Random observations in an ER

Due to a serious car accident (don’t worry, everyone is fine – the car, not so much) I got to spend several hours hanging around an emergency room observation area on Friday. When you have nothing but time on your hands it’s interesting what you can see and learn.

First of all their procedures. All the medical stuff seemed okay to me; how would I know otherwise? But the non-medical was the worst hodge-podge of systems and processes I’ve seen in a long time, in fact since I was in the hospital myself a few years ago. One example: The central monitoring area was replete with large screens, patient status information, etc. However when x-rays and CT scans were called for the ER faxed (that’s right – faxed!) the request to the appropriate department, they’d get an acknowledgement back, and a porter would eventually come and take the patient for the requisite test and then return them to the ER afterwards. Their central system has all the information – I could see it on the screens. Why are the imaging department and others not simply plugged in to see what tests are required and proceed accordingly? Faxed? How 70s. 

The porters work their asses off – literally. The one young lady I spoke to says she walks, usually pushing a bed, some 20 to 25 kilometers per shift. That’s in the region of 5,000 kilometers (3,000 miles) per year. As she said, “I don’t need a gym membership.” I didn’t ask if she got to write off her sneakers as a tax deduction, but I bet she goes through numerous pairs a year.

The young (and very handsome, according to the missus) ER doctor took his lessons on bedside manners a little too much to heart. I understand the need to not talk past the patient, but when I would ask direct questions about possible after affects or treatment plans for her injuries he would always respond to her directly, and not to me. The only problem was she was still in shock and somewhat sedated and hardly able to remember anything he said. Of course if that’s the only nit I have to pick (and it is) I suppose it’s no big deal; it just struck me as odd.

And when it comes to odd, one unfortunate woman came in apparently suffering some sort of seizures. The paramedics brought in not only her but also her companion dog, a male golden retriever. While a number of the staff were attending to her another nurse put together a water dish and a mattress pad for the dog’s comfort. Of course the dog preferred the bed and staff had to keep moving him so they could get at his owner. But it seemed just as normal as anything that there’d be a dog in the ER, the porters would carefully move beds around him, and every so often one of the nurses or other patients would stop and scratch his ears. It was quite heartwarming to see.

I remarked to one of the nurses that all the biologic and dangerous waste bins were in locked cages, and most were bolted to the walls. He replied it was for staff and patient safety as apparently it’s not uncommon for some visitors to the ward to flip out (non medical term) and try to get at needles or other dangerous items to do themselves or others harm. Not really surprising when you think about it, but a bit shocking to see the extremes staff have to go to to feel safe when they’re just there to help.

I would like the contract to provide the ER (and the hospital in general) with hand sanitizers. They go through the stuff by the gallon. I can only imagine how dry the staff’s hands are after 8 or 12 hours of rubbing them with what is essentially alcohol every few minutes. Actually, perhaps a contract for hand cream would be more lucrative; I didn’t see any of those dispensers around.

And finally, after all this attention and care, x-rays and CT scans, finding out that there are no injuries other than scrapes and bruises that will heal with time is simply awesome!