I haven't heard of "self-service er's." What's that about? How does it work? I recently had a patient who got tired of waiting for the doctor to make rounds so he, the patient, just got up, walked off the nursing unit and over to the doctor's office next door to the hospital, without telling anyone. At the same time, the doctor happened to make his rounds and came to find me to ask me where the patient was. As I started looking for the patient, he just happened to be walking back onto the unit (because the doctor was out of his office). The same patient, after being seen by his doc, remembered that he wanted a sleeper for the noc and so came back out of his room to the nursing station where the doc sat writing his note, and the patient asked for and got his sleeper order. I thought to myself this patient should just give himself his own iv antibiotics, take and record his own vital signs, etc. How this could be applied to an er I don't know. Don't people come to er's because their health condition has suddenly become more than they can handle on their own?