This past Saturday I loaded the family up and we headed to a family get together in my home town. We were just going for the night, it's a bit of a drive for just one night but we decided to go and enjoy some family time.
On the way there we decided to make a few stops to get a couple of things. We haven't been to the city closes to my home town in a long time and decided to hit a few stops there that we never get to go to. At our first stop my partner D went to just run in and out so my son and I stayed in the car to wait. As she went to jump out of the car she put her foot down and twisted her ankle on an uneven sidewalk. I didn't realize she had done this until she was on her way back to the car.
At first we both thought she had just hurt it a bit, but not seriously so we continued on with our day, stopping at a couple of other places, her limping away as we went. It wasn't until we arrived at my families place that we realized that it was more than just a little twisted ankle...it was twice it's normal size and there was obvious bruising starting to develop. It was 4:20 in the afternoon. My mom suggested we go to the ER in town, before it got to late, and have it looked at...so off we went.
Our small town ER experience left something to be desired....and here is the story.
When we pulled up at the entrance I dropped D off at the door so she wouldn't have to walk so far (I know, so uncharacteristically kind of me, but I guess I was having a nice day)...and then I went to park the car. The front parking was full so I had to park at the back parking lot, quite a distance from the front door so the decision to drop her off was a good one. By the time I arrived inside D had already had a bit of an ordeal. When she went inside she walked to the unmanned front desk. On the window it said "if by chance this desk is not manned please go to the ER desk to be helped". She did that, limping all the way. I would say that the ER desk is about 250 feet from the front entrance...not far for most, but a long way when you have an injury of this nature. When she got to the ER desk a woman dressed in pink asked her why she was there and then told her to go back to the front desk and she would be there in a minute. When I walked in D was sitting on a chair outside the front desk waiting for the lady in pink to return. I stood there for a few minutes waiting with D and getting the full story up to then, and after waiting I walked over to the ER entrance and had a seat on the chairs outside...looking into the ER. There were three people at the ER desk, the lady in pink whom had talked to D about returning in a minute, and older woman also dressed in scrubs (who we would later find out was the triage nurse) and a blond woman (who we would later find out was the Dr on call that afternoon). They were all standing or sitting around the ER desk, eating and laughing. When I sat down in the chairs the girl dressed in pink looked at me, and after realizing that they were doing nothing but making someone with an injury wait unnecessarily, I gave her a look....you know the kind, the ones that only mothers can make. In seconds she was walking out of the ER to wait on D. I was so happy that she could put the food and conversation aside long enough to help the patient....imagine that! I have to add here that in that front entrance they have this picture (I think there are 5 woman in the picture) and over the picture it says something to the effect of "Our focus is on the patient, and the great care for those patients" so far that wasn't something that was happening.....I don't think it's "great care" when you ask someone injured to walk at least 500 feet more than necessary, simply because you would rather socialize than do you damn job!!
Needless to say the woman in pink was not very amused that she had to actually do her job, being very sharp and in some ways uncaring while she took all of D's information....D standing at the window the whole time....seems to me one would get her a chair to do this, but hey, care is their most important focus right! After finishing with the woman in pink D was instructed to walk over to the ER entrance and wait there until they were ready for her. The wait at those chairs was not long, thankfully.
From the chairs she was taken by the triage nurse to do some injury history, as well as cover some medical history. She was a bit nicer than the pink girl was, but still not overly thrilled to be doing her job. I just have to add here that why does one pick health care careers when they are not interested in dealing with patients??? Or care for that matter??? it seems to me that overwhelmingly they are not happy, not caring and not interested, so why did they do it in the first place....health care isn't usually something you choose unless you are made up of the right stuff to work in that field? You know, working in a factory or something alike is a field that sort of just comes your way, you just deal with it, but choosing a career, now that's a decision, you should be thrilled to be working in you chosen field shouldn't you?? It doesn't seem that way when it comes to the medical field. I recognize that health care professionals in Canada can, and often are overworked, understaffed, etc. etc. But that is NOT the case here in small town Ontario. They are fairly staffed, not overworked, and work in a much better environment than that of the big city....stop hating on everyone!!!!! End of rant! for now!
From triage she was told to walk to room 4 and get on the bed. It was now 5 pm.
Room 4 consisted of 3 or 4 beds, each separated by those wonderful draw curtains. No real privacy, but that's okay, can't expect much privacy in the ER now can you. In the bed furthest from us was a mother, and her young son. He was likely 3, and was a very busy little man. They were talking, she mostly telling him detailed explanations for various things....like "what is Angelina Ballerina??" "What does she like to do", "what is a ballerina"....and these question went on and on, and we heard each and everyone of them. At about 5:30 the doctor finally came in to see them, and it was then that we found out that this boy was here because his mother suspected that he had impetigo, as he was diagnosed with it two weeks prior, and all the spots had come back.....and she had washed everything and had kept him home from daycare and gymnastics for over a week, how could this be??? The doctor looked at him, took a swab and then 15 minutes later was sending them out the door with a new antibiotic script. I was grateful they were out the door...not because he had a very contagious skin condition, but because the level at which they were talking was getting on my nerves...not sure why anyone wants everyone around them to hear ever single word they say, but yet there are those ones. Bye little boy, I hope you pussy face clears up fast so your annoying mother doesn't drive you to drink hard liquor at the age of 3! The doctor then headed back to the desk, eating, talking and laughing....for more than 10 minutes....I timed her!
