Why Am I Waiting in the Emergency Department?
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- Опубликовано: 9 фев 2017
- Produced by Reframe Health Films www.reframehealthfilms.com/
Thanks to St. Michael's Hospital www.stmichaelshospital.com/ Mount Sinai Hospital www.mountsinai.on.ca/ and the Toronto Central Local Health Integrated Network www.torontocentrallhin.on.ca/ for their support
Dr. Mike Evans is a staff physician at St. Michael's Hospital and an Associate Professor of Family Medicine. He is a Scientist at the Li Ka Shing Knowledge Institute and has an endowed Chair in Patient Engagement in Child Nutrition at the University of Toronto.
©2017 Michael Evans and Reframe Health Films Inc.
This video would be nice to watch while waiting in the emergency department.
The "trick" to not having to wait in the ED is really simple: **actually be in an emergency**. The lack of GP/family doctor's is the biggest problem over-crowding the Emergency Department currently.
Wow these video should be played on all ED waiting areas . Informative and entertaining
Fredy Rojas of course,peoples has to know what is real emergency and other.
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.
well done Mike and team!
I'm citing this for a school project thank you my guy!
Excellent video, thanks
Great video as always. What I liked the most in this video is the cultural diversity in its characters. Well done :)
cultural diversity is more appreciated/welcomed in Canada than in US what u say?
This was another great video as you noted. Full of good, solid information and the animation was absolutely brilliant. It is nice to see anything produced that accurately depicts who we will see in the event of an ER visit. Cheers to you Doc and everyone else involved in bringing this informative series to fruition.
Thank you for posting..
After 50 years of crohnic illness mostly that causes me to frequent ER, I have to say respectfully changes need to be made.
Waitime: Yes, like an assembly line, we wait for blood draws, EKGs, Imaging, etc. In most cases, each test actually take only a few minutes, and usually in my experience, patient don't wait long for these tests and there is hardly ever a line. Techs who carry out test like CT Scans for instance are waiting for the next patient.
First Triage Nurse:
I had to leave ED after 6 hrs yesterday because at 19° in Chicago, the inability for me to breathe was increasing. I had to decide, leave dehydrated, needing fluids, and other symptoms due to an IBD flare, or risk passing out going home with 1 functioning lung. I doubt the expert Triage nurse assessed my other health issues when she told me after 6hrs, there was no way of knowing when I'd be seen by a Doctor.
Rules of Engagement: last night, there were triage personnel not wearing masks, with signs posted that everyone should wear a mask. Every sits in the same seat to have vitals taken when you come in. There is no cleaning of that seat between patients, and so much more. Including a man who was sent to ER from infectious disease having been diagnosed with a virus of some kind, why did the expert triage nurse have him sit with everyone? Patients are expected to respect the safety of every where such issues always fall behind with those who are professionals.
The point is, my average wait time to see an ER doctor that is... is about 15 hours at a medical center that ranks high in the nation, and I will say what I said last night, there is no excuse.
Brilliant...very interesting and helpfull.
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!
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...
I hope that no one makes the mistake of skipping the ER when doing so results in a permanent deformity and I send my condolences if this type of mistake is something you know from experience! I am assuming with your response you are referring to making it clear that a patient can leave the emergency department in any scenario whether it be in the waiting room, waiting in an emergency room bed, or having been treated and just waiting for someone to tell you that you can leave. I definitely respect your desire to place patient autonomy above everything else in allowing them to know all their options including leaving so that they can choose what they think is best.
From my medical school experience sitting in the medical ethics course this past week, I have to say that there may be times that withholding some options the patient has may be beneficial. From what I understand there are 3 standards to disclosure: professional, reasonable patient standard, and subjective standard. All together these standards include disclosing what a reasonable doctor would disclose, what a patient would find needed for the medical decision, and what a particular patient as an individual would find pertinent. In this case I believe that the patient, if they had expressively told the doctor they were in a hurry, should be informed that they can leave due to the subjective standard based on what the patient as an individual has expressed.
All other patients who have not expressed an intense need to be out of there as quick as possible, might benefit by not knowing they can leave. This is because some patients, possibly irate, uncomfortable, or in excruciating pain, may think going home is better for them so they can relax, when in reality they could be in serious need of medical attention. When patients are tired of waiting and want to move on with their day, their emotion may cause them to make a rash decision if they knew that leaving was a possibility. Of course they shouldn't be cuffed to the bed or forced to stay, but verbally letting them know they can leave could cause even more problems for a patient who really does need to see a doctor. Hopefully most patients know that they aren't held against their will ever and that in the end patient autonomy is held to the highest regard as long as they are competent and capable.
Well done 👍
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.
It's really nice to show cultural diversity ☺
Very appreciated !
cultural diversity is more appreciated/welcomed in Canada than in US what u say?
your too sensitive ... your comment is silly
Please consider a primary care GP/NP before going to Emergency.
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?
Agreed with you!
Yes to both your questions.
Because hospital staff are incompetent; no other reason to be waiting for more than an hour just to be checked in 😄
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.
amen! I try nicely enforcing this viewpoint when people complain about wait times to me. I think people have a hard time understanding that pain doesn't necessarily equal the highest priority, although the squeaky wheel almost always gets the grease.
Link doesn't work any more - a clip about grilling is shown!
خمس دقايق الله يجبر بخاطرك ياخي😘
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?
Only in major area disaster, such as earthquake.
Only in mass casualty events
What do you recommend for me I have sore ears but I don’t want to wait in the ER because where I live it sucks the public health system please help
I was told that because the docs are union, smaller towns may not have an ER doc at all in Canada.
You were told wrong
Also smaller towns in Canada do not have subways transit or airports.
Heck the town my mom lives in doesn't even have a traffic light.
There is no such union. Docs are notoriously uncooperative with each other.
