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Emergency Room Challenges for Rosemary

Senior Health:  Emergency Room Challenges

Georgia tells Rosemary that she has been given some pain medication that made her more dizzy and tired.  The nurse tells Rosemary and Georgia that they are now waiting for the results of the x-ray, and to let her know if they need anything while they wait.  Georgia refuses more pain medication because it made her feel funny.  Now they wait.

Georgia needs to go to the bathroom.  Rosemary steps out of the room to look for Georgia’s nurse, everyone is walking so quickly and not making eye contact.  Rosemary goes back into the room.  She does not know what to do but Georgia is desperate so Rosemary goes back out of the room to find someone.  Rosemary stops a woman wearing a white coat who ends up being a doctor, the doctor states she will send someone in to help.  Rosemary goes back into the room, Georgia still has to go to the bathroom; Rosemary holds her hand to try to comfort her.  After what seems like a lifetime, a nurse comes into the room to place a catheter for Georgia so that she can go to the bathroom.  Georgia is not allowed to get out of bed.  Rosemary is sent out of the room for this procedure.  She feels uncomfortable standing in the hall and tries not to be in the way of the stretchers and the multitude of people rushing by.

Rosemary is let back into the room and the nurse rushes off.  Rosemary notices a bag hanging on the bed nearly full of urine.  Georgia makes a face about having to have a “tube put in her bladder” but she admits that she feels better.  Now they wait and Georgia dozes.

Emergency Room – What is taking so long?

Most people have visited the emergency room at least once in their lives, if not to seek care personally, then to visit someone else.  You may have wondered what is going on in there and why it seems to take so long.  Accessing emergency care can be confusing, stressful, and scary.  Here are a few things to debunk some of the mystery.

Six common misconceptions about the emergency room

1.  Everyone is sitting around

It may appear that people are sitting down, but keep in mind some things need to be accomplished away from the bedside such as calling a patient’s family, calling pharmacy for medications, charting, setting up bed assignments, viewing x-rays, CT scans, and lab values.

2. It does not take my doctor this long when I go to his/her office.

Testing done in the emergency room in a single day would take week or more if completed as an outpatient.  The emergency room houses many disciplines as well as a multitude of diagnostic equipment.  It may seem like it is taking a long time, but a few hours is replacing weeks of waiting.  When someone presents to the emergency room with an emergency, testing is done quickly to rule out life-threatening illness.  Your primary doctor should order all routine testing for all non-life threatening conditions on an outpatient basis.

3. I did not get a room right away after I was triaged, they must not believe me.

When a patient comes into the emergency room they are triaged by staff trained to recognize life-threatening conditions and facilitate immediate care for those people.  The most commonly used triage model is the three level scale.  The three levels are emergent, urgent and non-urgent.  Emergent patients present with a problem that involves and immediate loss of life or limb and are seen immediately.  Urgent patients require prompt care, but can wait several hours safely.  Non-urgent patients need attention, but time is not a critical factor in ensuring a positive health outcome.

4. It does not look busy, there are only three people in the waiting room.

Even if the waiting room does not seem busy, emergency rooms also receive ambulances that do not arrive in the waiting room.  Ambulance traffic to the emergency room is unpredictable and requires the immediate attention of staff.  In addition, the acuity of patients currently in the emergency room may change waiting times for those in the waiting room.  Emergency personnel are utilized to stabilize emergent patients before they can care for urgent or non-urgent patients.

5. I was here first, why am I not getting service right away?

When someone sees his or her doctor in the office, there is a set time for an appointment.  In the emergency room, there are no appointments as patients are evaluated with a strict set of guidelines based on acuity to provide the safest care possible.  Society is so used to the first-come-first-served-rule, but it does not provide a safe sorting system for the emergency room, only the appointment-based doctor’s office can support this rule.

6. I am being discharged from the emergency room and they did not fix my sore leg.

The purpose of the emergency room is to rule out or treat life threatening conditions.  Presenting to the emergency room, being cleared of a life threatening condition that does not require immediate care, often results in the patient being referred back to their own doctor or a specialist for treatment and follow up care.

For more information about triage







Comments (0) • Posted April 18, 2011

Author: Julie L., BS, BSN, RN
Julie has worked as a Registered Nurse in the emergency room, as a clinical nursing instructor, and as a director of clinical services in home care.

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