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I wish to share with you some of the Feedback comments posted on the online edition of Hernando Today in response to the Sunday column ‘Holiday’s ER sign a farce” printed two weeks past. [Note: The editor’s use of ‘Holiday’ was an aptly placed, but apparently ignored, descriptive word.]
Posted by (Rached): “Dental pain is not an emergency. The patient already was on pain medication. Paying $1 to be seen by a medical professional is typical of patients who think the world owes them. Go to a walk in clinic next time. Oh wait! They make you pay, don’t they?”
I bet a whole donut to a donut hole that (Rached) is not among the 32 million people meant to receive medical coverage from the healthcare reform bill. Might not (Rached) be one of many Americans who are reliant on the gracious benefits of the biggest of all federal entitlement programs – Medicare – that keeps her healthy, wealthy and selfish?
Being that “Dental pain is not an emergency”, time wouldn’t have been ill-spent and the hospital wouldn’t have been short-changed $1,999 for a butt injection of antibiotics and a script for amoxicillin if Pat had been made fully aware of what, and why, he was up against in a waiting area adjacent to an Emergency Room. (Rached)’s comments were pointless.
Posted by (mickster): “There is no excuse for being rude to the registration clerk. Unless you are dying, if you are rude or entitled then you wait longer. This column is incredibly irresponsible journalism, presenting a very skewed opinion that is one-sided. Before you write your next piece about an ER, talk to the people that work there about what they are dealing with on a day to day basis.”
The clerk was there to take a name, address, telephone number and alternate contact. She did her job, as do customer service reps at phone/cable/credit card companies, all of which are easy targets of consumer discontent and anger. Of course, no one ever gets upset that the first point of contact can’t identify and resolve a situation with a flick of a switch or a few taps on a computer keyboard. The (mickster) dipped below the ballast line of the column, which was more about relating an experience rather than expressing an opinion.
Posted by (DoctorSmith): “If they told you up front the wait would be 3 to 4 hours, why are you complaining that it took 3 to 4 hours? Seems like they were up front an honest with you. There are other hospitals in the area with ERs. Did you call those to see if they had a shorter wait time?” No, but Pat did. The person at Oak Hill Hospital couldn’t provide the slightest hint of how long the wait might have been. (DoctorSmith) needs a more temperate thermometer.
These posts were puppy dog yips compared to emails received from RNs and a CEN. Although critical of the column, it was because they interpreted it as being inconsiderate of the professionals in the rooms beyond the waiting area. At no point in the column did I hint there was a lack professionalism of the caregivers. As stated, once in triage, the necessary care was resolved in fifteen minutes – ten minutes of which were spent making sure Pat had no adverse reactions to the injection.
One of the emails was from Nurse Kelly. Before reading the full text, a neighbor who works at BRH suggested she is a head nurse in the ER. Later, when I actually read parts of the text, I saw it signed, “Peace and God bless, Kelly J. Conner, RN, Sunrise, Florida”. I thought, what’s with a professional on the other side of the state making comments on what was strictly an experience in Hernando County?
Checking the other emails, none suggested they were sent by a local reader. I went back to Nurse Kelly’s email and found the paragraph, “Also, so you know, this is how emergency room nurses across the country are responding to your article: www.facebook.com [followed by a series of words, letters, numbers and special characters].
“WHAT?!?!,” I exclaimed aloud. Facebook? One of the many social pit-stops in the twilight zone of the Internet?
Out of curiosity, I clicked and found myself directed to the Facebook sign-in/sign-up page. I don’t go there. I refuse to give out my email address and set up a password to be a part of, or subjected to, the invasive nature of online sites that cannot guarantee my secured privacy. They appear to be as big, or more of, a threat to our privacies than how Big Brother government has been portrayed.
The emails should have been sent to the editor of Hernando Today, whose readers were the only ones meant to read about the experience. Perhaps this time someone will offer responsible responses to educate our local residents. I can’t relay the info I received from the emails. While one nurse mentioned there are 5 categories used to determine the order of attention, another mentioned 3 levels. Too, there were comments about why a patient’s self-described pain level is often discounted.
The emergency care waiting area ‘Notice’ should be sided with a Disclaimer that explains ER standards and procedures. A Disclosure statement should advise those in need of care that the basic fee to obtain ER care starts at $2,000 so that people can decide if perhaps a doctor visit might be appropriate – during regular weekday business hours. “Oh wait! They make you pay, don’t they?”
