It's always a BAD sign when your patient signs into triage with a fully packed overnight bag ready to "check in".
What is this, a seaside spa?
If you FEED them, you'll never get rid of them. I had one dude check in yesterday 5 times for seizures. Always on his way to the Greyhound station, on his way out of town. No money to buy his meds, but backpack stocked with Absolut and Xanax. It took one meal to realize the spa was open and in service.
"EMOTIONAL DIARRHEA" is not a medical diagnosis. Especially when you can't even give me stool for a culture during your 6 hour stay at the spa.
If you come in with a complaint of chest pain, have EKG changes, then refuse cardiac enzymes and any other tests, WHY are you here? Especially when we had your previous EKG faxed over from another continent. And NO, you can't have any food right now. Spa Rules.
Don't come and bring a minor to the ER with a vague complaint like "chapped lips x 2 months". Especially if you're not the minor's guardian and can't sign consent. Especially if you won't give us Mom's phone so we can't get phone consent. Most especially when YOU reach Mom on YOUR cellphone and proceed to speak in Albanian to God-knows-who YOU say is Mom. And especially when we finally CALL Mom on our phone and she says NO WAY, what the hell is going on? tell her to take that kid HOME! It all smelled fishy from the beginning, and only went downhill. And the kid? "Hey, I'm not sick!"
Best Patient Award goes to the baby who swallowed a coin. He slept through everything: exam, x-rays, vitals, discharge instructions. We could use more of those at the Spa.