Overburdened E.R.'s

  1. Letter to the Editor of the New York Times

    http://www.nytimes.com/2009/06/14/op...4flu.html?_r=1

    Quote from www.nytimes.com

    The question policy makers and the public should be asking is this: If our emergency rooms were overwhelmed by the "worried well" fearing they had H1N1, what would happen during a more deadly outbreak of disease?

    And it wasn't just the uninsured. It was everyone, especially those with family doctors who actually protected their offices by sending flu cases to emergency rooms.

    Our emergency rooms are on the brink of collapse right now, and yet no discussion of health care reform seems to acknowledge that. If we do nothing now to shore up the nation's emergency medical care system, the next pandemic could show us what catastrophe really looks like.

    Nicholas Jouriles
    President, American College
    of Emergency Physicians
    Washington, June 11, 2009

    (hat tip PFI/monotreme)
  2. Visit indigo girl profile page

    About indigo girl

    Joined: Mar '06; Posts: 5,909; Likes: 1,741
    visiting nurse; from US
    Specialty: Too many to list

    22 Comments

  3. by   DeepFriedRN
    "Originally Posted by www.nytimes.com

    The question policy makers and the public should be asking is this: If our emergency rooms were overwhelmed by the "worried well" fearing they had H1N1, what would happen during a more deadly outbreak of disease?

    And it wasn't just the uninsured. It was everyone, especially those with family doctors who actually protected their offices by sending flu cases to emergency rooms.

    Our emergency rooms are on the brink of collapse right now, and yet no discussion of health care reform seems to acknowledge that. If we do nothing now to shore up the nation's emergency medical care system, the next pandemic could show us what catastrophe really looks like.

    Nicholas Jouriles
    President, American College
    of Emergency Physicians
    Washington, June 11, 2009"

    ITA with his sentiment, thanks for posting this indigo girl. I was discussing this with my husband the other day. The ER's were at breaking point with the people who came in just worried that they might have H1N1..The same amount of people or more coming in ACTUALLY SICK is definitely cause for serious concern..I forsee potential for chaos. I think that as healthcare workers we have to keep in mind, as well, that in the world today many, if not most, people rely on the "system" (of govt, of healthcare, of education) to do for them and theirs. For instance (and no I don't have statistics) I would guess that in 1918, people were less likely to go to the hospital for things--people were still giving birth at home, people still died at home, you got sick, you went to bed, got better(hopefully), and that was that. Nowadays, people bring their kid to the ER at the drop of a hat. Our system is poorly equipped to handle an influx of people that show up because they are poorly equipped to deal with an illness themselves.(not assigning blame or commenting on rightness/wrongness here, just stating a point of view) It's a potential recipe for disaster.
  4. by   oramar
    If they have to admit a lot of those people who come into the ER I got a feeling that there will be no beds on the unit(acute or critical) to send them to, a lack of vents to put them on, shortages of antibiotics to treat and a shortage of nurses to administer them. I don't know what is going to happen here as far as how wide spread and how sever the fall flu season will be but I got a bad feeling.
  5. by   DeepFriedRN
    Yup. I hate to admit it, oramar, but I feel the same way. I guess all any of us can do is be certain that we are as prepared as possible for the worst, and hope for the best.
  6. by   Multicollinearity
    We keep hearing that it's likely this is going to come back in the fall. That's when I'll be in my last semester of nursing school. I don't want to get sick then, during that stressful semester! I'd rather get it this summer and have some antibodies/immunity in the future.

    I've stopped washing my hands so much and caring so much about avoiding bugs. Today at the mall I touched a bazillion things, I ran my hands all along the grab handle on the escalator, and then went and ate tacos with my bare fingers. I'm trying, LOL.

    A few days ago at my doctor's office I purposely sat next to a coughing sickly looking woman.

    I'll report back if I finally have success.
    Last edit by Multicollinearity on Jun 15, '09
  7. by   lamazeteacher
    The lack of comprehension and conscience exhibited by your post, indicates that finishing school successfully is more important to you than using the education you were provided, to provide good, knowledgeable nursing care for sick people.

    Not only have you exposed yourself to myriads of microorganisms, you have deposited them on escalator handrails for possibly immunocompromised people to share. They will become ill and possibly lose the rest of their lives, due to your recklessness. All you might lose, is some time in your last semester!



    You may not like what you see, and hopefully you'll mend your ways when you take some time to look at yourself honestly and reevaluate your career goals, possibly with the assistance of a counselor. Turning your back on others makes you feel worse about yourself.
    Last edit by sirI on Jun 16, '09
  8. by   psychonaut
    Quote from lamazeteacher
    They will become ill and possibly lose the rest of their lives, due to your recklessness.
    My goodness, is this where "Pandemic Awareness" starts to edge towards "Pandemic Hysteria"?
  9. by   lamazeteacher
    No, psychonaut, this is where anger about inappropriate actions taken by a student nurse, Multicollinearis, was criticized by an infection control oriented, aware Public Health Nurse. That callous viewpoint expressed in post #4 of this thread, demonstrates how social consciousness needs to be inspired in nursing education, and those without it, who purposely cause illness in the unsuspecting public, need to be chastised.

    I hope that the student realised the impulsive errors she made, and that it was done due to selfishness, immaturity, and lack of regard for requirements that public health policies/protocols implemented during a pandemic, demand. I suggested that she obtain counseling, and certainly hope that she follows that lead. However I realize that untoward reaction formation could occur in someone so self involved and irresponsible.
    Last edit by lamazeteacher on Jun 16, '09 : Reason: addition, clarification, punctuation
  10. by   oramar
    Quote from lamazeteacher
    The lack of comprehension and conscience exhibited by your post, indicates that finishing school successfully is more important to you than using the education you were provided, to provide good, knowledgeable nursing care for sick people.

