Just beyond the ER curtain that makes your room as private as an Emergency room bay can be, your ER Doc has just exited your room; You feel slighted, ignored, unimportant but thus far, have done nothing to utilize what control you can still maintain while in this setting. As you sit analyzing your perception of your experience - this is what is happening beyond your curtain.
Your ER Doc has only taken two steps out of your bay, as he walks, chart in hand, he reaches to the wall to his left, pushing a dispenser that delivers a healthy amount of alcohol to his hands, he puts your chart under one arm, begins rubbing his hands together when three things happen. He notices that one of his patients from bay #28 is being rushed from their original room/bay to what in ER terms, is called the "crash room or trauma bay" pick your favorite, both are pretty scary terms.
He begins to quicken his step heading toward the nurses pushing his patient when he is intercepted by another RN who says "our patient in bay 16 is losing his blood pressure, do you want me to hang dopamine?" to which your ER Doc says "who??" the RN now matches his stride as she begins to pull his attention more toward her patient. As they round the corner, the ER Doc is watching out of one of his eyes as numerous nurses swarm the patient now in the crash room. He asks the nurse now running beside him "what's the pressure?" to which she replies "50/28." Start some Dopamine 5mcg/min/kg and I'll be right there, watch the urine output and pressure. And before your ER physician can quite make it to the crash room, another nurse grabs him by the arm and is saying "I need you in here, I have an allergic reaction." to which your ER Doc says, "check allergies, follow protocol." and he disappears, FINALLY into the crash room where skilled ER RN's are well into ACLS (Advanced Cardiac Life Support) techniques and medications as they work along side the ER Tech's, Respiratory therapist's and X-ray Tech's.
Your ER Doc is focused and on the spot with his assessment and within moments he has intubated, assessed and continued stabilizing treatment on a patient that came in healthy but has had a "change" in their LIFE situation. When your ER Doc feels confident that he can now leave the crash room, he stops off to check on the patient with having the allergic reaction, speaks briefly to them and to their RN and continues down, around and across the ER to check on his patient whose blood pressure bottomed out. Now assured that the staff has his back, his patients stable for this moment; he removes YOUR chart from underneath his arm.
Yes, astonishingly, he HAS not LOST you. You are right there with him. With out time to draw a breath, he re-reads your chart, re-reading his notes, thinking, pondering, assessing and he begins to enter his OWN lab requests, and any other tests he wants to be done on you. YES, he's entering his own orders on the computer. Because in almost every hospital around the United States, ER Doc's no longer can rely on the Unit secretary (I call them command central) to enter his orders, this task has been laid on his shoulders.
Officially, you are one of this ER Doc's 10 patients for this second. When another patient enters the ER, they could become his 11th patient. And if that's not pressure enough, with Obama Care capping costs, Doctors are having to see more people, getting paid less and must keep up a quota (on which they are normally evaluated) to keep their jobs.
And you thought waiting times were bad when you went to see your family physician? At least their appointments are scheduled and they know what kind of patients they're seeing each day during those appointments.
When you come to the Emergency department, you are going to leave with a diagnosis. You are going to have the results of all your xrays and labs, and studies and you will have medication either on board or a script to get them. Where ELSE but an ER do you get care like that? And yet you expect it FAST, KIND, SMILING, ARTICULATE......are you kidding? We strive....but this is an emergency department. Where we see the unexpected, we never know what is coming through our doors, we cannot limit the amount of patients we see each twelve hour shift. (By the way, we eat at our nursing stations because we rarely have time to eat lunch, drink water and or pee ourselves) - Remember perception???
Are you important to this ER Doc? You bet you are; Every single day, he puts it on the line to care for you; His perceptive is probably that he is doing the best he can, given his circumstances and I would place my bet, on the ER Doc - that if you had just trusted enough to speak your truth to him "I'm scared, I'm frustrated, please don't leave yet, could you repeat that" - that if he was to do the right thing, he would have hesitated long enough to listen to your concerns.
Perception for you; You don't matter. Perception for him: You matter so much he'll kill himself trying to get you seen. Reality? You and he needed better communication.
At the end of the day, Dear patient, we are all human beings and we are here to care about you; We want your trust and you deserve our respect and sometimes, we're just as scared as you..............
Dear patient; This isn't the end of your visit.
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