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40 pro tips for your loved ones’ ER visits

Rada Jones, MD
Physician
June 17, 2019
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1. Tell us about your loved one: What brings them in? What’s their baseline? What changed today?  But don’t speak FOR them, unless they can’t. That gets us worried. That’s what abusers often do.

2. Talk to us about your their code status (what should we do if things turn bad,) and leave us a phone number.

3. Pay attention to them. If things change – if they get worse, if they can’t talk, if they turn blue – call us. Not 911. The nurse call button.

4. Be supportive. Don’t rehash what they should have done. This is not the time. “That’s what you deserve, you moron,” won’t help, even if it happens to be true.

5. Don’t feed them. They won’t starve in an hour, but feeding them may delay lifesaving procedures like surgery or endoscopy. That last burger may just be their last.

6. Don’t picnic in the treatment room. Step out if you need to eat. Your loved one won’t steal your food, and the staff won’t keel over because of the smell.

7. Bring their medications, their allergies, and their doctor’s phone number. You’ll get brownie points, they won’t get stuff they’re allergic to, and their doctor will get a call. Win-win.

8. Bring something to do: A book, your knitting, an Ipad. Expect to be here for hours. In the ER, things take time.

9. Standing in the door giving us dirty looks won’t make us work any faster. If you have to wait, that’s good news. In the ER you don’t want to go first.

10. Don’t let them pee. In the ER, urine is as rare as gold. We need it. If we miss it, that may mean waiting a couple more hours for the next one. You don’t want that.

11. Don’t make love in the treatment rooms. Not even oral sex. It’s awkward for the neighbors, and it will put you last to be seen. Those who are dying don’t have sex. Those having sex aren’t dying. Unless they’re driving.

12. Don’t surround your loved one to keep us away. We need to see, hear, and touch them. If you don’t want us touching them, try telemedicine

13. Don’t interrupt our care to chat. Let us do our job. “Oh, Margery, how good of you to come! How’re the kids? Good! We’ve been here for hours. He’s hurting – aren’t you, Jo? How’s your aunt’s dog? I saw him on Facebook. Not your aunt’s? Her neighbor’s?”  as we wait to speak to the patient. It’s a treatment room, not a cocktail party.

14. In the ER, VIPs fare poorly. Asking: “You know who I am?” won’t buy you special treatment (unlike our usual crappy one.) Unless you’re here often, and then your special treatment may be a care plan. Few people like them.

15. Don’t take away your loved one’s glasses and hearing aids. They’re expensive, and they may get lost, but your loved one needs to communicate. Taking away their senses is like blindfolding them before sending them to a scary new place.

16. Ditto for dentures. We promise we won’t steal them, even if they look real.

17. Bring them something nice: a book, a picture of the cat, a letter from the kids.

18. Don’t bring them alcohol or drugs. Even if they ask for it. If that’s what they need, they’d be better off at the bar down the road.

19. Ditto for cigarettes, lighters, guns, knives and razor blades.

20. Don’t make a point of taking notes. Why document for trial before badness even happened?

21. Don’t record us during procedures to put us on social media, even if you love Dr. Pimple Popper. Our makeup is never on point, and we don’t get Hollywood pay.

22. Advocate for your loved ones, but don’t tell us what your hairdresser said we should do. Same with Dr. Google. We’ve all heard of Google and Facebook. We’ve even had a little training beyond that.

23. Don’t get touchy-feely with us. We don’t look for dates at work. That’s what Tinder is for. Plus, those stains on our scrubs? Probably not coffee. Keep your hands to yourself.

24. Please talk to your family. We’ll talk to an extra person or two – the mother, the nurse, the POA. Not to all 12 siblings, though we understand they’re lovely people.

25. In the ER, “He has a high pain tolerance” means: “He has a high tolerance for pain meds.”

26. Don’t threaten us. It won’t get you what you want unless it’s a security escort. Talking about lawyers won’t help either.

27. Don’t key our cars. Don’t slash our tires. Security cameras are everywhere. It won’t feel good for long.

28. Do what your loved one would like. If they like flowers, bring them flowers. If they like Sudoku, bring them Sudoku. If they want DNR, let them be DNR.

29. Don’t lie to them unless they want you to. We all deserve the truth if we can handle it.

30. Don’t give them their home meds. They may make them worse. They may even be why they’re sick.

31. Don’t wait until discharge to bring up new issues – like yesterday’s chest pain.

32. Take notes of the doctor’s explanation, discharge instructions, follow up. Ask for permission to record it for your loved one to revisit later.

33. Feel free to ask about our credentials. We love to brag.

34. Not all males are doctors. Not all doctors are male. Not all females are nurses.

35. Let us know if you’re a health care professional. If you introduce yourself as a doctor, please be aware: In the ER, the only real doctor is a medical doctor.

36. Most patients worry more about their kids, pets or spouses than about themselves. Who’ll take Joey off the bus? Who’ll let Trixie out? Who’ll get Hubs’ dinner? Help them plan so they can stay to complete their workup.

37. Don’t bring infants, immunocompromised, or anyone who doesn’t need to be here. The ER is Germs Swing Disco. Don’t expose your newborn, your pregnant wife or your mom who’s on chemo to unknown badness.

38. Limit visitors. Patients in crowded rooms get worse care. They can’t rest. Performing a rectal exam or getting a urine sample is like relaxing in Walmart – desirable, but unlikely.

39. Get them out of here ASAP. In the ER, every moment is fraught with peril. Every sneeze can be the flu. Every handshake can get them sick. Take them home.

40. Bring them back. If they get worse, if they don’t get better, if you can’t follow up as directed.  We’d rather correct our mistakes than bury them.

Rada Jones is an emergency physician and can be reached at her self-titled site, RadaJonesMD, and on Twitter @jonesrada. She is the author of Overdose.

Image credit: Shutterstock.com

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40 pro tips for your loved ones’ ER visits
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