Untold Secrets of the Emergency Room
Whether you're a doctor, nurse, or another medical professional, working in the emergency room is one of the most stressful jobs out there. E.R. staff are never sure what they might face during one of their long shifts. Life-threatening injuries from a car accident? A man having a heart attack? Or maybe just a scared mom whose child has a marble stuck up his nose? Anything is on the table!
But what is working in an emergency room really like? From why you have to wait so long to be seen by a doctor to advice that could save your life — here, emergency room staff reveal all.
The Emergency Room Is Nothing Like You See On Television
We all love a good medical drama like Grey's Anatomy and ER, but these series are far from what life in the emergency room is really like. In reality, emergency rooms might not be as dramatic as a Shonda Rhimes plot, but they are fast-paced. Oh, and hooking up with your coworkers? Save that for the Netflix binge.
One anonymous commenter from the BuzzFeed community says, " The emergency department is nothing like Grey's Anatomy or Code Black. It's faster-paced and people do not hook up with each other in the hospital!"
Medical Staff Train On Your Body
The average American physician spends about 14 years training for his or her job. But when it comes to training, there isn’t a perfect analog for a living human being. Medical professionals can only learn so much with cadavers, dummies, and simulations, so sometimes, they turn to real, living humans instead — especially in the E.R.
It makes sense — after all, this is why training hospitals are a thing. But it also means that at some point, you may be the patient someone is training on.
Ambulances Don't Use The Sirens Unless It's a Code 1
In certain areas, an ambulance is sent any time someone calls 911. This means that medical professionals sometimes get sent to a scene where there isn't exactly an emergency happening (like a broken arm).
While the injured individual may get a ride to the hospital, often times the siren won't be on. "Your emergency isn't necessarily our emergency," says Connie Meyer, an R.N. and paramedic. "In my region, we send an ambulance for all calls, but we don’t use the sirens unless it’s Code 1, which means someone’s bleeding or having chest pain or shortness of breath — basically things you could die from in the next five minutes.”
Doctors Google Your Illness Sometimes
Believe it or not, doctors don't know everything there is to know about your body or any other patient's body for that matter. Sometimes, a patient will show up to the emergency room presenting symptoms of a rare condition. If a doctor wants to research the suspected condition, it's not unfathomable for someone to turn to Google for some quick information.
Ultimately, there are so many things that can wrong with the human body that it's impossible for any doctor to remember every single ailment!
Yep, Doctors Judge Patients
Doctors and medical professionals have a duty to uphold to patients. Of course, they're responsible for providing care to those who walk through the E.R. doors, but this doesn't mean they're not judging you.
“If you come in with a bizarre or disgusting symptom, we’re going to talk about you. We won’t talk about you to people outside the ER, but doctors and nurses need to vent, just like everyone else," says an anonymous emergency physician from the Northeast.
Taking an Ambulance Won’t Get Your Treated Faster
Sure, an ambulance may get you to the emergency room faster, but that’s about it. Once you’re there, that ambulance arrival doesn’t guarantee you’ll be seen right away. When it comes down to it, patients in the E.R. are treated in order of urgency.
When you arrive at the E.R., you’ll see a triage nurse who will rate you somewhere between “please have a seat” to “get me a doctor now!” While the former means a longer wait time, be glad you're not first in line.
Your Doctor Can Help You Get Seen Faster In the E.R.
If your physician sees you and believes you need urgent attention, he or she may be able to help you get seen by a doctor in the emergency room faster. Most emergency rooms have “pre-expect” forms, which they fill out with a patient’s information whenever a doctor calls on their behalf.
Not only will this make arriving at the emergency room more efficient, but some nurses say they bump these patients up on the triage list.
Speaking of waiting in the E.R...
The E.R. Staff Knows You’re Waiting
If you’ve ever had to go to the emergency room only to end up sitting in the waiting area for what seems like hours, don’t worry. Even though it can seem like the emergency room staff has forgotten about you, they haven’t.
Joan Somes, a long-time registered nurse, says, “Waiting is good. It means you’re not going to die. The person you need to feel sorry for is the one who gets rushed into the E.R. and treated first."
Patients Lie About Their Symptoms All the Time
Waiting in the emergency room is stressful, but lying about your systems to get bumped up on the triage list is one of the worst things you can do. Not only does this put other patients at risk, but faking “symptoms” can send doctors and nurses looking into certain diagnoses that are very wrong.
M.D. Allen Roberts says "Never, ever lie to your E.R. nurse. Their B.S. detectors are excellent, and you lose all credibility when you lie." Another incentive not to fib? Lying, or even just exaggerating about symptoms, could waste your money by having unnecessary tests run.
