Our emergency department was very busy recently. The hospital was full and we were holding patients. Three had been in the ER many hours; one waiting for a bed for six hours, another eight hours, and still one more for eleven hours. Of course, ambulance traffic hadn’t stopped and the waiting room was full, with patients waiting too long to be seen. (And we all know that the media loves to highlight bad outcomes from the ER waiting room!)
Administration set up a ‘command post’ to try to arrange beds, discharges and moves. At one point I asked one of our administrators to move those waiting the longest to hallway beds up on the patient floors. He told me that he couldn’t because each of the two floors in question already had one patient in the hall. And besides, it would violate the patients’ privacy and make it too difficult for the nurses to do their admissions assessments.
I pointed out, ‘our nurses do assessments in the hall, our patients don’t have privacy and sometimes we have to work with seven or eight patients in the hallway!’
He replied, ‘yes Dr. Leap, I know, but I won’t move anyone else to the hall upstairs. I just won’t.’ I asked why. With a slight sense of obvious discomfort he replied, ‘because there is a different standard. When patients leave the ER, they expect to go to a better place.’ Read more »
*This blog post was originally published at edwinleap.com*