The 700 Club with Pat Robertson


The Real E.R.

By Tim Branson and Zsa Zsa Palagyi
The 700 Club“I don't think we see the frequency of the high acuity of what you see in an one-hour show like ER, but we’re very busy,” says Dr. Jon Mason, an emergency room physician at Sentara Norfolk General Hospital in Virginia. “We’re taking care of trauma patients and cardiac chest pains, patients that attempt suicide, psychiatric illness and then your run-of-the-mill homeless person who doesn’t have a place to stay on a cold night.”

Nobody plans to end up in the emergency room, but at some point, you or a loved one might have to. So what can you expect on your visit to the E.R.?

“Sometimes we have people lined up in halls, waiting in chairs in the nurses station,” says Pamela Streetman, an E.R. nurse. “It depends on what time of the day and what day of the week. Some days we get trauma alert after trauma alert after trauma alert.”

More often than not, trauma victims are rushed in by ambulance or helicopter. Their vital signs are taken on the way to the hospital. These patients are usually met by an extensive trauma team. But what about everyone else?

“If you don’t come to the emergency room by ambulance, there’s still some steps you have to take before you see a doctor. The first of those is registration.”

Tammy GravesTammy Graves, Registar nurse, says, “We check them in when they first come in the door. We get the name, date of birth, social security, put an arm band on them, then they have a seat in the waiting room.”

The waiting room – not a popular place when you’re in pain.

Pam says, “The major complaint that we hear is the wait time -- how long it takes to get treated.”

You might have to wait four to six hours or more in some hospitals to see a doctor. But there’s a reason for that.

“One of the problems with emergency rooms and the overcrowding is that the hospitals have decreased over the years but the patients keep coming. So hospital beds and patient beds are reduced,” Pam explains.

At the same time, hospital emergency rooms have become many patients’ primary health care facility.

“[Patients] have a perception that it’s faster, that they can’t get an appointment with their doctor,” Pam says. “They sit at home for three or four days with a cough or a cold and a fever. All of a sudden they wake up, they’re not quite feeling as good as they were, so they think, ‘I’ll just go to the E.R.,’ because they think it’s quick medicine. When it’s clogged with those kind of patients, it’s not quick medicine.”

Everyone that comes into an emergency room has to go through triage.

PEggy Ware-HarperTriage nurse Peggy Ware-Harper says, “What I’m trying to do is figure out what is wrong with you, what tests are going to need to be run, how quickly they need to be done, and what type of bed in the emergency room you’re going to need… I do tell the patients what their blood pressure is and whether that’s okay or not.”

If you’re in for an emergency, Peggy would ask you to “rate my pain” on a scale of 0-10.

“The pain scale has nothing to do with how quickly you will be seen or not be seen,” says Peggy. “It just gives us some idea as we’re treating you. Is your pain getting better or worse?”

Many people don’t know that there is an order of priority that E.R. staff go by.

“We call it A, B, C’s. It’s airway people, if they’re having some kind of problem relating to their airwaves. [That’s] our No. 1 priority. B is breathing. The third priority is called circulation.”

No matter what your priority is in the waiting room, triage nurses will re-check your vital signs and re-assess your condition every two hours. But realize they can not administer pain medication without a doctor’s order. Once you get back to an examination room, the doctor will do a thorough evaluation and run tests to determine the best course of action.

Dr. Jon MasonDr. Mason says, “We always give the patient the benefit of the doubt. Our basic desire is to treat each person respectfully and with compassion and respect their complaints and try to figure out if it’s a true emergency medical condition.”

Working in the E.R. comes with its challenges.

Dr. Mason shares, “Seeing patients that we have no personal relationship with on a routine basis, we have to start from scratch. Get the history best we can, find out what meds their on, if they have an old EKG. We’re always scrambling to find an old EKG to compare with the one we have to see if there are any changes.”

There are things you can do to make your visit to the E.R. easier.

“Know your immunization history, know your diagnosis, know what medicines you’re on and why you’re taking your medicines,” Dr. Mason says. “Bring us the name and the telephone number of your doctor, if you have it.”

You might want to have this information for you and your family members written down on an index card, so you don’t have to scramble when an emergency strikes.

Upon discharge, you’ll receive some follow-up orders. This is also where patients make mistakes.

Tim Branson at Triage“They don’t follow their instructions for discharge,” says Dr. Mason. “If you’ve gotten stitches, we tell you how to treat it. [If] you don’t, then you end up with an infection. A lot of patients lose their prescriptions for pain medications, they don’t take them and then they end up back in the emergency room as a patient.”

Remember, if your condition isn’t critical and you want to avoid a long wait at the hospital, consider your health care options. Assess your medical situation. Then call an advice nurse, visit a local urgent care facility, or set-up an appointment with your primary care physician or specialist. But, if you have broken bones, chest pains or any serious problems with your airway, breathing or circulation, do not hesitate to call 911 so you can get to the emergency room as quickly as possible. Your visit to the E.R. could mean the difference between life and death.

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