I came in with absolutely no wait..ambulance directly to a trauma bay, no waiting, no clothing, no nothing.
After about six hours they figure out I was not going to die and was relatively okay. Okay here means two broken legs not “walking around”. Half of the patients at this hospital had covid and I have a five month old at home who isn’t vaccinated (obviously).
Once I got admitted to the trauma floor for a couples days it was like I didn’t exist. The staff seemed totally overwhelmed and it took hours to get some simple things like water. Without visitors, a bag of belongings got delivered by being isolated in a chair well out of my limited reach. Took me eight hours to get my laptop from that bag. I was okay with that because I wanted to interact with as few potential covid vectors as possible but wow.
I think, from my experience there are a couple of things happening:
1) staff are overwhelmed to day with the ratio of patients to staff. I can’t comment why but the nurses I saw weren’t sitting they were constantly moving.
2) staff are demoralized and frustrated. You could hear it in their voices and tone and body language. They were trying but grumpy.
3) shit rolls down hill. Drs. (Save one angel who talked with me for 30 minutes about life) where in and out for brief profunctory conversations that had no communicative value about what was
They need more nurses. And like everywhere else it seems no one is willing to pay them more or treat them better. We can pay execs millions with no qualms and no evidence it works. But as a patient having the worst day of my fucking life, I interact with front line staff and they are out there getting run into the ground and being treated like shit for it.
I’m so sorry for your wife, I was so lucky I had a different experience. But the shared thing, I think, is that the American medical system is going through a full and complete collapse and no one with the power to change things is willing to do anything.
I’m terrified.
A explanation why people are frustrated, who work hard and intense, take all the risk - but only get low pay?
And people wonder why nurses are pissed off?
Stress is why I made the firefighters put in safety glasses and got angry at them that I couldn’t find my glasses. Both while trapped under a literal oak tree
In the interest of profits we have wrung every ounce of every part of the system that runs healthcare. And at the end of all of those elements are human beings. Such systems are unstable. They work but are not fault tolerant at scale because no one ever really looks at the whole system they just look at a part of the system they control. I’m okay if healthcare is more like an a320 as opposed to an F22 because the F22 needs 50 man hours of maintenance to fly and the a320 does it’s thing in a much more germane fashion. Jwst can have 184 single point of failure actuators because it’s the bleeding edge, healthcare needs to have -184.
The problem is we see humans as humans. A machine breaks, it is not perceived as having agency, autonomy, or humanity we don’t blame it. When people die waiting in an er or healthcare personnel are short with patients or quit in droves there is a person whose actions and motives we can question and blame. We understand that experience slightly more and can find ways to question it.
It isolates the problems from view. When no one’s looking at the whole system (and being listened to) no one can shift course. It was not efficient to build capacity for truly abnormal events, so it didn’t make financial sense For anyone to do so. And now nurses are testing and isolating…and. Not just. And.
They fucked around with these people for so long that when they need them, actually need them, they aren’t there. They rolled the dice in an assumption that they held sufficient economic power to control them. Now they are left exposing patients to covid as a necessity to prevent their operations from completely ceasing.
That is failure by any other name.
But if you came pre-covid during say weekend night and you were not clearly about to die, 10+h waiting time in emergency was not unheard of (wife was serving there for some time as doctor, those folks deserve some proper respect). Simply overwhelmed, not enough staff comprised mostly by junior doctors. Now they are properly good in diagnosing whether your excruciating pain is life-threatening or not, but it must suck big time to be on patient's side.
This is by far the biggest emergency in whole canton. Any private clinic or smaller medical centre will send serious cases straight there.
Its not something discussed frequently but that's just how things are, in one of the richest and well-organized countries in whole world. Don't expect much better experience if you have bad luck with timing.
That means, I had to wait only a short time once, but that was after a dog bite to my face and it just looked horrible with blood all over it.
But the next time, with an deep open wound in my leg, which was actually way more dangerous, I had to wait quite some time, before they even checked.
Last week, my son had COVID (tested positive) but mild symptoms. At some point he says "I have a blue tongue, I don't remember having that before". Doctor and wife want to rush him to the ER and I say no. My daughter and I debugged it a day later (he had just taken a blue gummy pill, and somehow didn't think to mention that). What would have happened if we went to the ER? Shrugs from the doctor after sitting around the ER at midnight-5AM ("yeah I guess it's not cyanosis and it's gone now"), my wife and I have increased exposure to COVID in the ER, and a $3K bill for looking at a tongue.
1. Many hospitals are under staffed. Schools that produce nurses have stayed steady state while demand has increased. This was before the pandemic. During the pandemic many nurses left due to mandates, being treated poorly (by hospital mgmt and people in the hospital), being overworked during shortages, and more. This has all made staffing a huge problem.
When hospitals don't have the staff they close beds down and can't operate at full capacity.
Hospitals that used to only hire RNs with bachelor degrees and wouldn't consider an associates (it's the same amount of schooling in the nursing portion) are now trying to hire LPNs.
2. Some emergency rooms are seeing a crazy number of people. More than usual. This is for a variety of reasons. COVID is one but also people putting off having things treated so they are now emergencies is another. Couple this with the staffing shortage and it's even worse.
Do you know that it would have been a shorter wait time during a period where the hospital wasn't overwhelmed? If so, how much shorter? Perhaps the medical staff were able to tell the signs of ectopic pregnancy in a way that allowed them put your wife lower on the triage priority list than you thought she should have been.
Does your area have any sort of restrictions? If not, how would the amount of time you had to wait be changed in a world where your area did have restrictions?
Even if you can show some benefit from the restrictions, are the benefits great enough to be worthwhile given the costs?
Vaccines are entirely different story. They seem to have little effect on transmission (maybe enough to be useful after three doses but maybe not), but they seem to substantially reduce the number of people who end up hospitalized. So more vaccines would lower the curve, not flatten it.
(Take this with a grain of salt. Great data on vaccine efficacy in the US is a bit hard to come by, and I haven’t run the numbers.)
Actually I had to go to the hospital (not covid) and it was almost deserted with reception coming to check the desk they were supposed to be attending half an hour after we were supposed to be there. People generally went less to the hospital because of the pandemic (which causes other problems).
The time I had to wait 2 hours in SF, with a kidney stone was not pleasant, but it was at 3 AM at a hospital that does charity for the homeless, so that was a bit exceptional.