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How the heck do hospitals function?
- Thread starter GFLPraxis
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Years ago I broke two bones in my hand and waited for hours in the empty ER (it was late at night) and a nurse finally came around and said if I lived close I should probably go home and rest 'cause no one is gonna be able to see me until 7 or 8 am (when the day shift arrives). I left, came back, waited some more before I finally got X-rays done. I then had to wait a few more hours for the orthopedic specialists to arrive because my injuries were beyond what the ER could fix. Before seeing the Ortho though I had to go across the street to fill out paper work (which sucked because I'm right-handed and that's the hand I broke) because I was a US citizen studying in the UK at the time.
So I finally get to see the Ortho (my hand has been broken for probably 12hrs by this point) and he tries to set the bones by hand (so as to avoid surgery) and that hurt like a b*tch. And ultimately failed which means I had to get scheduled for surgery. For the time being they put a cast on my hand and set scheduled a surgery for Tuesday morning (this was friday morning) which means I needed to check into the hospital Monday. So I show up at the hospital for my schedule appointment w/the Ortho at 1pm to go over what exactly is going to happen during surgery. At 4pm I finally see him. I then have to wait around until 1am for a hospital bed to open up (and I can't leave the hospital otherwise I lose my place in line waiting for a bed).
Ah, the memories. On the upside, all that waiting makes you a much more patient person.
Lethal
So I finally get to see the Ortho (my hand has been broken for probably 12hrs by this point) and he tries to set the bones by hand (so as to avoid surgery) and that hurt like a b*tch. And ultimately failed which means I had to get scheduled for surgery. For the time being they put a cast on my hand and set scheduled a surgery for Tuesday morning (this was friday morning) which means I needed to check into the hospital Monday. So I show up at the hospital for my schedule appointment w/the Ortho at 1pm to go over what exactly is going to happen during surgery. At 4pm I finally see him. I then have to wait around until 1am for a hospital bed to open up (and I can't leave the hospital otherwise I lose my place in line waiting for a bed).
Ah, the memories. On the upside, all that waiting makes you a much more patient person.
Lethal
This is true, although from what I understand, non-emergent use of the ER is a problem in most countries with nationalized health care also. Particularly among lower income / more poorly educated patients.
I think we all have to remember to consider the ER's success rate with life threatening conditions in balance with the nuisances of receiving care for emergent but non-life-threatening conditions.
Also for everyone receiving outpatient care, don't feel bad to have the doctors and nurses be very concrete with you about when and how to escalate care seeking. That is, exactly what circumstances should cause you to ... seek out ER care, call the 24 hour on-call, etc, etc. Not just so you can avoid going to the ER unnecessarily but also so that you do not ignore potentially serious complications or adverse reactions.
here we have two types of ER's
true ER for the trauma, heart attack, stroke and near drowning
then the Urgent Care Units for the broken bone, stitches, 'my back hurts'
the wait times for let setting broken bone are about ~3 hours at the ER, ~1 hour at the UCU.
I go to the UCU often for my really bad migraines and wait about 30minute before treatment - but the staff there all know me by name so...
true ER for the trauma, heart attack, stroke and near drowning
then the Urgent Care Units for the broken bone, stitches, 'my back hurts'
the wait times for let setting broken bone are about ~3 hours at the ER, ~1 hour at the UCU.
I go to the UCU often for my really bad migraines and wait about 30minute before treatment - but the staff there all know me by name so...
I've been to hospital once, and was treated immediately. However, I did have blood pouring out of my head at the time, so I guess I did deserve urgent treatment
Well, it would appear that triage is alive and well, in your hospital at least.
GFLPraxis, could you at least favour us with the hospital and city?? Thanks.
2500 patients per day is amazing. Really.
At the hospital I do research in (6 to 8 month gig, plus spurts over the past 3 years), we do 1 patient every 48-60 hours.
That's why you have to know someone that works at the hospital, that way you've got connections
My mom is a business consultant for a hospital. You should hear the behind the scenes drama. Lets take just one of the many sagas: CEO for some reason not firing some high level lady even though she is a crazy- she has physically pushed people out of meetings, squirted Windex at a coworker because she was mad, instigated fights with everyone below her, tried to get people fired for expressing their concern about her ability to lead with the CEO
And my favorite...
The lady wrote a letter to a coworker who she hates on a post card from Paris with a French stamp (although no postmark stamp) apologizing for the tension in the office and then signed it "Nancy" to make it secret, even though the coworker recognized the hand writing and the crazy lady had been in Europe the week before.
