By now everyone has heard the story of the woman who died of a perforated bowel in an emergency room waiting area in Los Angeles a couple of days ago. This article on the internet talks about it. This is going to affect ERs across the country. Patients will see it and bring it up to us in the ER, maybe even trying to get back sooner
24 hour nurse talks about it on her blog today. She points out the coverage has been one sided. Its typical of to days journalism, sensationalizing an event and using it to get people stirred up.
Its depressing. No one should die in an ER waiting room. But no one ever asks why are ERs so crowded? People are always shocked when they come into an ER and see what really happens there. They don't realize what is going on in medicine and they don't care if it doesn't affect them. Witness this discussion relating to one of charity doc's posts at outside the beltway.Why are ERs overcrowded? A lot of it is a nursing shortage all over the country. There are not enough nurses to staff hospitals and therefore there are less beds to send ER patients to and they sit in the ER waiting, taking up those precious beds. Then there is our immediate gratification society that prompts people to go into an ER for things that are not an emergency and waste everyones time, (we can't possibly have any discomfort these days or wait to see a doctor in an office) again taking up more precious ER beds. Doctors in ERs, so worried about liability and lawsuits, order complex tests so that the they won't be sued for something they missed and that causes longer ER stays that use up those precious beds. These are only a few reasons why you have to wait when you come to the ER. It isn't because we are mean, don't care. We do the best we can. We use our knowledge to prioritize patients. Sometimes mistakes are made. We aren't perfect. We try hard. No matter what, it seems like it is never enough.
5 comments:
The story obviously points out a problem at that ER, but I'm very suspicious that there's more to it on the patient's part.
We shall see...
I'm sure there is more to it,but the only part that really matters is the fact that the woman did this for 45 minutes and no one helped .She was laying in the ER floor for 45 minutes.I mean come on they could have a t least done something about that and made her last 45 minutes caring ones.
Also the way I am understanding it she was at the hospital on several occassions for this same thing,only to be given pain meds and sent home each time.the dispatchers at 911 made things look horribly bad for the health care world.When 911 Emergency dispatchers don't care then who will.JMHO
Yes there is more to it than just Staffing issues, but that plays a significant part of the whole problem.
Resources, ER throughput, misuse of the ER. There are only so many beds in an ER and when they are full it makes for some creative triage, not to mention increase the Stress level of the triage nurses.
No in an ideal world no-one should die or have an untoward event in an ER waiting room and in an ideal world there would always be a bed for those that are of significant acuity.
In Canada we have had similar incidences and I am not sure what the answer is. Nurses do the best they can and make a triage call based on the best information they have, we are all human and unfortunately there will be errors.
I feel sorry for the families of patients that experience these very rare incidences, and I do feel for the Triage nurses that made the call and have to live with and repeatedly relive the memory of the incident.
What the answer is ??? Tough question!!!
Also consider that this is an ER in a poor urban community- between EMTALA and piss-poor Medicare reimbursement, they are probably hemorrhaging money. Not to mention multiple ER closures in LA in recent years further enhancing over-crowding. So they are most likely over crowded, underfunded, understaffed, and under-equipped, and also dealing with multiple traumas (as most ERs in any urban community are on a Saturday night). I guess I can speculate all I want, but it's just plain horrible that this woman died. Still- too bad the media can't look at some of these problems too instead of just one-sidedly reporting it.
Love your blog!
ER nurse in Cali
I think the ER staff was very much indifferent in the LA case. It speaks for itself. If the shoe fits.... if not, don't sweat it.
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