When I am in triage I see just how acute our ER has become. It is one train wreck after another. People with chronic complicated illnesses. Very old people. People who don't speak english. More and more of the mentally ill. The homeless. Drug seekers. Drunks.
The days of lacerations, ankle sprains, appys and such are long gone and they ain't coming back. Our inner city ER has become a place for those with complex medical or social problems, on the one hand, or a place for the hood rats to use as a clinic for abdominal pain, back pain, colds, etc.
Sometimes it feels like I work in a high tech nursing home.
I pity the ER nurses of the future.