Days like this....ERs in the western states

[anewbiewannabe]

So, over the weekend I managed to hurt myself while sitting down and bending over slightly for something. Local ER, well it's a joke, so I ended up walking out after 3 hours waiting on a slow night in a tiny windowless exam room. I figure I must not have ruptured anything important or they might have moved faster. Guess I'll check in with my new doctor later this week, maybe.

So, anyhow, there are times where I have to go to ER and can't just walk out without treatment. Hopefully the shot I need is carried in all ERs---don't ask me what it is cause I don't know, it's for SVT. It made me wonder if anyone had any experiences with the ERs around Q or Flagstaff?

Hope I make it out on the road within the next couple years and avoid having to check them out in person though.

 

[Almost There]

Only 3 hours!!

I wish. At our local hospitals 3 hours won't even get you seen by the triage nurse if you're not bleeding all over their floor. If you're puking you might get handed a catch basin...maybe!

I spent many hours this past summer at the ER with my mom. She'd be transferred by ambulance from the nursing home and I got to watch what was happening. Some days I was there for 12 and 14 hours waiting for her to be admitted to a bed.

2 man ambulance crews were standing around monitoring their patients for upwards of an hour before ANY ER staff even talked to them. At one point I watched 4 ambulance crews all stuck in the ER with their patients while staff took their sweet time before dealing with them. My accounting brain kicked in to overtime at that point as I assessed the cost of having enough ambulances and paramedics on shift each day to allow for the delays at the ER...ca-ching, ca-ching, ca-ching! And I wonder why our health care system costs so much to run!

Ok, I'll stay off my soapbox...

I googled SVT because it wasn't familiar to me. Maybe the wrong thing came up but came up as Supraventricular Tachacardia. If that's what you need treatment for sometimes, I'd lay good odds that all the ER's have the heart drugs in stock.

If you're travelling with a heart condition, IMO it would be of great benefit to have your medical records with you including the names of the drugs you're used to receiving. Having to do a complete workup each time is counter-productive and will slow the response time.

 

[anewbiewannabe]

That 3 hours was in my lil room which I got to immediately upon arrival because I timed it so ER was empty. They were real efficient for the first 45 minutes---records, insurance, etc. LOL Vampire came with her cart, stepped out for a minute and nobody never came back. I know triage order so I can have patience when I pick the wrong time to need them. No major influx of patients and none in worse shape than me. I figure that answered whether it was anything important.

I don't do well in tiny spaces with no windows or entertainment---it's in my records as I've been there a few times. It's not the first time I've walked out of an ER after they leave me alone for hours without anyone checking on me. I just wish that doctor offices could carry my shot since that's all I need when get SVT and can't get it under control myself.

Yeah, if I get to travel I'll have my whole medical with me. Probably get a med bracelet too because of all my allergies and such. I've been living with heart issues all my life.

 

[cyndi]

I was told, by a nurse in the ER, if I needed attention badly to tell someone I can't breathe.

Also, in most of the states I've been to there are Urgent Care/Redi-Med type places. My insurance prefers I go to one of those over the ER, unless the situation is life threatening.

I hope you're feeling better!

 

[jimindenver]

Priority can have a lot to do with it, so can having insurance. I've sat half the day waiting to get my back or arm looked in the city ER. I went to a insurance covered ER complaining of chest pains/ shortness of breath and barely had time to give them my card before I was in a wheelchair on the way to a room with people waiting. You sure can get a lot of dirty looks as they wheel you past the rest of the people waiting.

 

[anewbiewannabe]

I do have a hard time breathing in hospitals because of the EI/MCS---one of the reasons I get impatient to get out...that's a great idea! I get oxygen if I travel by squad since the diesel fumes get up in the compartment.

Our local urgent care is only open during business hours?!?!?!?!?!?! They are separate but part of the hospital. As long as I don't cough or move wrong I'm okay. What I really need is an ultrasound, not blood tests.

Thanks

 

[anewbiewannabe]

Almost There, the part about the squad dudes didn't sink in before. WOW!!! Yeah, I got stories I could tell. I've spent way more time in ER before but there were GSWs and HAs and such coming in.

JiminDenver, uhm, chest pain and shortness of breath is first priority in most cases so makes a difference. Until you get in the bed. Seems unless surgery is imminent then they slow down around here.

