Having worked in the emergency department for some time now, I feel like there are misconceptions about what it takes to keep an ER running smoothly. We encounter cases for which we have no time to prepare; that is the nature of the job. We do our best to plan for everything, but frequently, ER staff has to be ready to jump in and quickly adapt to whatever comes our way. This very nature complicates our tasks of triaging, treating, and discharging patients in ways a lay person may not understand.
Having been a patient myself and having brought my own children to the ER several times, I can empathize with the sense of urgency people feel sitting in the ER waiting room. You don’t know what’s going on behind the scenes; all you see is what you think is happening in the waiting room, so your frustration seems justified. I understand. Working in the ER is one of those jobs that I feel like everyone should do at least once in their lives in order to gain perspective, but since we can’t do that, maybe I can shed some light on how things work.
There’s a method to the madness.
All ERs utilize some sort of triage system. For example, one method of triage is the Emergency Severity Index (ESI). Based on specific parameters, patients are assigned a number 1-5 upon arrival. This number denotes the patient’s acuity; in other words, patients meet certain criteria that determine the order in which the provider sees them. For example, a patient in cardiac arrest would be assigned an acuity level of 1, while a patient with mild cold symptoms and no fever might be a level 5.
Even if a level 5 patient has been waiting a while, any patient triaged at levels 1-4 might be seen before that level 5 patient because those 1-4 patients have been triaged as more critical, meaning they require more immediate resources. Prioritizing patient safety means prioritizing the order in which our patients are seen based on their unique needs. This also means things can and do change in an instant. Even once you’ve seen a doctor, if another patient comes in the meantime with a higher acuity, your treatment could get put on pause. As frustrating as that may be for you, it can literally mean the difference between life and death for someone else.
Call us anytime, but know that we may not be able to help you.
We cannot give out medical advice over the phone. There is so much risk involved even with what you think is a “simple question.” If you think your child needs to be seen, bring them to us. We cannot give out wait times. Things change at the drop of a hat around here; there is no way to predict how long you’ll have to wait, but be assured, if your child is in distress, they will be seen and treated accordingly.
Looks can be deceiving.
You may see a patient who looks better than your child. You may be confused as to how that patient was seen before your child although you’ve been waiting longer. What you may not know is that that patient has a chronic, invisible illness, and the tiniest issue could have catastrophic implications for them. We know these patients, and these patients get the VIP treatment because we know how quickly things can go awry for them.
Where are all the nurses?
You are waiting for your paperwork that your nurse went to retrieve 45 minutes ago. Exasperated, you peek your head out the room and see that staff are nowhere to be found. Just know that something major is going on. Another patient needs us, all of us. Please give us some grace, and be thankful that there aren’t ten physicians and nurses in your room.
Get established with a PCP.
We won’t turn away anyone. However, there are cases that present to the ER that would be better suited for a primary care provider’s office. If your PCP’s office is closed or you don’t have a PCP, by all means, come see us. In general, though, it’s always a good idea to get established with a PCP and see them for non-emergent concerns. They can always escalate the situation to us if needed.
We will welcome you back.
Don’t feel bad about coming back if your symptoms haven’t resolved despite following the discharge orders. Doctors and nurses make mistakes. A patient’s condition can change. It happens. Come back, and seek care.