I have to just say here that there were two other people ahead of us in this ER. One being a teenage girl, the other being woman who seemed quite ill as they had her door closed.
After 10 minutes the Dr made her way down to the teenagers room. I think she must have had something stuck in her leg or something, as there was a bunch of loud painful sounds coming from the room....which was at the end of the ER...quite a distance from where we are. Along with the painful moans, there was also the voice of the Dr saying "just look away, this isn't going to hurt so just stop moaning"....apparently they teenager was moaning over the injection of freezing that the Dr was administrating....not the actual removal of whatever it was in her leg. After the Dr was done there she returned to the desk, eating some more of whatever it was that was there, and talking it up with the triage nurse and the girl in pink. Boy, they sure seem over worked to me!
At 6 pm a nurse came into our room and asked D if she would like some Tylenol or Ibuprofen for the pain. It took them more than an hour to suggest to this person, with an ankle twice the size of normal, that she just might be in enough pain to warrant some Tylenol??? An hour?? I get it if they were run off their feet, as they are in a city ER, but really, these people are too busy eating and talking to actually follow that saying in their front lobby....that thing about patient care first. D thanked her for the suggestion and welcomed the chance to maybe take some of the edge off. The nurse returned with 4 pills and a small glass of water....and then was out the door.
At this point I am looking at the front desk and the blond Dr eating again and talking to a male dressed in scrubs. I recognized the man in scrubs to be a young man I remembered from my childhood. He was much younger than me, I don't think we were ever in school together, but I knew who he was. He was the son of the veterinarian in town, and I remembered hearing that he grew up and became a human doctor, not following in his daddies footsteps of being a 4 legged doctor. I had heard good things about this guy, so I was expecting to not see as much tom foolery and more medicine being practiced. I would be disappointed.
After about 20 minutes the new, male doctor, walked into our room. He looked at D's chart and then asked a few questions about the injury, how it happened, how long ago that sort of thing. He then began an exam on the ankle and determined from that exam that she would likely need an x-ray to rule out a break. Wow, we are there almost 2 hours and just now they are thinking maybe an x-ray might be needed....I don't know, I am not a nurse or a doctor, but one would think that any injury that makes ones joint be more than twice it's regular size is going to warrant an x-ray, well at least until doctors come equipped with x-ray vision....which I'm sure is just around the corner. The doctor than explained they would have to call the technician in, and it would be about 20-30 minutes, but that he usually doesn't feel too bad about the wait with people who are used to larger centers where they wait for hours to be seen. Off he went and a few minutes later the triage nurse came in carrying another set of pain pills (just like the ones the other nurse came in with) she went to tear them open when D told her another nurse had just came in before the doctor and she had already taken them.....so they were trying to now kill her....great small town care there...maybe if they weren't so interested in chatting, and more interested in referring to the chart (or better yet actually updating the chart) they wouldn't be trying offer lethal levels of pain relief....ugg! It's a good thing I was there, and D was still sharp and not at all groggy, she would have just mindlessly taken the meds and then I think her ER stay just might have turned into a hospital stay!
At this point another mother, with her teenage son, came into the ER. Again, the girl in pink was not manning her entrance desk, but rather was standing at the ER desk chatting it up. The mother explained that her son is susceptible to bronchitis and has in the last few days formed a cough, so she wanted to be more pro-active and maybe get it under control before it turned into the more advanced condition of bronchitis. The triage nurse sent her and her son to the bed that was just a half hour or so ago filled by the three year old with impetigo.....yes, and you guessed it...no one had changed the sheets or cleaned after that three year old was there...so now they were putting an out of province teenager, with a compromising medical condition sit in a bed that was just moments ago filled with a child with a very contagious skin disorder....hmmm??? does this sound like they are putting patient care first?? Not to me....it seems to me that once again putting chatting and eating first on the list....and then "oh, am I here to be a nurse, I thought I was here to socialize". They put a mask on the teenager and then let him sit on the bed in those impetigo crusted sheets...that poor guy, I sure hope his junk isn't covered is pussy red blotches today....I should have said something but honestly, I would rather write a witty blog about the whole thing than get involved in this.....next time I will say something...as I will be less interested in the witty blog...you can only write so many witty blogs about the failing score of health care these days. The triage nurse asked the mother of the teenager to come to the desk, where they then talked for more than 20 minutes about BC....as that was where the mother was from, and the triage nurse's son and newest grandchild was from.....they had something in common, and they bonded....nothing wrong with that, as there were no new cases of anything coming in, and it made the mother feel a connection. I honestly didn't see a problem with it, but really, most people don't have 20 minutes at their over paid job to just sit and shoot the shit...most people have to actually work to make their living, to keep their job, to finished all the work they need to do. I wonder if a factory worker were to stop and talk to the newest stranger for 20 minutes and just not do what he was supposed to do on the line for that period how that would effect the rest of the line??? Hmm...but then again, most people don't choose factory work, it is sort of the thing you just resort to, health care is more of a chosen field.
