Ways To Tell You’ve Spent Too Much Time In The ED

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docB

docB

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  • Ending patient encounters with “I’LL SEE YOU IN HELL!”

  • Pass group of young women on street and only thought is “Vag bleeders.”

  • Able to eat, sleep, talk on phone, read newspaper, etc. in same room as corpse and not think it’s weird.

  • Just sort of assume that everyone under 60 is on meth and everyone over is demented.

  • You’ve ever just thrown away a brand new pair of shoes after a day at work.

  • Are able to listen to and even retell, with a straight face, entire description of how can opener wound up in rectum.

  • Have ever intubated someone to avoid talking to them.

  • Believe you can diagnose a UTI by smell.

  • Have had threshold for what constitutes “a lot of blood” permanently raised to Dawn of the Dead levels.

  • Mental pain scale is 1-7=nothing, 7-9=might have some pain, 10=malingering.

  • Feel it’s not really hyperglycemia if the glucometer can read it.

  • Have ever run a pregnancy test on a 55 yo F because you’ve been “burned before.”

  • Have quit arguing about it and just order the foley that the nurse already put in.

  • Have ever said “It’s not Sunday. It’s Wednesday. It’s not July. It’s January. And even if it were 1978 Truman wouldn’t be the president now would he?”

  • Get terribly angry when you see people doing stupid things like riding a motorcycle with flip flops.

  • You agree that ATVs should be called quads but not because they have four wheels.

  • Have ever looked in the Bible for verification that mankind was given Haldol by God and Demerol by Satan.

  • A patient ends a long story that involves a hooker, a crack pipe, foul smelling discharge and a baggie full of oregano with the phrase "You know what I mean, Doc?" and you know what he means.

  • You’ve ever stripped down naked outside your house and walked directly to the shower after a day at work.

  • You’ve ever explained to someone how to use an anoscope (including the story about how your residency classmate proved you must always wear a face shield when using said device) while eating lunch and it didn’t seem odd.

  • You told a demented patient they were wrong about the month and then realized that while they were wrong you were wrong too.

  • You just naturally shout at anyone over the age of 55 or so because you assume they’re hard of hearing. Bonus points if you’ve ever accidentally done it in a social setting. Grand prize if you’ve ever done it to your inlaws.
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another great classic by docb
 
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docB said:
  • You’ve ever explained to someone how to use an anoscope (including the story about how your residency classmate proved you must always wear a face shield when using said device) while eating lunch and it didn’t seem odd.
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  • One of the funniest stories during residency was when an attending was showing me how to use an anoscope on a patient with lower GI bleeding that we thought was from a hemorrhoid.

    He says to the patient: "This is going to feel like a dildo going into your rectum."

    The patient says: "Wha, wha, what?!? Yo man, I don't want no homo stickin' a dildo in my arse. Get your gay arse away from me."

    I really didn't know how to react after witnessing all that. I never fully appreciated the humor of it until after leaving the room.
 
docB said:
  • Mental pain scale is 1-7=nothing, 7-9=might have some pain, 10=malingering.
Click to expand...

I have never had an ED pt tell me that their pain is less than 6/10. It's as if values that low don't exist. My favorite is those that tell you that their pain is 10/10 and are comfortably sitting there talking on the phone or texting or enjoying their free meal.

Great work docB.
 
Annette said:
I get all the others, but sleeping with a corpse???????? :eek:
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Once while on my second year trauma rotation (needless to say I was tired) I had crashed out on a gurney in the decon shower which at UC Davis is this fairly big, tiled room at the end of the hallway leading from the ambi doors to the resus bays. I'd been out for about 40 minutes (most sleep I got on that whole rotation) when my pager woke me up. Look over and someone had parked another gurney with a body on it next to me. The wild thing was that my first thought was not "Ewwwwww!" It was that it must have been a medical patient because my trauma pager hadn't gone off.
 
I'm no longer surprised at the 60 year old women with old school silicone breast inplants hanging off of her like two oranges in plastic shopping bags suddenly going into respiratory arrest. Turns out we didn't get her dilauded fast enough for her "12/10" rib pain..so she broke out her private stash and downed a few without telling anyone before getting her shot....nite nite grandma!
 
docB said:
  • Just sort of assume that everyone under 60 is on meth and everyone over is demented.
Click to expand...

*snort* :D

docB said:
  • You told a demented patient they were wrong about the month and then realized that while they were wrong you were wrong too.

