Waiting in the ER - at what point does waiting become unacceptable?

ENS Private RallyPoint Member — Tue, 09 Aug 2016 17:12:43 -0400

A trip to the ER can take all day. I personally have waited hours to be seen by the medical staff. At what point does waiting become unacceptable?

Response by LTC Private RallyPoint Member made Aug 9 at 2016 5:14 PM

LTC Private RallyPoint Member — Tue, 09 Aug 2016 17:14:48 -0400

when the agony of the wait overcomes the ailment that brought you to the ER.

Response by Capt Tom Brown made Aug 9 at 2016 5:15 PM

Capt Tom Brown — Tue, 09 Aug 2016 17:15:40 -0400

This is a good question for some of our loyal medical & nursing staff. Maybe Col Dona Marie Iversen and Col Rebecca Lorraine as well as others of our medical members can offer insights on endless waits in the emergency room, whether VA or local hospital.

Response by SGT Jerrold Pesz made Aug 9 at 2016 5:22 PM

SGT Jerrold Pesz — Tue, 09 Aug 2016 17:22:30 -0400

When you die before anyone sees you.

Response by SFC Private RallyPoint Member made Aug 9 at 2016 5:41 PM

SFC Private RallyPoint Member — Tue, 09 Aug 2016 17:41:39 -0400

Once it starts healing on its own, I have to throw in the towel.

Response by PO3 David Fries made Aug 9 at 2016 6:10 PM

PO3 David Fries — Tue, 09 Aug 2016 18:10:11 -0400

The only time I go to the ER is if I'm in pain above my typical tolerance level. The last time was years ago for kidney stone. That was a good 6 hours of agony. Did I want to get seen ASAP? Of course. However, as a former Corpsman, I know how triage works and I'm a bit more patient, even when I'm in pain.

Response by LTC Private RallyPoint Member made Aug 9 at 2016 6:53 PM

LTC Private RallyPoint Member — Tue, 09 Aug 2016 18:53:01 -0400

The challenge here is process. A huge numbers of ER visits could have been appropriately dispositioned by the Primary Care team IF they can get access (same-day) appointments. While there are certainly some cases that MUST be managed by the ER, there are huge volumes of low acuity (not very sick peeps) that sit in ER beds resulting in low throughput (longer wait times). At our ED, the busiest in the state, about 30% of patients get admitted to the hospital (due to risk aversion or significant illness/injury). Those beds stay filled until a hospitalist/specialist come to admit them. This has given rise to the "minute clinic" or "urgent care" business where rapid assessments and quick dispositions are business models and drive profits (for those with cash and/or great insurance). The ER sees you regardless of severity of illness and ability to pay....they come in droves, and camp out. George, I feel your pain....and mine is greater.

To your point, average times are tough to compute because boarders skew the data. The facts are these. Wait times are going up. Obamacare has increased access to care, but often inappropriate access via emergency rooms rather than primary care.

Peeps get triaged by priority, not by wait time. That said, the scariest patient and sometimes the sickest, is the dude rotting in the waiting room... It is a national problem.

Response by SGM Erik Marquez made Aug 9 at 2016 7:18 PM

SGM Erik Marquez — Tue, 09 Aug 2016 19:18:05 -0400

So long as your initial triage and condition has not changed, is monitored, and you are being considered for service ....you will be seen when medically relevant based on need and relative to other patients that present with more serious conditions.

Response by Capt Private RallyPoint Member made Aug 9 at 2016 7:20 PM

Capt Private RallyPoint Member — Tue, 09 Aug 2016 19:20:14 -0400

Reminds me of when I worked in a hospital in Iowa. The ER left a man alone in an exam room for more than 3 hours. He had been told to undress and they would be in shortly. After three hours he decided to roam the halls nude.

Response by MAJ Private RallyPoint Member made Aug 9 at 2016 7:31 PM

MAJ Private RallyPoint Member — Tue, 09 Aug 2016 19:31:29 -0400

The ER is for emergencies, think heart, brain, lungs or prevent loss of life , limb, or eyesight. If you are there for any other reason (sniffles, my knee hurts, etc), you will wait, wait for those who are there, triaged by urgency, to be seen first. If a same day sick call, urgent care type clinic available, use that.

Response by CPT Private RallyPoint Member made Aug 9 at 2016 7:56 PM

CPT Private RallyPoint Member — Tue, 09 Aug 2016 19:56:45 -0400

Consider yourself lucky if you are waiting. Its the patient's who are being hurried back that are having an emergency. An emergency is something that is a threat to life, limb, or eye sight. It is not a sore throat, back pain, migraine, or an STD. The reason waits are so long is that ERs are overused and abused by people without true emergencies and who do not utilize primary care. Do not begrudge the medical providers - you are triaged and seen by order of importance and severity. If the sore throat has been waiting for 8 hours, they will not be seen before the chest pain patient simply because they got there sooner. If you have a non emergent issue, an urgent care or primary care is more appropriate and will free up the ER to do what they are there for - EMERGENCIES.

