This is the time to speak your truth, especially if you want to stay alive and feel better. The healthcare team works for you, you are the boss. This is not the time to be embarrassed or shy. You must speak up, be forthcoming and honest. There is nothing you can say that we haven’t heard or seen.

You do not want to be misdiagnosed or your treatment delayed because you neglected to mention details about what you took, behaviors you were engaged in or watered down what you are feeling. For example, if you took some kind of recreational drug and don’t communicate that, we may eliminate certain relevant causes or differential diagnoses or administer you medication that can cause a negative reaction, possibly resulting in harm and worsening your condition.

It’s also important to ask the ER providers to be straightforward and honest with you and not leave anything out. Because ER providers have limited time with and knowledge about you, and by nature of the name itself, the emergency room is not the place where you will receive comprehensive care.

If you’re feeling short of breath, the ER provider may order a chest x-ray, some labs and a breathing treatment to improve your symptoms as the workup is done. If the chest x-ray shows a mass or fluids in the lungs but your symptoms have improved and you’re stable enough to go home, they will suggest you follow up with your primary provider for further care. But ask the doctor to be very honest. What could it be? Is this an urgent matter? Did my tests reveal anything else I should be concerned about?

Too many times I’ve seen patients leave the ER with improved symptoms but with test results suggestive of a serious diagnosis — like cancer or heart failure — yet, the information isn’t conveyed with gravitas to the patient.

And more often than not, a fair amount of ER users don’t even have a primary care provider. Either they don’t have health insurance or, if they do, they haven’t established a relationship with a primary care provider yet. Let your ER doctor know that. Establishing a doctor-patient relationship will take time and you may not have that kind of time to wait, which may result in the ER doctor admitting you instead because your problem could worsen during the time you’re trying to get an appointment.

And never assume that no news is good news. The truth is the ER providers are very busy and, again, they’re focused on your priority complaint. They aren’t going to do your full cancer or cardiac workup — and they’re not checking you for everything. They will check only necessary things based on your complaints and stabilize you so you can follow up with your primary provider and insurance plan.

Nurse Alice

Writing since April 2022 · 3 stories contributed