I am in complete agreement with the nurses and doctors that are posting about these wait times. When I read this article I couldn't believe what I was reading. I was a night charge nurse in a Level One Trauma Center and I was NEVER told to keep admitted patients in the ER to boost the bottom line. I do agree that boarding admitted patients in the ER is a huge problem and the hospital that I worked at was doing everything they could to rectify the problem.

However, I wholeheartedly believe that the problem with the ER system is MISUSE! Patients complain endlessly about the wait times but they don't realize that they are the cause of it. If the ER's were used for emergencies only and the minor complaints such as sore throats, colds, nonexistent fevers in children, etc. were told that they did not have an emergency and they needed to follow up with a regular doctor, the wait times would greatly decrease. Also the level of care that patients have come to expect would be easier to deliver. We are not able to tell patients that they do not have an emergency due to several restrictions placed upon us by governing agencies. Basically, if you check in, you HAVE to be seen. This would have to change. People today are rude and can become hostile when they are actually told something that they don't want to hear. I don't know why but people believe that they know more about healthcare and medicine than the people that are actually trained to deliver the service! Why is that?? Businesses all over the United States "maintain the right to refuse service to anyone." Why should ER's be any different? Patients check in and some of them immediately become rude and abrasive towards the nurses during the triage process, oftentimes refusing necessary tasks such as vital signs, blood draws, etc. It's ridiculous that these people are able to get away with this type of behavior. If they don't warrant emergency service then they MUST be turned away, to see an urgent care clinic or a primary doctor. Place healthcare back into the hands of the people that deliver it and wait times will go down and patient satisfaction will go up. It's that simple!

There is so much more to the problem than this but it's a good start. I would really love to see an article written about the class and quality of patient that we deal with in the ER and expose them as the rude, crude, and trash talking people that they are.

How true this is!! We are a small town ER and dont have to worry about boarding patients but what we do have to worry about is wait times on patients because people have learned that if they come to the ER they dont have to pay the $25-$30 co pay required at their primary doctors office! They use the ER as a clinic instead of what it really should be used for-EMERGENCIES!!!

We see the same patients over and over with bug bites, colds, coughs, things that can wait until the next day when they can go to their primary care providers but they choose to come to the ER instead where there is no co-pay and they can get enough medicine to hold them over until the next day. Most of the time they dont even get their perscriptions filled but come back to see us again for the same problems!

And if the government wants to fix the problem one good start would be to look at the Medicaid abuse! For some reason patients think that just because they have the red Medicaid card it gives them the right to come in anytime they have a slight fever or cough or heat rash.

This ALL takes away from the seriously ill people that come to the emergency room for TRUE emergencies and the people can be terribly rude and abusive to the ER staff!! Yet we have to smile and continue to give good customer service while being cussed at, etc then they file a complaint with the administration and we get a write up because we were "rude". Something needs to change and change quickly or the health care quality of the ER's are going to continue to go down hill and its NOT always because of the ER staff or the hospital....look at the main problem...the people who abuse the use of the ER!

BRAVO! I am PROUD to be an ER nurse in a Level III Trauma Center. Wait times occur because our department is filled with TRUE emergencies (people coding, getting intubated, high acuity care)--- which receive care PRIOR TO "emergency" runny noses and "emergency" sore throats.

What really slows down the flow? People who go to ER's for free medical care instead of seeing their family doctors. Why? Because government law does not necessitate that they pay for it and it does require us to provide care. I think we all know the devil is in the details- and it is certainly hand in hand with EMTALA laws. If tax payers had any clue how many non-paying "back aches" rolled through the ER on a weekly basis...they would come up for air.

So how do we fix the problem? Lawmakers caused the problems to begin with and because of HIPPA rules we cant complain to them to fix the problems. How can we legally make them aware of the abuse in the medical system?? Our governor cut back on medicaid but it only caused some of the ones that really need medical care to go without and let the people that are too darn lazy to work to still be on the system because they have children that they cant work to support! Someone in government needs to take a long hard look at the Medicaid/Medicare systems in each state!! How can a 25 year old, healthy young man be on medicaid instead of getting his ass out and getting a job to pay his own insurance?? It really saddens me because I work two jobs just to make sure my family has medical insurance and I dont have to live off the government! Its time to cut back on free benefits for people too darn lazy to get a job!

I totally agree with mkzm. I was shoked and disgusted by this article. I am a nurse in city of approximately 65000 citizens. I have worked at both local hospitals. Both are level 2 trauma centers, and both stay busy ALL THE TIME. Both hospitals are regional referral centers for a radius of 100 miles so they see patients from everywhere. While I agree holding patients in the ER is practice that is becoming ever more common and really needs to ba addressed, the main problem is all the abusers of the system. I don't care if you are black or white or brown. I, as a nurse, get paid the same either way. I don't care if you have insurance or not. I have never been told by either hospital to hold the noninsured in the lobby. I have always been encouraged to give the patients what they need and want, many times at whatever cost. Patients have obtained more power than the people (doctors and nurses). Most of the people that come to the ER for cough, colds, earaches and toothaches are the most demanding, rude, nasty, ungrateful and uncooperative people. They and their sometime obsured demands are what slow down our ER's. Patients sitting in hallways is a direct result of hospitals trying to give the patient what they want, to cross that great glorious gate to the care area of the ER.

Everyone deserves great care, and if you come into my ER im going to try my hardest to deliver the best care I can, but we work in an "EMERGENCY room". People seem to ignore that the letter E in ER stands for EMERGENCY. I recall a moment some years ago. I was taking care of a serious emergency, and the family of the patient (not the patient) demanded emediate care. She stated and I quote "We were here first." I emediatly told her that NO ER treats patients on a first come first serve basis. Im sorry a gunshot would comes before a toothache. A heart attack comes before an ingrown toenail.

If you ask me cities have urgent care facilities and private MD to take care of your cold. Let an ER be and ER and let the people work in an ER do what they are supposed to do.