50 Secrets the Emergency Room Staff Won’t Tell You

This astonishing insider information from doctors, nurses, and paramedics could save your life.

We do it because we care

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"We’re the only doctors who will take care of you first and ask questions about payment later, so we end up giving one third of our care for freeand lose about $100,000 of income a year. Yet we still do it. This is the best specialty in the world.” —Ramon Johnson, MD

Say "thank you"

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"In the ER, nurses provide most of the hands-on care. So be nice." —Donna Mason, RN (These are 50 secrets nurses wish they could tell you.)

An ambulance isn't a fancy taxi

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"When we arrive, don’t expect us to say hello. We’re focused on the patient. Once he’s stable, then we’ll introduce ourselves." —Don Lundy, paramedic, Charleston County, South Carolina (Doctors confess: Here are the 11 most annoying things patients do).

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Arriving by ambulance doesn't mean you'll get a red-carpet escort into the ER

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"You’ll get triaged like everyone else, and if you’re not that sick or injured, you’re going to wait." —Connie Meyer, RN, paramedic (Here are tips from doctors and nurses for a better, safer hospital stay.)

Yes, we know you're waiting... and waiting

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"Waiting is good. It means you’re not going to die. The person you need to feel sorry for is the one who gets rushed into the ER and treated first."

We need you to cooperate

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"When we say, 'Put on this gown,' we mean you should take off the clothes underneath so we can see the area that we need to examine. I once had a woman put the gown on over her clothes and her coat." —Allen Roberts, MD, emergency physician, Fort Worth, Texas

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If we tell you to stay in bed, we mean it

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"If we tell you to stay in bed, we mean it. Some medications make you uncoordinated, and we hate it when people fall down.” —Joan Somes, RN

We don't believe you

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"One of our favorite lines is 'You can’t fix stupidity.' If you complain of nausea and then eat a bag of chips, that’s what we’re thinking." —Joan Somes, RN

We play favorites

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"It makes me crazy when visitors wander around talking on their cell phones. You’re being annoying." —Joan Somes, RN

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We can only do so much

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"Not all ERs are equally equipped to deal with children. Check with your pediatrician to see which ER he or she recommends." —Joan Shook, MD (Here are 13 secrets your pediatrician wishes you knew.)

We're pretty used to people trying to intimidate us

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"Standing in the doorway and staring at us while we work won’t help your loved one get treated more quickly." —Joan Somes, RN

Speak up, please

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"An ER in a rural area might not have a doctor who is certified in emergency medicine, and the likelihood of having specialists on staff is very low. If you wind up in one, ask to transfer to a hospital that has more resources." —Robert Solomon, MD, emergency physician, Waynesburg, Pennsylvania

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We don't want you to have to come back

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"If you don’t understand what you’re supposed to do when you leave the ER, ask—and ask again if necessary." —Linda Lawrence, MD, San Antonio, Texas

Here's the 411 on 911

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"It’s incredible how many people having a heart attack drive themselves to the emergency room instead of calling 911. That’s just dumb. What are you going to do if you’re driving and your heart stops?" —Arthur Hsieh, paramedic (Never ignore these signs of a heart attack.)

Don't call from your cell phone

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"Calling from a landline can save your life because we can pinpoint your location instantly. If you call from a cell phone, we waste a lot of time asking where you are or searching for you." —Arthur Hsieh, paramedic (These are other dangerous first aid mistakes doctors wish you wouldn't make.)

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Denial kills people

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“Denial kills people. Yes, you could be having a heart attack or a stroke, even if you’re only 39 or in good shape or a vegetarian.” —Dennis Rowe, paramedic, Knoxville, Tennessee

Don't clog the system

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“Don’t call us for a broken finger. If there’s no real emergency, you’ve just clogged up the system.” —Arthur Hsieh, paramedic, San Francisco

We don't always use the sirens

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“Your emergency isn’t necessarily our emergency. In my region, we send an ambulance for all calls, but we don’t use the sirens unless it’s Code 1, which means someone’s bleeding or having chest pain or shortness of breath—basically things you could die from in the next five minutes.” —Connie Meyer, RN, paramedic, Olathe, Kansas

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Don't hang up on us

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“Don’t hang up after you tell us what’s wrong. The operator may be trained to give you instructions in CPR and other medical procedures that could be lifesaving.” —Dennis Rowe, paramedic

We're going to the nearest hospital

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“In a true emergency, we’re not going to drive 30 miles to the hospital that takes your insurance when there’s a good one two miles away. But if there are many ERs near you, know which one you prefer because we might ask. Find out where your doctor practices, where the nearest trauma center is, and which hospital has the best cardiac center.” —Connie Meyer, RN, paramedic

We'll respect your wishes

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“In most cases, we can’t transport someone who doesn’t want to go. Uncle Eddie may be as sick as a dog, but if he says he doesn’t want to get in an ambulance, we need to respect his wishes.” —Arthur Hsieh, paramedic

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We're not going to go 60 mph in a 30 mph zone

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“If the patient is stable, and 97 percent are, there’s no reason to drive 60 miles an hour on city streets. Have you ever tried to put an IV into someone’s arm in the back of a speeding ambulance?” —Don Lundy, paramedic

Out of beds equals wait time

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“We hate it too! But don’t be angry at us. If you’re waiting, there’s one reason: We’re out of beds.” —Jeri Babb, RN, Des Moines, Iowa

Come when we're not busy if you can

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“The busiest time starts around 6 p.m.; Mondays are the worst. We’re slowest from 3 a.m. to 9 a.m. If you have a choice, come early in the morning.” —Denise King, RN, Riverside, California