An employee at BRH, and x-ray tech who works long hours, sometimes six days a week and often still ‘on call’, prompted my writing about Pat’s ER misadventure. Unless she lied to me, she and nurses were gung-ho for me to explain that the problem lies with the administration, but not the highly educated medical professionals who save lives, cure illnesses, and go home crying because they see patients in excruciating pain or witness a child breathing his/her last breath. Moisture wells before my eyes, too.
Finally, also on Hernando Today’s website: Posted by (nikkinala): “It’s a shame that the cuts they’ve made are affecting service so severe. A little more concern/compassion from the desk clerk probably would have gone a long way.” Thank you for being attentive to the nature of my column.
As to those emails from a bunch of fricasseed Facebook fritters suffering from Disorder Deficit Attention? Securely placed in Yahoo!’s IDCU (I Don’t Care Unit) – Spam.
Saturday, June 19, 2010
Holiday ER Not Memorial
NOTICE: Our patients are treated in order of severity of illness or injury and not in order of arrival.
The engraved plaque outside ER 105 at Brooksville Regional Hospital proved to be a farce. Arriving shortly after 4 pm this past Sunday, Memorial Day weekend, the registration clerk in the Emergency Room advised the patient, Pat, that the waiting period would be three to four hours. It seemed excessive considering there were, at the time, but four or five other people waiting for medical attention, none of whom appeared to be in as bad a shape as he.
Pat’s face was swollen, very visibly so, especially his upper lip that had ballooned over a thirty-six hour period when a chipped tooth earlier in the week broke Friday evening. I first saw his condition Saturday evening when he and Lexi, his daughter, stopped by. I was truly shocked. He was in a fog from the infection that had spread to his nasal passages and kept in a fog from taking prescribed pain meds for a herniated disc.
Pat passed out on my sofa so he and spent the night. Zonked out until mid afternoon Sunday, he woke with a series of painful groans with a realization the only option was to go to an Emergency Room.
The job function of the person behind the desk was clearly clerically limited. Her actions led me to believe that she more a front line of defense rather than the first step to receiving medical attention. On this particular day, the priority of receiving care was one of first come, first serve. Even then, the care he received was out of order.
Other ER patients appeared to be in much less discomfort. Each was quick to get up from their seats when called by the triage nurse – one after another, in and out with no obvious ailments. Even after the others had been tended to, patients arriving later were taken out of order, before Pat. Questioning the person at the desk, the only response was she had no control – it was out of her hands.
Up to that point, the loudest wailing in the room came when the electricity went out and her data entries on the computer were lost.
At another point, a mother rushed into the ER with her baby girl, maybe three years old, demanding the attention of a nurse NOW, which she kept yelling. The only response from the woman behind the desk was that a nurse had been advised. By then, she had moved from behind the desk to face a wall, shuffling papers, seemingly to avoid further contact with the screaming mother.
The only words spoken by the little girl: “I need a band-aid.” No panic, no tears. Within minutes, a nurse simply taped three-inch squares of gauze over the wound. Although I didn’t see how severe the gash was, there was no blood appearing on the temporary bandage. The little girl was content as mom pushed her around in a wheel chair.
After waiting three hours, I became a bit testy, verbally suggesting Pat would get better care if he had insurance, were an illegal immigrants or – Pat had to hold back a laugh at this one – he would have been better off seeing a veterinarian!
The woman behind the desk asked why I was being mean to her, as did another person in the waiting room. The problem with the situation was that, at no time did a nurse appear in the waiting room to evaluate ‘the severity of injury or illness’ of those seeking medical attention. The ‘desk person’ was the only hospital employee available. (There was no security guard until 8 pm.)
After finally talking to the triage nurse, and given the care of a physician, Pat was released within fifteen minutes, just long enough to receive an antibiotic booster shot and a ten minute wait to make sure there was no adverse reaction, during which time a script was written for an oral antibiotic to be taken until he could see a dentist during normal weekday business hours for a tooth extraction.
From the get-go, there was nothing else that could have been done. The needed attention was unnecessarily delayed. There were no emergency ambulances on that day; otherwise the wait would have exceeded the five hours.
