I’m a medical student that is aiming for emergency medicine, and threads like these are a special kind of demoralizing. When I was working as an ER tech, there were a fair few times where aggressive or combative patients would only let me get anywhere near them for anything because I never showed any judgement or disdain. Not that I blame my coworkers. It’s hard to treat someone nicely after they fake having an overdose in the lobby and then assault one of the nurses after they “wake up” from the narcan.
I honestly think that most medical workers are a victim of the healthcare system and pharma drug pushing as much as the patients. If there was affordable healthcare and a focus on helping people live healthy lives, there wouldn’t be so much drama and life threatening decisions.
I know that the general public’s idea of what ERs are for doesn’t help. EMTALA doesn’t mean that everyone who comes into an ER will get treated for anything regardless of ability to pay. It’s that they’ll be treated and stabilized for any emergent medical condition, illness, or injury… And many people seem to have interesting ideas about what constitutes an “emergency”.
The presumption that every patient is someone who fakes an overdose until proven otherwise is precisely why so many people in this threat is suffering. We aren’t asking you to serve narcan on a silver platter to people who fakes an overdose. We’re just asking to be treated as humans, with empathy, without preconceptions about who we are or why we are at the ER based on our skin color, sex, age, and chronic medical conditions.
Trust us, we know what it’s like to feel demoralized at the ER. I’ve had enough close calls of neglecting life threatening conditions, enough of ER staff laughing off my pain, enough ER staff deliberately manhandling me and hurting my tender points to prove I’m ‘overreacting’, enough of waiting 6 hours only to be sent home with nothing and in more pain than I was to begin with, enough of being left to cry in pain for hours at the ER and being ridiculed for it. Many of us are demoralized to the point of fearing the ER and avoiding it even under life threatening circumstances, because going through another ER experience might be the tipping point to actually kill ourselves.
There is only so much suffering, pain, and psychological torture the human mind can endure. Most people in the ER have no idea how much chronic pain sufferers have at stake when going to the ER. I have had ER visits that left me more broken than being sexually assaulted as a teen. I trusted doctors, I trusted the hospital, and I trusted that I was in a safe space. Being painfully jabbed, mocked, laughed at, and told im lying and drug seeking were the last things I was expecting. Nothing will repair this breach of trust, because the stakes are too high. I cannot gamble away my physical and mental health for the sake of improving moral in ER staff. For you, at worse you become disillusioned with your career. For me, it’s my life that I’m risking.
He came in for an entirely unrelated complaint and faked the overdose to get taken back immediately. The only drug in his system at the time was meth. Literally every room was full except for the resuscitation bay where we took him, and we had to keep him there for almost 2 hours until we had somewhere to move him to. It was the biggest of the resuscitation bays we had, so if we had someone coming in that needed ECMO, we’d have been kind of fucked.
I wish we hadn’t had to deal with that guy. Every nurse in the department had minimum 5 patients, mostly high acuity, and his stunt backed up the department for an extra couple hours by pulling unnecessary attention. I much rather would have been helping the nice gentleman in the lobby who had been waiting 5 hours with chest pain and a cardiac history, or the sickle cell patient in pain crisis.
I don’t have a problem with drug seeking. Pain is horrible and substance use disorders are diseases, not moral failings. I do have a problem with attention seeking, malingering, and abuse or assault of staff. As a physician, I plan to treat pain appropriately with the necessary medications or therapies, and to treat abuse of my staff with extreme prejudice.
And an edit to add: a drug overdose is treated as the same level of emergency as a cardiac arrest. We don’t serve Narcan on a silver platter, we serve it via wide bore IV while getting set up for intubation and resuscitation if it fails because we mean to move heaven and earth to keep the patient alive. An OD gets you to the front of the line, almost no questions asked besides “what substance?” so we know what antidote to give.
I’m terribly sorry that you have had that experience, and I’m disgusted with people who have treated you that way. However, you are making similar assumptions about me that other people have made about you. Working as an ER tech, I’ve literally had mental health patients try to strangle me, then given 10 minutes or so to shake it off, and then run straight into another code on a 16 hour shift that did not include any other breaks besides that 10 minutes… and then I came back 8 hours later for another 16 hour shift because the department was so understaffed that it would have been disastrous if I called out sick.
I’ve come into work, wholly unrecovered from a kidney infection and my own trip to the ER as a patient, and never let a whisper of it show on my face so that I could provide the best care possible for my patients. I’ve been the patient in the waiting room with 9 out of 10 pain for 6 hours, and I know how much it sucks. That’s part of why I do everything I can to give every patient the time, attention, and care that they need to heal them as much as I can.
I’m sorry you had to deal with that awful guy. Abuse of staff isn’t something that you should tolerate, nor am I asking you to. All I ask is that patients are not profiled as this guy until they have proven otherwise.
This is a systemic issue, not something that you’re expected to fix alone. I’m not blaming you for all the failings of a medical system that is understaffed, underpaid, and overcharged by insurance companies. I’m just asking that people who have suffered at the ER before be heard and believed. I have tried countless times explaining the extent of this systemic issue to medical professionals, and was met with skepticism and outright disbelief about the magnitude of this issue. The many anecdotal experiences from ER visit should give an idea of how common this is among ER visitors.
Yes, it’s true that both sides are making assumptions here. However, patient assumptions that ER staff are capable of causing harm are there to keep themselves safe, and don’t turn them into abusive patients. Discriminatory assumptions made by ER staff can turn them into abusive staff.