Should you go to the Emergency Room?

Today is January 27, 2022 and the answer is NO unless it is a true emergency. On Monday of this week I had a fall in the snow and tried to go to #urgentcare for x-rays of my ribs. The technician was out and they sent me to a local #emergencyroom. Here is what I experienced and it is not the fault of the staff (well most of it).


As you walk in they are triaging all patients in the waiting room unless you come in by ambulance. This means that #hippa is out the window and everyone although "distanced" hears and sees your business. There are NO visitors or people allowed to wait with any patient unless it is a child. The only time I saw a deviation in this rule was a non English speaking elderly female with her son. There are people all over. They have created a waiting area with some plexiglass between sections but you still are 6 feet away from the next person in your "area." Some patients need beds and need them bad but there is none available. Some people are in significant pain, or throwing up in bags. Some need stiches and some have chest pain but everyone has to wait and the nurses are triaging the best they can. It is the first time I felt like we were on the cusp of socialized medicine. This wasn't an emergency room but a clinic.


After about an hour and a half I got a room. I heard the nurses desperately trying to get a PA to create orders for "fast track" patients that needed x-rays or get easy cases out of the way. Here is the problem; everyone and their brother is coming to the emergency room to get tested for covid-19 (omicron. delta, you name it) and backing up the system for people that truly have an emergency. I thought this was the case and confirmed it with my nurse. 99% of patients coming to the ER for covid-19 are discharged for homecare unless they are compromised and admitted but they are taking up the beds and creating major issues, and delay in care for true emergencies.


I got to the ER at roughly 3 pm and only went because they were concerned about my lung and needed a cat scan or I would not have gone near an emergency room. The cliff notes for me is they found some things on the CAT scan for follow up. I got discharged at 1 am the next day (10 hours). I was lucky because for most of the 10 hours I was in a private room but outside my room there was yelling in the hall because there were patients in chairs and gurneys, and they were significantly down in staff to patient ratio. I had an EMT from an ambulance rig do a covid-19 test on me. Guess what, it was the brain probe (PCR) that was supposed to go away at the end of 2021. I pushed back on the technician and they said that was all that they had. I said to her "you realize that the PCRs have been discontinued because they have many false positives and do not have the ability to differentiate variants. She agreed but I had to get the brain probe.


The nurses are using their phones with artificial intelligence to make and receive orders. It comes at a convenience but also as a #risk similar to Apple's Sire not getting what you are asking for correctly. I heard from the nurses that I interacted with significant stress, thoughts of quitting, burnout, and frustration. This is dangerous for all involved. I had 3 different doctors come in to speak with me and one came in and called me a diabetic. I am not, never have been and it's never been on my record. This is what happens in a stressed, overburdened, fast moving, low staff/patient ratio, patient frustration/anger, fueled environment.


This path that we are on in healthcare is dangerous. It is a petri dish for errors, mistakes, reduction of good care and medical mismanagement. It is also an extremely stressful environment for an already stressed healthcare workers. Many nurses particularly suffer from depression and PTSD due to the role that the need to take between one's family and dying patient during the height of Covid-19. Playing the role of the in between of a dying loved one saying their goodbyes to their family through facetime, a phone or other device day after day is not what they signed up for, trained for and very emotionally taxing.

I leave you with this:

  • Most people with COVID-19 do not need to go to the hospital and will have a smooth recovery at home.

  • Some severe COVID-19 symptoms that need medical attention include significant difficulty breathing, confusion or disorientation, or a bluish discoloration in the lips or hands.

  • In the ER, providers can check your vital signs and run some tests to see whether it is safe for you to return home or if you should stay in the hospital.

If you feel like you need a test there are places everywhere from pharmacies, to state run facilities and if you are lucky you can get a home test kit. As the narrative continues to change on Covid-19 I hope that the need for tests is reduced because currently there is no way to differentiate variants. Please use the emergency room as the last place you go to be tested because you are not only hurting the system but a patient that truly needs emergency care.

For further information on the decision to go to the emergency room or not the link below is a good summary: When Do I Need to Go to the ER for COVID-19?

https://www.goodrx.com/conditions/covid-19/when-to-go-to-the-hospital-for-covid


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