Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
It might be better for me to wait to start this topic. I have been so exhausted lately I can't tell if I am making sense in emails, etc. But this topic has come up quite a bit recently so I'd like to try to help.
By no means am I judging anyone. And I'm not excusing ER people. I'd like to give insight into the why... Why ER people act as they do and what you can do.
Healthcare work is exhausting. People lie to your face everyday, for a number of reasons. "He didn't hit me... I fell." or "I'm in pain, 10 of 10." But they're smiling. Compassion gets killed off pretty fast.
It's about assumptions... stereotyping... to avoid being "burned" by people who want the drugs not for pain relief, but because of addiction. No one wants to enable an addiction.
ER "people" (doctors, nurses, PAs, NPs, etc.) get cranky when people with "chronic conditions" come to the ER for management. The assumption, right or wrong, but right sometimes (at least once, not with you), is that you are not getting pain control from your relevant doctor, because he won't give it to you. You are "drug seeking" not for pain control but addiction. OR the other possibility is that YOU are not managing your condition well, not being responsible, and have to "use" the ER inappropriately. That is when you hear, "Oh you just want a med refill." Read, stop wasting my time.
It's funny how they get bent out of shape, right? They're thinking why can't people come in with real emergencies... but 90% of the time we see truly non-emergency stuff. Diaper rash, colds, ear aches. In their mind it's abusing the ER. It gums up a system meant to respond to life and death emergencies.
The ER is not the best place to manage chronic conditions. Yes... we know. But for uncontrolled 10 out of 10 pain, or anything new or unusual, go right ahead to the ER. That's darn well what it is there for.
Make it very clear this is above and beyond your normal, and normal is pretty crappy... Is NOT normal at all, and we live with pain every day... Make sure they know you follow up regularly with your rheumy (or whomever) and he will hear about it ASAP, but you need help Right. Now. Please. Here are the meds I take. I take them as prescribed. But this is something special. You might even have pain control that works most days but not this day.
So, be honest. Be nice if you can. Don't be overly dramatic. Make it very clear you are not an addict. (Don't be an addict, please.) And clear you're responsible with your condition. If an RA patient said to me "I can take a lot, but I can't take what is going on today." That would make my ears perk up.
I hope this helps you guys.
By no means am I judging anyone. And I'm not excusing ER people. I'd like to give insight into the why... Why ER people act as they do and what you can do.
Healthcare work is exhausting. People lie to your face everyday, for a number of reasons. "He didn't hit me... I fell." or "I'm in pain, 10 of 10." But they're smiling. Compassion gets killed off pretty fast.
It's about assumptions... stereotyping... to avoid being "burned" by people who want the drugs not for pain relief, but because of addiction. No one wants to enable an addiction.
ER "people" (doctors, nurses, PAs, NPs, etc.) get cranky when people with "chronic conditions" come to the ER for management. The assumption, right or wrong, but right sometimes (at least once, not with you), is that you are not getting pain control from your relevant doctor, because he won't give it to you. You are "drug seeking" not for pain control but addiction. OR the other possibility is that YOU are not managing your condition well, not being responsible, and have to "use" the ER inappropriately. That is when you hear, "Oh you just want a med refill." Read, stop wasting my time.
It's funny how they get bent out of shape, right? They're thinking why can't people come in with real emergencies... but 90% of the time we see truly non-emergency stuff. Diaper rash, colds, ear aches. In their mind it's abusing the ER. It gums up a system meant to respond to life and death emergencies.
The ER is not the best place to manage chronic conditions. Yes... we know. But for uncontrolled 10 out of 10 pain, or anything new or unusual, go right ahead to the ER. That's darn well what it is there for.
Make it very clear this is above and beyond your normal, and normal is pretty crappy... Is NOT normal at all, and we live with pain every day... Make sure they know you follow up regularly with your rheumy (or whomever) and he will hear about it ASAP, but you need help Right. Now. Please. Here are the meds I take. I take them as prescribed. But this is something special. You might even have pain control that works most days but not this day.
So, be honest. Be nice if you can. Don't be overly dramatic. Make it very clear you are not an addict. (Don't be an addict, please.) And clear you're responsible with your condition. If an RA patient said to me "I can take a lot, but I can't take what is going on today." That would make my ears perk up.