 

[No Prob Rob]

Worked in an ER for two years and saw both sides. Sure you will get back faster if you say you have trouble breathing or chest pain, but... You will pay through the nose for some very expensive tests like a ROMI panel, EKG, and let's not forget the wonderful arterial blood gases. Nothing quite like getting a needle shoved in an artery. Always be truthful. Those folks who put on a show to get back faster waited a lot longer than if they had just been honest. Besides when someone comes in that is really having a heart attack you waste a nurse's and doctors time finding out there is nothing major wrong with you. Just be honest with your symptoms and everything always works out better for everyone. If you really are dying or in extreme pain they are gonna work on you first.


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[anewbiewannabe]

Thanks No Prob Rob. Good to hear from someone who's worked in one.  I don't like getting IVs so there's no way I'd fake anything---don't like going to ER either so I avoid it where I think I can use different services.  Would take a whole lot of convincing before anyone tapped an artery. *shudder*

I get to spend a lot of time in ER after I get the shot.  Since squad gives me the shot in my driveway I wish I could skip ER.  I have a DNR so....

This time I just wasn't sure what was going on as it's not a familiar experience for me. Thank goodness!

So, sounds like ERs are about the same everywhere, though I think the one here is "speshial" for a few reasons, one of which is they've had birthday parties in the ER while making patients wait when I've been there before.

 

[TrainChaser]

That sounds like the entire Providence Hospital system! If you're in the west (they're mostly in the w. coastal states) it's hurry up and wait. I have friends who work at both of the local ones, and they don't have ANYTHING good to say about them. The only reason the hospitals stay in business at all is because of some of the employees who care. A friend has a brother that has had epilepsy his whole life. He was on the sidewalk in Phoenix and had a seizure. He was taken to the local Providence. His sister/my friend, who lives in CA, keeps pretty close tabs on him, and then he 'disappeared'. He was in the hospital for ten days, and kept asking the nurses if they had called his sister. They said they 'would check', but no one ever answered him. And the hospital never called her. They had her number, they just didn't call.

 

[StarEcho]

I can't say that this was the case for you, but keep in mind that the nurses can be busting their butts to get you in and out, but sometimes (many times) the backup is that the doc needs to see you.  And maybe there are only 1 or 2 docs on duty, maybe a PA (physician assistant) or NP (nurse practitioner).  So if your problem needs a doc, you may end up waiting a while.  I worked in a free standing ER at night back before they became popular.  We had 1 RN, 1 CNA, 1 MD and 1 PA, and a lab tech.  Just enough to call a code.  So the CNA and I could whip you back to a room right quick, but you might have to wait a bit for the doc to wake up (assuming the PA couldn't handle the problem) and even if he/she was up and about, if there was anyone in front of you, you'd be looking at a long wait.  The PA would be taking care of 2 or 3 patients and if there came more than that, THEN, they'd wake the doc up.

So ok, in small areas that is most likely the case.  In large areas though, the ratio is still heavily in favor the support staff vs MD, so it's entirely possible to get a backup waiting for a doc to diagnose and then sign off on treatment.

 

[jimindenver]

Worked in an ER for two years and saw both sides. Sure you will get back faster if you say you have trouble breathing or chest pain, but... You will pay through the nose for some very expensive tests like a ROMI panel, EKG, and let's not forget the wonderful arterial blood gases. Nothing quite like getting a needle shoved in an artery. Always be truthful. Those folks who put on a show to get back faster waited a lot longer than if they had just been honest. Besides when someone comes in that is really having a heart attack you waste a nurse's and doctors time finding out there is nothing major wrong with you. Just be honest with your symptoms and everything always works out better for everyone. If you really are dying or in extreme pain they are gonna work on you first.


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Like I said, I have been in both situations. I've sat there in considerable pain and got a considerable amount of attention from having chest pains. In fact I was still getting attention the next day.

On the other hand. The last few years I have seen my parents have to go to the ER simply because they couldn't get a appointment to see their doctor for months. Others go in for much simpler things like it is the clinic.

 

[eoewan]

Showing my ignorance but here goes...does the States not have Medical Centres where you can go to instead of the ER? In Canada we have ERs that are connected to the major hospitals but we also have emergency Medical Centres where you can go. If it's life threatening or serious enough where a hospital stay is required then you are taken by ambulance over to the hospital.

