Thursday, August 16, 2007

ER Wimpgar

I came across this recently when I was cleaning out some old papers and thought some of you might appreciate this.

The following Wimpgar was a collaborative effort among the ER staff I worked with when I first started working at the hospital about 20 years ago. Most of the people have long since moved on. They were and are some of the most compassionate and dedicated professionals I have had the pleasure of working with.

My M.I.A. ER nurse friend from Miami may remember this. BTW - this nurse was my first friend at the hospital and the first one to invite me back to hang out with the ER staff and is therefore responsible for my corruption - in a good way. :) Ha! One night we were walking out after our shift and she said to me,"You know...we are totally different and I don't know why I like you...but I do." I agreed because I felt the same about her. She was/is an excellent nurse and a good friend. (just never see her anymore!)


You know they are wimps, but how do you document it? Wimp titers can be ordered by MD's, but most facilities take days for results.

The Wimp Scale will make an accurate, quick, and uniform assessment.

Give 2 points for each applicable categories.

__ 1. screaming upon arrival
__ 2. hyperventilating
__ 3. crying when uninjured part is palpated
__ 4. asking inane questions; Do you have a doctor here? Have you ever done this before?
__ 5. exacerbation of pain when audience arrives
__ 6. prolonged compensatory whining
__ 7. requesting general anesthesia before registering
__ 8. demanding 100% of the staff to give 100% of all nursing attentions 100% of the patient's

0-4 wimpitis vs chronic whiner

4-10 acute & chronic wimpitis

10-16 terminal wimpitis

Nursing Intervention

a. Put in room far away from nursing station
b. Banish all family and clinging loved ones to OP
c. Refuse to cut any clothing, especially tight long underwear- explain said cost of garments
and need to be thrifty, review sky rocketing health care costs
d. Ignore all crying & associated whining, unless death is imminent.

I have to say that I am not at all an ER wimp. That 1st rabies vaccine is a tough one and I didn't make a sound..because I passed out. No I didn't -I handled it. Sutures no problem. Blood work -can I watch? Keep me waiting? I'm a patient patient. Kidney stones -more drugs please, still doesn't touch the pain and I am nice and try not to bother the staff.

I will say that a couple of weeks ago, I did for the 1st time ever have a mini meltdown after being in the ER for 11 1/2 hours, from 17:00 to 04:30. Just a few tears while waiting to go up as an admit to the floor. This is because I was in pain, FREEZING, exhausted, hungry, alone, and concerned with the dx while I was an ER patient. I know better. I know how hard they all work. I heard the rigs rolling in one after the other. I will do a future post on this experience. No - I am definitely not an ER wimp.

But put me in the Urolgist's office and I AM A TOTAL WIMPETTE!!!

My urologist is a great doc and he and the office staff go out of their way to ensure that I am comfortable, etc., but do an office procedure - I don't care what it is - I am a wimpette, even if I have percocet in me. I find those uro procedures to be exquisitely uncomfortable!

I wonder if there is a UROGAR or more appropriately a UROWIMPGAR? :)


Elaine said...

Hi Seaspray, absolutely LOVE your Wimpgar score.

Sorry about your medcal problems. Betterness soon.

SeaSpray said...

Good morning Elaine!

Yes -pretty funny. :)

I am much better now - Thank you.

Chrysalis Angel said...

That brought a slight smile to my face. I saw somewhere one guy's take on how the pain scale should go. I wish I'd copied it. It wasn't someone I usually read, but that was good!

SeaSpray said...

LOL! We just posted at exactly the same time!

Only a slight smile? Not a full smile? Your not rotfl?

You know I am teasing you. :)

Pain scale? I have learned from the blogging ER docs that you can't go over a 10 with the pain scale. Seems to make em crazy. :) Now I know why my uro doc had a momentary look of disagreement when I said my pain had been a 12 when I was relaying a post-op incident to him.

I recently read where another blogger described their pain as a 25.

I only have Done that because I am emphasizing the fact that the pain was horrible. Evidently totally unnecessary. :)

Chrysalis Angel said...

Ha, that made me laugh Seaspray - I can see them flipping out now. Now I'm tempted to do it just to raz them...Then quickly explain sense of humor could get me into trouble. I just get sooo tempted at times.:)

SeaSpray said...

LOL!!! Yeah, we ought to go into random ER doc blogs tell a true story but then say our pain scale was a 38 or better yet a 10 1/2 or 10 3/4! How about a 7 2/3? :)

(it seems I'll do anything to avoid going out to look at cars today -leaving now!)

Using the criteria they use for the pain scale, I shudder to think what condition a patient with a 38 would be. :)

Anyway, I figured writhing in pain while vomiting incessantly would be a 10 but based on an ED pain scale I saw recently - that would only come in as a 7 or 8. YIKES!

SeaSpray said...

That is writhing in pain with a big kidney stone that isn't passing with incessant vomiting would be a 10 and was surprised to here it wasn't.