Help me help you: tips for getting through an ER visit

There’s something you should know.

Hospitals are dangerous. Now I’m not saying my hospital is dangerous, but that hospitals in general are. How can a place with so many well educated, well meaning people with access to some of the best science and technology our time has to offer and with so many regulatory bodies breathing down their necks be dangerous?

Well, for several reasons. The first is there are so many moving parts. In one ER visit your care will pass between a triage nurse, ER tech, imaging tech, lab tech, ER nurse and ER doctor. And perhaps a Pharmacist, radiologist, respiratory therapist, and admitting team. And each of these people is managing a constant battery of tasks and distractions. Also, they are all decidedly human, which we all know sets the stage for all sorts of issues.

Another reason hospitals are problematic is all the other people there. Are you a cancer patient on chemo with no immune system waiting in line to check in? The person behind you could very well have the flu. You take the seat of a young man who gets called into triage. Unbeknownst to you he is being seen for a recurring abscess on his thigh as a result of an antibiotic resistant organism. Sick people congregate in hospitals. And so do their contagions.

Lastly, (for this limited article), hospitals are unpredictable. What was perfect adequate staffing at 9 am can turn woefully inadequate when 15 minutes later a person in cardiac arrest and a shouting, spitting, wildly thrashing patient hyped up on some sort of substance and vowing to kill the world roll in back to back sucking up all sorts of resources. A mild day can turn on a dime. While hospitals work on predictions and averages, they are yet to discover the crystal ball science that will allow us to know what’s coming.

And yet hospitals are necessary and they do a great deal of good. So here’s a few insider tips to help you navigate this crazy world in the event you need to.

1. Avoid the hospital. The best way to avoid all of the above problems is to avoid the hospital. If your problem has been going on for some time, make a doctor’s appointment. If it falls under the category of common cold, suspicious itch, cough, cut, sprain, strain or break – visit an urgent care. ERs are the most expensive care you can get. Even if you get the exact same treatment, you are paying for the 24 hour availability of all our expertise, whether you need it or not.
2. Don’t be a jerk. Nobody likes to wait. Who likes to wait? I don’t like to wait. But my friends, ERs and waiting go together like chest pain and a heart attack. Now if you’re having a heart attack, you’re not going to wait, but most of you aren’t having a heart attack. You’re having reflux or an anxiety attack or a twitch. So if and when you have to wait, please realize it’s not the result of the incompetence and apathy of the staff. You have no idea the balls we’re juggling. Yelling at the front desk staff is not going to get you to a room faster, but it is going to add one more ball to the air.
3. Do be an advocate. If you are in a crowded ER waiting room with symptoms you are worried about, you have a right to be worried. An overcrowded department is unsafe. Bad things can and have happened. And just about every urban ER deals with overcrowding at one point or another. But you will do yourself and the staff a world of good if you are gracious. We deal with anger and contempt perpetually. A simple, “hey I’m sorry I know you’re so busy, but I’m really concerned about____” will get you so much further than insinuations and insults.
4. Leave the littles at home. If you have kids that aren’t patients, please try not to bring them. Especially young kids. Hospital floors are a horrifying place for babies to explore. I mean, seriously. So gross. We mop, but it would take a perpetual bleach bath to make them baby safe.
5. Be prepared to repeat. Hospitals are painfully redundant. You will be asked to tell your story several times. Is it annoying? Yes. But you would be surprised how many different complaints come from the same person from one ask to another. The doctor will ask the same questions the nurse just asked. It will feel like groundhog day. It doesn’t mean no one is communicating, just that the pace of the day and past experience means it’s safer to ask again.
6. Be clear and precise. Try and think of how to explain what’s going on ahead of time. Statements like “I don’t feel good” and “I just feel sick” may be true but they are really unhelpful. Also, be clear with WHO will communicate. If you’re an adult and you can, please answer your own questions. Mom, auntie, and Charlie don’t need to compete to give your history of present illness. Nothing is worse than an entire loving family answering for a perfectly competent adult. It just muddies the water. And puts the doctor in a terrible mood.
7. DON’T BE A JERK! They did a study in a pediatric ICU that found that staff who were subjected to rudeness by parents actually performed worse. You’ll remember I mentioned the humanness of hospital staff. Anger, insults, demands and psychological pressure increase people’s stress levels which can decrease their ability to perform at the highest level. You are also contributing to the soaring rates of burnout, further perpetuating inadequate staffing concerns. I can tell you from personal experience, when I go to start an IV and someone looks at me threateningly and tells me I “better get it the first time” I can immediately feel my odds dropping. When you’re a jerk to your care team you are literally hurting yourself.
8. Trust us. But not implicitly. I can tell you from my almost decade and a half of working in the ER that the staff is amazing. We genuinely want to help people and do good. We want to make the right calls. Please don’t approach us like we’re enemies, letting us know you’re watching and that you have a lawyer you’re gonna call if we screw up. That being said – people make mistakes. Sometimes terrible mistakes. Pay attention. Ask questions if you don’t understand. If things are moving too fast and you feel uncomfortable with what’s happening, ask for a timeout. Seek clarification. Speed is a necessary evil in our busy, overcrowded world and it can be a hazard.

I could go on… but I think this is long enough. Stay safe out there!