My shift on Sunday night was nice, relatively easy, only one ICU admit, a few other non-ICU admits, a few discharges, and a whole lot of "hurry up and waiting!"
I guess as a provider, I have a more realistic expectation, perhaps experience, with the whole Emergency Medical process.
When someone is truly life-threatening/critical... a lot of resources are gathered and expended in a very short period of time. So yes, when a patient is having chest pain, a lot of things are done quickly, and if it is an Acute Myocardial Infarction (heart attack)... one can be in and out of the ED and on their way to the Cardiac Cath lab in about 10 minutes.
In those same initial ten minutes the ED can rule out the life-threatening problem. Now it becomes a minimum of a four hour rule-out... and even then, one might still get admitted for observation and further non-emergent testing in the morning.
Yet it's not just chest pains. Breathing problems, headaches, abdominal pain, etc... all of these have potentially life-threatening causes. The ED has to quickly determine the probable cause and either intervene, or treat and observe.
What truly amazes me, is that someone can be triaged and end up waiting several hours, only to finally get back to a treatment room, and start complaining that they have been here for "8 hours." A quick check of the computer, and they have only been in the ED for about 5 hours. I try to explain the process, yet once someone is upset, there is very little one can do sway them.
I think that the problem is that people think of the Medical System as a Service Industry. Like going to a restaurant, or getting one's A/C repaired. TV shows have not helped either, when a show depicts a patient's complaint being tested, diagnosed, and fully treated in a 30-60 minute episode!
Less than 10% of all visits to an ED, are truly life threatening (trauma excluded).
Regardless, I got home this morning, had some dinner, relaxed, watched the news... and finally fell asleep around 9am. I woke up a full 12 hours later! Good thing I have tonight off!
Now, what to do tonight... I guess some laundry is in order.
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