August 2, 2008, 10:40 pm

Etiquette in the ER

I don’t think I’ve ever had a patient plead for coffee.

Back in the old days (pardon me, sonny, while I put my teeth in…), patients in the Coronary Care Unit were not allowed to have caffeinated coffee.

No stimulating cardiac muscle in my department!

All we could give them was Sanka.

Freeze-dried Sanka.

It would be a cold day in Hades before I’d be pleading with anyone for coffee, leaded or unleaded. I’d get it one way or another!

Even if it meant my husband had to sneak it in under his coat!

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

While at the BlogHer08 conference a few weeks ago, I had the pleasure of meeting Emily Post’s great-great granddaughter, Anna Post. (Yep, THE Emily Post!). Anna writes a blog entitled What Would Emily Post Do? , focusing on modern etiquette and, along with other members of the Post family, contributes to The Emily Post Institute.

Our conversation turned to etiquette in the emergency department, something that was not covered in any of the great books on etiquette available that day.

I remembered writing a post on ER etiquette, and a quick search of the archives turned up “Mind Your Manners and Call Me in the Morning”, first posted back in 2005.

It holds up pretty well, but I thought it could use a bit of refining. So, here it is, The 2008 Emergiblog Guide to Emergency Department Etiquette.

**********

The easiest way to understand emergency department etiquette is to realize that the majority of the issues revolve around privacy and confidentiality, both yours and that of other patients.

Therefore:

  • Don’t ask about the condition or status of other patients in the department. Staff can not and will not discuss another patient with you.
  • Stay in your room. Don’t congregate in areas where patient information can be overheard, including hallways or the nursing station. Use the nurse’s bell to summon staff for questions or requests.
  • Limit your visitors. Ideally, bring no more than two with you to the ER. However, if you do have more than two with you, the others need to wait in the waiting room.
  • Don’t stare into other patients’ rooms or at other patients as they go past on gurneys or in wheelchairs. Staring is just rude, period.
  • Keep it to yourself. Don’t repeat what you do hear. Sometimes it’s impossible not to hear what is going on in another cubicle, especially when separated by only a curtain.
  • If you are dealing with a very personal issue/condition yourself, it is perfectly okay to ask the staff to conduct your interview in a private area.

The next area of etiquette would revolve around cell phones. Cell phones are now permitted in some hospitals (in all areas except the intensive care unit), so it is important to discuss their use.

  • Before you enter the emergency department, tell your family/friends that you will call them once you have been seen at triage. It’s easier on you to have them wait for your call than to have to ignore multiple incoming calls. Because…………
  • Answering a ringing cell phone at any time while you are being examined or treated, either at triage or in the treatment room is a major breach of etiquette.

A major source of frustration in the emergency department is waiting. It’s inevitable. You will be waiting. You will wait to be triaged, wait to be treated, wait for test results and wait to be discharged.

  • Asking for a time frame, or an update on where you are concerning test results is perfectly reasonable. A specific time can not always be given, but staff is happy to give you an update on your progress.
  • Expressing frustration with the process can be therapeutic. Chances are the staff is just as frustrated as you are with any delays. Yelling, screaming and cussing at the staff is inappropriate and will not get you seen/treated/discharged any faster.

Etiquette in the ER is really no different than etiquette anywhere else. “Please” and “Thank you” go a long way. Treat others with the same respect with which you expect to be treated, and remember that the need to be polite does not end at the doors of the emergency department.

A visit to the ER is never easy. Observing etiquette in the ER makes your visit a more pleasant experience, not only for you, but for those around you.

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13 Comments

  • Roschelle
    Roschelle

    August 3, 2008 at 3:48 am

    Bravo on all tips! Working in the ER (as you know can be so frustrating). I wish there was a way for visitors to actually get these tips and put them in practice….oh…in the perfect world.


  • Strong One
    Strong One

    August 3, 2008 at 5:47 am

    LOL.. Too funny.
    I think this etiquette applies to most areas of nursing, not just the ED.
    I know in the ICU, I can empathize with all the above.
    Thanks for the laugh.


  • de rn
    de rn

    August 3, 2008 at 7:33 am

    Oh how I wish this could be posted in our ER. Would also like to add that children should not be brought back to the trauma rooms just to visit.

    I had a man screaming at me yesterday because I would not allow a 6 yr old back to see grandpa. BTW: we had allowed a short visit, grandpa was stable, talking, etc… Grandpa had 6 adult visitors in the room (should have run them out too) I just allowed one visit from the child though.

    How rude and insensitive I am to not want to run over / traumatize a 6yr old in the event grandpa coded and we had to get to him quickly. I did not really care if we ran over the adults!


  • My Own Woman
    My Own Woman

    August 3, 2008 at 7:44 am

    I think we need to make all the patients sign your etiquette policy before being seen in the ED!!!


  • AlisonH
    AlisonH

    August 3, 2008 at 6:52 pm

    Hey. Starbucks could put a store in the ER. Think of all the waiting/family member/intrusion-on-other-patient problems it would solve, and you could listen to Paul while you work. Heh.


  • Heniii
    Heniii

    August 4, 2008 at 5:02 am

    this (post) is sooooo true.hehe. it should be posted in all hospitals.


  • Bianca Castafiore
    Bianca Castafiore

    August 4, 2008 at 10:16 am

    Kim, the intro to your etiquette guide struck a chord and engendered a blog entry of my own, titled: “I don’t *do* decaf.”
    Thanks for the inspiration!


  • healthcaretoday.com
    healthcaretoday.com

    August 4, 2008 at 12:13 pm

    Etiquette in the ER // Emergiblog…

    Great story about the dos and don’t in an emergency room…


  • Joanne
    Joanne

    August 5, 2008 at 7:52 am

    This is great, and ER units should hang these rules up in their dept. I’ve visited the ER twice in one month most recently so this definitely struck a cord with me. Thanks Kim.


  • disappearingjohn
    disappearingjohn

    August 5, 2008 at 8:11 am

    I’m laughing as I read this, for many reasons…

    I actually thought of you and wanted to “stop in” and say Hello. I am actually sitting in a Starbucks in Southern California, blogging! (while on vacation)

    As soon as I opened up my blog, I thoguht to you!

    John


  • NPs Save Lives
    NPs Save Lives

    August 7, 2008 at 8:18 am

    I think this should be posted in our office as well! I have patients who answer their phones in the middle of an exam and expect me to “wait a minute.” ARGH!


  • Maverick Monk
    Maverick Monk

    August 9, 2008 at 1:58 pm

    Asking for a time frame or an update! Its such a simple thing, but neither sides of the healthcare divide do it often enough.

    Often, people wait until they are extremely frustrated and angry to ask about what is going on for fear of seeming demanding.

    Many times, healthcare workers are so caught up in carrying out our tasks, that we forget to share new developments with patients.

    Like you pointed out in your post, a little bit of planning and open communication can save us all a lot of misery.

    I dont work in the ER, but your post seems so appropriate and holds true for patients and healthcare professionals on other floors as well!


  • Kimmie
    Kimmie

    May 9, 2011 at 5:14 pm

    I also wish that these rules of ettiquette can be posted!!


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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