January 20, 2012, 5:04 pm

Not A Laughing Matter

Tea time at the nurse’s home!

Considering it’s been a full two months since my last post, I’d say I took a rather extended “tea time”!

I didn’t intend to take a hiatus, the hiatus just sort of took me!

I’ve actually been blogging regularly, both Masters In Nursing.com and All Healthcare Jobs.com, but it’s time to sweep away the cobwebs and spend some time at “home.”

This post was originally written for my column at AllHealthcareJobs.com. It’s about emergency nursing, so I thought I’d get back into the swing of things by posting it here at Emergiblog.


Working in the emergency department is never dull. Oh, we have our moments of down time, but they can be shattered instantaneously by the blast of an ambulance ring-down or a critical walk-in patient (or three!)

Not all cases are serious, life threatening or traumatic. Some chief complaints are downright odd. If the truth were told, some of the reasons people present to the emergency department are downright humorous.

Humorous to everyone, that is, except the patient. No matter how off-the-wall the complaint, it is always serious to the patient.

People come to the emergency department because they are (a) in pain, (b) worried, or (c) have come to the end of their ability to cope with a problem. Sometimes it’s all of the above, but every ER patient is worried.

They are worried that they are sick, worried that what they have is serious, worried that they are pain, worried that nothing they have tried has helped.

Or, they are worried because they looked up their symptoms on the internet and are convinced the tiny red dot on their forearm is melanoma and their friend’s sister’s co-worker’s cousin had the same thing and it’s 3 am and they can’t sleep because they are worried.

This means that while the stated reason for the trip to the emergency department may make me want to roll my eyes and smack my head, the real reason the patient is sitting in front of me in triage is worry.

And worry is never funny.

Unfortunately, the availability of information on the Internet seems to have done more to escalate worry than to alleviate it, as patients look up symptoms, see the worst possible diagnoses as possibilities, and feel an ER visit is imperative.

So much of what we do in emergency care is reassurance. Reassurance and education. We examine patients and reassure them that they are okay. We educate them about their problem, giving them information that will help them cope or ally their fears, so they need not worry.

As an ER nurse, I may find a chief complaint humorous after the fact. But when a worried patient is in front of me, it is not a laughing matter. For that patient, at that moment in time, it’s the most important thing in the world. It’s important enough to get them out of bed and into an ER in the middle of the night.

That needs to be respected.


  • Kerri.

    January 20, 2012 at 5:20 pm

    This is a really lovely post, Kim.

  • David Wander

    January 20, 2012 at 7:24 pm

    Awesome post. Rolling one’s eyes should never be an option for an emergency caregiver. I know it is tempting sometimes to minimize a patient’s concerns, and as ERs get more and more overcrowded the frustration level with conditions that really didn’t merit a trip to the ER will grow, but the fact remains that people come to us because they are hurting, anxious and need help.

  • Shelley R

    January 20, 2012 at 8:55 pm

    Love this post! So true!

  • SmalltownRN

    January 21, 2012 at 11:04 am

    Great post and yes so very true. I like how you narrow it down to the “worry” aspect that brought them to the ER. I never really thought of it that way. From a personal perspective I can see that as the only reason I would ever go to an ER would be because I was worried and concerned about a health issue that I felt need immediate attention.

    I think you have given me a light bulb moment.

    Thanks for the enlightening post!

  • The Nerdy Nurse

    January 21, 2012 at 12:19 pm

    I am reminded of a patient I encountered during my short stent in the ER.

    She came in to see if she had Herpes.

    I guess to her that was an emergency.

    Truthfully, her emotional state was one that merited the ER visit more than anything else.

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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