An employee assured me that on most days the ER operates efficiently. But the hospital has initiated severe cutbacks in hours, thus coverage. Another hospital employee, who works in transportation services – he pushes gurneys to and from technicians who perform tests to diagnose patient ailments – is retiring soon, at which time the position is expected to be eliminated, leaving the technicians themselves doing the push and pull. Volunteers will offer limited assistance due to liability concerns.
This may lead to longer delays in responding to and evaluating the needed care of patients. My assumption is that this could, in turn, increase overnight admission$.
Unfortunately, the timing of Pat’s needed care was on the weekend, the cost of which was in excess of two thousand dollars. I paid the ‘good faith’ down payment – one dollar.
The engraved plaque outside ER 105 at Brooksville Regional Hospital proved to be a farce. Arriving shortly after 4 pm this past Sunday, Memorial Day weekend, the registration clerk in the Emergency Room advised the patient, Pat, that the waiting period would be three to four hours. It seemed excessive considering there were, at the time, but four or five other people waiting for medical attention, none of whom appeared to be in as bad a shape as he.
Pat’s face was swollen, very visibly so, especially his upper lip that had ballooned over a thirty-six hour period when a chipped tooth earlier in the week broke Friday evening. I first saw his condition Saturday evening when he and Lexi, his daughter, stopped by. I was truly shocked. He was in a fog from the infection that had spread to his nasal passages and kept in a fog from taking prescribed pain meds for a herniated disc.
Pat passed out on my sofa so he and spent the night. Zonked out until mid afternoon Sunday, he woke with a series of painful groans with a realization the only option was to go to an Emergency Room.
The job function of the person behind the desk was clearly clerically limited. Her actions led me to believe that she more a front line of defense rather than the first step to receiving medical attention. On this particular day, the priority of receiving care was one of first come, first serve. Even then, the care he received was out of order.
Other ER patients appeared to be in much less discomfort. Each was quick to get up from their seats when called by the triage nurse – one after another, in and out with no obvious ailments. Even after the others had been tended to, patients arriving later were taken out of order, before Pat. Questioning the person at the desk, the only response was she had no control – it was out of her hands.
Up to that point, the loudest wailing in the room came when the electricity went out and her data entries on the computer were lost.
At another point, a mother rushed into the ER with her baby girl, maybe three years old, demanding the attention of a nurse NOW, which she kept yelling. The only response from the woman behind the desk was that a nurse had been advised. By then, she had moved from behind the desk to face a wall, shuffling papers, seemingly to avoid further contact with the screaming mother.
The only words spoken by the little girl: “I need a band-aid.” No panic, no tears. Within minutes, a nurse simply taped three-inch squares of gauze over the wound. Although I didn’t see how severe the gash was, there was no blood appearing on the temporary bandage. The little girl was content as mom pushed her around in a wheel chair.
After waiting three hours, I became a bit testy, verbally suggesting Pat would get better care if he had insurance, were an illegal immigrants or – Pat had to hold back a laugh at this one – he would have been better off seeing a veterinarian!
The woman behind the desk asked why I was being mean to her, as did another person in the waiting room. The problem with the situation was that, at no time did a nurse appear in the waiting room to evaluate ‘the severity of injury or illness’ of those seeking medical attention. The ‘desk person’ was the only hospital employee available. (There was no security guard until 8 pm.)
After finally talking to the triage nurse, and given the care of a physician, Pat was released within fifteen minutes, just long enough to receive an antibiotic booster shot and a ten minute wait to make sure there was no adverse reaction, during which time a script was written for an oral antibiotic to be taken until he could see a dentist during normal weekday business hours for a tooth extraction.
From the get-go, there was nothing else that could have been done. The needed attention was unnecessarily delayed. There were no emergency ambulances on that day; otherwise the wait would have exceeded the five hours.
An employee assured me that on most days the ER operates efficiently. But the hospital has initiated severe cutbacks in hours, thus coverage. Another hospital employee, who works in transportation services – he pushes gurneys to and from technicians who perform tests to diagnose patient ailments – is retiring soon, at which time the position is expected to be eliminated, leaving the technicians themselves doing the push and pull. Volunteers will offer limited assistance due to liability concerns.
This may lead to longer delays in responding to and evaluating the needed care of patients. My assumption is that this could, in turn, increase overnight admission$.
Unfortunately, the timing of Pat’s needed care was on the weekend, the cost of which was in excess of two thousand dollars. I paid the ‘good faith’ down payment – one dollar.
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