Not ER, but still a highly informational case where I was "lucky" enough to be an observer.
When you are a male going in for a simple, outpatient procedure involving your upper thigh, please empty your bladder completely and fully before being wheeled into the procedure room. Otherwise, this might happen....
Patient is brought in and prepped. Has opted for a light, conscious sedation with plenty of lidocaine. He is hooked to an IV at a high flow rate and given versed and fentanyl premedication. For some reason, the surgeon is delayed (discussing another case with a resident or something...) Anyway, just after the surgeon comes in, the patient asks for a foley.
You all know where this is going. But it's the details that make it sooooo much better.
Patient is asked how bad he needs to go. He says something non-committal. Surgeon says a foley is not indicated at this time. Procedure begins.
Procedure goes on for a half-hour or so, then the patient again asks for a foley. Nurse grabs a urinal and tried to get a response. However, the patient explains that he has a case of urinary retention and, being a second year med student, insists he knows a little bit about what he's talking about. Apparently some part of this goes over everyone's heads, because they leave the urinal nearby but do nothing more at that point.
Then two things happen at once. The surgeon asks for the urinal to be moved further from the surgical field, and the nurses switch shifts. In the confusion, somehow the urinal gets lost and the incoming nurse has no idea that the patient has complained of urinary retention while simultaneously claiming to know a little bit about said condition.
New nurse goes to assess the patient and finds him more responsive and oriented than she had anticipated. Patient asks her for a foley, as she is a new face and might say yes. Nurse says "the chance of UTI are very high," as rationale for denying the request. Someone else mentions "He's asked that twice already."
Apparently the new nurse diagnoses the patient with excessive nervousness or tension. She prepares a little bit more versed and fentanyl and tells the patient he's going to get a "little bit more medicine." Patient says "Okay."
The amount she gives is a tad more than was strictly needed. As a result, around two minutes later, the patient becomes incredibly and abruptly disinhibited as his urethral sphincter relaxes and releases a vast amount of pressurized renal filtrate. In the ensuing controlled chaos, the surgical site and surgeon get splashed. Also, the urinal can't be easily found, which results in a large amount of renal filtrate being absorbed by towels, sterile drapes, and running onto the floor. The chaos results in the patient giggling uncontrollably as if he's been given a large dose of opiates (...oh, wait... he has).
The surgeon has to leave the room to scrub up again. As he leaves, he barks orders to everyone in view. By the time he returns, the mess is cleaned up, all the sterile dressings have been changed, the patient is out cold, and there is a foley in place to prevent any of this from happening again. The rest of the procedure goes by swiftly and smoothly, with virtually no talking between anyone in the room. The surgeon is obviously frustrated, and he has enough clout that no one wants to risk annoying him more.
The lesson? Empty your bladder before your procedure, otherwise you may wake up and find yourself in recovery, with a foley in place, and more dope onboard than you ever anticipated.
...Oh, and a surgeon who doesn't want to speak with you for extended periods of time.
...And... you may be the joke of the ward for the next couple days.