WhiteCoat

“Floor Throwing”

Want to get out of the waiting room more quickly when you’re in the ED? Throw yourself on the floor.

A patient who has been to our hospital 350 times in the past 8 years (that’s as long as we have been logging the visits) for complaints such as headaches (don’t worry about tumors – you’ve been radiated enough to cure any of those that might pop up) and back pain (no, mild bulging discs that haven’t changed on the last 12 MRIs are not a medical emergency) came during a very busy time. Isn’t it funny how severe pain incrementally increases on subsequent visits? If “0″ is no pain and “10″ is the worst pain in your life, how is it that someone’s pain can be a “10″ on their last consecutive 27 ED visits? I have to raise my eyebrows when someone with 350 hospital visits for pain complaints rates their pain as a “10″ on a 1-10 scale. Then the next day, after depleting the hospital reserves of Demerol, this poor soul is seen lifting grocery bags 4 at a time into the trunk of her new Cadillac. But I digress …

Not only were there no beds in the ED, there were no seats in the waiting room. She had to sit in a wheelchair. With a 10 out of 10 headache (that is worse than the 60 or so previous headaches for which she has sought treatment in the ED in the past 8 years), she didn’t like that very much, so she threw herself out of the chair and laid on the floor.

Of course, that created a problem because several of the patients who were waiting ahead of her then came up to the registration window and said “there’s a woman lying on the floor out here.” What those people didn’t realize is that this woman who was gaming the system just gamed them as well. She just jumped the line. She is about to cut in front of everyone. Yes, ladies and gentlemen, you’ve been waiting patiently but because the amount of circulating narcotics in this woman’s bloodstream has hit a critically low level, she will now be seen immediately – ahead of you.

The nurse came out to the waiting room and told her “Ms. Hammer, get up. You’re too heavy and I’m not going to try to lift you.” Of course, she got right up and sat back in the wheelchair. Then she was wheeled back into the ED with a smug little grin on her face.

Bottom line: floor throwing works

6 Responses to ““Floor Throwing””

  1. ERnursey says:

    Oh no, not at my ER they don’t. We don’t play that game.

  2. Kiki B. says:

    “Then the next day, after depleting the hospital reserves of Demerol, this poor soul is seen lifting grocery bags 4 at a time into the trunk of her new Cadillac.”

    WONDERFUL!! She won’t be needing any more narcotics for back pain. Taking all of your Demerol obviously cured her. CONGRATULATIONS!! Great job on curing a patient of chronic back pain. I am indeed impressed. ;-) Feel free to use this against her if she comes in again c/o back pain.

  3. Dr. WhiteCoat says:

    Kiki, I wish it was that easy. This lady pages her primary care doc to the ED from the ED phone to complain if she doesn’t get pain meds quick enough. She knows I won’t give her any, so usually if she hears that I am working, she will leave and go to another hospital.

  4. Michael says:

    Soon as she walks in you should have the front desk page you overhead whether you are working or not. Hearing your name she will hopefully hightail it out of there.

  5. burntoutnurse says:

    I think there is one or two..maybe 3, no I can think of 4, wait, wait, no 5 off the top of my head of similar patients I deal with on a regular basis in the ER. Sigh… some days I wish triage would be able to “just say no”….

  6. [...] the bias is gone. Swear at me, pretend that you’re passed out from severe pain, or engage in floor throwing and the bias is [...]

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