Bringing Your Paperwork Will Make Your Life Easier
Having to take a trip to the emergency room is already worrisome enough without the added stress of detailing your primary care doctor’s information, your medical history, and your list of medications. If possible, bringing any medical paperwork you already have can make things much easier once you get to the E.R.
At the end of the day, you are your best advocate when it comes to your health!
Bringing a Friend Along Can Help Too
You might be your best advocate when it comes to your health, but that doesn’t mean you shouldn’t rely on your friends and family either. Whatever your reason is for visiting the E.R., it's a good idea to have a trusted friend or family member to help.
This person should be someone you trust, who can help you relay information to the E.R. staff and help you remember all of the information given to you by your doctor.
It Is Possible To Be Forgotten
In most cases, constantly bugging the emergency room staff won’t get you anywhere, so it’s important to accept that you will likely have to wait. With that in mind, it is possible to be forgotten. Young-Jin Sue, an attending ER physician at Children's Hospital at Montefiore Medical Center in the Bronx, New York says this can happen when the emergency room is especially busy.
Sue also adds that if your pain becomes unbearable while you’re waiting, don’t hesitate to talk to the triage nurse. "It can be as simple as telling her your fever seems higher or your pain is more intense. Triage understands people's conditions change and may very well raise your priority," says Sue.
Monday Nights Are The Busiest
Accidents happen around the clock, but this doesn't mean that the emergency room isn't busier at certain times. It turns out that emergency rooms see the most activity on Monday night.
"The busiest times starts around 6 p.m.; Mondays are the worst," says R.N. Denise King. "We're slowest from 3 a.m. to 9 a.m. If you have a choice, come early in the morning."
The Majority Of E.R. Visits Are Unnecessary
Have you ever contemplated going to the emergency room but couldn't quite judge how serious your symptoms were? You're not alone. A study by Beckers Health Review found that around 71 percent of emergency room visits are unnecessary.
"The problem is that the decision to go to the emergency room is fraught with uncertainty," says David Anderson, an insurance expert at Duke University. "Most people know that something is wrong and they don't know if it is really, really wrong or mildly wrong."
Up next: a helpful tip if you're feeling overwhelmed in the E.R.
There's a Social Worker On Duty Who Can Help If You’re Feeling Overwhelmed
It can be easy to feel lost in the shuffle when you’re waiting in the emergency room. If you find yourself feeling overwhelmed and the E.R. triage nurse isn’t able to help you as you’d like them to, a great tip is to ask to see the social worker on duty.
Jacqueline O'Doherty, owner of Healthcare Connect, LLC, a patient advocacy practice in Califon, New Jersey says, “Just about every E.R. has [a social worker].” O’Doherty also says, “Social workers may not be able to get you treated sooner. But they are generally very nice, can calm everyone down and help ease communication between you and the ER staff."
Not All Emergency Rooms Are Equally Equipped
Did you know that not all emergency rooms are equipped to handle the same types of cases? For example, some E.R.s might not be fully equipped to deal with children as a children's-specific hospital would. That’s why sometimes it’s best if you can call your current doctor and get an ER recommendation.
Of course, if you’re having a serious, life-threatening emergency, get you or your loved on to the E.R. as soon as possible. But, if your child might have a broken bone, for example, calling your pediatrician ahead of time to get an E.R. recommendation is a good idea.
Don’t Be Afraid to Ask Questions
When it comes to medicine, there is rarely one right way to do something. If a medical professional says that you need a test or procedure, don’t be afraid to ask what it's for and what your other treatment options may be.
"Don't assume that there's only one right way," says Jacqueline O'Doherty, who owns a patient advocacy practice. "As a patient, you have the right to know your treatment options and that you have the right to choose.”
Denial Is a Killer
It's true that thousands of people go to the emergency room unnecessarily each year, but that doesn't mean you need to be in denial about your symptoms. Each year, doctors see tons of patients who come to the emergency room when it's too late.
"Denial kills people," says Dennis Rowe, a paramedic from Knoxville, Tennessee. "Yes, you could be having a heart attack or a stroke, even if you're only 39 or in good shape or a vegetarian."
Doctors Don't Have All of The Answers
If there is one thing emergency doctors (and all other doctors) wish patients knew, it's that they don't know everything. Contrary to popular belief, just because you are in the E.R., doesn't mean you will get all of your medical mysteries solved.
“If you come into the ER with a virus, don’t get mad if we can’t tell you exactly what it is," says Jeri Babb, a registered nurse. "If we’ve ruled out any serious problems, you’re going to have to follow up with your primary care doctor.”
Doctors Sleep Whenever and Wherever They Can
Emergency room doctors (and pretty much all medical staff) work insane hours. Some doctors work 36-hour shifts or 80-hour work weeks. Although they may seem superhuman, doctors are people, not machines, and need sleep just like the rest of us.
