Best approach to patients and relatives complaining about "long wait."

babynurselsa, RN · Jan 6, 2008

Well I am sure that you have noticed that the ones who are complaining are the ones who typically LEAST need to be sitting in the ER.

I simply tell them that currently all beds are full, and we are making every effort to get them back as soon as possible. I also remind them that the most acutely ill patients will be roomed first.

If they start to act too angry or start causing a disruption in the waiting room then I call and have security come hang out.

Unfortunately we can only do what we can. No matter how much I wave my little magic wand I cannot make more rooms and beds appear....

ukstudent · Jan 6, 2008

My idea, that will probably never happen is to have a large electronic display showing the average wait time for non-emergent care. People will still be upset if they haven't been seen in 2 hrs, but less likely to go off on the triage nurse if they can see that the average wait time is 5 hrs. It also, if displayed adequately enough, stop people from signing in if they understand from the start that they are looking at a long wait, thereby making the wait time less.

flightnurse2b, LPN · Jan 6, 2008

My idea, that will probably never happen is to have a large electronic display showing the average wait time for non-emergent care. People will still be upset if they haven't been seen in 2 hrs, but less likely to go off on the triage nurse if they can see that the average wait time is 5 hrs. It also, if displayed adequately enough, stop people from signing in if they understand from the start that they are looking at a long wait, thereby making the wait time less.

thats a really great idea! it would be like waiting in line at disney world... except no fast passes.

anyway, when i used to work triage i would gently remind them that all the beds are full, and since it is the emergency room, that the most critical and emergent cases will be seen first, but we will get them back as soon as possible.

and when they get mad and yell, i would either call security, or give them another gentle reminder that there is another hospital that is not a trauma center about 5 miles down the road.

ERRNTraveler, RN · Jan 7, 2008

thats a really great idea! it would be like waiting in line at disney world... except no fast passes.

Maybe if someone comes in and hands you their baby that is blue, that could be considered a "fast pass"

But I agree with the others- explain that the most critically ill patients need to be seen first, and they will be brought back to a bed as soon as one is available for them.

Altra, BSN, RN · Jan 7, 2008

I have told people who sign in with obvious ridiculously minor stuff that they should have stayed at home for and then complain about the wait, "well, you really never want to be the one that we're rushing back ... because it means you're trying to die."

Shuts 'em up: even if they think I'm unreasonable, they know that the topic is closed.

alkaleidi · Jan 7, 2008

I think the "Estimated wait time" display would be awesome. Kind of like when you call an 800 number for customer service and they say, "We are experiencing unusually long wait times. Your estimated time to hold for a c.s. rep is XXX minutes (HOURS!)." I wonder what JCAHO and Press Ganey would think about that?

I think education and being firm is key. I have gotten to the point that I don't feel I owe anyone a lengthy explanation -- I usually respond informing them the same old thing... we take the sickest patients first, people who come by ambulance take priority over stable patients in the waiting room, and if you waited a week to come in with a cough and runny nose, you might want to just take some OTC meds and go to your PCP or a local urgent care in the morning. It just floors me when people sit in a waiting room full with no seats open and at least 10-20 people STANDING... and complain that their lady partsl discharge isn't being addressed quickly enough.

webbiedebbie · Jan 7, 2008

Is there a reason why non-emergent patients could be directed to an Urgent Care Center? It would make sense to have one next to the ER.

Toquay · Jan 7, 2008

The ones that don't want to wait will often call and ask how busy we are or will triage in and do a trial wait and LWOT (leave without treatment). They usually return between 3 and 5am, I guess they set their clocks for their emergency care. I am pretty sure Urgent care wants money from them so why on earth would they go there?

Toq

scattycarrot, BSN, RN · Jan 7, 2008

My idea, that will probably never happen is to have a large electronic display showing the average wait time for non-emergent care. People will still be upset if they haven't been seen in 2 hrs, but less likely to go off on the triage nurse if they can see that the average wait time is 5 hrs. It also, if displayed adequately enough, stop people from signing in if they understand from the start that they are looking at a long wait, thereby making the wait time less.

We use these in the UK and have done for a while. In my expereince, they work with the reasonable individuals but as we all know, the people who come in with their 4 month history of back pain or 2 week GI upset and complain the loudest, don't tend to be reasonable. However, it does help turn people away as they come in and see that the sign says...Estimate wait: 3 hours, sudddenly feel better and turn round and leave. Yea!

mom2michael, MSN, RN, NP · Jan 7, 2008

I try to educate those poor souls who have drug themselves out of a deep sleep to come to the ER at 1 a.m. for a chronic problem that they'll be treated based on priority 1st and they WILL wait and they WILL see people go ahead of them and back to rooms quicker, because we treated based on priority of the illness. That usually keeps them at bay for at least 2-3 hours.

I also remind people during triage that it can take 2-3 hours to be seen and another 2-3 hours once they get back to a room so if they have appts. to be made or a dinner date at 8 p.m. and it's 6 - they need to do some rescheduling of something.

We have this great - large sign that says....You can expect a wait time of at least 3 hours. Please contact the triage nurse if your wait has exceed 3 hours. For those that read and comprehend - that also helps.

I find the biggest help is to be brutally honest with them during triage. If you have 10 EMS crews in the back and every bed full, tell them such. Explain there will be a long wait. Tell them to expect to sit out in the waiting room for hours. I try to be as nice as possible when explaining this but sometimes honesty during triage is the best policy.

I love it when they say....Fine I'll go down the road to X hospital because they don't have a wait time. HAHAHAHAHAHAHA....if we have a 4-5 hour wait...guess what...so do they. I just smile and tell them to drive safely.

**canoehead, BSN, RN** · Jan 7, 2008

I usually tell them in triage that the last person I brought back waited x amount of hours, and we have had ambulances since then (assuming we have). Then they have fair warning, but I encourage them to let us know if they get worse, or if they decide to leave.