A Night At The E.R.
© Dmae Roberts
I’ve been to the emergency room only a few time for myself or family members. Usually we had fast response and care. But nationally E.R. wait times have increased since the recent economic downturn. A 2010 Press Ganey Pulse Report revealed that the average length of stay in a U.S. emergency department increased to 4 hours, 7 minutes.” More people are using the E.R. for primary care.
That was evident last Sunday night when my brother came to my house around midnight with a bloody hand. He had cut it on a lawnmower blade earlier that night. I immediately took him to the E. R. at the neighborhood hospital. These are the approximate times of our night.
12:25am – I take Jack to the E.R. The desk nurse puts some gauze on his deep gash and loosely wraps it with a bandage.
12:40am – He’s checked in. Someone takes his blood pressure. We sit in the waiting area. About 25-30 people, half are people of color, are in the waiting area. Some look like they have sprains. Some are coughing. One man had a bag of ice on his jaw. A woman in front of me looks like she’s about to vomit.
1:30am– Jack is registered.
2:30am – My brother nods off in the waiting area. I ask the desk nurse if we should just see our family clinic, which opens at 7:30am. She cautions it’s a serious cut and he should be seen right away. I remind her it’s been two hours.
2:35am – The desk nurse apologizes to those waiting. Ambulances have been bringing in people through the back entrance, she says. An elderly woman moans, “but I arrived on an ambulance a long time ago.”
3:10am – A young man in a leg brace and his two friends leave the E.R. laughing. A woman being wheeled by in a wheelchair munches on a sandwich. My brother is in pain. He’s received no medication. About 20 people are in stages of sleep around me.
3:15am – My brother’s name is finally called and we take the long walk to the treatment area. We see nurses and doctors chatting and laughing. No one seems to be emergency mode. I’ve walked into more hectic offices. We’re shown into a room with a hospital bed and left there.
3:20am – A nurse asks if I’m a family member and I say yes. She asks my brother to take his pullover shirt off so she can take his blood pressure, but he’s scared to hurt his hand. I later look at his chart and it says ‘patient refused to remove shirt.’ The nurse pulls the curtain over the sliding door so we can’t see out.
3:25am – I open the curtain slightly to look at the nurses station. The same nurse who took Jack’s blood pressure asks if there’s a problem. I say, “yes, my brother has a deep cut and we’re waiting.” I stare out so we won’t be forgotten. I read out loud a sign posted on the wall about patients’ rights and advocacy. The title: “SPEAK UP.”
4:00am – The doctor appears. He says the cut needs to be cleaned and asks my brother if that’s all right. Jack’s tired and in pain and isn’t responding. I say, “yes, it’s all right. Let’s do it.” The doctor is perturbed. “Are you a family member?” Yes, and we’ve been waiting since 12:30am. He apologizes and says that when he came to work at 10:30pm, he had 20 cases already. “Must be a full moon,” he ponders.
4:10am –The doctor sticks a needle filled with lidocaine several times into Jack’s hand. Jack groans in pain. The doctor leaves.
4:20am – A different nurse washes Jack’s wound. I hear the doctor on the phone in the hallway.
4:30-4:45am – The doctor returns. I watch him make seven sutures. I’m relieved the wound isn’t exposed anymore. The doctor talks about follow-up care and a temporary cast. We’re glad the ordeal is almost over. We wait.
5:00am – A young male nurse enters and says a fiberglass cast will be faster but he likes to do plaster ones. I say whatever is quicker. We’ve been here since 12:30 am. He replies back that he’s been there since 10:30 p.m. He leaves.
5:15am – The male nurse returns with the cast and molds it around my brother’s forearm. He bandages everything. It takes 10 minutes. But we still need to wait to be released.
5:35am – We exit through the waiting area. The desk nurse waves a goodbye. Might have been a full moon, but we didn’t see it. It’s now daybreak.
I don’t know if this was a portent of things to come or if this wait time was an anomaly for Portland. I left angry and disappointed, not with the care itself, but with the lack of urgency. I know if I hadn’t been there as an advocate, it might have taken longer. Quiet people seemed to take longer to be seen. Maybe the medical staff moved more quickly with emergencies brought in the back entrance. But it didn’t seem like they were in emergency mode to us. I wonder if the hospital could truly handle critical emergencies if something catastrophic occurred. With more people unable to get insurance or primary healthcare, I can’t help thinking the wait for emergency care will only get worse.