    Not only have you exposed yourself to myriads of microorganisms, you have deposited them on escalator handrails for possibly immunocompromised people to share. They will become ill and possibly lose the rest of their lives, due to your recklessness. All you might lose, is some time in your last semester!



    You may not like what you see, and hopefully you'll mend your ways when you take some time to look at yourself honestly and reevaluate your career goals, possibly with the assistance of a counselor. Turning your back on others makes you feel worse about yourself.
    I suspect she was joking a bit. I can't always tell when people are putting me on either, especially in print. You can't read their expressions.
    Last edit by sirI on Jun 16, '09
  11. by   indigo girl
    We do need to cut each other some slack, and allow a little levity.

    There is some serious enough stuff happening, and it is still very early in this pandemic.

    Let's be kind to each other. We are all we've got, folks. We have to lean on each other.
  12. by   indigo girl
    Swine flu puts pressure on Manitoba health system

    http://www.edmontonsun.com/news/cana...10216-sun.html

    Speaking of overburdened health care systems:

    Quote from www.edmontonsun.com

    As 33 new confirmed cases of the H1N1 influenza virus in Manitoba were announced yesterday, officials continued to work to manage stresses on the health system.

    Last Wednesday the Winnipeg Regional Health Authority started moving elective surgeries from St. Boniface General Hospital to the Victoria General Hospital to allow extra staff for the intensive- care units treating patients with severe influenza.

    "It's so we can free up staff in the recovery room area if the intensive-care nurses are not enough,"
    said Jan Currie, chief nursing officer for the WRHA. "Staff at Victoria, because they have smaller numbers of influenza cases, aren't in that situation."

    The new cases bring the total in the province to 152.

    Manitoba's chief medical officer of health, Dr. Joel Kettner, said one to three new cases per day of serious influenza-like illness are requiring admission to hospital intensive-care units. He said suspected serious flu-like illness should be treated quickly.

    "The key is feeling short of breath or out of breath," he said. "That is not typical with influenza, and people who have those symptoms should not hesitate to get prompt medical care. We're talking about people who become very ill very quickly, within the first 24 or 48 hours."

    There are now 68 confirmed cases of H1N1 in Winnipeg, 57 in the Burntwood/Churchill RHA area, 12 in Northern Manitoba, seven in Brandon, three each in the Interlake and North Eastman, and one each in Parkland and South Eastman.

    "We can't say where we're at for sure in this epidemic curve," said Kettner. "It looks as though we may be plateauing a little bit but I don't want to make any predictions yet."
  13. by   lamazeteacher
    When posts are submitted, it would be a good idea for the poster to indicate their drift, if it's not serious........ for those of us gullible enough to take them that way. Multicollinearty was specific about her actions, which were microbiologically ill advised. (slightly light)
    Last edit by lamazeteacher on Jun 16, '09 : Reason: wanted to refer to a comment on a different thread, but couldn't find it
  14. by   psychonaut
    Quote from multicollinearity
    I've stopped washing my hands so much and caring so much about avoiding bugs. Today at the mall I touched a bazillion things, I ran my hands all along the grab handle on the escalator, and then went and ate tacos with my bare fingers. I'm trying, LOL.
    The tone is exaggerated for humor, but I essentially agree with the basic idea. I am Jeckyl/Hyde with this in my personal and professional lives; hygienically hyper-vigilant to the point of obsessive in my professional role as NICU RN. I have clashed with my unit hierarchy regarding personal use of ppe and it's use by families. Me and my fellow nurses are of one mind in wishing we could require much stricter IC precautions, which have been greatly reduced in the name of "family-centered" care.

    However, in my personal life, I embrace the concept that there can be such a thing as "overly hygenic." The immune system exists to be challenged. I live by the rules of personal hygiene my mother taught me as a lad: wash hands before eating, after the bathroom, cover coughs and sneezes, etc. etc. No antiseptic wipes on the shopping cart handle (and don't lick it, either). You can smooch your dog on the head, just don't make out with it. You don't need to rub cal-state on your hands every 5 minutes (again, completely different story at work).

    Quote from lamazeteacher
    No, psychonaut, this is where anger about inappropriate actions taken by a student nurse, Multicollinearis, was criticized by an infection control oriented, aware Public Health Nurse. That callous viewpoint expressed in post #4 of this thread, demonstrates how social consciousness needs to be inspired in nursing education, and those without it, who purposely cause illness in the unsuspecting public, need to be chastised.

    I hope that the student realised the impulsive errors she made, and that it was done due to selfishness, immaturity, and lack of regard for requirements that public health policies/protocols implemented during a pandemic, demand. I suggested that she obtain counseling, and certainly hope that she follows that lead. However I realize that untoward reaction formation could occur in someone so self involved and irresponsible.
    Snideness followed by a smiling icon = passive aggressive to me, but whatever.

    You all could be right, p95 masks and ppe may be required to go pick up some McDs in the drive through, and those of us that think you have gone off the deep end may be leading us all to the end of civilization as we know it (see, exaggeration to make a point, I can do it too). I've read Stephen King's "The Stand" probably 4-5 times in my life, I guess I should know better.

    This flu situation bears watching, but as things stand now, I won't be queing up for flu vaccines or Tamiflu. More for the rest of you!

    EDIT: ...and I realize I'm helping to steer this thread off topic, so I won't belabor my point any further here. I'll leave you to your Pande-noia (ha!) in peace.
    Last edit by psychonaut on Jun 16, '09 : Reason: 'cause I'm being a bit of a troll

close