Why Am I Waiting in the Emergency Department?

hi I’m dr. Mike Evans and welcome to the emergency department or the Evie so it’s a busy place with people of different ages and incredible mix of injuries and illnesses so there’s one question probably everyone here asked themselves why am I waiting great question so I think the first thing is to step back a bit and consider the physical emergency department is actually interconnected with a much larger web of people and services right around the whole Hospital and sometimes beyond from the highly specialized IDI nurses in charge of assessing patients and keeping everything organized from the front lines to the doctors on call experts in surgery obstetrics general medicine cardiac care and so on to networks of testing services like labs radiology and imaging technicians all these moving parts work in your finger if your problem is complicated or urgent but it also means there are a lot of places where care may take more time and slow down such as a lineup for the CT scan and this this can lead to waiting emergency departments are carefully staffed with more dogs and nurses when we know there will be more patients but even so like at a busy restaurant when it’s full the waiting will be longer the second concept and this is key is that unlike your local walk in the emergency department is not a first-come first-serve place edie staff have to decide who needs medical attention most urgently and they do this using a process called triage it’s a French term so let’s start with a French leader that knew something about strategy napoleon bonaparte specifically his surgeon in chief a man named bevel and Dominique Jean Louise now Napoleon like fighting or at least having a soldiers fight and this led to thousands of wounded soldiers needing care at the same time traditional army clinics were overwhelmed and many died as he tried to treat everyone at once dr. Levey realized he needed a system for deciding who to treat first and who could wait and still be okay so he developed a system of triage which means to sort where he established triage rules treating the wounded according to the seriousness of their injuries and urgency of need for medical care regardless of the rancor or an nationality even soldiers of enemy armies retreated and this tradition continues in this emergency department the triage nurse you first saw actually specially trained to pick up on clues and might make your condition more time-sensitive separating a run-of-the-mill chest or stomach pain from more serious cardiac event or appendicitis can make a big difference in your health may be the person being whisked in before you doesn’t look as bad as that guy over there with a large cut on his head or or swollen and purple ankle but if delayed their condition could be life-threatening the triage is an art and a science and your condition might change and if it does don’t hesitate to talk to the emergency staff once triage has been done the research shows that other big areas that reduce waiting and improves the health of people in EE D is what’s called the four basic rules of easy engagement the first is that every patient can have one additional family member or friend with them in an examination room wait why can’t I have the whole family with me well along with practical concerns there is a need for patient privacy and safety patients are often separated only by a curtain and while you might feel better with your whole lot of funny family with you on the other side of the curtain could be someone who’s seriously sick and needs quiet the second rule of engagements to keep your cell phone or camera in your pocket or purse again because the privacy rights the examination room isn’t a place for taking selfies or videos rule number three the evie is a major area for communicable diseases so by keeping it clean and sanitizing the germs off your hands you protect all of us rule of engagement number four is about making the emergency department safe for all patients and health care staff and that’s why there’s no tolerance for swearing or aggressive behavior and why there may be security guards to help ensure everyone’s safety and enforce this rule it’s hard when your pain or worried about a loved one to keep your cool but it’s better for all if we can try the one print of the IDI experience it doesn’t get the attention it deserves at least in my opinion is a discharge research shows that the quality of the discharge how the IDI stock provides their final information and answer your final questions is critical to a successful IDI visit take a moment to ask yourselves do I understand the instructions do I know my next steps may be monitoring for certain signs red flags you need to watch for getting a prescription or make an appointment with your family doc or or rather follow up written instructions are better easier to remember so maybe take some notes or ask for a summary to be written down for you lastly when coming to the IDI please remember to bring the medications you’re currently taking the spelling of your family doctor’s name and address and make sure we have the correct address and contact number for you so I hope this has helped make your wait in the emergency department easier shorter and better for your health thanks for watching and sorry waiting you

25 thoughts on “Why Am I Waiting in the Emergency Department?

  1. Doc,
    if the waiting time in ER Room equals the charges levied then ?So if someone with non emergency visits ER Room ,and nurse thought ,not a priority.But the hospital bill says you spent 3 hours here is your 4500 USD hospital bill.

    Do you know patients are seen as per the health insurance they have. Better the health insurance ,quicker u get to see the doctor.

    What if the ER staff doesnt give full information and keep repeating we dont know.

  2. Great video as always. What I liked the most in this video is the cultural diversity in its characters. Well done ūüôā

  3. Emergency rooms should make it clear that you can leave, no problem if you decide you can wait until morning (instead of sit at the ER untreated for another 3 hours). Definitely skip the ER if you won't die or get a permanent deformity or something. Won't make that mistake again! Think about these things ahead of time…

  4. I love the video! One small critique, is there any way to get better sound? currently, it sounds like you're sitting in a closet about 4 feet from the mic, lots of bass and low volume. Thanks for your hard work on this! very informative and helpful!

  5. And then you see news of a pregnant woman that lost her baby because she waited for 3 hours in the emergency room. I don't disagree with the video. But if you write rules and guidelines that are neglected, what excuse will you give to the patients? (short on staff? too busy? doctors' mistake?)

  6. The reason many people over-use emergency rooms in this country for illnesses that are not emergent is to avoid paying any up front charges.  They know that EMTALA laws apply, which stated simply, means that an emergency room cannot turn away a patient based on their ability to pay.  The triage process in most ER's now includes screening for common life threatening illnesses such as a heart attack or heart failure, stroke, dangerously high fever and/or infections.  Patients who do not present with life threatening illness are often referred to a clinic for assessment and treatment at a later date at an off-site location or a "fast track" clinic situation where they are seen and treated by less specialized personnel (e.g. nurse practitioner or physician's assistant).  Some patients also seek prescriptions for controlled substances in ER's when or if they have exhausted other avenues to obtain a refill.  Because of the backup this has caused in efficiently treating patients, many ER's have limited stocking or stopped carrying class 3 or higher narcotics, altogether.  Emergency rooms are there to save lives. Not to provide a convenience for free. So DON'T clog them up!  If you need a refill, see your doctor.  If you have a cold, flu, minor cut or sprain, go to an after hours clinic.  As our ER doctor's used to say, "Don't be a GOMER! Get Out of My Emergency Room!"

