"What are they doing here?" asked Shannon. "They shouldn't be here. It's an emergency room, for goodness’ sake."
I nodded in agreement. "Yeah, can't they see we're too busy?" I added. At the time I had only been working in the emergency room for six months, and like all good junior staff, I was mimicking my seniors.
You see, the problem was that we were ridiculously busy, with every bed full and the waiting time a staggering four hours.
"I wish we could turn them away," Shannon said. "Oh well, they'll just have to wait. Maybe they'll choose to go to their family doctor when I tell them that they will have to wait four hours."
Shannon was irked that a mother had come in with her two children, four and six years old: both had diarrhea—and both could have been treated by their family doctor. There were always GP patients turning up to the emergency room and many if not most of the nursing staff had at some point vented their varying degrees of annoyance.
I genuinely felt this way myself at one time. But that all changed. A number of years ago one of my young nephews got sick with an ear infection. He ended up at the family doctor's clinic. One hundred dollars later he was sitting at home taking his antibiotics and analgesia. The doctor's fee was $65, while the medicine cost $35. Over the weekend he got worse, and he had to see the emergency doctor--another $150. Fortunately he got better. Unfortunately my other nephew developed an ear infection as well. Another $100.
Now I’m different when I see people in the emergency room who probably could have visited their family doctor. I'm much more understanding. It's not just about the money; it's about coming to the understanding that people often don't know where to turn. Patients come to the hospital for many reasons, but they all have one thing in common. They are worried.
Why would you bring yourself to hospital in the middle of the night when all you have is diarrhea? It's because you're scared. Sometimes people just need some simple reassurance and some education.
I still look up to nurses like Shannon and turn to my seniors for advice, but I no longer parrot their cries of despair at the inconsiderate GP patients. I haven't confronted them about their attitude, and it's too late now as I work elsewhere. But during my last several years in the emergency room, I did my best to make those often less urgent patients feel at ease and feel important. I guess it's all about caring.
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April 17th, 2008 at 7:18 pm
Four hours waiting time? You are lucky!!! The ER I work at is a busy one right outside of DC and the nurse’s are assigned hallway beds as well as regular rooms. Sometimes the wait can be like 8 hours. I really do feel bad for the patients, but you know it probably explains some of their irritability when they finally come back!
April 18th, 2008 at 4:06 pm
Your second to last paragraph makes a great point. Worry is a powerful thing. It’s even more frightening without a medical background.
I, too, work in an ER and get irritated when the GP patients come in… especially during office hours or when an urgent care is literally across the street. I forget that these patients do not have the education we do; they don’t know when to worry and when not to. Nurses aren’t immune to this, either – we see many nurses as our patients who are embarrassed b/c it’s a simple thing they’re worried about, or they’re stubborn and haven’t been worried about something serious.
Thanks for this. The misuse of the ER is a huge problem, as we all know, but we cannot change this overnight. Education and reassurance might be the best immediate treatment for this problem.
April 21st, 2008 at 9:41 pm
I had a patient this week who’s infant was in the Intesive Care Nursery. The infant came up to our floor – Maternity & Term Nursery – but no one had sat down with the mother to listen to her concerns and explain things to her. She had had an emergency c-section and all the little things just built up and build up over the next 2 or 3 days.
I had been on the previous two nights and seen the nurses struggle with how often she put her call bell on. I was dreading having her as my patient. 15 minutes after my shift started she put her call bell on and asked me to come in. She “wanted to get things straight.”
Apparently, right before I came on shift, the father tried to bring the infant back to the nursery so that they could get a little sleep, the nursery nurse snapped at him and told him to take the child back and feed him because he was crying and that she had 5 minutes left in her shift and that she couldn’t do it.
Not only that, no one ever took the time to listen to her concerns or answer her questions. That last incident broke the camel’s back.
I took 30 minutes to listen to her and do you want to know how many times she rang her call bell on my 12 hour shift? TWICE.
Just by listening to her and her husband, she went from scared and extremely upset to actually smiling and thanking me by the end of my shift.
A lot of times we forget that we aren’t just treating what is wrong physically. We’re treating a person. We can’t ignore the fact that there is a person who more than likely doesn’t have much of any control over what is happening to them. Just by listening to them and educating them, we give them a little bit of control back.
June 17th, 2008 at 3:16 am
I worked in the ER for two and half years and I remember in the beginning feeling terribly frustrated with having a full house and probably 60-70% of the patients not really needing to be there. At best they would have been just fine going to the Urgent Care Clinic. Many would have been fine just staying home and waiting out whatever was wrong.
And then I started learning more about insurance. Urgent Care’s can legally deny treatment if the patient is uninsured. The only medical facility that is required by Federal law to treat any and all patients regardless of ability to pay is the Emergency Room of hospitals.
After I understood that I no longer resented the snotty noses and sore throats that came into the ER. It was the only way many of them would ever get any kind of medical care.