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Vomit gets you a room

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“People who are vomiting their guts out get a room more quickly. The admitting clerks don’t like vomit in the waiting area.” —Joan Somes, RN, St. Paul, Minnesota

We like the fast pace

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“We like the rapid turnover, so we don’t want you stuck in the ER while you’re waiting to be admitted. If we wanted to care for the same patient for hours at a time, we would work on an in-patient ward.” —Denise King, RN

Please know how the ER works

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“Never tell an ER nurse, ‘All I have is this cut on my finger. Why can’t someone just look at it?’ That just shows you have no idea how the ER actually works.” —Dana Hawkins, RN, Tulsa, Oklahoma

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Hospitals are overcrowded

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“Don’t blame ER overcrowding on the uninsured. They account for 17 percent of visits. The underlying problem is hospital overcrowding in general.” —Leora Horwitz, MD, assistant professor, Yale University School of Medicine, New Haven, Connecticut

Tell us your medical history

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“We don’t have time to read the background on every patient. So if you’re having stomach pain, and you’ve had your appendix or gallbladder removed, tell us so we don’t go on a wild-goose chase.” —Dana Hawkins, RN

Be honest

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“Be honest about whatever happened. Don’t be a hypochondriac, and don’t answer yes to every question. It will only screw up your care.” —Emergency medical technician, Middlebury, Vermont

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Know what medications you take

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“I once had a patient say he didn’t take any medications. Later he mentioned he was diabetic. I looked at him and asked, ‘Do you take insulin?’ He said yes. Well, that’s medicine.” —Allen Roberts, MD

Tell us if your kid isn't immunized

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“If you haven’t had your child immunized, admit it. That’s important information for us to have.” —Marianne Gausche-Hill, MD, emergency physician, Torrance, California

Visitors get in our way

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“Some ERs don’t allow more than one visitor per patient for a reason: You get in our way. Nominate someone to be in the ER and have that person relay information to everyone else in the waiting room.” —Donna Mason, RN, ER consultant, Nashville, Tennessee

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Tell us about any herbal treatments

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“Tell us about any herbal treatments you’re taking. I treated a young man who had put aseptil rojo on some abrasions. It turned his urine red—but we didn’t find the cause until after we’d done a lengthy workup.” —Marianne Gausche-Hill, MD (Doctors wish you knew these plain truths about alternative medicine.)

Tests will be done in the ER

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“It’s not uncommon that I get a patient who refuses to have the tests I recommend. I had a volatile conversation with a family who didn’t believe in medicine. What did you expect in the ER?” —Joan Shook, MD, emergency physician, Houston, Texas

Don't lie

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“Never, ever lie to your ER nurse. Their BS detectors are excellent, and you lose all credibility when you lie.” —Allen Roberts, MD

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We can tell when you just come in to score pain meds

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“Some of us are pretty good at spotting people who come in to score pain medication—especially if you’re specific about the drug you want or you don’t look like you’re in that much pain but you drove an hour from your home to get there.” —Denise King, RN

We've heard it all

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“We hear all kinds of weird stuff. I had a woman who came in at 3 a.m. and said she’d passed out while she was asleep.” —Emergency physician, suburban Northeast

Don't be entitled

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“Get rid of your entitlement mentality. It’s bad in your general life but really bad in the ER. We’ll treat you, but we might not be nice.” —Allen Roberts, MD

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We don't want to hear it

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“Your complaints about your prior doctor will not endear you to us. The more you say, the less we want to deal with you.” —Allen Roberts, MD

We vent to each other

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“If you come in with a bizarre or disgusting symptom, we’re going to talk about you. We won’t talk about you to people outside the ER, but doctors and nurses need to vent, just like everyone else.” —Emergency physician, suburban Northeast (This is some of the outrageous medical lingo doctors and nurses use behind your back.)

We can't always give you answers

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“If you come into the ER with a virus, don’t get mad if we can’t tell you exactly what it is. If we’ve ruled out any serious problems, you’re going to have to follow up with your primary care doctor.” —Jeri Babb, RN

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Don't come with cold symptoms

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“We really don’t have anything to offer the person who comes to the ER with cold symptoms that have lasted a day or two. It’s a waste of everyone’s time.” —Emergency physician, suburban Northeast

Don't overmedicate your kids

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“It’s common to see families who have overmedicated their kids with asthma medication. You can’t just give your children two or three times as much as they’ve been prescribed.” —Joan Shook, MD

You might have to wait in the ambulance for a bit

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“Because so many hospitals are overwhelmed, we may not be able to unload the ambulance as soon as we get there. We’ll stay with you until we can hand you off to the nurses. We do the best we can with a bad situation.” —Connie Meyer, RN, paramedic

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It's your job to know your insurance

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“No, I don’t know what your insurance covers.” —Allen Roberts, MD

Have your doctor send orders to the ER

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“If your doctor sends you to the ER so you can be admitted to the hospital, ask him to send the orders to the hospital instead. It’s more paperwork for him but could be quicker for you. And it doesn’t jam up the ER with nonemergency patients.” —Denise King, RN

Don't try to test us

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“Some patients withhold information they’ve already received from their primary care physician just to see if we come up with the same diagnosis or treatment. Don’t. All you’re doing is slowing us down.” —Joan Shook, MD

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Be grateful

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“Some people have no clue how close they came to dying before being saved by emergency interventions. I’ve seen serious stroke, heart attack, and trauma patients lead normal lives after events that should have killed them. If only they knew.” —Ramon Johnson, MD, emergency physician, Mission Viejo, California

We can recognize an unusual diagnosis

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“ER staffs are pretty good at zebra hunting—recognizing an unusual diagnosis—because we’re looking at your symptoms with fresh eyes. We’ve diagnosed cancer and brain tumors in the ER.” —Joan Somes, RN

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