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.
If only you knew how often patients do this, go through triage and end up going back to the same waiting room they would've gone from the start. Whatever game you think you'll be able to play in the ED... we're already a step ahead of you. If you want to know the secret to being seen quickly in the ED, I'll tell you! Be sick.
So cynical. Hopefully you pay $$$ for the ambulance ride if you're just faking it
Not going to work man, we have keen noses honed in to bullshit - we’ll triage you right to the lobby, where you belong.
Why you are waiting? Because you are not dead!!!
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.
In Palestine we don't have a triage system. We treat tens of patients at the same time. The most aggressive patients and family gets to be treated first. And most of them are aggressive. We don't have any kind of security inside the hospital.
Problem is there's an explanation for "why am I waiting 6 hours to see the doctor" but nobody in E.R never knows shit
I'm am I the Er room Dr has come in say or getting me a room for the night I've been here since 4 it is now 12 I'm not any better I'll tell him if I don't take my not medicine my infant Ripley hundred 50 mg that my migraine was set in well I haven't got my medicine and now my migraine has started I don't know what else to do Apollo and I just told me they're working on it
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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.
Yes sir!! i am talking abt American System.Isnt this video abt General American ER Room ?
This is a Canadian video.
My apologies
3 hours, $4500 us !? No wonder faith healers are still doing business down there. I'm kinda partial to our Canadian version of communism that allows every citizen to be equally sick regardless of social standing or bank balance. Being free of the stress of dying because your poor, one more freedom that the land of the free is missing.
Yes sir 3 hours 4500$.insurance declined to pay as they say u shd have gone to urgent care.how do I know if I she go to urgent care or ER Room.
I cant pay and I didn't pay. 4500$ is now on my credit history as collection and my credit score has dropped to 650 point
I am again sick because of flu from past 1 week.but I can't go to doctor because minimum charge I will get is at least 500$ USD.But I have to go to work.otherwise no pay for the day missed
the sound of writing is really disturbing .. making me nervous =P
Pls turkısh translation❤❤❤
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?
NEPHiLiX1 so when you get sick, fly to Korea.
Korea spends tons of money on healthcare. Where are your figures??
Do people really not understand the vast majority of this information? Seems very basic to me.
I can say from experience this information is lost on people when they are in the midst of their own personal emergency. I am sure the people who yell and scream at ED staff are usually NOT this way in their day to day lives. But when they are sick or in pain, or if their loved one is suffering and there is nothing they can do for them, this often makes basic understanding of what is going on around them non-existent.
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?)
I'm not so sure that would happen unless the hospital really can't handle it. They wouldn't wait around just doing nothing if a woman is obviously in labor.
It happened. This/These may be exceptions but I think my point is still valid. I am a perfectionist BECAUSE sometimes, the failures of others are THIS significant.
As for that story I would like to know in what country/setting this happened and if that woman was properly examined, and if so, how complicated was her case? Also, how busy was the hospital during the time she was waiting. Medicine isn't a clear cut "I see stomach pain, it's dyspepsia, take an antacid and go home." So many factors come into examining a patient and the doctors/nurses/staff aren't perfect people that can work tirelessly and perfectly all the time.
I'm Portuguese and this happened in Portugal. I don't know the details. It was in the news and, of course, without details, we can't be sure of what really happened.
Also, I am not a doctor, I am a software developer; I merely confessed a personal principle that drives me.
And you are right. No one is perfect; no one should work tirelessly and perfectly all the time but as I heard once: "in search of perfection, we achieve excellence" so I try. As for doctors, their mistakes cost more than a few bugs on a computer program (sometimes).
Bottomline, life is not simple enough to be so easily illustrated.
I see. Fair point, but I'll have to point out that it isn't necessarily the fault of the doctor as well. ED staff are faced with terribly hard decisions. I'm Filipino and there was a case here of a woman losing her child because she wasn't attended to and in her attempt to find a different hospital, coming back when the first one she went to didn't have the equipment necessary, lost her child. However, media immediately blamed the doctor and most people didn't have the complete details (Like yourself, in this situation). People don't know that Triage was performed and she was examined. At the time she was rejected, she was stable but her condition changed during the travel time.
Like in the case of that woman in your setting, an OB case can suddenly develop or change but I am almost sure that, if the hospital is sufficiently competent, that woman was examined but a sudden complication occurred.
Also, I'd like to thank you for keeping this civil. Rarely find that on the internet, nowadays.
You’re waiting because you don’t have an actual emergency.
:)
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!
Then, there are four basic rules, and discharge. None of this explains wait times. Very bad video title.
11pm is actually a common time for a line in CT. The night shift doctor usually starts at 1030 or 11pm so none of the doctors already in the ED really order much because they'll be leaving. When the night shift doctor comes in, that's when all the exams start blowing up. Source: am CT tech.
First of all WRONG. ANY patient who shows signs of change in condition ie stroke, fall, etc will in fact get a CT scan. Whether or not they are in the ER. They could be inpatient or simply observation and supersedes some or most cases seen in ER.
WRONG! Im an RN and patients from all over the hospital need CTs at various times. In my hospital outpatient MRIs are performed until 2am
Dear Richard: You have no idea what goes on in a hospital.
Actually many mental health patients are stuck waiting for hours on end
Not in all cases. I know the ED I worked at had a special zone for mental health. They would be cleared medically (which could take awhile if there were emergencies ahead of them) but then would go through a different track in the ED. If they presented with a mental health crisis they would certainly obtain a higher CTAS score upon arrival.
I hear what you are saying though. Healthcare needs to place much more emphasis on mental health and there is ALWAYS room for substantial improvement
Great point: EmPATH units are now being implemented in order to address this issue: en.wikipedia.org/wiki/EmPATH_unit
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