"I can tell, from the minute I woke up...its gonna be a lonely,lonely, lonely day."
Here is the break down, as I see it, for emergency room treatment in this area. First and foremost I feel that the average citizen, for the most part in the dark of most things medicinal, expects too much from modern medicine. They are not capable of being told "We don't know what is wrong with you.", or simply won't except it without cussing their doctor or nurse. Most are also not willing to accept that they are the reason they are sick, or that they might have to change some portion of their lifestyle to feel better. That is not the answers the doctors on Grey's Anatomy, ER, or Scrubs give their patients weekly.
Secondly, time and again I've had patients ask me "How long until I get to go to a bed?" or "How long until I can leave?" The absurdity of such a question floors me. And while it may be human nature to want to be better as quick as possible I'd want to be sure we've tracked down the problem first.
On a daily basis the St. John's emergency room sees an estimated 90-150 patients per 24 hour shift. Each one is there for a different reason. This means different test, treatments, and consultations with possibly 90-150 different family doctors (if the patient has one) or specialist if needed.
The time until you get to leave is based on how much time it takes lab to spin your blood, culture your nasal/throat swab, ultrasound to send your test results to a doctor and have them read, X-ray to have a radiologist read said X-rays, pharmacy to mix and deliver your drugs, house keeping to clean a bed (if you are being admitted), old charts to be found, and verbal reports to be given to nurses who will be taking over your care. This does not even count the time it will take for a Tech to take your vitals, your nurse to asses you, and finally your doctor to come in and make his initial assessment based on the tech and nurses' findings. Then to take all of the results, from each test, meld them into a diagnosis and choose a proper treatment plan that coincides with your specific medical history.
Lastly we deal with economical issues of Anderson. Many, and I'm not going to throw around numbers because I am ignorant of exact figures, do not have insurance, jobs, or family doctors. Many of these same patients are the ones who come in demanding simple, quick, free answers to their problems. If I had a nickel for the number of times I heard "I should have gone to Community.", per night, I'd be rich. I'd also be better off financially if I had a nickel for every patient that comes, to the EMERGENCY ROOM, for EVERY cough, sniffle, and sneeze. Forgive me for not wanting to participate in your "Emergency" while I'm trying to treat someone else who is having chest pain.
I understand that when you do not have a doctor you have to go somewhere for medical care. And I understand if it is late at night that MedCheck or MedOne is not open. I do know why you are sitting in front of me saying you've had a cough for one day and haven't been to CVS to buy some couch syrup. Because you don't have insurance, or you are on Medicaid/Medicare and you know that A)you are not going to pay your bill or B)Medicare/Medicaid will cover the cost of an $800-$1500 ER visit, but not an $8 bottle of Nyquil. Why do I know this? Because I've had patients matter-of-factly say so to me.
Call me cynical, say I've lost my compassion, but when you are bombarded with grown adults, many of the same ones on a nightly basis, that you are so familiar with their drug habits and professed "ailment" that you can recite their social security number without seeing their paperwork, you'll know how I feel. How many times can you sit there, straight faced, and be told "I'm here because someone broke into my house and stole my pain pills. I think they are called ox..oxycon..oxcontins or something." I know darn well you know the exact name of "your" pain medication. You likely know the exact street value of it. And IF someone actually broke into your house and stole it, it was because you weren't selling it at a price they could afford. I've never had anyone break into my house for anything, especially just to ransack my drug cabinet in my bathroom. You know why; because I don't advertise when I'm on painkillers to all my friends and family.
Who do I feel sorry for then? The children of the people I’ve mentioned above. Many are actually sick, and often times they come to the hospital days after they should have been brought in. When their fever is 104 and they are too lethargic to cry when you draw blood from them.
I feel for those who have no where else to go. No where to sleep that night, and maybe by telling us they are suicidal they can get a night in from the cold at the Anderson Center.
And when an elderly person is neglected and left alone, days after the family noticed a change in their level of consciousness (likely caused by a stroke), to slowly wither. But more often than not that same family member is the one cussing me for not getting the patient into a bed quickly enough.
What to do? Bite my tongue mostly. But I want to so badly say; "Do you know that the window for treating a stroke is 3 hours? And you waited how many days, after she started "acting funny", to cuss me for making you wait 5 minutes so we can clean some beds?"
I feel sorry for those who are truly sick. I think about them after I leave. I wonder what happened to them. I sometimes search for them upstairs and visit with them briefly. I look for their names in the obituaries and when I do not see their name I count it as a little victory.
I’ve been around long enough that 90% of the time I know who is sick, and who is faking. Whom is in dire need of help and who can probably sit in the waiting room while some more critical patients go back for treatment. I hear your comments about “that as*hole” taking back that “old person” before you, even if you did “get here first.” I see your gestures made behind my back after I try to explain it is not “first come first serve.”
And I hear you say, one last time as you walk out the door “I should have gone to Community.”
Lately I have responded to that sentence without biting my tongue. “Go to Community if you don’t like coming here.”
Be forewarned, if St. John's ER is busy it is VERY likely that Community ER is just as busy.
In short, health care is NOT Burger King. Things cannot always be “had your way.” You are asking us for help, and we are giving it as best as we know how. And believe it or not, as quickly as we can, because believe me, we would love to sit around and have no sick people there. We enjoy each other’s company and like to talk about our families and friends and where we are all going together next weekend. We also get a chance to eat dinner when there is no one there...and we all know I enjoy me some food. And while you are mad that you've been waiting on test results for an hour, I haven't peed or gotten a drink in the past 8 hours. I likely haven't sat down for more than five minutes during an entire 12 shift.
Dr. House is not on call to find the miracle cure to your "mystery" sore throat. At no point will Dr. Meredith Grey have a long soliloquy about "helping others" or her love life on the overhead speakers. And no, Dr. Carter is still not back from Africa.