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:laugh:
"Can you tell me what day it is?"
Patient: *looking around* "I dunno. What day is it?"
You: *thinking for a bit* *whispers to nurse* "What day is it?"
 
Wackie said:
*snort* :D




:laugh:
"Can you tell me what day it is?"
Patient: *looking around* "I dunno. What day is it?"
You: *thinking for a bit* *whispers to nurse* "What day is it?"
Click to expand...

I was in the ED one night when the dr kept saying it was Thurs, even in reference to getting a paycheck the next day. After about 5 hours, I realized she really did think it was Thursday, so I had to let her know it was really only Monday. :laugh:
 
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Walking down the hall when attending number one passes out right in front of me. I go grab attending number two, who walks over takes attending number one's pulse and announces "Yeah, its probably vasovagal" Turns and walks away, leaving number one on the ground. :eek:
 
I dictate my charts and in order to pause the chart to go on to the next chart you press 9 on the phone. I found myself trying to press 9 in order to end my call with an admitting physician one day rather than just hanging up the phone.
 
Dr.Evil1 said:
I dictate my charts and in order to pause the chart to go on to the next chart you press 9 on the phone. I found myself trying to press 9 in order to end my call with an admitting physician one day rather than just hanging up the phone.
Click to expand...

Or worse yet is when you find yourself reaching for the pause button when a consultant is on the phone but you get inversed in the conversation(s) around you.
 
I love it when people bring their luggage to the ED like they're going on a cruise....If you have time to pack your socks, crusty boxers, shaving cream, razor, and every other article of clothing AND most importantly your tattered copy of playboy (caught a glimps while he was digging out his medications) it's probably not an emergency admission. The best is as I'm leaving he says "I think I have rheumatoid arthritis and need to stay here," and the drunk in the next bed awakens from his deep slumber after siphoning off his second banana bag sporting fresh staples running across his head like a railroad track and says "Me too man...I got that I need to stay too :confused:"

BTW is referring to an intoxicated unconscious hispanic patient in the hallway with no ID as "Juan Doe" considered racist?
 
Lately for me its... Ways To Tell You've Spent Too Much Time In the VA

* 99% of medical problems are caused by Mustard Gas or Agent Orange

- The fact that you smoke 4 packs of cigs per day for 40 years has NOTHING to do with the end stage COPD you have, or the laryngeal cancer he has

* Agent Orgent evidently causes Cirrhosis as well.

- Again, nothing to do with the fact that you drink 8-12 beers DAILY for 30+ years.

The VA is killing me...
 
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EM OR BUST said:
ROTFLMAO!!!:laugh::thumbup:
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Glad to know I wasn't the only one who found that hilarious...but since it was prefaced by is it racist, I didn't want to be the first to laugh in public (grew up in an area where racial slurs were thrown all the time and half of the time I had no clue they were racist until I had to become conscientious...now I err on the side of not saying anything that has the possibility).

/back to thread now
 
In the winter months the 7am-7pm shift has made you forget what the sun looks like or if you working the night shift you realize you have the same hours as the meth heads.
 
docB - I just realized how much I've missed reading SDN!

:laugh::laugh::laugh:
 
EM_Rebuilder said:
Lately for me its... Ways To Tell You've Spent Too Much Time In the VA

* 99% of medical problems are caused by Mustard Gas or Agent Orange

- The fact that you smoke 4 packs of cigs per day for 40 years has NOTHING to do with the end stage COPD you have, or the laryngeal cancer he has

* Agent Orgent evidently causes Cirrhosis as well.

- Again, nothing to do with the fact that you drink 8-12 beers DAILY for 30+ years.

The VA is killing me...
Click to expand...
I did recently have a guy who claimed to be a homeless vet and a victim of Agent Orange in the psych ward. Amusing conversation:
Me: How did you get exposed to Agent Orange when you're only 35?
Patient: I was in the first Gulf War.
Me: They used a lot of defoliant in the Gulf War huh?
 
My buddy told me a funny joke about the VA


What's the difference between a VA nurse and a bullet?


A bullet will draw blood.
 
dmitrinyr said:
I have never had an ED pt tell me that their pain is less than 6/10. It's as if values that low don't exist. My favorite is those that tell you that their pain is 10/10 and are comfortably sitting there talking on the phone or texting or enjoying their free meal.

Nothing like the positive cell phone sign. :D

Great work docB
Click to expand...
 
