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you forgot a few problems
by Diana2
+1 Reply

In addition they don't have any responsibility to feed you, only the hospital does. Unless someone is with you to go to McDonald's and bring you some food and beverage to drink. You are basically going to starve while waiting for a room. I now see vending machines in the waiting area because of this problem. They can make more money off of these.

Next, they are now outsourcing emergency rooms to another company. Providence in Everertt, WA has done this. They say you are covered by your insurance if you ask ( I did), but because this company refuses to sign an agreement with your insurance company you pay a fortune when the bill comes, only the hospital bills are covered. You are going to pay at least 50% of a huge bill.

Next, I have brought my husband in on oxygen but the entire tank was used up on the drive and I needed another oxygen tank. I asked for help and was ignored. My patient went without oxygen until I could get back to the garage, get another tank, and get it to him. It's a half hour drive to get there and he needed a lot of oxygen. If you aren't admitted yet you are not their responsibility I guess. No one is really checking people who are seated.

Next, I went to his pulmonary care specialist at the hospital (with an oxygen generator this time) and tried to bypass emergency to get a room (he was in afib) and the doctor said I had to go through emergency to get a room. I have no idea why, maybe liability? His primary care physician taught me the trick where he makes a reservation for a room, by passing the emergency room which is there for no reason (as far as I am concerned) except getting a room and charging a fortune for their "service" plus a huge wait when my husband should be in intensive care.

In addition, you should always call 911 and have your patient delivered by the fire department when things might be bad. If you take your patient to a clinic (they actually have doctors working on Saturday, etc) they will just call the fire department for you. The fire department can jump the line in the emergency room.

I would say average wait for a room at Providence Emergency is being checked in at 7 pm and get a room at 6 am. Bring a book. However I don't know how long patients have to wait for admission since I know better than to go for minor stuff. I tell patients a clinic is a better bet if you actually want to see a doctor. The clinic might not always be open but Providence has 2 emergency rooms now, one for real emergencies.

I always got stuck waiting for a room and check in was skipped. Check in people can easily be panicked into letting you get in if you list the problems. You can also freak out the doctors but they pretend they aren't panicked.

My biggest problem with emergency room doctors is they send me home and I have to go back 2 days later with a seriously ill patient. They tend to dismiss things like pneumonia and stuff even though I know better and brought the patient early. Consequently I ended up with 3 day hospital stays or more every time. If any doctors are reading this, yes you can get bacterial pneumonia 3 times in a row.

In addition if you are stabilized and in a hallway lying there waiting for a room, remind them you are there and remind them to call about your room, again. Patients often get lost while waiting for a room.

In addition, we kept detailed drug lists (multiple copies) because the emergency room staff don't communicate with each other or the hospital and lose the list. Just keep handing out the copies. Until you are in a hospital bed and the right nurse whose job it is to setup your prescription database has done this, you aren't done. Providence has spent money on computerizing this it should be better.

The other thing to worry about is nurses going off their shift and wanting to leave. Shift changes are dangerous. My husband was sent home with a collapsed lung and another time was given way too much blood too fast and made ill. They also try to kick you out of recovery as quickly as possible when they need the beds. I asked about this beforehand because I suspected there would be a problem and was promised it was not an issue. I was having an allergic reaction and nobody paid attention until I upchucked. A large hospital is not a great place for surgery. I had a much better experience at a small one. I actually woke in a hospital room and not a place that looked like a factory.

Do not leave a patient alone if they are not fully aware of their surroundings and able to monitor their own care. My husband made sure he had the right blood (they had the wrong one once) and drugs administered, but one time he wasn't able to defend himself and almost died when they gave him something he was allergic too, then they gave him two shots for his allergic reaction instead of one (they lost track) and he had just been sent to that part of the hospital because he was considered better from open heart surgery and didn't need as much care.

Be very leary of small emergency rooms milking you, if you have insurance, maybe even if you don't. My husband and I have had very bad experiences with this. For instance insisting on an xray for a cat bite. These bites are more serious than I thought but I didn't need an xray. I got mad and left, but my husband got mad about his treatment and made sure a very large company no longer sent patients to that emergency room. We need to fight back.

Re: you forgot a few problems
by jesse obed boaz

DIANA2

Why would you think that you have some sort of right to be fed just because you're in an ER waiting room? Secondly, I've never met a seriously ill patient with a true medical emergency that had a "hankering" for some greasy McDonald's food.

Also, you seem to be quite the expert at making diagnoses, so why even bother seeking care from a qualified physician? All in all, your response is nonsense. You ma'am are part of what is wrong with our system.

