A visit to the emergency room

[Meadbh]

Most of the knocks on our Canadian medicare system are about the waiting times,looks like OP is getting the worst of both worlds ,having to wait and having to pay.

This is a very interesting thread for me to watch. Many Canadians assume that in the US there are no wait times. NOT!

I think none of us can take a "holier than thou" attitude. Wherever you look, healthcare systems are under severe stress. And the ER is a difficult place to exercise market forces.

 

[Moemg]

The problem is multifactorial The main culprits are fewer Emergency Dept's, (they lose money in most locales), increased number of ED visits and fewer inpatient beds for admitted patients to go to. These all lead to overcrowded ED's with increased wait times. Now try to imagine if a true flu pandemic were to strike - it would be a national disaster as there is no capacity to handle it.

DD

Another problem I think having worked in hospitals for many years is the ever increasing documentation . I recently took my Mom to the ER and I could not believe the charting required . We arrived at one a clock were taken into a treatment room quickly and were there for five hours for six stitches . The last hour was spent waiting for them to finish the paper work. It was the most inefficient use of equipment I've ever seen . One of my last jobs was in Endoscopy at a hospital and I also worked at an Outpatient Endoscopy Center . The difference in paper work was mind boggling at the hospital we had at least six different forms we had to have the patients sign including giving them instructions on the flu vaccine ,smoke ending and Living will . At the outpatient is was two papers permit and insurance info ...

 

[DblDoc]

Another problem I think having worked in hospitals for many years is the ever increasing documentation . I recently took my Mom to the ER and I could not believe the charting required . We arrived at one a clock were taken into a treatment room quickly and were there for five hours for six stitches . The last hour was spent waiting for them to finish the paper work. It was the most inefficient use of equipment I've ever seen . One of my last jobs was in Endoscopy at a hospital and I also worked at an Outpatient Endoscopy Center . The difference in paper work was mind boggling at the hospital we had at least six different forms we had to have the patients sign including giving them instructions on the flu vaccine ,smoke ending and Living will . At the outpatient is was two papers permit and insurance info ...

You are correct, there is much more paperwork. JCAHO keeps adding further burdens. In recent years we have added screening for domestic violence, vaccination status (and have started vaccinating patients in the ED) and most recently medication reconciliation. While they do add value to the patients care (in some cases) they have all been essentially "unfunded mandates" and burden an already overwhelmed system.

Looking to the future we have electronic order entry touted by many as a cure all for inefficiencies and medication errors. My experience to date has been abysmal. Errors continue - they are just made in different ways - and it is much less efficient. I now spend more time clicking a mouse and watching an hourglass then with direct, hands on patient care .

DD

 

[Meadbh]

You are correct, there is much more paperwork. JCAHO keeps adding further burdens. In recent years we have added screening for domestic violence, vaccination status (and have started vaccinating patients in the ED) and most recently medication reconciliation. While they do add value to the patients care (in some cases) they have all been essentially "unfunded mandates" and burden an already overwhelmed system.

Looking to the future we have electronic order entry touted by many as a cure all for inefficiencies and medication errors. My experience to date has been abysmal. Errors continue - they are just made in different ways - and it is much less efficient. I now spend more time clicking a mouse and watching an hourglass then with direct, hands on patient care .

DD

Oh boy, DD, Moe and I can really relate on this! I'm sure Rich in Tampa can too.

Our ER volumes are skyrocketing. We do medication reconciliation on patients who are slated for admission, but frankly, we can't do it on the other 90%.

When it comes to electronic order entry, the devil is in the details. When Children's Hosptial, Pittsburgh initially installed it, their ER mortality and morbidity went UP because the RNs and MDs were forced to spend so much time on the computer that they could not care adequately for the patients who were sickest. I think they had to switch it off. And the design of the decision support systems is key too. CPOE may reduce some errors, but it can introduce a whole new array of errors too.

 

[Rich_by_the_Bay]

It's a good time to think about early retirement .

 

[REWahoo]

It's a good time to think about early retirement .

Or at least upping your percentage...

 

[ls99]

I vote RiT up his retirement percentage to 98%.

 

[Meadbh]

It's a good time to think about early retirement .

I think, therefore I am?

 

[Moemg]

There is nothing like a locked medication system for all meds . Imagine being in the middle of an important surgery and you have to run out enter your code enter the patients name , the medication you want , the amount and how many are left while the surgeons are waiting . Wonder why I'm retired ?

 

[Rich_by_the_Bay]

I think, therefore I am?

I'm working on it...

 

[Zubini]

Kidney stones

I was taken by ambulance to Kaiser in California for what turned out to be a kidney stone. The 20 minutes I waited in an examination room for drugs was the longest 20 minutes of my life. It's the only time I've ever begged for anything! Having had several broken bones, 5 abdominal punctures from laparascopic surgery, etc. nothing can compare to the pain of a kidney stone. There are no words to describe it. Glad you are feeling better and hope you never have another stone!

 

[LOL!]

I found these pictures which show my injury, surgery, number of screws, and post-op X-rays:
An Update on Lance Armstrong’s Collarbone | BicycleSpokesman.com
Those are even the same Steri-Strips as mine.

Unfortunately, those of us who have had kidney stones will answer the following question, "On a scale of 1 to 10 where 10 is the worst pain you have ever felt, how does that broken bone feel?" with the answer: "Oh, about one-half."

Perhaps only burn victims are in more pain.

Thanks for all the well wishes. I am feeling much better!