Determining Severity

I’ll keep this short. The emergency room is not a fucking deli. You don’t take a number, and are then seen when a room becomes available. Don’t come bitching to me that people who arrived after you are being seen first. Patients are seen in order that they need to be seen. Your tooth pain is not going to be seen before someone who can’t breathe. Period. As I’ve said before, don’t be a dick.

So here’s how the process works, and pay attention so next time you go to the ER, you don’t ask a retarded question.

After you check in, a nurse will triage you. This means he/she will do a basic evaluation to determine if your complaint is bullshit or not. The bullshit-o-meter is based off of two main questions.
1.) “Does this patient need immediate life saving intervention?”
2.) “How many resources will this patient need?”
The answers to these two questions will determine your place in line, and basically how long we have to watch you go “Ahh. Ahh. My jammed thumb hurts so bad” off in the corner while we quietly mock you behind your back. The nurse will have assigned you a number between 1 and 5 in the computer system. This is your ESI (Emergency Severity Index) number. ESI 1 means you require immediately life saving intervention like, you know, when your heart stops. ESI 5 means you should have stayed the fuck home. “But wait, how can the nurse determine that in just a few minutes of interaction?” Because we went to mother fucking school that’s how. Oh, and by the way, our bullshit-o-meter works when you lie too. “I’m here because my back hurts and someone stole my pain meds….oh….and I have chest pain.”
“I’m sorry to hear that. We’ll call you when we can” *assigns patient an ESI 5*.

Every damn day I get the following questions and complaints:
“How much longer? I’ve got things to do”
“How come people that came in after me are already being taken to a room?”
“My ear hurts so bad. I need a doctor now or I’ll sue.”
“This is a joke. This is supposed to be an emergency room. I’ve been here 6 hours”

Fuck, I once actually had a mother bring in her 3 year old with a fever, and stand outside another patients room trying to get our attention. While we were actively performing CPR on a dying man, this woman said, “Excuse me. How much longer? We’ve been here an hour and my son is really warm” I shit you not this lady actually wanted us to kill someone because she was too stupid to give her kid some Tylenol at home. The thought of stabbing this woman crossed my mind briefly. She’s lucky her child was there. Instead we all collectively told her to kindly fuck herself.

So now you know how patients are picked to be seen. Don’t bitch when people are seen before you. That’s a good thing. That means you’re not dying


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