Re: you forgot a few problems
by lizzyrein

Are you for real???? I would think that if your having such terrible abdominal pain, you would not want to eat anything from that vending machine you think the hospital is making money off of (which by the way is not owned by the hospital). Not to mention, by stuffing your face while waiting to be seen, you put yourself at risk of further delay in treatment should you need surgery since many anesthesiologists require a certain amount of time to elapse between last meal and surgery time. Why, you ignorantly ask? because you put yourself at risk of aspirating vomit into your lungs and acquiring pneumonia (now a very long hospitalization with potential for many complications). All b/c you are offended that we don't feed people. People need to take responsibility for themselves!

Next, just because you arrived to the ED via ambulance doesn't mean your "emergency" is any more serious than someone walking in through the front door. You will be triaged and seen accordingly, and receive a large ambulance bill (which medicare and medicaid are becoming stingy in paying for in case you don't keep up with changes coming down the pipeline).

If everyones physician had the ability to directly admit patients to the hospital, there would be no available beds EVER! How do you suppose the beds be accounted for? How do you suggest we decide who will be discharged? What kind of criteria should they meet to be admitted? I'm sure your answer is that you and your husband's long laundry list of health problems, whether they were accumulated through poor self management, bad luck or congenital, should put you at the top of the admission list. There is a process that hospitals follow when admitting people. Do you think it would be safe for your husband to have gone to a hospital room immediately, having bypassed ED, and potentially have a nurse who doesn't know how to care for A.fib (much less even know what A.fib is). Not all nurses have the same skills and abilities when it comes to certain conditions. An ER nurse wouldn't know what to do in the OR and vice versa. We may all be nurses but our skills, abilities and specialized training vary.

FYI, I love it when patient's bring in a list of their current medications and allergies. I really do love it and am very thankful and often tell the patient and his or her family how helpful that is for me. I make sure that the information is updated in the computer (in between all the other tasks I have to do). But I still encourage you to keep taking those copies into the ED with you b/c you never know when a new program was installed and subsequently wiped out all of the prior information requiring it to be updated. And, FYI, the ER nurses do talk with the floor nurses to make sure that the most accurate and updated information is transferred to the floor. Many times we request reiteration of health history and medications to do our own double check. You would be surprised how much "new" information comes out of those reiterations.

In the end, we are here for you as a patient and as family of the patient. My goal as a nurse is to get you and your family back to a functioning state so that you can go forth and manage your care effectively. My job is not to cater or cower but to assist patients and family in finding ways of taking care of one's self!!

Re: you forgot a few problems
by battazzo
Seems to me you are a big PART of the problem. Why would you go to the Emergency room for a little cat bite? Was your whole hand bitten off? Were you bleeding to death? Was this a case of life or limb? If not....you are the reason the ER is backed up with patients. If you and your insurance wielding husband would take better care of yourselves, see your PCP regularly, you would not need to abuse the ER staff and system so regularly.
Re: you forgot a few problems
by dmitc1232

To clear up a couple of misconceptions,,,you will not skip ahead in line from critically ill patients just because you choose to call an ambulance.....Sicker patients will always take priority...Actually,,it's an abuse of the 911 and emergency response system to use them if the situation is non urgent....

Secondly,,,you wouldnt walk into any other public facility and expect to be fed by them so why would you expect a hospital to??? Certainly in the 7 ERs I've been employed by we've compensated those that needed it,,, a meal tray....But it is the patients responsiblity to eat prior to coming.....Just as you would while shopping or doing anything else with your day...

Re: you forgot a few problems
by TNT ER-RN

You sound like a very bitter woman. I worked in the Seattle area for 15 years and they have some of the finest hospitals in the country. By the way, atrial fibrillation DOES NOT require ICU admission. Millions of patients live many many years in A Fib. It is treated with Diltiazem or Digoxin then the patient is started on Coumadin to prevent blood clots. There are outpatient procedures that may help like abolation but is never a first line approach. Your lack of medical knowledge is inversely proportional to your arrogance. It also sounds like maybe your husband is too ill to be cared for at home any longer and may require a higher level of care. That is a very difficult decision but one that is made thousands of times every day across the country. The reality is, as you age, your body starts to fail. There is only so much that modern medicine can do to stave off the ravages of age. Its a bridge we all will face one day as did all our ancestors before us. I truly am sorry for yours and your husbands suffering but your anger is truly misplaced. I watched my father make this same horrible journey you now are witnessing and I understand your frustration and sadness. Incorporate family in the care of your husband. There are many fine social services in the Seattle area that can provide help as well, including visiting nurses and mobile physicians. You also should join a support group. There is strength in the wisdom of others that have traveled the road you are on.

Best of luck to you and your husband.

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