[jenna_rn]

Here is a link:

http://www.canada.com/calgaryherald/...c62464&k=76770

This has been an ongoing issue in the ER.Looking for feedback & comments!

[babynurselsa]

This is an ongoing problem everywhere jenna.
When the ER is packed and there are no beds, what are you going to do?
It is tough.

[SMK1]

I feel so sorry for those people, but going to ER for heavy bleeding at 3 months...I don't think they will do anything for you anyway...How devastating for the families though. Certainly more tact could have been used by the triage nurse, and more education about miscarriage from the OB.

[SmilingBluEyes]

Waited in the ED for more like 8 hours to be seen and diagnosed as having an ectopic pregnancy loss. It was hell, waiting, bleeding and not knowing what was wrong, so I can feel for this person. Nothing is much worse than losing a pregnancy, no matter where it occurs (ED, at home or in the OB unit). However, I was not left bleeding and waiting in a waiting room; I was in a private room in the ED itself, so I was spared the indignity of the experience this poor lady endured.

Yes, Overcrowding and understaffing are big problems, but I feel there is no excuse for making this woman endure a public miscarriage. It's horrible, and so very wrong, on so many levels. I can't believe they could not find SOME place private to place this poor lady and her family in this case.

I don't think these nurses are "scapegoats" so much as people who ought to look at the triage process (with the management and docs) and their own lack of sensitivity, with a very critical eye----so this type of thing does not happen again. I also saw this is not the first time this has happened at this place, so I think there is a real problem there.

I can't imagine being in this lady's shoes; at least I was not losing a baby in a waiting room! And imagine, she could have been hemorrhaging and in real danger, for all they knew---after all, she was begging nurses for help on more than one occasion, yet told "to wait"! Wrong!

[jonear2]

I cant imagine being in the position that those women were in. Bleeding heavily in an ER waiting room, knowing you are losing you baby has got to be pure hell. My heart goes out to the mothers.

[SMK1]

It osunds like it has happened a lot recently in the same hospital as well...I understand that an early miscarriage in progress can't take priority over serious traumas and chest pain etc... but it seems like after the first 1 or 2 paitents that this happened to they could have come up with some ideas to improve the situation. A private room etc... not to mention the fact that the bleeding is an infection issue for others and can be very painful. Maybe they could send persons like that up to the L/D area if there isn't a full house up there. At least then they could get some pain relief, monitoring and a quiet cubicle to miscarry in relative privacy. I have had a miscarriage myself at a very early stage and it can be painful and emotionally draining. How sad.

[Altra]

Originally Posted by SMK1

It osunds like it has happened a lot recently in the same hospital as well...I understand that an early miscarriage in progress can't take priority over serious traumas and chest pain etc... but it seems like after the first 1 or 2 paitents that this happened to they could have come up with some ideas to improve the situation. A private room etc... not to mention the fact that the bleeding is an infection issue for others and can be very painful. Maybe they could send persons like that up to the L/D area if there isn't a full house up there. At least then they could get some pain relief, monitoring and a quiet cubicle to miscarry in relative privacy. I have had a miscarriage myself at a very early stage and it can be painful and emotionally draining. How sad.

What would your suggestions be? If an ER is routinely packed to the gills, expansion might be in the hospital's long-term capital improvement plan but that is a years-long process. Sometimes, many times, there simply isn't anywhere to put another patient. Can those of you who work in inpatient units imagine treating patients in a hallway? We do in the ER, routinely.

I have lost a pregnancy myself, and my heart goes out to any woman enduring the same ordeal. But that doesn't change the reality of the multitude of factors that create ER overcrowding.

As far as sending patients up to OB, that sounds fine to me ... except that OB is very firm about only seeing patients who are 16 weeks or more along. And that 16 weeks is only because I work for a Catholic hospital - the norm at other hospitals in my area is 20 weeks. I have lost count of the number of patients I've triaged who said they were pregnant and bleeding "heavily" when upon exam they had scant to light bleeding, and their urine and/or serum quantitative tests came back negative. These women may well have been pregnant at some point, but the reality is that they were not pregnant when they presented to the ER - hcg levels will remain detectable for at least several days after a miscarriage. What these women were having was a normal menstrual period.

Again, my heart breaks for the couple mentioned in the article. But making the ER staff a scapegoat is not the answer. OB practices always have one or more providers on call, do they not? Would it be an alternative for patients less than 16 or 20 weeks who are potentially miscarrying to be seen in the office instead of being directed to the ER?