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Secrets of the Emergency Department

I worked in the emergency department at BC Children’s Hospital as a research assistant for a year and gained a lot of insight into the health care system. It’s no surprise that one of the problems in the ED is overcrowding which leads to longer waiting times (average wait time is about three hours) before patients are seen by a doctor. Keep in mind that this is BCCH so only patients seventeen years and under are admitted.

1. Arriving by ambulance doesn’t mean that you will receive special treatment or get special status. You will have to wait in line to get triaged like everybody else.

2. Be nice to everyone, especially nurses since they are the ones who take care of you. Doctors just come in and tell what is wrong with you.

3. You will have to repeat your story several times separately: to the triage nurses, MSIs/residences/fellows, emergency physicians and possibly specialists. You will save yourself and all the staff a lot of time if you tell the same full story each time.

4. It’s not a bad thing if you have to wait for hours, that means you are not going to die. You should feel sorry for the one who gets rushed into the ED and is seen by a doctor immediately.

5. Doctors do not cure stupidity. I have seen patients that came in and said “My son ran up a set of stairs and now his heart is beating faster than usual” and “My daughter has been coughing and having a runny nose for days, does she have cancer?”. It’s comforting to know that those people are part of the reason why patients are waiting for hours in the ED.

6. Doctors spend a large time doing paperwork. I can tell you, to the second, precisely how much time physicians spend on administrative duties. Believe me when I say they do not idle around.

7. If you come in with a broken bone, be prepared to stay for several hours at the minimum. During triage, most, if not all nurses, know you will need an x-ray, but they are not allowed to order it for you. They can order x-rays for only specific body parts (I don’t remember which ones). Once the doctor calls you in, he or she can do the (re)assessment and then will order the x-ray. You will have to wait until the radiology department is free. After the x-ray, you go back into the waiting room again until the physician gets a chance to see the images and calls you back in for a casting procedure.

8. Staff at BCCH are much more cheerful and lively than staff at Vancouver General Hospital. Not sure why, but you guys can make educated guesses.

9. The staff ARE trained to deal with emergencies, that’s why they work in the ED. There was an incident where a pregnant person came and gave birth to a child. The reason it was done in the ED and not maternity ward: she concealed her pregnancy entirely from her parents until that day.

10. There are optimal times to come to the ED (by optimal I mean least waiting time). During last season’s Stanley Cup playoffs, I had a Saturday afternoon shift during a Canucks vs Sharks game. There were any barely patients that day, guess where all the children were? It’s also safe to assume that patient flow would increase slightly the very next day.

Categories: Research
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  1. January 7, 2013 at 2:51 pm

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