Emergency Room Visit

July 9, 2008 at 9:20 pm (Family Life)

To keep you from worrying, everything is fine.  My wife suffered hyperextension of her fingers & wrist, and sprained her shoulder and neck, and has a nice sized goose-egg on the back of her head.  But she’s home and relatively comfortable, even after the shot has worn off.

My wife fell Monday evening, and injured her hand/wrist/arm/shoulder, as well as hitting the back of her head on our table.  After a call to our HMO, we called 911 and she went in the ambulance to the emergency room.  A friend of ours who is an EMT came over and went with her in the ambulance, as I gave the kids instructions and followed a few minutes later.  The fall happened about 7:15pm, the ambulance left about 8:00pm, and I got to the ER at about 8:30.

Because my wife was having pains in her neck and back, they strapped her to a backboard to immobilize her  during transport and until she could be checked.  This was made worse because of the bump she received to the back of her head, and the complete lack of cushioning of the backboard.  When I arrived, she was still on the backboard, which was on a bed, sitting in the walkway next to the nurses station.

Here is a timeline of events after we arrived in the ER:

  • 8:30pm – Arrive in Emergency Room
  • 10:00pm – Removed from backboard and examined by doctor.  This required cutting her shirt off, so I went to the Marts of Wall(tm) for a replacement, during which time she was taken to radiology for a CT scan of her neck.
  • 1:00am – The scan of her neck showed an old injury, but no damage from this incident.  She was sent to x-ray for her hand/wrist/shoulder, during which time I took the friend of ours out to grab something to eat.
  • 2:00am – she was finally able to sit up enough to take a muscle relaxer, and they gave her an injection for the pain.
  • 3:00am – I went out to the truck to take an hour nap, as the lights in the ER had given me a headache.
  • 4:00am – Back from my nap, there was some disagreement as to if she needed another CT for her lower back, or if she had already had it done and we were waiting on the results.
  • 5:30am – Doc confirmed that she needed another CT for her lower back, as something on the previous one looked unusual, but was at the edge of the image.  I took our friend home so that she could get a little sleep before going to work, as my wife went down to radiology once again.
  • 6:30am – Back at the hospital, I called my boss & let him know that I wouldn’t be in.  Still waiting on the results from the last CT scan.
  • 7:30am – CT results are finally back, the abnormality was another old injury.  A prescription for a muscle relaxer and motrin, and we went home.

You will notice that missing from that list is ‘moved into room’, because it never happened.  We spent the entire time in the walkway between the nurses station and the row of rooms.

I can’t use the word ‘incompetent’ to describe the care that she received, as it wasn’t.  The doctor & staff did everything they should have.  The delay was entirely the fault of the radiology department, who has contracted out the reading of the scans.  Either that, or the staff there just decided to throw the faceless department under the bus.

It was, however, EXTREMELY slow care.  Slow enough that a woman who had been in a rear-end accident and injured her neck decided to have her family drive her to another hospital, after having waited over 7 hours on a backboard and in a neck brace.  Another family with an ill toddler tried to walk out, but was convinced by a nurse to stay.  They had only been there for four hours.

Compounding the problem was the perception that there were a TON of people there who weren’t doing very much at all.  The nurses station was an elevated ‘cube farm’ in the center of the room, ringed with patient rooms.  The dozen or so nurses and doctors spent the vast majority of their time involved in paperwork (or conversation) in this area.  The patients in rooms may not have been aware of what was going on outside, but from our vantage point, it was entirely visible.  The impression that I got was of a normal office environment where the majority of the work comes in spurts, the remainder of the time being taken up by socializing.  And the spurts of work really are an interference to the other activity.  NOT what you want to see in an emergency room.  Combine that with the extreme lack of communication typical for the medical profession, and I can easily see how anyone capable of leaving would do so.

And that doesn’t even begin to cover the lobby full of people waiting to get back to the emergency room.  Several of them had been waiting for the entire time that we were there.

So as not to present a problem without offering a solution, it seems that there are a few changes that could drastically improve the perception of what is going on:

  • Send a nurse, orderly, candy striper, janitor, someone around to each patient every half hour to see if they need anything and keep them updated on the status of what is happening to them.
  • Move the paperwork area  from the center of the room to the corners.  Keeping the number of people gathered around chatting to a minimum would go a long way toward convincing patients that they are the reason everyone is there, and not an inconvenience during an otherwise pleasant gathering of friends.
  • Be honest about what is happening and what is going to happen.  A whiteboard for each patient with a list of the tests & steps needed to be completed would greatly help.   It would have been nice to know what was coming next, and about how far we were before we were through.
  • Overhaul the triage process.  Backing up the entire emergency room with people waiting for radiology while the lobby is full of people doesn’t make any sense at all.  Not all patients need all services, so if someone comes in with a dog bite, they shouldn’t have to wait for a room to clear out because someone needed an x-ray.  Separating the patients by the services they will need would help to eliminate any single point of failure delaying everyone’s treatment.

There were a few amusing things that happened, so I had a few minutes of entertainment.  They have a pneumatic type unit like banks use at tellers to send things around the hospital.  Stuck to the front of the unit was a sign that said ‘DO NOT SEND URINE SAMPLES’.  I know the sign wasn’t put there before someone did it.  I just wonder how much of a mess it made.

Also, the police brought two people in.  One was a small woman who was either drunk or in an altered state of consciousness for another reason.  At one point she started screaming ‘help me, somebody help me’, which immediately got a lot of attention from the nurses.  That was until I told them that what she probably wanted was help getting out of the handcuffs.

After that ordeal, having been up for nearly 30 hours, I went to sleep when we got home and didn’t get up until that afternoon.

Advertisements

1 Comment

  1. Bookmarks about Geek said,

    […] – bookmarked by 3 members originally found by yoparts on 2008-08-19 Emergency Room Visit https://capitalggeek.wordpress.com/2008/07/09/emergency-room-visit/ – bookmarked by 1 members […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: