Emergency Rooms: The Canary in the Health Care Coal Mine

The Atlantic ^ | Dec 9 2010 | Megan McArdle

[Grampa Dave]

About 3 weeks ago, a friend had an accident at work probably to due to over zealous enviroism at the store where she worked. She tripped and fell before the store opened for business. The store to save on energy had very few lights on in the store, and the escalator and elevators were not running. The employees to get up and down the 3 stories had to use the stopped escalator with poor lightening to save on money.

The escalator’s last step to the lower floor had stopped about 3 inches below the floor and wasn’t even. Our friend in the semi dark couldn’t see the uneven step and tripped.

She caught her foot while falling and ending up with a break in her ankle and two bone breaks in her feet.

The time of the accident was about 9:30 am. An ambulance picked her up and took her to the ER at our local hospital.

At about 11 am after going through the paper work, medicare, a supplemental insurance and workman’s comp. She was admitted to a exam/treatment room about 30 minutes later.

Shortly after she was put into an exam room, two serious patients were brought in. One had been in a serious traffic accident and the other was having a serious cardiac event.

When our friend was brought into the treatment room at about 11 am, called another couple. They arrived at 11:30 am, and due to the two emergencies, our friend was basically untreated until about 2:30. A non ortho tech/aid put a temporary/light/mobile cast on her.

We got a call at 3 pm from the first couple, who had to go to an important appointment. We got to the hospital at about 3:15, more on the patients coming in below.

At about 4 pm we went into her treatment room. There had been a shift change and there was a new RN in her room. She and my wife knew each other via phone calls as my wife has been a lead office RN for decades. She showed my wife our friend’s chart, and my wife said the temp cast was not what the Ortho doc on call had ordered. There was a quick consultation, and the ER doc for the next shift came in. He agreed with my wife and ordered a sturdier cast for our friend. He said he wanted the Ortho tech to take off the incorrect cast and to put on the new cast. The ER nurse said that the er was filling up, he discussed/tiraged the patients and told the RN that our friend had been there for over 6 hours, hadn’t been fed and needed to be treated and sent home.

When the Ortho ER Tech arrived, I went back to the ER waiting room which was getting packed. Most of the potential patients and those waiting were not English speaking people.

There was an Asian group, their family member had the severe Cardiac event. None of them spoke English. The patient was in cardiac surgery, and the family was so large in number, several members were waiting in the ER waiting room. A Hispanic family/group were waiting for their family member, who had been in the accident.

The rest of the patients with the exception of two tough looking women spoke in various non English accents. One of them, the one with the purple hair and just a tee shirt had a book about how use Medicaid. Her Green haired friend with even more tramp tats apparently was the patient.

We got our friend out at about 5 pm. She had been in the ER for about 7 hours. After the ambulance arrived with our friend at the hospital, she was put into a wheel chair and taken to the ER waiting room which was packed by people waiting to see the doctor. Fortunately, the ER nurse got her out of the waiting room into a treatment/exam room and got her shot of Toradol to help ease her pain.

Our hospital has good ER Docs/RNs and techs, but like so many ER’s it is overloaded by non American patients with ear aches to serious cardiac and car accidents.

One of our inlaws back in the mid west is the person who gets called when one of her grandkids/nephews/nieces has to go to the ER. I have posted about her before. She carries and ICE Hat and Jacket in the trunk of her car, which she puts on before she goes into the ER waiting room with an official looking clipboard with a walkie talkie attached. She uses the WT after she goes in to say she is at the hospital. One of more relatives reply, and the waiting room hears the replies. She said that clears out a lot of trash in the ER.