 

[ArtW]

we do have those
As one poster pointed pout they are not 24/7, and sometimes the competence of the staff there is not good
I blame one of them partly for Jeanne becoming full blown diabetic, She was already pre diabetic, and they gave her a steroid shot + prednisone by mouth
Two days later she was in the ER with a blood glucose reading of 600ml/dl

The worst ERs are the ones that are 'owned' by the city, in my experience
I recall going to the ER once with a wound I had been treating myself that had become infected
At the time I had no health insurance so a visit to a regular Dr was out (most won't even see you if you don't have insurance, in Austin)
Yes, I sat a long time
Just before i was called back, a fellow came in with a bloody towel wrapped around his arm, which was still dripping blood
When they called me, I suggested strongly (read, demanded) they take him in first, as the arm looked 'off' to me
He thanked me as they took him back, he'd had a chainsaw accident and near cut his arm off

 

[jimindenver]

We have Urgent cares here that were I to come in with chest pains, they would have packed me off in a ambulance for a real ER.

 

[Gunny]

Showing my ignorance but here goes...does the States not have Medical Centres where you can go to instead of the ER? In Canada we have ERs that are connected to the major hospitals but we also have emergency Medical Centres where you can go. If it's life threatening or serious enough where a hospital stay is required then you are taken by ambulance over to the hospital.

Here in Texas and I believe most states, we have hospitals run by the county and supported by taxes. They will still bill you or attempt to collect but they will treat you money or not. It's an issue when many illegals use the ER'S there as a clinic instead of seeing a regular doctor. 

All hospitals in Texas with an ER will have a sign advising that they are required to treat all emergencies but when stabilized off to the county hospital you go. 

Many of the county hospitals have clinics throughout the county but they normally don't do emergency medicine, just primary care and referrals. At least in my small little world here in North Texas.

 

[dragonflyinthesky]

Flagstaff is exellent. I was very I'll the end of July here in camp. A friend took me to the er. I was close to rare mexedema coma, thyroid related and could have died. Often its not diagnosed in time. I was in for 3days and well treated.

In the three days I was hospitalized, the crvl camp I was in took good care of my 2 dogs. When I was brought back, they took good care of me.

Last Nov I had to go to an er in buckeye az, they were good too.

 

[anewbiewannabe]

Showing my ignorance but here goes...does the States not have Medical Centres where you can go to instead of the ER? In Canada we have ERs that are connected to the major hospitals but we also have emergency Medical Centres where you can go. If it's life threatening or serious enough where a hospital stay is required then you are taken by ambulance over to the hospital.

I can only speak for my area as my experience anywhere else is completely outdated. Our rural counties have regional medical centers (hospitals) and urgent care, which in my county is basically a walk-in doctor office only open during the day during the week. (They don't carry SVT shot or treat anything that wouldn't be treated in primary care physician office.) The more suburban areas have actual emergency medical centers run by the various hospitals in the big cities. (They would have the SVT shot.) The suburban urgent cares keep evening and short weekend hours. The suburban emergency medical centers are 24 hour like the hospitals so far as I know. If the condition is bad enough then the regional hospitals and suburban emergency centers will send a patient to one of the hospitals in one of the cities.

My experience over the weekend made me wonder about how things are run in the SW US. Since we don't have just one healthcare system how things are run is dependent on the corporation running the area medical care network. There are, or at least were, some really great medical centers in the cities in my area. The corporations and insurance companies are having a major effect on treatment from just basic doctor office visits to actual hospital visits.

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The poor around here who can't afford to pay a doctor up front as demanded (includes urgent care) or who can't find a doctor that takes their state insurance do use the ERs for medical care since the free clinic doesn't exist anymore. Hospitals are required to treat whether a patient can pay or not so they get a lot of business that would be better served elsewhere.

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So I guess my follow-up question would be is the medical system in the SW like the rural system or the suburban system described above? Most specifically around Q and Flagstaff? I'm guessing the urban and suburban systems are similar.

 

[dragonflyinthesky]

I was taken care of in both hospitals with my Obama care from Ohio.

 

[anewbiewannabe]

Dragonfly, thanks. Glad you got treated in time and that your experiences went well. In an emergency insurance doesn't matter to me.

I had to go back and read everyone's last few posts since they didn't show up when I posted before. Sounds like SOP I guess. *sigh*