I've only been to an ER 2x. One time I was 6 and had food poisoning so being so small I think I was prioritized. I also broke my arm and my mom called my pediatrician who is affiliated with a hospital so I got in fairly quickly.
My mom is a business consultant for a hospital. You should hear the behind the scenes drama. Lets take just one of the many sagas: CEO for some reason not firing some high level lady even though she is a crazy- she has physically pushed people out of meetings, squirted Windex at a coworker because she was mad, instigated fights with everyone below her, tried to get people fired for expressing their concern about her ability to lead with the CEO
And my favorite...
The lady wrote a letter to a coworker who she hates on a post card from Paris with a French stamp (although no postmark stamp) apologizing for the tension in the office and then signed it "Nancy" to make it secret, even though the coworker recognized the hand writing and the crazy lady had been in Europe the week before.
I've only been to an ER 2x. One time I was 6 and had food poisoning so being so small I think I was prioritized. I also broke my arm and my mom called my pediatrician who is affiliated with a hospital so I got in fairly quickly.
I love the fact that my mom is a managing nurse in the ER so when (yeah i say when because it's not an "if" I hurt myself) I get right in
I've cut my head open 3 times (once in Macdonalds, once doing a backflip and once doing a frontflip off a spring board
), once when I was attacked and another when I damaged a nerve.My brother takes the crown though. Was playing cricket in a field, ball went into schools ground, climbed the fence and got impaled on it. Somehow he got himself off and walked home. I was out walking the dog at the time so I saw a huge blood trail leading to the front door. His chest was like mash, so so many layers of insides. Lovely! He got seen instantly (duh!) and only spent 1 night at hospital.
This reminds me of the time I was back in Seattle.
I was sick with a very bad cold so I decided to visit the local clinic. Unfortunately, there was an issue with my insurance coverage. While we were working through the issue, the nurse that I was working with suggested that I go up the street to the local hospital and visit the emergency room to be looked at. She did this to try an help me save some funds.
Anyhow, my insurance issue was solved and I was seen at the clinic. I can't imagine going to an emergency room for being sick with a cold. However, apparently, I guess quite a few folks do which drives up our insurance costs.
My God - a topic on Emergency Medicine, I may actually be able to contribute something worthwhile.
I'm an Emergency Physician in a large teaching ED in Australia but have also worked in Emergency Medicine in the UK.
Being a patient in the ED is no fun (nor is being a doctor to be honest). All of the EDs I have worked in, bar none, are not so much understaffed but over-patiented (if that makes sense).
The bulk of my work is not dealing with very sick patients like you might see on the TV on ER (although they do happen). The majority of patients I see have presented to the ED for one of two reasons:
1. Convenience. Australia is (largely) public healthcare system (as is the UK) so insurance worries are not an issue. Patients will frequently come to the ED with problems they have had for weeks or months but have decided that they can only now spare the time for a consultation and can't wait 'til the next morning to see their family doctor with their minor ailment.
2. Poor education - both on a personal and a society level. So many people who present come with such frivolous conditions. Practically everybody in my state who has a single vomit and a couple of loose stools will come to the ED with "gastro" thinking they need bloods and fluids. Sometimes I do feel a little sorry having made them wait two hours to simply send them home with none of the above.
MadDoc,
I'm an Emergency Physician in a large teaching ED in Australia but have also worked in Emergency Medicine in the UK.
Being a patient in the ED is no fun (nor is being a doctor to be honest). All of the EDs I have worked in, bar none, are not so much understaffed but over-patiented (if that makes sense).
The bulk of my work is not dealing with very sick patients like you might see on the TV on ER (although they do happen). The majority of patients I see have presented to the ED for one of two reasons:
1. Convenience. Australia is (largely) public healthcare system (as is the UK) so insurance worries are not an issue. Patients will frequently come to the ED with problems they have had for weeks or months but have decided that they can only now spare the time for a consultation and can't wait 'til the next morning to see their family doctor with their minor ailment.
2. Poor education - both on a personal and a society level. So many people who present come with such frivolous conditions. Practically everybody in my state who has a single vomit and a couple of loose stools will come to the ED with "gastro" thinking they need bloods and fluids. Sometimes I do feel a little sorry having made them wait two hours to simply send them home with none of the above.
MadDoc,
Both of the above points are completely true in the USA as well. The only thing I wouldn't agree with is the suggestion that being a doctor is "no fun".