The x-ray technician arrived, wheeled D off to shoot her ankle. Finally things were moving in the right direction. A few minutes later she was being wheeled back into the room, and there she sat for 35 more minutes....until the doctor remembered that he needed to actually look at the x-rays that he had ordered. I know they were ready long before that as the technician had joined the group at the desk at least 15 minutes before that to join the conversations.....meanwhile, the doctor had gone in to see the mother and her teenage son. He listened to his lungs, told her everything seemed really clear. He didn't suggest anything at this point, she suggested that he write a script for an inhaler for, just in case, as they were from out of province and this would save them another visit to the ER. The doctor agreed to write the script, and then sent them on their way. I think they were there for no more than 45 minutes maybe.....but their short stay was filled with infectious sheets so they can't feel too lucky now can they!
When the doctor returned to D's room he said that he hadn't detected any break on the x-ray, that he felt it was soft tissue, but after I said something like "you don't detect any obvious break" he then replied with, "well I have looked at 1000's of x-rays, but yes, I am not a radiologist and until a radiologist reviews the shots we can't be absolutely sure there isn't a break somewhere, but we will call you if he does see anything on Tuesday". He told her to put some frozen pea's on it and take Tylenol....but no other sort of pain med was going to be prescribed....and we were finally on our way.
We were there 3.25 hours, and really weren't much better off after than we were before. So, now I would like to add my suggestions to improve here.
1st, I'm going to state the obvious. If there is someone being paid to sit in the front desk, they better be there unless they are on a break or there is an emergency somewhere in the hospital. I think as a tax payer I would appreciate my tax dollars going to people who are interested in doing their job, not socializing.
2nd, why is it that triage nurses in this country are not nurse practitioners?? We under use these professionals in this country, when using them would cut time and cost. If that triage nurse had been a nurse practitioner she could have evaluated the ankle, ordered the x-ray and had D all ready when the Doctor was ready to come and look at her....he would have had all the information, and the time in the ER would have been a fraction of what it was. This can be said for so much, that little boy with the impetigo could have been seen and sent on his way in minutes, that boy with the possible bronchitis could have been seen and sent on his way right after triage.....the time and money that could have been saved is just insurmountable, yes a nurse practitioner would be more expensive than a regular nurse, but the Dr wouldn't have had to come in for 4 out of 5 of those cases in the ER....and yes, that would save a lot of money.
3rd. Cleanliness needs to be a focus in a medial facility....this is a no brainer. Why anyone would think its okay to just herd patients into rooms without cleaning in between is just beyond my understanding. This is not good for the patient, and it's not good for the cost of health care. Simple cleaning would lead to less cross contamination which leads to less illnesses which leads to less ER and doctor office visits. Stop throwing our money away!! I am sick of the high costs of medical care in this country, and these are just a few of the reasons why they are so high.
It's time we spend less on Doctors and more on nurse practitioners. It's time we have less ER's and more urgent care facilities. Lower the cost, increase the service, make citizens happier folks. And for heavens sake, stop eating and starting working!!!
In August I went to the ER here in Windsor. I waited 5 hours to be seen, I was offered Tylenol 3 when I finally made it to a bed, and then I was sent home with a script for Tylenol 3's. An e-ray was taken quickly and the results were read within minutes. No, waiting 5 hours is not good, but you have to keep in mind that there were between 35-45 people ahead of me. When we arrived at the small town ER there were 3 people ahead of us....we stayed 3.25 hours and were not offered any continuous pain relief solutions. What that means is in the city 7 people per hours are being seen....in small town ER 1.5 patients were being seen per hour. Who is doing it more efficiently??? You tell me!! So no Doctor "young boy I remember from childhood", small town ER's are not better in any way than city ER's, you just don't have the volume so you get to play more!!
I just want to finish this by saying that I am in no way bashing the Doctors here. I think small town Doctors work hard, are better in many way than city Doctors. In my sons earlier years I often took him to seem my family doctor in my home town, as I trusted him more than the doctor we had in the city. He knew his patients better, he took his job seriously, and he wasn't afraid to get his hands dirty....if he could fix it he did, he didn't just send off the problem to a specialist like we get with our city doctor. There is room for improvement in both places, this experience was just shocking to me. This particular ER has been fighting to stay open...the citizens of this small town and fought to keep it open, along with the small hospital....but when you go there and this is what you experience you don't have to ask why.....you have to wonder why not....these people don't want it opened, obviously, what they want is to no longer have their cushy job, but to go and work in ER's that are non stop....they want to actually work for that pay, I guess!
