i read the link with interest. it is my dream someday that a ER wont be just a beginning point but the first step in good care for seriously ill patients. i envision a triage set up, with one set of patients go to a clinic type setting, who need fluids or antibiotics, for instance.
the other set is truly in a life or death situation (why we have paramedics who triage daily and know how) and those go to the other side, with fully trained trauma drs and nurses. they are fantastic people. board certified in trauma medicine.
unfortunately, this is gonna cost money. bottom line is patients are not insured, or medicaid at times which pays about a nickel to the dollar on bills. and most bottom line hospitals are concerned with one thing--profit.
reading the posters story of being the only nurse on duty, i can hear your pain. it is a fact that humans have 2 arms, 2 legs, and can only do so much at one time. my grandmas rest home had 1 RN for 100 patients, no house keeping or med aides at night, and 2 LVNs. that is simply physically impossible for 100 elderly or disabled human beings. but..its called money. profit. it isnt like medicine is meant, to help people. somehow that got lost in the shuffle. it became business.
ERs are not cost effective. they are not the money makers of the depts. and many poor MDs, (poor in ability to be one) moonlight for extra money. they assume, wrongly, trauma is not a speciality requiring intense, deep training. imagine for once a unconcious person comes in? how many possibilities could it be? 100s? at least. this takes training.
some level one trauma units are exceptional. absolutely fantastic.
some ERs, as one i wont mention in texas, has a minimum of a 14-16 HOUR wait to be seen. the same drs who resus someone also see the baby with the ear infection at 3 am. unless you are in cardiac arrest, or arterial bleeding, get comfy. you arent going anywhere for a long time. my daughter has been in it more than once. beds are actually pushed almost together with curtains between. crowding is just appalling. if i had to work there, i would no doubt be a basket case in less than a week.
to all the health care professionals who try and care, i applaud you.
when money is no longer the bottom line, things will change. when specialists are on call, xray is ready for trauma work, and nurses are trained in emergency, it will change. until then, push for it. admins answer to boards. CEOs answer to boards.
health care will change when the people vote in enough politicians who care.