Saturday, August 20, 2016

Random observations in an ER

web IMG_20160819_171233362Due 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!

14 comments:

  1. Oh my, the car looks mangled. Glad you both came out of it unharmed. Some hospitals seem to be stuck in the past millennium, and in dire need of improving their communication systems... Not only in Canada, same in Germany. Fax? What the...?

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    1. yeah, I don't get it. With all the pressures on medical costs you'd think this stuff would be a no-brainer.

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  2. Glad everyone is OK......sounds like the hospital staff are working very hard......better if they work smart too....IMHO

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  3. Glad to hear everyone is OK. Please take care of yourself.

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  4. So glad to hear both of you are virtually unharmed when car is decidedly a write off the look of it.

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    1. I'm waiting for confirmation, but I don't think there's any doubt it's toast. Replacing all the air bags alone would cost more than it's worth.

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  5. I am glad to hear the car got the worst of it. Hope everyones aches and pains heal quickly.

    Quite the observations from the ER.

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    1. Thanks Trobairitz. The car did what it was supposed to and took the brunt of the hit.

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  6. The car does look totaled. Glad that you two are in much better shape.

    I think that the archaic communications are a result of the legal system and discovery. If you use electronic means, then copies of your communications are everywhere where a fax exists only at the sender and receiver. No other copies exist anywhere.

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    1. Thanks Richard. You may be right, but I really hope not. I'd be happier thinking it was just aversion to change than to think it's for legal reasons - which are generally the worst reasons to do or not do something..

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  7. Glad all is fine!

    As for faxing, it is still the preferred method, I do it every day with requisitions. Its more reliable than the computer.

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    1. Dar - Interesting that it's considered the preferred method. I guess, as a computer guy, it just seems so anachronistic to be physically shuffling bits of paper around instead of letting the "system" take care of the drudge work. But if it truly offers a better, more reliable service, then it's hard to make a case against it. Thanks for your comment - gives me something to think about.

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