should come up off the floor within three days.

16 Comments

  • rlbates
    rlbates

    November 6, 2007 at 6:13 am

    Wonderful post!


  • tbtam
    tbtam

    November 6, 2007 at 1:42 pm

    Question – what’s a very funny blog post?
    Answer – This!


  • Payne Hertz
    Payne Hertz

    November 6, 2007 at 2:36 pm

    So let’s see, if you’re worried about becoming addicted, you are “unclear on the concept of pain medication.” But if you are clear on the concept of pain medication, and make the mistake of asking for it, you’re an addict.

    I’ll take self-abuse for $5,000 with a 10 percent co-pay

    The answer: “You’re a drug seeker!”

    The question: “What is every ER doctor’s favorite response to reports of severe pain, drug intolerances and failure to moan and groan at the level the doctor deems appropriate?”

    I’ll take Useless wastes of time and money for $10,000

    The answer: “these are generally acknowledged as being the worst place in the known universe for someone with chronic pain to go to, the Gulag excepted.”

    The question: “What are ERs in the United States?”


  • Dawn
    Dawn

    November 6, 2007 at 3:14 pm

    Payne Hertz – ERs are not set up to handle people with chronic pain. That’s what pain specialists are for, not ER docs.

    If you have having an exacerbation of your pain, which is usually controlled well by your medications, your pain doctor should contact the ER and let them know 1) that you are coming in and 2) what the best treatment for your pain is. That’s HIS/HER job.

    And, I’ll introduce you to wonderful Dr Y, who IS a pain specialist, sets up great contracts for treatment with his patients, and makes sure, if they do need to come to the ER, that they are treated appropriately either by coming in himself to see them, or calling the ER doc and consulting with him/her regarding your treatment.

    Then no one will think you are a drug seeker. You are a patient with CHRONIC PAIN, under treatment, who is having AN EXACERBATION that needs to be handled outside of your doctor’s office hours.


  • Payne Hertz
    Payne Hertz

    November 6, 2007 at 8:04 pm

    “Payne Hertz – ERs are not set up to handle people with chronic pain. That’s what pain specialists are for, not ER docs.”

    I understand where you’re coming form with this statement, but why do you expect every patient who walks in the door to understand this? The fact is, not everyone out there even knows pain specialists exist, let alone has access to one. Many people can’t afford medical care, or can’t afford to go to a dentist, but if their insurance will cover a trip to the ER and they can get treatment for a toothache that way, can you really blame them? It’s senseless and uncivilized to ever ask another human being to suffer for nothing.Why is it so hard for ER docs to see what is so obvious to the rest of us?

    Most people don’t know how the ER operates or understand that it is set up primarily to deal with life-threatening emergencies. Everyone very naturally thinks their problem is an emergency, and at some point instead of blaming people for using the ER in ways you, but not they, think are inappropriate, don’t you think it’s time for hospitals to maybe start adapting to the fact that people are going to use the ER this way and provide for it accordingly? 24-hour urgent care centers next door to the ER seems a logical first step in separating the toothache cases from the heart attacks. You can complain forever or you can adapt to reality. Don’t blame the patients for the fact hospitals and doctors seem to prefer the former.

    “If you have having an exacerbation of your pain, which is usually controlled well by your medications, your pain doctor should contact the ER and let them know 1) that you are coming in and 2) what the best treatment for your pain is. That’s HIS/HER job.”

    Don’t tell me that, tell the pain specialists. It is unrealistic to expect anyone to be on call 24/7 and at some point, there has to be some coordination between local doctors–pain specialists or otherwise–and ERs to take up the slack and enable pain docs to do something else like sleeping. Don’t blame the patient for failing to hold a gun to his doctor’s head and make him do his bidding, because we have almost no power in this system, especially when it comes to rocking the boat with that rare doctor who will prescribe pain meds. It is the duty of physicians to organize the medical system and coordinate care, not patients. A good idea might be to have everybody adopt EMRs and then charts could be shared electronically between hospitals and local doctors with the patient’s consent, and there will no longer even be a need to contact the patient’s doctor as you have the record right there.

    “And, I’ll introduce you to wonderful Dr Y, who IS a pain specialist, sets up great contracts for treatment with his patients, and makes sure, if they do need to come to the ER, that they are treated appropriately either by coming in himself to see them, or calling the ER doc and consulting with him/her regarding your treatment.

    Then no one will think you are a drug seeker. You are a patient with CHRONIC PAIN, under treatment, who is having AN EXACERBATION that needs to be handled outside of your doctor’s office hours.”

    I wish there were more doctors like this out there, but unfortunately it is all too easy to get the drug-seeker label both in and out of the ER and there is only so much we as pain patients can do to overcome bigotry.At some point, the medical profession needs to confront the fact that many of its members hold attitudes towards the customers that would make a grand wizard of the KKK whince.


  • Mon
    Mon

    November 6, 2007 at 8:56 pm

    Well, i really think it’s funny.


  • WhiteCoat
    WhiteCoat

    November 7, 2007 at 7:30 am

    Started my day off with a laugh. Thanks!


  • mck
    mck

    November 9, 2007 at 3:17 pm

    payne hertz-
    get a grip.
    “Everyone very naturally thinks their problem is an emergency, and at some point instead of blaming people for using the ER in ways you, but not they, think are inappropriate, don’t you think it’s time for hospitals to maybe start adapting to the fact that people are going to use the ER this way and provide for it accordingly? 24-hour urgent care centers next door to the ER seems a logical first step in separating the toothache cases from the heart attacks. You can complain forever or you can adapt to reality. Don’t blame the patients for the fact hospitals and doctors seem to prefer the former.”