I hope this helps you guys.
makes me think of my jaded sister in law who no longer wants to listen to "folks whine in their therapy talk appointments" (her words) - my first thoughts with her is why not switch out to another area of the profession since she has heard everything possible to personkind in her area of psychotherapy and no longer want to hear it. she could be missing something big since she is so burnt out.
something I think to tell her then I just shrug it off. must suck for her to be so unhappy in her her job everyday or a big component of it anyway
Oh for sure, that comes up a lot. That is, why are you doing this if you hate it? This applies across all of the levels too, RNs, MDs, everyone. As you mentioned, it also applies to anyone who is involved with people, period.
A lot of people, who can, move on to other specialties or areas that do not involve as much patient care.
Most people in this business start out truly caring, I believe. It just gets done in nail by nail, sometimes.
I think even the most optimistic idealist would walk away from any time in the ER with an adjusted outlook on humanity. I could go on and on for days with reasons, examples, and stories...
To see people take advantage of others - depressing.
To see kids and animals mistreated - depressing.
To see our government abuse power - depressing.
Even the church (as a whole) and those that do wrong in the name of God.
I think when we reach a certain age, the truths to so many things are revealed and it's sad.
On the flip side, it seems that life itself and the innocent (kids and animals) become more precious in our view.
My parents say that as I get older, forgiveness and understanding will come. Hope so!!!
I don't know why they removed it but made good sense to have a set up like that.
My recent ER visit was with nasty chest pain.
Wall to wall people. Nurse explained since changes in insurance everyone who could not find or get into a doctor came into ER. With things like sinus infections, colds etc...
They were not happy & held up care for those really needing it.
I was ready to leave after hours of waiting. Just got up to tell the desk when they called my name. They did an initial eval on me then sent me back to the waiting room. Did my best to get the doctor to send me home but Cardiac is something they like to rule out by observation & testing. After being left in a crowded hall with none of my meds, no food for over 24 hrs I pledged it would be my last trip unless forced to go.
A patients health history should make some kind of statement.
Also learned to get all my doctors practicing out of same hospital & if pain related have them call my PM doctor.
Landed in ER post op after my cervical fusion. Although my PM dr practiced out of the hospital they never placed a call to him.
He was furious to hear this & told me any more visits my husband was to let him know if my trip was pain related.
Been to ER more then Id care to think of. With sick family & so on..
There are to many that just don't care. One of my recent visits with my Aunt right before she passed away had a nurse actually mock me. When we got her settled upstairs the nurse on duty said she had heard other unpleasant stories about this nurse & I should report her. My poor aunt was in ER on a regular basis at that point. Told one nurse to please stop raising his voice when speaking to her.
Alzheimers patient so she was constantly setting IV alarm off. Even though we warned them repeatably not to place it in that location. Just awful & sad. Sure did not make it easy on patient or family. Ended up helping a nurse who could not get help from anyone else in assisting my aunt. To sad.
In the future I would not hesitate to report bad care.
Hit the nail right in the head. If you can't do or dislike your job get a new one.
For goodness sakes people are usually not feeling the hottest if they are sitting in ER. Last thing they need is poor treatment.
Any time I went to ER with pain speech was near impossible.
Had a dentist once tell me you can see true pain in a patients eyes & face. He's right. I get there are those good at faking it but I'd like to believe there's a way to know the difference. I never give a 10 for my pain level. A 10 would mean passed out. Eyes swollen nearly shut, gagging or vomiting, barley able to speak is a 9 to me. All my trips were with neuropathy spinal pain & that is no cake walk. Visible & palpable muscle spasms. I'd think they would be able to tell the difference.
Having low blood pressure alone has had me under the micro scope. Not every single patient has high BP in pain. It's an awful experisnce begging for help & not receiving it. Thank god for my PM doctor.
That is to sad Depot. Caring for others in any capicity can be draining.
There does come a time we need to take a break or reevaluate if we are able to give what is needed.
Sammy
But in my first ER visit discussion of the physical problem continuation from the urgent care clinic to the ER, sure must have been informative. To warrant the hmms and short answers to anything by the nurses and Dr's. No mention of pain except for the area treated by the application of a physical devise. and my reflective memory of when that problem might have started, which was a few days less then 72 hours. None of the nurses or Dr.s even asked if wanted or event informed me as too what meds I was being given and for what in my IV. Which is just strange, except for that they (Dr.'s) ordered it.
Both of those ER's and hospitals to me were just messed up.
Thanks.