https://edwinleap.substack.com/p/going-to-the-er-brace-yourself

 

Going to the ER? Brace Yourself.

It’s a bumpy ride. But I have tips.

There are always more patients than beds. So, your stay in the waiting room might be very long unless you’re having a very dangerous medical issue.

Waiting Room Tips:

Bring a book. Bring your phone and headphones. Bring a charger! Bring a blanket. It’s usually cold.

Take your necessary medications before you go to the ER and bring your medications with you in case you have to wait for a long time.

If your children have to tag along, or are patients, bring something to entertain them. They get bored and restless too, and no wonder!

If you have abdominal pain, a broken bone or any serious thing that might need sedation and a procedure, do not eat or drink before you get there or while you’re there unless you ask staff if it’s OK. (Diabetics, you’re different so talk to the triage nurse.)

In the ER tips:

When you are called back, you may well find yourself in a chair, or on a bed, in the hallway. If you’re in a room, you may find yourself suddenly and unexpectedly moved elsewhere for a critical patient to take your room.

Many things are out of your control there. But you can at least manage your expectations. Things are moving slowly. There’s a huge nursing shortage and a not-insignificant physician shortage. Odds are you aren’t being ignored. It’s just that the staff is quite literally overwhelmed by numbers of patients and the acuity (the high degree of illness or injury) of those patients. Not so long ago, doctors would enter orders for medications and they happened fairly quickly. It’s harder now. It’s frustraging but try to be kind.

If you have a change, become more short of breath, have new pain, bad chest pain, abdominal pain, anything concerning, ask someone walking by to get your nurse or physician.

Again, don’t eat or drink unless you’re told that you can. This isn’t to punish but to keep you safe.

Communication Tips:

Always bring either your medication bottles or a list. Your smartphone probably has an app on which you can list them. Or at least, take photos of the bottles or your list and keep it readily available.

Keep a similar list of your medical and surgical history. Not all hospitals have computer systems that communicate so one may not have access to your information.

If you have family members present, appoint one to be the spokesman and relay things to the rest. It’s much easier for everyone

Admission Tips:

If you get admitted, you may be in the ER for 12 hours or three days. It’s hard to say. Nobody is trying to be difficult, it’s just that hospitals are completely full these days. If you want to talk to the charge nurse or a patient advocate to ask questions, it’s fine. Just understand that the staff want to move you into a bed as much as you want to go to one. Also, due to the busy nature of things, admitting doctors (called hospitalists) and consultants like cardiologists or surgeons are also very busy and trying to get to you as soon as possible.

Tips on What You’ll See:

The ER is a scary place. Whenever it can be safely avoided it’s best to do so. But while there, it’s not unusal to see people receiving CPR, crying family members, demented patients screaming out in confusion, injured people crying out in pain.

Likewise, it’s not unusual to see men or women in handcuffs as well scuffles between security or police and patients who are either mentally ill or under arrest.

Those with psychotic mental illnesses may leave their rooms and have to be redirected or restrained by staff. Some of them are delusional and hallucinating. Likewise, those using drugs like methamphetamine or cocaine, or marijuana and other hallucinogens may seem very odd or confused. They can seem frightening. If you are uncomfortable with someone, please tell the staff.

You may also see angry, exhausted nurses and physicians. They are really just frustrated, understaffed and often overworked. But they come back day after day to do the right thing.

Tips on Transfers:

If your physician recommends transfer to another hospital, and it’s going to take a long time, ask if it’s possible to driver yourself. In some instances, heart attack or stroke, or major trauma, that obviously can’t happen safely. But sometimes it can, when it has to do simply with absence of a particular specialist. A plastic surgeon for instance, or an ophthalmologist.

Furthermore, you aren’t a prisoner and if you want to sign out and go to another location, it’s your right. As long as you understand the risks.

I offer this because these are difficult times in medicine. And having done emergency medicine for 29 years, I want to make sure everyone understands how to navigate these times.

Stay safe and stay healthy.

Other physicians, nurses, etc. are welcome to add their own tips in the comments.

Edwin