The young man came to the window and said that he had burned himself and would like to be treated. We asked him if he was trying to hurt himself? He replayed ” No its not like I was fooling around with some friends and thats how it happened. OK! said the nurse, so she got his vitals and took him back to a room. This is where I come in. I walked into the room and asked him to show me his burn. He looked at his sisters and back at me then stood up turned around and dropped his pants to the floor. I kid you not I stood amazed and dumbfounded at what was before me. Both checks were covered with second and third degree burns. So I asked him how this happened? He replayed “I was out camping with friends and we had been drinking. I thought it would be funny if I mooned them so I did. I lost my balance and fell right in the fire.

I looked at him and in the straightest face possible said ” Well at least you didn’t do a half assed job” We all laughed to the point of tears and I then spent the next hour scrubbing and peeling the dead and burned skin from his body. If any of you have had a bad burn then you know how hard it is to numb the skin as well as how much I would have to scrub to get the burn clean to reduce any chance of infection. Needless to say I believe this young man learned his lesson.

1.The world of the er does not revolve around you. There are sick people here and you may or may not be one of them. We get to decide that. If it’s chronic, and already diagnosed by your doctor,its not an emergency. (Ex: back pain for three years).

2.Our definition of sick may not be your definition of sick. If a member of the ER staff says that someone is sick,it means that they are in the process of DYING. They have had a massive stroke,are bleeding out, having a heart attack, or have been shot. We don’t consider a tooth ache as sick. Painful yes. Sick no.

3.Don’t be a whiner. Do not ask for a meal tray and a warm blanket before you get into the gown. This is not a bed and breakfast. It’s also rude to eat and then leave against medical advise.

4.Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonalds, and you very well NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets, the lights dimmed, and the TV on the channel of your choice, go to a hotel.

5. If you have one of these four things, go to you own doctor in the morning:

1. A cold 2.The flu 3.A stomach virus 4. Anything chronic

6. If your child has a fever, you had better have given him Tylenol before coming in. Do NOT let the fever remain high just so we will believe the child has a fever. Do you want your child to have a seizure? Well do you?

7.We have priorities. We understand that you have been waiting for two hours in the waiting room. If you don’t want to wait make an appointment with your doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. Thats why she goes first.

8. Do not ask us how long it will be. We don’t know. We don’t know what’s coming through the door in 30 seconds from now..so we surely don’t know when you’ll be getting a room. Never ask the triage nurse if you’ll be admitted.

9. We are not here for primary care. An EMERGENCY is something that is life or limb threating and that requires immediate attention. Get a family doctor and go see him.

10. If you have diabetes and do not control it, you are committing slow suicide. Non-compliance will not get you much sympathy. Especially the fourth time this month.

11. We know how many times you’ve been to the ER. We can usually tell you are faking it or just seeking drugs in the first 5 seconds of talking to you. Do not lie to us. If you lie about one thing, we will assume you are lying about everything. Coming in for de-tox 2-3 times a week is insincere.

12.If you are well enough to complain about the wait you are well enough to go home.

13. If your mother is the patient and we ask her a question, let her answer it. We are checking her level of consciousness, not yours.

14. If you see someone pushing a red cart down the hall at full speed and you hear bells going off..do not ask for a cup of coffee. Someone is dying.

15. If you have any sort of stomach pain and you ask for something to eat, you are not sick. If you are here for vomiting, we are not going to reload you.

16.If you can complain about the blood pressure cuff being too tight, or that the IV needle is hurting, you are not in that much pain. PS if you have more than three piercing or tattoos, don’t tell me you’re afraid of needles.

17. If you want to get something be nice. I will go out of my way to tick off rude people.

18. Do not talk badly about the other members of the staff. I work with them. The doctor that you hate i work with every day, and i know that he knows what he’s doing. I trust him a LOT more that i trust you. I am not here to be your friend, and neither is he. I will tell him what you say, and we will laugh about it.

19. Do not utter the words “you have my records.” I don’t have your records and I don’t have time to call and get them. Just tell me what I need to know. Answer my questions even if I ask them more than once.

20. Do not bring your entire family with you. One person at the bedside is all you need. It is really difficult to work around seven people in the event that you really are sick. This is a hospital, not a place for a family reunion.

21. Bring a current list of your medications and allergies. Include the doses. Nobody should be taking medications if they don’t know what they are or what they are for.