  7. This video made it very clear that a hospital is not first come first serve. The rankings are based on a triage assessment. This procedure is brilliant. It is a way to asses those who are in more dire need. I would gladly let someone with a brain injury ahead of someone with a common cold. Of course it is not that simple. The extreme cases are sometimes put against one another and it is up to the professional to make their judgment of who to put first. It is with great hope that their years of schooling and training has made their judgment calls accurate. For those who do not understand this policy of the rankings, you will be very upset when your child who needs stitches is waiting while attend to those in a more alarming situation. Can parents really be blamed for getting frustrated while waiting as others who arrive after them are seen by the doctors first? Most parents try to put the needs of their kids first, which may result in the snarky attitude while sitting hours in the lobby. Some parents waiting even result to yelling and complaining about the time they have to wait. Of course this is not just parents who are waiting, it’s all sorts of people. People tend to put their needs first in emergency situations, probably the reason we do not have many heroes in our world. The rude comments about the doctors taking too long, and the moaning and groaning of having to sit and watch others be seen before themselves, is all useless. Nothing can be done to make the doctors and nurses change their order of who is in more need of help. The under-staffing could be blamed of course, but where does the money come that would pay for more employees? It is strange, however, to see how many unneeded and unwanted government officials there are, while little Johnny is sitting in the waiting room for a CAT scan because the hospital is understaffed. People need to understand that the employees at working at the hospital are doing what they can to help their patients. And if that means waiting, then that what needs to be done.

  8. The doctor's trying to explain the appearance of symptoms without reference to the disease.

    For example, Korea is an advanced country with healthcare that easily surpasses Canada's in terms of availability, quality/tech, and especially affordability, and yet wait times in Korea are about the same as you would expect if you walked into an Apple store to buy a new laptop.

    This in spite of the fact that Korea also uses the triage system, respects privacy, discharges with care, etc. etc. On top of that, Koreans spend far less on healthcare than Canadians do.

    So what's really the cause of these wait times, then?

  9. One minute in, and he lies! A line for the CT scan? At 11pm? The only people who might need one are actually IN the ER!

  10. I assume that most people knew this without this video.
    I ask what the doctors, nurses and all the staff are doing all that time?
    From experience of everyone that I know who has been in ER for some reason, life threatening or non-life threatening all the people had few minutes interaction with doctors or nurses.
    Even if you have 200 hundred people dying at the same time and you spent 30 seconds with each one of them, how does one wait 5-7h just to get into examination?
    Is there sooo much paperwork that needs to be done or such a shortage of staff?
    If there is such a shortage of stuff why there is 7 differently ranked nurses taking care of you?

    If anyone can please clarify?

  11. Why am I waiting in the ED? Be thankful you're waiting because if we hustle you to the treatment area right off the bat, you're probably in pretty deep trouble.

  12. The emergency department waiting room has definitely been labeled as a place you don’t want to be. I can relate because recently I almost had to take my wife to the emergency room and I was dreading just the thought being in the waiting room all night. We wish that the hospital was more staffed at certain times, but it is not in the best interest of the hospital to always overstaff in the E.D. Hospital triage has been well thought out and designed over the years to categorize patients according to their needs. These doctors and nurses are trained very well to sort through patients and determine which ones need the most care in what timing. This sorting is based upon the ethical principles of beneficence and non-maleficence, meaning that these physicians seek for what is best for each patient and they also try to avoid harming the patients that are waiting. It is important to know and trust the triage system that is implemented in our hospitals even though it may mean that we wait for some time before being seen.

  13. In the warfield the triage system also included to decide when someone was too ill to be treated. I'm quite certain that doesn't apply in a emergency department?

  14. Shut Up & Listen! I've worked in the Emergency Room(E.R.) for over 20 years (two different E.R.'s). Here's the main reason your waiting in the waiting room. Ready? Here is wisdom: A lot of people are using the emergency room for non-emergencies! That's it! Example: 40 year old female patient has a stomachache for an hour since she ate a whole basket of fried pickles. Instead of going to the bathroom (like she should), she goes to the emergency room. She waits it out in the E.R wait room and eventually gets a E.R. room. Great. Problem: Now she is occupying an E.R. room! Since the greedy hospital has ordered every test imaginable on her (blood work, X-Ray, EKG, CT scan) she will not be discharged until all of these tests are completed. This easily takes a few hours. That's why your waiting! This type of nonsense is approx. 50% of E.R. patients. As background, this patient does not have a primary care doctor. Also, patient is on Medicaid. The enormous bill being generated is all on the state. She pays nothing. Enjoy your wait.

  15. It’s possible to go to an ER, have someone pick up your documentation, then put it back in the bottom of the pile for an additional three hour wait. If you have a real emergency call 911 and be brought in by EMS.

  16. Why Am I Waiting in the Emergency Department?

    Because it is nigh impossible to see a GP.
    I am in full-time work
    Booking online is difficult if you are not computer savvy, my family of 4 needs 4 E-mail addresses (One each)
    The receptionist will not allow me to make an evening appointment unless I ring on the day in which they are already booked up.
    A Dr will call you back, but will not be able to take a heart sounding over the phone.

    For a blood test and heart sounding that takes 15 minutes, I have now spent hours faffing about and still not any nearer being seen by a Dr.

    The system is just not joined up.

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