What is an emergency anyways?

As an ER nurse for the last several years I have learned that there is an incredibly broad definition of what constitutes an emergency. The lucky nurse who gets to triage on a Monday evening knows the frustration of triaging the 20th patient with some ridiculously minor complaint. I often get frustrated by the abuse of the emergency department and agitated with the amount of resources needed to care for these complaints, they clog up the waiting room!
After my last busy shift in triage, I began to really think why patients come to the ED with minor complaints. Why does one patient’s cold mean an emergency to them versus the patient who stumbles in with 10/10 crushing chest pain?
I am constantly asking patients “if this has been going on for x amount of time why is it an emergency today, what has changed that made you want to get evaluated?” By pointing out the lack of emergency their situation is I hope they will think twice next time before sitting in our waiting room for 4 hours to be evaluated for perceived purple boogers (seriously, that happened).
Not only do less than emergent patients clog up the waiting room but they also take away valuable resources. Patient’s often complain about long wait times, hurried nurses and doctors who “don’t really listen to them”, well when your staff is being spread so thin trying to take care of Mrs. M having an MI in room 21 and then the stubbed toe sitting in the hallway, I think any nurse would be a little frustrated. Wait times get long when nonsense complaints fill the department, each of these patients need to be evaluated and treated which takes away valuable time from the truly sick patients.
One of the ways I have learned to manage the ever-changing definition of an emergency is try to put a patient’s complaint into perspective, especially when they start to get ornery about sitting in a hallway or having an extended wait time to see a provider. I like to remind them that there are often very sick people in the department and if one of their family members was sick they would want all the staff’s attention on them. Sometimes patients get it and sometimes they don’t, often when they don’t understand it’s not worth your time or energy to try to argue because you have lives to save!
As frustrated we all get with Timmy toe pain for ten months, the variety these patients bring to the ED is the silver lining of emergency medicine. The variety we see shift after shift keeps it fresh and exciting, and lets all be honest, when you have three telemetry admits with new EKG changes, on heparin drips, the level 4 knee pain in the hallway is a welcome reprieve even if they do have Q2min snack and Percocet requests.
So, next time your frequent flyer knee pain comes through the doors, give them an honest perspective on their situation with a side of humor, compassion and respect but please, hold the narcotics (we don’t need to perpetuate the problem!).

What is an emergency anyways?

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