I ran across a couple of these:

1) you believe some patients are alive only because it's illegal to kill them.

2) you recognize that you can't cure stupid.

3) you believe that any job where you can drive to work in your pajamas is a cool one.

4) you consider a tongue depressor an eating utensil.

5) eating microwave popcorn out of a clean bedpan is perfectly natural.

6) you've even placed a bet on someone's blood alcohol level.

7) you believe that not all patients are annoying...
some are unconscious.

8) your idea of fine dining is anywhere you can sit down to eat.

9) your idea of a good time is a cardiac arrest at shift change.

10) you believe that 'shallow gene pool' should be a recognized diagnosis.

11) you believe that the government should require permits to reproduce.

12) you believe that unspeakable evils will befall anyone who utters the phrase 'Wow, it's really quiet, isn't it?

13) you have even wanted to write a book entitled 'Suicide: getting it right the first time.'

14) you have ever had a patient look you straight in the eye and say 'I have no idea how that got stuck in there.'

15) you've had to leave a patient's room before you begin to laugh uncontrollably.
 
As a student, you know you've spent too much time in the ED when...

* Every time an instructor utters the phrase "Emergency Room," you utter a silent voodoo curse

* Your classmates recoil in horror at your lunchtime 'previous experience' stories

* You have to stop yourself from saying "no $@!t, Sherlock" a few times a month

* You smirk uncontrollably when students in clinicals complain about "mean patients"

* You recall working with those students, and pray not to become one of them.
 
Febrifuge said:
As a student, you know you've spent too much time in the ED when...

* Every time an instructor utters the phrase "Emergency Room," you utter a silent voodoo curse

* Your classmates recoil in horror at your lunchtime 'previous experience' stories

* You have to stop yourself from saying "no $@!t, Sherlock" a few times a month

* You smirk uncontrollably when students in clinicals complain about "mean patients"

* You recall working with those students, and pray not to become one of them.
Click to expand...

These are right on!! :laugh::laugh::laugh: Especially the lunchtime stories and "mean patients"
 
Is a tongue depressor not a satisfactory utensil for slicing department birthday cake? A scalpel is overkill for that, right?

More signs you've been there too long:

You can comfortably eat to the sound of retching in the distance, however McDonald's gives you nausea because of the association you've made since too many vomiting complaints have been accompanied with mostly eaten Happy Meals in the room.

You've stopped questioning how someone vomiting violently enough they feel they need "emergency care" can stop at McDonald's on the way to the ED.


You've met a non-disgruntled RT who's happy to do that breathing treatment.

You assume that the asthmatic smokes. No. You actually know the asthmatic smokes because you've seen that very same patient twelve times in the last three months who always says they're "going to quit after this".
 
When you can tell how many pack/years a patient has smoked from down the hall at the nurses station 30 feet away just by sense of smell.
 
I have friends who claim they can identify no fewer than four microorganisms by smell alone.

You know you've spent too much time in the ED when you move your spare trauma shears to the silverware drawer because you're sick of kitchen tools that can't cut through a bag, a box, a twist tie... a whole chicken... whatever.

You know you've spent too much time in the ED when you sit to watch the baseball game, see an injury, and mentally assign the poor guy an acuity level. And maybe a room as well.

In fact, you've worked the ED too long if you associate the time of year with a type of sports injury.

You've spent too much time in the ED if you're downloading a movie file online, and explain that you can't watch it yet because it's still "cooking."
 
You've spent too much time in the ER when

  • you can pinpoint rotavirus by smell alone.
  • you know 'spider bites' are never caused by spiders, but by staph
  • you know parents lie
  • except when they don't and in medico-legal terms, you're hosed
 
Febrifuge said:
You know you've spent too much time in the ED when you move your spare trauma shears to the silverware drawer because you're sick of kitchen tools that can't cut through a bag, a box, a twist tie... a whole chicken... whatever.
Click to expand...

This is normal, right. :laugh: I don't spend too much time in the ED. Really. And actually, two pairs are a safer bet, because you know they walk away...

I keep several pairs throughout the house. Best gardening tool ever.
 
You know that a kid eating Goldfish and Skittles is not a sick kid.
You know that Mom/Dad/Grandma will never think to give tylenol/motrin to the 3yo with the 104.5 fever. "He was so hot I just brought him right on up here!"
You know that there will always be job security as long as there are stupid people doing stupid stuff. You will still once in a while take care of people who really need you and be really grateful that you did.
 