With that in mind, it's not uncommon to see a doctor sleeping somewhere during your trip to the E.R. Don't judge them — they're fitting in time to rest whenever they can so they can adequately provide care.
Be Specific
Emergency room professionals advise patients to be as specific as possible when describing their symptoms. Leana Wen, MD shared this tip in her book When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests. "Eighty percent of diagnoses can be made based on what patients tell us," she wrote.
Include any relevant information when you're speaking to ER staff. As . "If you just say you have a headache, we might assume anything," says Wen. It's better to say, "I have a history of migraines, this is the worst one ever, and I've had it for three days."
The E.R. Is Not The Place To Go For A Chronic, Non-Life Threatening Condition
Sometimes people who are struggling to find answers for their chronic conditions end up visiting the emergency room in the hopes of getting another opinion from someone who's not their regular doctor. This is a bad idea, say ER doctors like Kimberley Brown, M.D.
She says, "the emergency department is not the best place to have these conditions reassessed if there is no change in symptoms. If we order tests and workup in the ER, it often is more expensive to you in the long term." And you'll possibly prevent people who have life-threatening issues from getting the help they need in a timely fashion.
ER Personnel Care Deeply About Their Patients
The people who work in the E.R. are highly committed to helping people, and have a "treat the patient now, worry about financial details later" policy about their work. As one emergency room physician, Ramon Johnson, MD, shared with Readers Digest, “We’re the only doctors who will take care of you first and ask questions about payment later, so we end up giving one-third of our care for free—and lose about $100,000 of income a year."
He added, "Yet we still do it. This is the best specialty in the world.” That's real dedication!
Be Calm And Polite
Being polite to others is always a good policy but when you're talking about the kind of situations faced in emergency rooms, it's even more important.
A nursing student explained it this way. "I should hope that no matter what the situation is they will always get the best care but you will be treated better if you are polite and patient and understand triage." As they say, you catch more flies with honey than with vinegar.
You Can Request To See A Physician
Many times if you visit the emergency room you'll be treated by a nurse practitioner or a physician assistant. They're perfectly qualified to tend to patients, but some people prefer to see a physician when they're in the hospital. You have the right to ask for a physician.
As ER Dr. Kimberley Brown explains, “You may go to a fast-track or rapid assessment/treatment area where you are seen by a nurse practitioner (NP) or physician assistant (PA). They are capable of addressing your needs and are supervised by physicians, but at any time you would prefer to see a physician, it is your right to ask.”
Don't Rely Too Much On Apps
There's an app for just about everything these days, but doctors say that relying too much on health-related apps is not helpful when you're visiting the E.R. The people treating you might not be familiar with the apps you use and don't have time to learn how to use them.
It's better if you can bring in a printout of the data or just give your health care provider a verbal summary of your concerns. There are also apps that supposedly tell you when lines are the longest at your local E.R., but you shouldn't let those estimates determine whether you seek medical treatment or not.
The E.R. Is Not The Place To Be Shy
Some people might feel a little bit shy in the emergency room, since they're dealing with unfamiliar doctors and staff. Emergency personnel say that a trip to the E.R. is not the time to be shy, however.
In an interview with Reader's Digest, a Fort Worth E.R. doctor named Allen Roberts said, “When we say, ‘Put on this gown,’ we mean you should take off the clothes underneath so we can see the area that we need to examine. I once had a woman put the gown on over her clothes and her coat.”
What's The Best Time To Go To The E.R.?
It turns out that there's a particular time of day that some E.R. staff say is the best to visit. One R.N. who works in an emergency room said that the time "from 6am-12 patient load is the smallest, everything happens faster."
Conversely, you want to try and avoid the busiest times if at all possible, with the nurse saying that it's "hard to deliver the best care with 45 in the waiting room & no beds.”
Be Honest
This advice goes along with not being shy around emergency room staff, but it's important to reiterate. You should be honest when discussing your symptoms with health care providers. This means fessing up if you haven't been taking your medication as prescribed or admitting to any behaviors that could be affecting your health.
Melissa Barton, MD, says that “there’s no reason to be embarrassed and trying to hide information may cause us to search for a problem that doesn’t exist or miss something very important … If you haven’t been taking your blood pressure medicine, tell us. If you used illicit drugs just before you started having trouble breathing, tell us.”
Follow Your Doctor's Orders
It's very important to follow the directions given to you by emergency room personnel. When you're waiting for a long time and perhaps feeling a bit impatient, receiving an order to stay in bed might seem like you're being dismissed or ignored. But it turns out that this is a very important piece of advice.
A nurse named Joan Somes told Reader's Digest, “If we tell you to stay in bed, we mean it. Some medications make you uncoordinated, and we hate it when people fall down.”
