....The surveillance video of Green collapsing and lying untended, as hospital staff at Kings County fail to respond to her collapse, is inexcusable by any stretch. And so Nancy Grace, for one, focused on the negligence. But what's largely missing from this story is the likely cause of Green's pulmonary embolism. The answer lies in a far more systematic and widespread danger in hospital care: E.R. waits. Why was Green sitting and waiting while blood pooled in her legs? Despite increasing evidence that crowded E.R.s can be hazardous to your health, hospitals have incentives to keep their E.R. patients waiting. As a result, there has been an explosion in E.R. wait times over the past few years, even for those who are the sickest.....
Here's the link..
http://www.slate.com/id/2195851#
I almost cried for joy when I saw this on Yahoo's front page. ER holding is going to be what runs me out of emergency medicine. I can take the crazy patients, the bumbling interns that lose my charts, the freaked out ER docs that scream at me for their laryngascope handle (when it's in their hand!), the (ahem) "strong" personalities of my coworkers, etc... I love it all and thrive on it. But when I walk in and see that I have 6-7 patients that are all holds, and there are no beds available (and won't be for the rest of the shift, if then)...my heart just sinks.
I work in a 14 bed medical ER (soon to be 22 beds, with no new staff...but I digress...). The other night, 13 of our 14 beds were holds, all waiting 14+ hours post admission. There were three of us working, two of us with less than two years combined nursing experience and the third was charge/triage. I had six patients that were holds...2 ICUs (one-on-ones) and four PCUs...in addition to the actual ER patients that came in. We actually charcoaled an OD in the hall, and their psych eval was done right there too (in front of everyone). We were deciding between cardiac patients who was more in need of the monitor ("sorry sir...your chest pain isn't as suspicious as his chest pain...so please go sit in that chair for a while"). One of my ICU holds was a #300+ patient with a HR of 170 and a crap BP. Since they had been admitted, the attending was responsible and when I called, was told to give a 250 ml NS bolus "She's just dry". Attending is a GP, and wasn't happy when I explained that 250 ml was basically a mouthful of spit to her (luckily, my ERP got involved and we got way more aggressive). The other nurse was dealing with the same kind of crap, and the triage nurse was trying to treat people in the waiting room.
None of anything that happened that night was safe. And it's an every-shift occurance. The best part is when EMS shows up with a patient and assures us that they're a direct admit. Talk about mixed emotions..."Whew! It's not for us!" followed by "Wait! There really are rooms available, but we're transfering patients in?"
Like the article says, how can an ER function as an emergency room, when all the beds are full of admits that are past the emergency stage? At my hospital, we're told, "Tough. Figure it out." And I don't blame floor/unit nurses, patients, or physicians. It's administration that's putting lives and careers on the line for their own gains.
Sorry for the rant...the article just hit close to home. (Can you tell this was a rough week for me? LOL!)
Would you like to comment?