Next time you are in the ER, for a couple of hours, think about if you are asking the impossible.
Ask yourself “How long will my test take to get results back?”
Not, “Hmmm…I wonder if Community could have gotten me in and out quicker?”
Secondly, time and again I've had patients ask me "How long until I get to go to a bed?" or "How long until I can leave?" The absurdity of such a question floors me. And while it may be human nature to want to be better as quick as possible I'd want to be sure we've tracked down the problem first.
On a daily basis the St. John's emergency room sees an estimated 90-150 patients per 24 hour shift. Each one is there for a different reason. This means different test, treatments, and consultations with possibly 90-150 different family doctors (if the patient has one) or specialist if needed.
The time until you get to leave is based on how much time it takes lab to spin your blood, culture your nasal/throat swab, ultrasound to send your test results to a doctor and have them read, X-ray to have a radiologist read said X-rays, pharmacy to mix and deliver your drugs, house keeping to clean a bed (if you are being admitted), old charts to be found, and verbal reports to be given to nurses who will be taking over your care. This does not even count the time it will take for a Tech to take your vitals, your nurse to asses you, and finally your doctor to come in and make his initial assessment based on the tech and nurses' findings. Then to take all of the results, from each test, meld them into a diagnosis and choose a proper treatment plan that coincides with your specific medical history.
Lastly we deal with economical issues of Anderson. Many, and I'm not going to throw around numbers because I am ignorant of exact figures, do not have insurance, jobs, or family doctors. Many of these same patients are the ones who come in demanding simple, quick, free answers to their problems. If I had a nickel for the number of times I heard "I should have gone to Community.", per night, I'd be rich. I'd also be better off financially if I had a nickel for every patient that comes, to the EMERGENCY ROOM, for EVERY cough, sniffle, and sneeze. Forgive me for not wanting to participate in your "Emergency" while I'm trying to treat someone else who is having chest pain.
I understand that when you do not have a doctor you have to go somewhere for medical care. And I understand if it is late at night that MedCheck or MedOne is not open. I do know why you are sitting in front of me saying you've had a cough for one day and haven't been to CVS to buy some couch syrup. Because you don't have insurance, or you are on Medicaid/Medicare and you know that A)you are not going to pay your bill or B)Medicare/Medicaid will cover the cost of an $800-$1500 ER visit, but not an $8 bottle of Nyquil. Why do I know this? Because I've had patients matter-of-factly say so to me.
Call me cynical, say I've lost my compassion, but when you are bombarded with grown adults, many of the same ones on a nightly basis, that you are so familiar with their drug habits and professed "ailment" that you can recite their social security number without seeing their paperwork, you'll know how I feel. How many times can you sit there, straight faced, and be told "I'm here because someone broke into my house and stole my pain pills. I think they are called ox..oxycon..oxcontins or something." I know darn well you know the exact name of "your" pain medication. You likely know the exact street value of it. And IF someone actually broke into your house and stole it, it was because you weren't selling it at a price they could afford. I've never had anyone break into my house for anything, especially just to ransack my drug cabinet in my bathroom. You know why; because I don't advertise when I'm on painkillers to all my friends and family.
Who do I feel sorry for then? The children of the people I’ve mentioned above. Many are actually sick, and often times they come to the hospital days after they should have been brought in. When their fever is 104 and they are too lethargic to cry when you draw blood from them.
I feel for those who have no where else to go. No where to sleep that night, and maybe by telling us they are suicidal they can get a night in from the cold at the Anderson Center.
And when an elderly person is neglected and left alone, days after the family noticed a change in their level of consciousness (likely caused by a stroke), to slowly wither. But more often than not that same family member is the one cussing me for not getting the patient into a bed quickly enough.
What to do? Bite my tongue mostly. But I want to so badly say; "Do you know that the window for treating a stroke is 3 hours? And you waited how many days, after she started "acting funny", to cuss me for making you wait 5 minutes so we can clean some beds?"
I feel sorry for those who are truly sick. I think about them after I leave. I wonder what happened to them. I sometimes search for them upstairs and visit with them briefly. I look for their names in the obituaries and when I do not see their name I count it as a little victory.
I’ve been around long enough that 90% of the time I know who is sick, and who is faking. Whom is in dire need of help and who can probably sit in the waiting room while some more critical patients go back for treatment. I hear your comments about “that as*hole” taking back that “old person” before you, even if you did “get here first.” I see your gestures made behind my back after I try to explain it is not “first come first serve.”
And I hear you say, one last time as you walk out the door “I should have gone to Community.”
Lately I have responded to that sentence without biting my tongue. “Go to Community if you don’t like coming here.”
Be forewarned, if St. John's ER is busy it is VERY likely that Community ER is just as busy.
In short, health care is NOT Burger King. Things cannot always be “had your way.” You are asking us for help, and we are giving it as best as we know how. And believe it or not, as quickly as we can, because believe me, we would love to sit around and have no sick people there. We enjoy each other’s company and like to talk about our families and friends and where we are all going together next weekend. We also get a chance to eat dinner when there is no one there...and we all know I enjoy me some food. And while you are mad that you've been waiting on test results for an hour, I haven't peed or gotten a drink in the past 8 hours. I likely haven't sat down for more than five minutes during an entire 12 shift.
Dr. House is not on call to find the miracle cure to your "mystery" sore throat. At no point will Dr. Meredith Grey have a long soliloquy about "helping others" or her love life on the overhead speakers. And no, Dr. Carter is still not back from Africa.
Next time you are in the ER, for a couple of hours, think about if you are asking the impossible.
Ask yourself “How long will my test take to get results back?”
Not, “Hmmm…I wonder if Community could have gotten me in and out quicker?”