Quote from 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?