Be Honest in the Emergency Room

LEXINGTON, Ky. (Feb. 28, 2012) - The following column appeared in the Lexington Herald-Leader on Sunday, Feb. 26.

By Joanne Matthews

Be honest in the emergency room. <?xml:namespace prefix = owc /> Not telling emergency room workers the correct information about your drug and alcohol use can impair their ability to care for you correctly.

Here are just a few examples.

• You arrive at the emergency department in an ambulance after a car accident. The pain in your leg is intense. You learn that it’s broken in two places. You are given the standard medicine to help control the pain while plans are made for surgery. You get no relief and are given a second dose of pain medicine. You get little relief, and you begin sweating profusely and vomiting.

You didn’t mention your addiction to OxyContin. You are having withdrawal symptoms from the drug. But you didn’t share this history with the nurse. The emergency department physician reassesses you to try to find out the reasons for these new symptoms. Are they related to the accident? Did they miss something? What could be wrong? More tests are done. Your surgery is delayed. Why? Because you didn’t speak up.

• You go to the emergency department complaining of stomach pain. After examination and blood tests, you are diagnosed with acute appendicitis.

While being scheduled for emergency surgery, you tell the staff that you have had very little to eat or drink for the last two days because of the stomach pain. You didn’t tell them that you normally have 12 to 24 beers a day. You are given IV fluids and are taken to the operating room. You are in the recovery room waking up from surgery. You feel restless and agitated, and you’re trembling.

The nurse taking care of you notices your changing status and notifies the doctor. Too late: You are now having seizures. You are experiencing withdrawal from alcohol because you didn’t speak up.

The Speak Up initiative that most hospitals are promoting encourages patients to speak up if they have questions or safety concerns about their care while they are in the hospital. For example, a medicine that you normally take at home looks different than the pill you are being asked to take. Speak up. Maybe it is the wrong drug. Maybe it is just a generic version of your medicine.

Speaking up honestly about how much you drink or use prescription or street drugs is for your safety, and it might save your life.

Hospitals are required to keep your medical information confidential, and emergency rooms staff will not call the police to report you for drug or alcohol use.

Whether you are addicted to painkillers, drinking under the legal age or using street drugs, your nurse will protect your right to privacy. Nurses can better care for patients who share their drinking or drug history. The ability of the hospital staff to care for you safely and effectively relies on honesty.

Between 25 percent and 40 percent of all patients admitted to the hospital have problems with addiction. But unless you speak up, the staff will not know. Not knowing can lead to delays in your care, many unnecessary diagnostic tests and possibly dangerous symptoms needing emergency and critical attention.

Be an honest partner in your health care. Allow those you trust to trust you. Take control over your health: Speak up about your drinking and drug use.

Joanne Matthews is a clinical instructor in the University of Kentucky College of Nursing.