Tuesday, December 31, 2013

What A Year


So many things. So many changes. So many accomplishments. So many places. So many.


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Thursday, December 26, 2013

Preach it Sista! --A Must-Read

I came across this blog post and the following reply linked on facebook by two of my friends and former co-workers in New York. It is too good not to share. I can't tell you how tired I get of hearing people complain about how long they had to wait in the ER that one time when they had to go. A former patient of mine said it best on a particularly horrendous night at Mission Hospital in Mission Viejo, CA. He had just been assigned to a room, I came in and apologized for the wait. His reply has stuck with me for six years. He said, "You know, I never feel bad about having to wait anymore because there was one time I didn't have to wait. I brought my five year old son in who was not breathing. We were rushed back and immediately surrounded by a team of nurses, physicians, and techs. My son is alive because of those people, and I hope I never have to not wait again. Every time I have to wait, I thank God." Emergencies don't wait. That's what it boils down to. Remember that before you call your local ER to inquire what the wait time is. We will NEVER be able to answer that question because we can't see you over the phone. Hint: if the wait time or weather has any effect on your "need" to go to the emergency room, it's not an emergency. Rest assured, if you have an emergency you will not wait. It is called an emergency room, not a convenience room. That's my ten-years-experience two cents on the following article and reply. The blog post was written by and ER nurse and the follwing reply was written by a man who has been an ER physician for fifteen years.

Someone named Rose replied to the original blog post with her opinion that being busy is no excuse. An opinion that seems to be popular among those who have never seen the inner workings of the emergency room --be it as a healthcare worker or emergent patient. The following is the reply of Derek, an ER physician --priceless:

Rose, you must have accidentally thought you went to the “Convenience Room”. Believe it or not, you actually went to the “Emergency Room”. In theory, there should not be a single test performed in the ‘Emergency Room’ that we can just ‘send you home and call you later’. We are testing for, well, “emergencies”.
Can you imagine: Ring, ring… “Hey, Rose? … Dr. Smith here. … Yeah, so the tests came back. … You are, in fact, dying. Rather quickly, actually. … What?. … I know, right?! … Yeah, so, an-tee-way, do you mind, like, coming back in?… Great!…. Also, please stop by Arby’s and have a double roast beef and supersize curly fries before you come back. Thanks! Drive careful! … Of course you can have a work note. See ya in a bit! We’ll get the Demerol ready!”
The reason you are waiting so long is people have lost sight of what the emergency room is about. ED staff are overwhelmed with noise and trying to pick out that signal in the noise is becoming even more difficult. That includes PMD’s, specialists, nurses and especially patients.
Seriously, last shift I worked these were some of the chief complaints: ‘vomited once 3 hours ago’ … ‘no complaint- car accident yesterday, wants to get checked out’ …. ‘no complaint- had positive pregnancy test at home and wants to confirm’…. ‘bloody nose in a 13yo *yesterday*; mom read on internet it could be cancer; wants cancer testing’- at 3am …. ‘rash for 2 weeks, called PMD answering service at 2am, Told patient to go to ED’
The reason we ignore you is the same reason you turn the radio down when you are following directions. We need to concentrate so we don’t get lost. I say this about 10 times a shift, “If you are waiting in an emergency room it is a good thing.” You don’t want to be the person that doesn’t wait. Trust me.
The average stay for an ED visit is 4 hours. *Average*. So half of all ED visits will be over 4 hours.
God forbid you call your primary, wait 1 or 2 weeks and then to go to your primary, then wait another 2 weeks for results. Honestly, your problem will most likely be resolved before you get to the appointment. You can then cancel your appointment then BAM! Money in the pocket.
50-70% of what comes through the door does not even need to be there. Remember the Great Runny Nose Epidemic of 1746 that killed 17 million people? Exactly, because it didn’t f’ing exist. Colds just go away after 2 weeks. So does most everything else.
Also, when did fever in otherwise well appearing children become an emergency? And vomiting? Geez, when I was a kid I didn’t even wake up my parents. I would just get a trash can and vomit all night. By the next day gone.
Wait, you don’t have a primary? If only they could invent something, like a book that would have phone numbers in it– we could call it a “phone **book**”. We could even separate businesses from regular people. Perhaps, a different color of paper, like green, red… no! How about yellow?
Wait, you have no money? How can you then possibly justify a $1500 ED bill for cold like symptoms vs a $300 office visit? Don’t forget the $700 ambulance since you couldn’t find a ride.
BTW, No, I will not give you a work note; i need you to go to work and pay off your *&%$-ing bill so everyone else doesn’t have to pay double on account of your lazy ass.
Also, don’t tell me you don’t have $300, when you spend $2098.76 a year on cigarettes. What? Oh, you just bum them off of everyone else and don’t ever buy them? Ah, Just like your healthcare.
ED doc for 15yrs.