22. I know you doctor said to “go to the ER and I will call and tell them you are coming.” He probably didn’t. And the chances are even less that he will “meet you there later.”

23. If your doctor sent you here because his office was busy you may want to let him know that you waited 5 hours in the waiting room with 60+ contagious people and 4 more hours in the actual ER to get your sore throat looked out.

24. Its not cool to call 911 and tie up an ambulance crew for a non-emergency just because you don’t have cab fare. Coming to the ER by ambulance does not guarantee you will get right in. We routinely move people from the ambulance stretcher to a wheel chair to the waiting room.

25. If you come in on Tuesday with chest pain that started on Saturday don’t expect us to get excited..you didn’t.

26. We’ve seen it ALL. Moaning, writhing, and screaming. Falling to the floor or faking a seizure will not speed up the process one bit. Making obnoxious retching noises and then spitting in an emesis basin is not convincing either. If your going to barf, BARF!

Later that night close to 10p.m. the patient returned to receive her antibiotics. The doctor on duty went to see the patient and asses how she was doing. She stated she was feeling better but she still had pain and wondered if she could get more pain medication. The doctor replied “O.K. well, when you get home just take some of the pills we prescribed to you earlier.” The girl then said “Well I wont be going home right away I am going shopping with my child.” The doctor then said “At ten o’clock at night isn’t that a bit late, Listen we will start your antibiotics and I am not going to give you anymore pain meds. You’ll just have to wait tell you get home to take them.” The doctor then turned around and walked away, to which the girl then flipped him of with her middle finger behind his back.

With these long wait times we have had some unfortunate problems arise. Most of this increase in wait time are due to the lack of resources available to those who don’t have health coverage. Or wait! could the long wait times be due to the drug seekers, hypochondriac’s, lazy doctor offices? At any rate people are increasingly using the E.R. for their personal doctor office, demand pain med’s, who seek tests that are unnecessary and unwarranted.

Now I would hate to sound too insensitive but if you knew me, many of you do, it’s not that hard. But on this rather busy night previously mentioned we had a real emergency. A man in his forty’s came in and asked to be seen. He stated his tooth hurt really bad and had to see a doctor right away. When we told him it would be a while he then asked how long. We let him know we do not know exactly how long it would be but we would call him when we were ready for him. He then said in a annoyed manner “So I am going to have to wait” as his alcohol breath is waffed in my face. I replied “Yes it’s going to be a while so please have a seat and we will call you up when we are ready for you.”

He then turned around and headed toward the door. On his way out he stopped at the candy dispenser, looked at the candy, grabbed the top of the dispenser with one hand wrapped the other around the base and pulled. This allowed the top to come off. He then reached into the candy, grabbed a handful, placed the top back, and continued on out the door. I then said out loud to the clerk “I bet that candy is really going to help with his tooth pain.”

So we let the couple in and started to take his vitals and asking a few general questions. The nurse then asked “what can we help you out with today?” The young man replied “I just want to die”. “Oh!” said the nurse “and why do you want to die?” “Do you plan on harming your self or others?” “No! No!” replied the young man “I don’t want to kill myself I just want to die.” The nurse then said “Well then what do we need to treat for you today?” His girlfriend standing in the corner then spoke up “Just tell them, look this morning we were fooling around and he got a dildo stuck up his butt”. “Oh! OK” replied the nurse. Then we finished with the patient and then took him back to a room awaiting the physician.

Once the couple left triage all of us broke down laughing, it was to hard to hold it in. The sad part is the girl with the young man was not sympathetic towards him at all. We then got an x-ray to see how far up his butt the dildo was and its location. The doctor also questioned the couple to see how this happened. The woman said ” I was holding on to the end of the dildo when all of a sudden it slipped out of my hands and slid up on its own”. In the medical field we call this “the point of no return.” That is the sphincter tightens up so much it not only lets things out put keeps thing from falling out on their own. The next step was to consult a surgeon to see if the young man would have to go into surgery to have the dildo removed. The surgeon felt pretty confident that he could remove the dildo with just a local anesthetic and some ringed forceps. He was right and he pulled out a nine inch dildo out of a 5′10″ 140lbs. guy. The nurse looked at the girl and she said ” Don’t look at me its not mine that’s way to big for me”.

Ok since no one left a comment I am going to give everyone 24 more hours to guess what’s up my butt. Now get on it and start guessing what’s up my but.