This week, White Coat Black Art deconstructs the wait in emerg...why you wait in the waiting room and inside the sliding doors themselves. As I mentioned in the show, the triage nurse at the front door to the ED assigns you a priority of 1 to 5 based on how sick you are. Ones and Twos (for example, people in cardiac arrest, with severe breathing problems, or unconscious) get in pretty much right away. Fours and fives are people with fairly minor problems.
It's the 'three's' that I worry about. These are people with urgent problems that aren't immediately life threatening....things like appendicitis, a tubal pregnancy or a bowel blockage. Threes are supposed to be brought in fairly quickly, yet overcrowding and lack of beds mean they often wait far longer to be seen by a doctor than they should. I've seen patients with appendicitis whose appendix burst while they were in the waiting room. I've also seen women with a tubal pregnancy that burst while they waited.
All the more reason why you should check out our interview on this week's show with two experienced triage nurses who work in Calgary. Triage nurses not only assess you at the front door; they keep reassessing you to make sure you're stable while you wait. And they do that while taking verbal and sometimes physical abuse from angry patients. I wouldn't want their job. I'm amazed they do it as well as they do!
Here's some take home advice. Next time you seek treatment in emerg, and you're asked to take a seat, ask the triage nurse what number you've been assigned. If you're a three, keep asking the nurse when you're going to be brought it, especially if you're feeling sicker. Just do it nicely!
In the weeks to come, we'll visit the emergency department at Hotel Dieu Grace Hospital in Windsor, Ontario, to show you the innovative things they're doing to shorten the wait.
Next week, we look at a very uncomfortable subject for people on the inside of medicine: how to deal with incompetent doctors. If you have an opinion on the subject, check out our latest question. That's medicine -- on my side of the gurney!