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primadonna22274 said:
You know that a kid eating Goldfish and Skittles is not a sick kid.
You know that Mom/Dad/Grandma will never think to give tylenol/motrin to the 3yo with the 104.5 fever. "He was so hot I just brought him right on up here!"
Click to expand...

1st is positive Cheetos Sign

2nd is MPAS (my parents are stupid)

:thumbup:
 
....a non-disgruntled RT who's happy to do that breathing treatment.
Click to expand...

I believe that is better known as an RT student. :laugh: Once we get out of clinicals, we're pretty much all disgruntled.

I have friends who claim they can identify no fewer than four microorganisms by smell alone.
Click to expand...
Pseudomonas, rotavirus, C. diff, and trich?

Just sort of assume that everyone under 60 is on meth and everyone over is demented.
Click to expand...
Bonus points if they are all three (over 60, on meth and demented).

Have had threshold for what constitutes "a lot of blood" permanently raised
to Dawn of the Dead levels.
Click to expand...
I was called- by my own mother- "insensitive" because I corrected her when she screamed for me to come help that my brother had "just split his head open!". "No Mom, there's no gray matter showing. That's barely a flesh wound." Mind you it was 8" long "flesh wound" that require over 200 stitches.

A patient ends a long story that involves a hooker, a crack pipe, foul smelling discharge and a baggie full of oregano with the phrase "You know what I mean, Doc?" and you know what he means.
Click to expand...
Or you could just live in or near Pontiac, MI. :laugh:


You just naturally shout at anyone over the age of 55 or so because you assume they're hard of hearing. Bonus points if you've ever accidentally done it in a social setting. Grand prize if you've ever done it to your inlaws.
Click to expand...
I guess I win the grand prize. I did this to my father-in-law (or soon to be FIL to be correct). Ironically, he is also one of those people who blames all of his health problems on Agent Orange. About the only rebuttal I have not had to give yet is "Mike, the last time I checked, there's no evidence that dioxin is the source of crabs."
 
DrMars said:
1st is positive Cheetos Sign

2nd is MPAS (my parents are stupid)

:thumbup:
Click to expand...

I've seen it called "perioral cheetosis" on this board (maybe by EF)

SPS - stupid parent syndrome
 
I've seen it called "perioral cheetosis" on this board (maybe by EF)
Click to expand...

Actually, if memory serves me, DKM and Doctawife joked on one of the post padding threads about writing it up on for the CMAJ annual joke issue. However, I forget who originally coined the term "perioral cheetosis".
 
SoCuteMD said:
I've seen it called "perioral cheetosis" on this board (maybe by EF)

SPS - stupid parent syndrome
Click to expand...

Great to hear that the lingo is very consistent!

Here is a new one...

You know you've spent too much time in the ED...

when an attending, a resident and an ED tech spend an hour and a half in the ED with surgical instruments to gently separate the foreskin and zipper of a patient who zipped his "junk" into his fly after taking a "piss" in the backyard, the morning after a party.

----> post removal of the very difficult zipper....

pt to ED tech while in process of bandaging laceration: "what do you think about legalizing marijuana?

Tech: "......ummm I would be worried about other things first..."
 
You know you've spent too much time in the ED when:

You tell a frequent flier claiming to be suicidal "Yeah but you've never killed yourself any of the other times I've thrown you out of here. So lets roll those dice again."
 
docB, you are my hero. One of these days I might be brave enough to use this line on one of our favorites :cool:

Just had a super-sick delightful woman that we admitted for urosepsis, DIC, hypotension, yada yada, but quite alert and talkative (her schizoaffective d/o is currently at bay....) I threatened to bring all the whiners into her room because she is the sickest in the dept and she's not whining AT ALL. Except she's too sick to risk it.
gotta love the ER....

docB said:
You know you've spent too much time in the ED when:

You tell a frequent flier claiming to be suicidal "Yeah but you've never killed yourself any of the other times I've thrown you out of here. So lets roll those dice again."
Click to expand...
 
What about when you take a wrong turn and end up in the "bad" part of town and realize you know all the "street people" by name...
 
docB said:
Winner!: Could have phrased this better award. It both alarming and at the same time assumes the patient knows what that feels like.
Click to expand...

Actually, I thought it was alarming because it assumes the attending who said it knows what that feels like.
 
When you here a code blue called in the unit and rejoice that a bed might become available.
 
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