August 5, 2008, 4:24 pm

Grand Rounds: Brought to You by Cheesy Poofs!

I’ve seen some fun Grand Rounds themes over the last few years, but this one takes the cake…or the cheesy poofs!

In honor of the theme chosen by Jake at Pure Pedantry , I’ve co-opted the South Park theme (with apologies in advance to Matt and Trey…)

I’m goin’ down to Grand Rounds
gonna have myself a time.

Friendly bloggers everywhere
posting perfect posts on health care.

Grand Rounds read at Starbucks,
gonna leave my housework woes behind.

Ample parking day or night,
people shouting GIVE ME LATTES!

Clicking links at Grand Rounds
gonna see if I can’t find,

Funny, poignant, information – add my share of commentation

So come on down to Grand Rounds
and meet some friends of mine!


Okay! I have put up the Change of Shift schedule through the new year on both Emergiblog and Blog Carnival, so if you see a date that works for you and you would like to host, shoot me an email.

The next edition will be here, and I’m taking submissions until tomorrow night at 5 pm PDT so there is still time to send in your best posts!

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.


  • 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.

11:07 am

You Can’t Always Get What You Want

Oh, I don’t even know where to start with this one!


The caps are beyond the pale.

The one on the right is shaped like an envelope, the one in the middle I’ve seen on many a waitress and the one on the left…

…what the heck is that? It looks like she stood under a soft-serve machine.

The Emergiblog Cap Rating Scale may have to go to negative numbers for these specimens!

And is it just me, or does it look like the building on the left is buckling?


Wow! Emergiblog was listed in the LA Times as one of the best known health care blogs! Many thanks to Melissa Healy, Staff Writer. Check out the list – and congratuations to all the bloggers included!


Dear Patient Family Member,

Thank you for choosing Superior Medical Center’s Emergency Department for your health care. We appreciate the fact that you trust us to care for your child. We are here to serve.

We would also like to politely inform you that yelling at the nurses because there are “sick people everywhere around here” is, well, confusing.

You see, you chose to bring in your Precious Polly Pumpkin with her baby boo-boo to our nasty, infested “icky” place of care.

Then again, perhaps you did not know that the emergency department is a hotbed of illness.

Let us tell you about the sick patients, as you seem most concerned with their presence.


We have patients who are febrile, vomiting and having diarrhea in the next room. You say you saw a patient walk by with their official Tupperware vomit holder. They walked by your door on their way to the bathroom.

We apologize for what must have been a traumatic visual.

Ever heard of MRSA, or that “bad staph infection everyone is talking about”? It was right here, up close and personal, about two doors down from your room.

Across the hall was Harry Homeless. He brings his pets with him. Actually, they live on him 24/7. And yes, that smell was quite obnoxious. It’s called alcohol with a hint of urine incontinence. Yes, we are quite sure pretty Polly is not used to hearing such language. We apologize for the auditory assault.

Oh, the x-ray that took, like, forever? We’re so sorry, but those folks having strokes, bowel obstructions, appendicitis and dissecting aneurysms need cat scans and take precedence over Polly’s puny pinkie injury.

But, then again why should you have to wait just because they are there?


Our apologies for not being the Ritz-Carlton. You see, for every affluent patient/family with a sense of entitlement, such as yourself, we see ten economically challenged patients who need our services. For every patient/family who has to peer down at the lowly emergency department worker bees because their nose is so high in the air, there are ten patients who are grateful we are available to them.

You want a germ-free environment for your offspring. Unfortunately there isn’t an emergency department in the world that can make that claim.

Including ours.

We apologize for not meeting your expectations, and hope that if you do find a ER that can, you let us know.


Superior Medical Center RN


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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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