Yes, I had, and they actually brought me meals during my 12 hour stay, much to the envy of other people waiting in the emergency room.
The overall wait time is going to depend on that particular hospital and its customer base.
The ER at San Francisco General Hospital is widely known for long wait times - 8 hours is typical for anyone well enough to walk in - because the hospital is the only trauma center for all of San Francisco, and they’re also the only hospital that accepts Medi-Cal psych patients.
Compare that to the ER at an HMO like Kaiser, and wait times are far shorter as there’s not a parade of ambulances bringing in car crash victims and homeless people that were found unresponsive on the street.
So, how do we get all of these people out of the ER? I can’t find the exact stat at the moment, but I’ve seen that over half of the people seen at SFGH’s ER have no insurance and no normal primary care physician. The ER is their doctor.
The op started out anouncing he was an anarchist. Pointing out the irony of complaining about the services provided by the establishment is no more pit material than the original statement.
Maybe the English I am reading is different than what you see, but in the OP he claims he is a stoic and a buddhist. Being at an anarchist bookfair does not necessarily make one an anarchist.
[ex-EMT ballcap on]
What kind of MD, What kind of RN?
Emergency services is not first come first served and they don’t advertise whats going on in the back when you walk in the door. They could be working a string of immediate life threatening patient situations for several hours, and running code blues and such is often a 3-4 person job. For the time that a critical patient is brought in and being stabilized its not unusual for little other direct care to be going on for 20-30 min even in a decent sized ED. In my day Fresno Community Hospital had 3 MD’s and 7 RN’s and an MICN or two, on duty in emergency. Two or three serious patients could keep all of them tied down for a while. In a large city its very easy to get a string of such patients 1 per hour or so, for 12 hours straight.
The normal thing I tell people when they are complaining about how long they waited to be seen was “Thats because you were breathing”.
I could write a couple thousand words on peoples misconceptions about how the world of emergency medicine works, but work will not permit right now. To sum it up, its about keeping people alive. Its not about who has the best insurance, the cutest kids, or might have a scar if they wait 12 hours.
The issue is not that he might have a scar. THE ISSUE IS THAT THE MD BLAMED THE PATIENT WHEN IT WAS NOT THE PATIENT’S FAULT! The patient had NOTHING to do with how long he was waiting, and had NO RESPONSIBILITY to know that waiting longer than 12 hours would cause an infection.
If I come into the ER with chest pain, they tell me they’ll get to me when they can, then 12 hours later, the MD says, “You idiot! Why did you wait? Now you have permanent tissue damage from your heart attack and are likely going to have a stroke due to that massive clot!”
How the hell should I have known any of that? That’s why I came to the ER in the first place!
That’s exactly what I was asking about. I had (and have) no objection to waiting 12 hours if necessary in an emergency room for a non-life threatening medical emergency. What surprised me was to be chided by the doctor for waiting that long, the implication being that I had some control over that wait. The only thing I can imagine is that I’m expected to raise a fuss, and that failure to do so is regarded as evidence that my problem is not very urgent or important.
Just adding my recent ER experience here:
My brother went to the ER on a Sunday around noon with an “infected toe”. He’s unemployed and uninsured, so my other brother just dropped him off at the local county hospital and called to tell me (the nurse) about it and ask me to follow up, warning me that the whole foot looked “really bad”.
I expected a long wait, so didn’t go check on him unitl Monday night. He was still in the ER on a gurney, admitted, but waiting for a room. He received a new diagnosis of diabetes and had a gangrenous foot.
He was moved to a room about 34 hours after appearing to the ER, made “NPO” and scheduled for surgery to amputate the some or all of the foot.
He finally went to the OR on Thursday.
I’m not clear about why it took so long to go to the OR. Did he need antibiotics? Were they busy? Do they schedule their OR’s the same way they do the ER’s? Were they waiting for him to get septic? All questions were met with “I don’t know”.
He was moved from a 4 person shared room to what he called a private room (really, an isolation room) because the gangrene smelled so bad and the other patients didn’t want to share the one restroom with him. Can’t say I balme them. Gangrene stinks.
The first surgery just carved away the bad part of the foot. He stayed another week and a half for a second surgery to clean and close the wound, which involved another couple of days without food, because “he needed to be ready for the OR at any time”, and then was sent home. He is unclear about follow up.)
Highlights:
*watching the ER nurses shove the gurneys around because the place was so crowded with gurneys that several needed to be moved to reach any particular patient;
*watching employees spill blood and then walk through the blood puddle and track blood all over the floor. This was never cleaned while I was there;
*watching two ladies get off their gurneys and get into a fist fight because one of them touched the other one’s stuff;
*finding the public restroom decorated with copious amounts of bloody toilet paper;
*finding a crusty, dried up, blood-covered glove in an alcove of the isolation room.
