Emergency Departments Are Failing the American Public

Having just been in the ED for 6 hours with a friend, I witnessed firsthand the secondhand, substandard grade the American College of Emergency Physicians (ACEP) has given to the state of emergency care in the U.S.

The care I witnessed wasn’t deplorable, but it wasn’t inspiring either. The staff’s empathy for a grieving family was hit and miss. The orthopedic resident’s technical ability as well as her interpersonal skills and judgment left a lot to be desired. And the hygiene of the department – well what can I say? It was as much of a hygiene risk as my 4-year-old godson’s preschool playground full of little Ebola viruses.

ACEP reported in a Report Card on the State of Emergency Medicine that the “Economic woes and a failing health care system mean more people than ever before are relying on emergency care at a time when the nation is receiving a substandard C- grade for its support of emergency patients.” Dr. Nicholas Jouriles, president of ACEP said, “Policymakers can no longer remain oblivious to what is happening in emergency departments.” He called on President-elect Obama to make emergency care a top priority in health care reform proposals.

Dr. Angela Gardner, ACEP’s president-elect, said “The emergency care system is a ticking time bomb… a failing health care system means more people than ever before will be relying on emergency care meanwhile, every minute of every day in this country people need emergency medical care, and that need is growing as our population ages and lives longer.”

Emergency care is becoming primary care – it’s the frontline of medicine, and America’s losing the battle. This substandard care will increase the number of medical malpractice emergency cases and increase the demand for Certified Legal Nurse Consultants on emergency care issues.

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4 thoughts on “Emergency Departments Are Failing the American Public

  1. I have seen incompetance in my career in just about every specialty of medicine. I was talking with a friend of mine who is a local neurologist who has been building his practice here. He expressed frustration because a patient of his who was on a number of medications went to the Emergency Department of a local hospital complaining of a headache. He said “They loaded her up on drugs, sent her home and she died.” They didn’t even inquire about the fact that she was already on several medications that contraindicated the drugs they gave her. But I have seen this kind of thing going on in health care for 30 years. It is almost enough to make you want to throw your hands up and give up. I’ve seen over and over nurses who chart they give meds and the drugs are still in the box, bandages that are charted as having been changed and I go and find my initials still on it from the day before, turns charted as having been done every two hours and the patient is in a bed that is wet to the floor. I remember back when they wanted to make nursing required to be a four year degree so it would make people take more care in the training, but I don’t know if that would change it.

  2. I have seen the same things going on. I have also discovered that these nurses who “cut corners” get praised as to having gotten their work done on time. The nurses who actually do all of the work that they are supposed to do get repremanded for “taking too long.” It makes me wonder why this is backwards.
    I have worked in Doctor’s Offices and they get their patients in and out so quickly that many problems get overlooked, much like the ED.
    I was recently in the hospital for a total knee replacement and my dressing hadn’t been changed for several days and I told the nurse about it and she finally changed it for me. My assessments, sometimes hadn’t been done for days! Thankfully, I had no complications. The state of nursing is in a state of decline. Patients got better care 20 years ago!

  3. I think what is going to eventually have to come about is a permanent position in all areas of health care that builds in the watch-dog. Something that no longer relies on someone who will sue after an error has caused some problem or damage, but someone who will watch constantly following up on quality of care that is being given regardless of whether people want to keep up with their own continues quaility improvement. The state of healthcare in general is in decline. I was in the hospital in 1997 for a blocked kidney. I kept asking for a pain shot. The med I was supposed to get was buprenex, a very good med that doesn’t create addictions and yet still gives very good pain control. However, due to a transposition error, the pharmacy had sent bumex, a diuretic. I kept asking for my “pain med” as often as I could get it” because it wasn’t really helping me. Finally in the middle of the night, a night shift nurse let me in on the secret telling me, “Mamm, why don’t you try the pain PILL, the shot is just a water medicine and probably is not GOING to help.” When I heard what had happened I was livid. And the $)%&# hit the fan. My doctor was none to happy either. I had been going in this pain for a few days without relief. There should also be a way we could get something in the system in for a reform of the health care system to help President Obama with MAJOR Reforms. Hopefully changes can not only help with the quality of health care given but also with the cost it exacts on our resources.

  4. There is never a good reason for poor care or shoddy care. Every person has been touched by poor care, either perceived or real. However, in defense of Emergency room personnel, and as an ER nurse, the American consumer of medicine needs a wake up call. Emergency rooms are not designed for “primary care”, either in size or staffing. After spending 12 hours being hit, spit on, yelled at or worse by people who feel that health care should be free, that it is a right and that nurses and EMT personnel are glorified waitresses, I have to say, I can see how personnel get jaded. I can understand how mistakes and delays happen in a system that is supposed to pick up the slack for a medical system that is failing.

    You are right, our healthcare system is failing, and it’s failing because there are people who think every little splinter and every runny nose is a drama. It’s failing because the public believes that obesity, smoking and poor life choices can be fixed with a pill or surgery. Much of our public is fixated on instant gratification no matter what the cost is to someone else. It’s failing because people bring their child to the emergency room to have a temperature taken because they didn’t want to drive 2 miles to home to get the thermometer because it will take time away from her shopping.

    Yes, our medical system is failing, and as *%#@ rolls down hill, it ends up in the emergency room. Unfortunately, people who are desperately sick and in need of EMERGENCY medical attention suffer the consequences. What are the answers? Only time will tell, but it will take a major shift in the way we think about our medical system, both administratively and in the public sector.

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*The opinions and statements made by Vickie Milazzo, the founder of Medical-Legal Consulting Institute, Inc. are based on her experiences and expertise, should not be applied beyond the specific context provided, and do not guaranty or project actual results. Vickie Milazzo is no longer involved in the operations or management of the business, but is involved as an independent education consultant.

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