Some Helpful Hints to Avoid Long ER Waits
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CNN reported that, since 2002, the average waiting time for Emergency Room visits had increased 27 minutes. In 2008, the average waiting time in the ER was four hours and three minutes.
The increase in time spent waiting at the ER can be attributed to the increase in people who have lost their jobs and, in turn, lost their health insurance. These newly uninsured usually have delayed seeking medical care and are unwittingly putting strain on an already burdened system.
Here are some hints offered by four Emergency Room doctors to get attention in the ER if you feel that you or your loved ones will be harmed by delaying care:
1) Describe your loved one's worsening condition to the triage nurse:
This would work most of the time. If I got a hostile answer, I would ask to speak with the charge nurse or charge physician. If I felt like I was not getting anywhere, I would ask to speak with the administrator on call. The last resort is to call the hospital operator (dial 0 from the emergency department waiting room phone) and ask to page the patient advocate and hospital administrator. ... I would not use inappropriate or threatening language.
2) Don't be confrontational:
A basic principle of medical care is that 'the squeaky wheel gets the grease.' I would recommend advocating on behalf of your spouse. It's uncomfortable that it has to be this way, but it works the same in any service business. The more you complain, the faster the service. But it's a fine line. Complaining can piss off the staff, so it's important not to go over the top. Family members who are too vocal are sometimes escorted out by security.
3) Empathize with the fact that the ER staff is busy, but be persistent in advocating for your loved one:
I would ask to speak with the Emergency Department director. If they weren't there, I would ask to speak with the charge nurse or shift supervisor. ... I would advise them that you think the patient has an 'emergency medical condition that should be evaluated right away.' Most of us in emergency medicine define the urgency in those terms and should be responsive.
If you don't get a response, advise the individual in charge dispassionately and without confrontation, 'I understand you are busy, but I feel the patient will have a bad outcome if not seen right away.' If the person in charge was a nurse, ask to speak with the physician and repeat the same thing. If there's no response, further advise the individual in charge, 'I feel strongly about this and must call the administrator on call.' If no response, I would call the hospital administrator on call and advise him or her of those same concerns.
4) Name drop if necessary, but only with caution:
As far as invoking the threat of a letter to the CEO, that can trigger the 'VIP Care' response, which may save time, but also may expose the patient to increased risk by changing practice patterns. VIP treatment subverts the normal way we practice medicine and in my experience usually leads to medical errors. I have made my worst mistakes while treating friends, colleagues, and other VIPs. ... Belligerence, histrionics or requests for VIP treatment usually end up working against the doctor-patient relationship.
Basically, if you remain calm, but forceful in seeking medical attention for your loved ones, you may be able to decrease that wait time. The important thing to remember is to try to maintain a balance between respecting the ER staff while advocating for a patient.