I ended a very long wait in an ER waiting room by barfing all over the only couch.
Yes. Now a covered wound with a dressing on it (my stiuation), that’s a different story. You can’t do sterile procedures requiring a glove.
An emergency delivery in the ED with a baby falling out is a clean, but not sterile, procedure. Neither the birth canal nor Mom’s associated involuntary pooping is especially sterile.
To the OP’s point of waiting: ED waits are too long in too many EDs. The issue is multifactorial, and we on the ED side need to do a better job as well. His personal wait can’t be put into perspective without knowing the clinician’s side of the triage and what was going on in the ED that day. Such a wait would not occur in my ED, but we run it substantially better than most.
Why would the nurse keep asking him if he was in a lot of pain, if nothing was done when he said he was?
I have the tendency to look at the details rather than the claims, and here unfortunately the two don’t sem to add up. First the text in the OP, then the self-selected username, then the bio that SmashTheState self-generated when he/she signed up here (click on his/her username to see it). That’s one heck of a buddhist as far as I can tell…
They may have tagged him as a hypochondriac, I under stand that some people make a habit of going to the ER simply to have someone to talk to.
Declan
Im not sure if Quebec is different from Ontario, but here the Hospital ER is the after hours clinic. Some might be open to late hours, but 24 hour clinics are far and few between. Smash is from Ottawa, if I remember correctly, so even if he has a pri care doctor, its about 4 hours away.
Your second point is basically the same ansewer, in Ontario they are not redirected because there is no where else to go. It might be different if hospitals were set up to handle both emergency critical care as well as non critical care patients that a corpman could mainly take care of, but the money and the inclination is not there.
Declan
Perhaps you were doing such a good job of being calm and stoic that the triage people were de-prioritizing you.
Not trying to be a smart-ass here – just that if when you were asked if you were in pain you’d “nod and smile” is it possible that they were getting the impression that the injury wasn’t too serious?
…which would still have been 8 hours quicker.
I remember waiting 12 hours plus at least twice in an ER. My usual migraine medicine just wasn’t doing the job and I was in severe pain-----on that stupid 1 to 10 scale, I would have rated my pain at close to nineteen. But----I wasn’t bleeding and none of my bones were exposed and I was in the only hospital in town and the ER people were plagued by addicts trying to con drugs. After my darling Marcie had bugged the hell out of them and had shown them the medicine I usually took and after they had talked with my doctor by telephone, I was given a shot of Demerol and an apology. The next time I saw my doctor, she told me about the addict situation. I guess I can understand long waits under those conditions but if I had been the OP, I would have forgotten about being stoic.
That’s my wild guess. I’ve said it before here, don’t minimize your* symptoms just because you’re tough or whatever. If they give you the “1 to 10” scale for pain, don’t overthink it with the “well, I’m not shrieking constantly so it can’t be that bad, so maybe my agony is really only a 7” line of reasoning. Don’t come up with exotic tortures to peg the high end of the scale at.
The doctor shouldn’t have been a jerk**, but my guess is that the triage notes showed something to the effect of that you answered affirmatively to questions about being in pain but did not show any. They’re not going to administer pain relief unless they believe that you are indeed in pain, and smiling and nodding doesn’t do it. You don’t have to be screaming, but you do have to express the extent of the pain.
- Addressed to both you and the general public, not singling you out.
** It sounds like from your recounting of the story that he was blaming you for improper triage when his team knew you were diabetic.
This exact same thing has happened to me several times, with my husband having to raise hell for me to be treated. I have called my neurologist and been ordered to go to the ER; still they won’t give me a shot without an extensive delay. I understand they have to screen out the drug seekers, but when my husband gives them the neurologist’s phone number and tells them to call to confirm, and they could have me out the door in literally 20 minutes, why don’t they want to?
I have since learned that asking for Toradol instead of Demerol is a great help, as it’s a non-narcotic that works just as well for me and it doesn’t raise suspicions. If you have never tried it, ask your doctor about it. It might work for you and is not a controlled substance.
I don’t think it’s unreasonable to expect that if you have a condition like Diabetes or heart disease, that you know a bit about managing the disease. One of the things you should know is that infections are much more likely for diabetics and can be much worse. Similarly, if you have heart disease and chest pain, that’s something the medical professionals might need to know about.
Now, in the case if the diabetic, if there are multiple people who need triage or they migh DIE, you needing triage to prevent loss of a finger isn’t likely to get you ahead of anyone. But you do need to give them all the info you can.