Considering that people are more at risk of injury or death by hitting a deer while driving than becoming a victim of terrorism, is this really even a necessary question? As many as 50,000 people may be dead as a result of a recent storm, a real danger, unlike a the exaggerated threat of global terrorism. Why not ask if hospitals are suitably equipped to handle that kind of influx?

http://www.humanityovercomes.blogspot.com

AS an Emergency Department Physican Assistant, the overcrowding is paramount. It is a national concern, that sadly has not been addressed properly by those with oversight. Most of the patients I see, have common complaints that truly belong in a primary care office. But they often call their PCP only to be told that they are overbooked, and if they are concerned that they should report to the ER, which is a terribly inefficient and inappropriate use of resources. I just performed an I&D procedure on a patient who was seen less than an hour ago by his regular MD who recommended that he come here for treatment. This is not acceptable. It only creates further delays, and possibly increase morbidity in patients with more serious and pressing healthcare concerns. We need a serious overhaul on our current system.

I’ve worked in an emergency room for 5 year now. I’ve seen it grow from an average of 70 patients in a 24 hour period to 180 patients in a 24 hour period (Our senses has only grown by 3,000). The hospital has done a great job at enlarging the area to add more rooms and staff. It has also done many changes to establish a quick flow by adding a step down area for people with minor illnesses and injuries. We are also the leader in our area for disaster planning and drills.

However with all the changes and preparedness, I still believe in a true crisis we would have major problems. I believe the real reason for overcrowding has many factors. These factors are lack of affordable health insurance, lack of primary doctors( which stems from school costs and insurance costs), and a general disregard of what a true emergency constitutes by the general public.

It is indeed astounding the lack of common sense and insight many of our so called “leaders”have in regards to the challenges faced by the crisis in emergency care the US is experiencing. It is correct that simply throwing more money at the problem is not a solution, but cutting Medicaid funding and support, especially for the very hospitals that act as a safety net for our failed primary care health system is not the solution either. “The job of Medicaid is to take care of people who are poor, or indigent, or disabled,” not institutions or hospitals”…yes, Mr. Leavitt, but it IS those very hospitals that do take care of these people! When I started in Emergency Medicine nearly 25 years ago a typical community hospital would see 25,000 or so patients/year in an ED…now, it is common for this to be in the 45-60,000 range. In the Netherlands where I work now, a big teaching hospital sees 25,000 a year in the ED…why? because a funded and utilised system of primary care and access to outpatient specialty care is the “safety net”, not a crowded Emergency Department. There is indeed a crisis, and the solution is a total rethink of how best to provide a basic level of care to all Americans that is funded and efficiently utilises the resources we have. Simply slashing funding to the existing mess is not the answer.

It makes me sad to again realize that our legislators are so out of touch with the reality of the problems throughout the nation. The concern that the healthcare system is so insufficient and Medicaid benrfits so punitive is one I deal with daily. The overcrowded E.R.’s are at best a bandaid for larger problems and issues facing the elderly, the homeless, and the working poor.

In the issue of our emergency department and there use I find that we have allowed lawyers to dictate the course of care. I have seen so many repeat patients that have been seen at least two times in one week. The doctor’s office will send their patients to the ER knowing we have no beds in the hospital with inpatient orders in hand and we must keep them in the ER. The last thing is the nursing shortage. In the ER we hold patients awaiting a room for days sometimes. The nurses are asked to care of ICU, CVU, and Medical Surgical, and then the ER patients. It is no wonder why we have no good plan. Nothing will work without nurses.

Jerry R Lucas
Male Nurse Magazine

This is typical from goverment. Slash from the bottom up until they get to something of value to them stop and then anounce job well done. I’ve worked as a ER nurse for 10 years, and this over crowding problem is not new. It’s been increasing and getting worse every year. Rural city hospitals take the largest hit, and taking away money from the very people they say go to the ER for your care is stupid. ER Doctors are actually being put down on health questionaire as their primary doctor. That alone tells you the mind set of the patients that use the ER for runny nose, cough, and mosquito bites. The system needs a complete overhaul and to teach the general public what the ER is for

I work in a hospital. Reference to the terrorrism/ car vs. deer comparison. It does not matter what the chances are, just that there is one. I do not wish there to be an attack, but preparation for such a situation allows preperation for any natural disaster or catastrophic scenario, as well. The problems are legitimate. Our ER has a typical weekday wait of two to four hours. Therer just isn’t enough room. We do have to house lots of vagrant population, though. (By “have to,” I mean they scam the system by calling EMS on cold days or feigning illness to get a room, ASAP. It is frustrating, but it’s just the way things work out around here. Wolutions cost $ and no one wants to put any forward. “Don’t raise my taxes,” you scream, but they’ll get your money from you one way or another.

As someone chronically ill, and well-connected with a PCP, I have also been in the position where I’ve been told by my PCP’s office to go to the ED for treatment. I was ill with the flu 2 months ago. Due to the severity of the illness, as well as several pre-existing chronic issues I have, I immediately contacted my PCP’s office for an appointment for treatment. I was told I needed to wait for four days for an appointment to see her, and if it was that serious, I should go to the ED. I’ve used the ED before under other circumstances, such as broken arm and broken back, but I wanted to wait for my Drs appointment, rather than sit in the ED for seven hours (the typical time I’ve had to wait). I managed to stick it out for four days, but hallucinated for two of those days with a 105 degree temperature, making the illness far worse than if I could get it treated in the early stage.

Fact is, the system is badly in need of an overhaul. The ED, as well as most of the medical system, functions in crisis mode. This cannot work under any circumstance, let alone a major event, such as terrorist attach or natural disaster (think Katrina). Any cuts in funding, or lack of attention to change, will spell disaster for all.

Do we need a plan? Absolutely. It could happen. Do we need to have enough beds that that everyone could fit in the hospital at one time. No that’s stupid. And a waste of money. But definately a plan. Could more people come in, could you make a make shift hospital or transport people to another location. It may need to be worst case senario, but the truth is most places are unprepared for any type of major crisis.