The Seven Steps Of A 911 Call
911 operators are the unsung heroes of the world. With an estimated 650,000 emergency calls made in the U.S. each day, operators help nearly 240 million people each year. If it weren't for their services, millions of lives would be at risk. It's a crucial job that requires great attention to detail and the ability to keep cool during the most intense moments in someone's life. If you thought this position just involved picking up the phone and identifying the caller's problem, then get prepared to learn some of these secrets 911 operators have revealed. You're in for a surprise.
There is a strict protocol 911 operators must follow when assisting someone on the phone. Upon answering the phone, the operator must go through seven main steps. These steps include: question the caller regarding the emergency, help the caller to remain calm, record details of the call along with the information provided, and record the resources dispatched. While there are only seven basic steps involved, this is only the beginning of the responsibilities 911 operators have.
Verbal Abuse Is Part Of The Job
When citizens call asking for help, you can expect some of them to be hysterical. Lives could be at risk, so it might be difficult for people to remain calm as the dispatcher attempts to help. But during some calls, operators become subjected to verbal abuse.
"For every moment that I felt I was making a difference... there were ten calls where I was cursed at, called terrible names or turned into an outlet for venting civilians," one dispatcher told the Washington Post. They're just trying to help people, but people aren't always concerned with dispatcher's feelings during these harrowing moments. Their primary concern is getting help.
The Pay Is Nothing To Write Home About
What you might not know is how little 911 dispatchers earn in wages. Their job is imperative in the process of helping others, so it's a bit head-scratching that the average dispatcher makes around $36,000 a year. The top end earners make around $56,000.
911dispatcherEDU.org says that "education and experience both tend to play a large role... with higher salaries and advanced positions going to those professionals with more." If you plan on making this your career, be sure you get the proper education so you can pull in a bigger paycheck.
The Requirements To Get Hired Are Extensive
911 dispatchers have to meet lots of requirements before they're hired. Not only do they need a working knowledge of laws, legal codes, government regulations, and agency rules, but they also have to know the geographical area, including the names of highways and roads.
In some areas, employers require 911 dispatchers to be CPR certified. While having a college degree isn't necessary, there is still significant on-the-job training requirements all 911 dispatchers need to meet.
After You're In, Prepare For Training
After you've proven yourself worthy to accept the calls with your certified background, there is another hurdle to leap. Almost every job has some type of training, and it just so happens the training for this role is grueling. Many states require 40 hours of initial training.
In addition to the 40 hours, you must also complete continuing education. This includes, but not limited to courses in; Advanced First Aid/CPR/AED, Domestic Violence, Suicide Intervention, and Critical Incident Stress.
The Verdict Is In... They Don't Know Your Location!
It's a common belief that the dispatchers know your exact whereabouts when you call 911. Let's end that fallacy right now. Yes, it would be ideal if they knew where you were, but it doesn't work that way. Which is why they often ask people to provide their location.
Curtis Darnell was an emergency service worker for almost three decades. He confirmed in a Quora forum that dispatchers don't know where you are. It is best to provide them with the most information you can give.
They're Human Lie Detectors
Why would anyone want to lie about an emergency call? You might expect young kids who don't know any better. But there are others who like to call in and fib. How do operators combat this issue? 911 dispatchers are practically human lie detectors.
Retired dispatcher Cathy Looper revealed that "If you lie to a 911 operator friend and they don't call you out on it... trust me, they are just being nice to you." So go ahead and lie if you want -- they'll know.
The Things They Hear Are Sometimes Unbearable
One can only imagine the types of soul-sucking things dispatchers have heard. Emergency calls can range from death to robberies and everything in between. Operators do their best to provide the needed help before anything tragic happens, but sometimes it doesn't pan out.
Brooklyn Stabile, a dispatcher, told the Washington Post, "I've talked to parents who found their children dead, to kids who watched their parents die. It takes a toll." Don't ask anyone who works in this field what's the worst thing they've heard. You probably don't want to hear it.
Dealing With The Painful Calls
After hearing some of the tragic things dispatchers have heard they still have to push on. Their job doesn't end after helping with one horrific emergency. They may say they're okay when their manager asks, but that isn't always the case.
13-year veteran Ricardo Martinez revealed on his podcast TheJabberLog what it's like after the mayhem. "You're rocked and everything echoes in your head," he said. "Sometimes there's a debriefing after the shift is over, but not necessarily. Some dispatchers seek clinical therapy."
Never Hang Up Prematurely
Parents, please let your kids know that crank calls to 911 are not funny and it is a punishable offense. And adults, even if you call by mistake, you must never hang up early. Wait until the dispatcher tells you to do so, according to the national program behind emergency services.
If you end the call prematurely, the dispatcher must investigate, and that takes away from other potential emergencies. The bottom line is to remain on the phone no matter what until they say it's okay to hang up.