    REALLY?! so, hospitals and ER docs should do whatever a patient with no medical or health administration experience/knowledge/background decides “reality” should be? medicine is already going to hell in a handbasket as it becomes “consumer-driven” and this is another example of the absurd conclusions to which this leads. how about we treat chronic pain in conjunction with pain specialists instead of making the ER a 24-hr candy shop? and who do you think staffs the urgent care center next door? yep – usually ER docs from the same group that run the main ER. and i guaran-damn-tee you that they have no more patience for this crap when they’re next door.


  • Payne Hertz
    Payne Hertz

    November 10, 2007 at 5:23 am

    “REALLY?! so, hospitals and ER docs should do whatever a patient with no medical or health administration experience/knowledge/background decides “reality” should be?”

    Well, considering that most ER docs seem to expect their patients to be experts in how the ER runs and what is an is not an appropriate reason for an ER visit, I just thought I’d share some of my “expertise.” The reality is that you claim to have a problem, and it is abundantly clear you haven’t solved that problem. I can deduce this just by reading what you write. Now why you haven’t solved that problem is open to debate, but given that most ER docs seem to prefer to piss and moan rather than find solutions, maybe it’s time you start listening to the customers or anybody else who might have an answer for a change.

    “medicine is already going to hell in a handbasket as it becomes “consumer-driven” and this is another example of the absurd conclusions to which this leads.”

    You’re buying your own PR. Medicine is anything but customer-driven. It is greed and profit-driven. The very idea that so many doctors have a problem with customer input into the services they receive speaks volumes about the reality of medical care in this country.

    “how about we treat chronic pain in conjunction with pain specialists instead of making the ER a 24-hr candy shop?”

    That’s funny, I believe that was exactly the solution I offered, along with using EMRs as a tool of coordination. It took me 45 seconds to figure that out. It’s taken years for you docs to come up with a solution, but perhaps it’s that know-it-all arrogance that keeps you closed from seeing what is obvious to us mere mortals.

    “and who do you think staffs the urgent care center next door? yep – usually ER docs from the same group that run the main ER. and i guaran-damn-tee you that they have no more patience for this crap when they’re next door.”

    Well, I don’t understand why so many doctors consider someone in severe pain seeking medical attention to be “crap.” What’s “crap” is the barbaric attitude that people should just shut up and suck it up. When I’ve asked this question before, the answer I get is that ERs have more pressing problems to deal with like heart attacks and acute exacerbations of pain should be managed by the patient’s pain specialist, as if every patient has one or can get one. So the obvious solution is to have the ER dedicated to life-threatening or severe emergencies, and another area dedicated to dealing with treating pain, cuts requiring stitches, etc. There are 75 million people with chronic pain in this country, and tens of millions of others who will experience episodes of severe, acute pain. There are 5,000 pain specialists, a good many of whom are just block jocks who administer shots whether they’re needed or not or give advice for other docs to treat pain. Expecting them to take the load of this many patients is unrealistic.


  • susan
    susan

    November 10, 2007 at 3:25 pm

    that is a great post. lmao.

    payne hertz………..get a life.


  • Payne Hertz
    Payne Hertz

    November 10, 2007 at 4:41 pm

    Susan….get some original material


  • Fallen Angels
    Fallen Angels

    November 10, 2007 at 7:30 pm

    It’s really sad to see the way people behave in comments. Why must a suggestion/idea (whether it will work or not, whether it is cost-effective or not) always be followed by an attack? Both sides of the argument have valid points. Having a real dialogue might just help each side.

    The fact is that for various reasons (many of them valid) people with exacerbations of chronic pain end up in the ER and are treated like drug seakers. I’ve been fortunate to never have that happen…it has happened in my GP’s office though. GP on vacation, NP treated me badly (ignoring the note in my chart from GP and ignoring the fact that the last time I had been in for pain was more than a year previous…obviously I was drug seaking). Honestly I have no ideas and certainly no solutions. All I can say is a little kindness and understanding ON BOTH SIDES could go a long way.


  • deb
    deb

    November 11, 2007 at 12:35 pm

    Payne Hertz said “There are 75 million people with chronic pain in this country, and tens of millions of others who will experience episodes of severe, acute pain.”

    I believe the original post was only talking about Chronic pain. Acute pain is a different issue all together. Acute indicates a new problem, not an exacerbation of an on going problem. No one expects anyone in acute pain to not get treated in ER. Whereas Chronic pain sufferers will have a doc already & should’ve been given advice on who to contact if any deterioration.
    There is no easy answer to the problem. A grooup of sufferers will always be left in limbo, no matter how the system is changed.


  • Chuck McKay
    Chuck McKay

    November 15, 2007 at 12:15 pm

    Yes, there are people who can’t afford medical (or dental) treatment.

    There are also people who, when faced with limited resources, have chosen the satellite TV subscription, cell phones for every member of the family, and $200 sneakers in every color instead of paying for the medical treatment they can’t afford.


  • Payne Hertz
    Payne Hertz

    November 15, 2007 at 3:30 pm

    “There are also people who, when faced with limited resources, have chosen the satellite TV subscription, cell phones for every member of the family, and $200 sneakers in every color instead of paying for the medical treatment they can’t afford.”

    And there are people who haven’t. But I guess it’s easier to stereotype than work on solutions.


  • Loretta
    Loretta

    December 1, 2007 at 4:00 pm

    I love reading this. I was searching to see if there were any ERs out there having a working plan on handling drug seekers. we are been overtaken and not able to deal with true er pts for all the ones who come in EVERY day “playing the slots ” to see if this would be a win visit.


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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