Response by SGT Private RallyPoint Member made Aug 9 at 2016 8:39 PM

SGT Private RallyPoint Member — Tue, 09 Aug 2016 20:39:55 -0400

I had a broken leg and was not seen by a doctor for 6 hours. I was admitted and had surgery in the morning. A lot of pain in the meantime.

Response by SFC Pete Kain made Aug 9 at 2016 8:47 PM

SFC Pete Kain — Tue, 09 Aug 2016 20:47:04 -0400

unacceptable? When you are dead. until then suck it up, others may be in much worse shape. BTW welcome to Obama care.

Response by CSM Thomas McGarry made Aug 9 at 2016 8:58 PM

CSM Thomas McGarry — Tue, 09 Aug 2016 20:58:11 -0400

As said by others-when less serious cases have been taken care of or test results have come back-you can always sign out AMA

Response by 2LT Private RallyPoint Member made Aug 9 at 2016 9:45 PM

2LT Private RallyPoint Member — Tue, 09 Aug 2016 21:45:22 -0400

IF you are sitting hours in the ED, its bc you don't have anything serious going on anyways. The ED is not designed to treat a sore throat, give out free care to the bottom of society, or hand our free crutches.

Response by MSgt Steven Holt, NRP, CCEMT-P made Aug 9 at 2016 9:47 PM

MSgt Steven Holt, NRP, CCEMT-P — Tue, 09 Aug 2016 21:47:18 -0400

Unfortunately, ER's do not work on the "First come, First served" method. You will be seen based on the severity of your condition. Depending on patient density, that may be 10 minutes, it may be 10 hours. Be glad you are being made to wait. It means you are not in immediate danger of dying right then.

Incidentally, just because you arrive by ambulance does not mean you will be seen faster either. I've put dozens of patients in the triage waiting room to wait. The look on their face is priceless!

Response by SSG Michael Scott made Aug 9 at 2016 10:04 PM

SSG Michael Scott — Tue, 09 Aug 2016 22:04:04 -0400

Too damn long.

Response by CPT(P) Private RallyPoint Member made Aug 9 at 2016 10:23 PM

CPT(P) Private RallyPoint Member — Tue, 09 Aug 2016 22:23:23 -0400

As an ER provider - unfortunately many ER's are clogged up with people who really could of seen their primary care doctor or gone to an urgent care for management of non-emergent issues.
To answer the question though - it really depends on the complaint.. Plus the people waiting don't know what else we have going on in other rooms. It's hard to understand what's going on as a patient when your not seeing "chaos". Our work environment is typically a controlled chaos that many wouldn't understand. Luckily I work in a small ER now and don't have near the attitude I used to get at the big hospitals re: wait times.
I do understand wait times are issues for ER patients - all you can do is tell someone if your condition is changing for the worse - asking about your wait time won't help - we never know what's coming in the door next.

Response by TSgt David Holman made Aug 9 at 2016 10:26 PM

TSgt David Holman — Tue, 09 Aug 2016 22:26:34 -0400

It really depends, if you are bleeding out (legitimately, not perceived) or are having a true life threatening emergency (i.e. stroke, chest pain) then you shouldn't have to wait. That being said, if you are concerned about the wait time, you should probably question why you are in an ER. One of the biggest reasons that people's waits are so long is that the ER is highly overused, and understaffed. I have had waiting rooms full of people with what amount to the sniffles in an ER complaining about being seen at 1800, and I knew for a fact that there were unbooked appointments that day.

ER is a hard life, and triage nurses usually don't get enough credit for what they do, but believe me, we do what we have to to make sure that anyone who needs care receives it (bracing for flames in three... two... one...)

Response by PO1 John Miller made Aug 10 at 2016 12:21 AM

PO1 John Miller — Wed, 10 Aug 2016 00:21:08 -0400

Great advice you've already gotten. If it's something that isn't necessarily ER worthy, consider going to an Urgent Care clinic or a stand-alone ER. I live in the outskirts of Tucson, mostly desert and mountains. Earlier this year however a stand-alone ER was built about 2 miles from my house. I actually had to use it when I was running a temperature of approximately 104. Because of its nature and the ability to make an online appointment, I was seen right away, treated, and released a few hours later. Had I gone to one of the regular hospitals or the VA ER, I would have been there all night I'm sure.

Response by SGT Sarah Thiel made Aug 10 at 2016 12:51 AM

SGT Sarah Thiel — Wed, 10 Aug 2016 00:51:46 -0400

It depends on the severity. Every time you go to the E.R. you are triaged. At my hospital it's 1,2, or 3. 3 is you need immediate attention now I.e. unconscious or serious injury. 2 is like you're bleeding a good amount and need stitches. 1 is well we will get to that person when we get to that person. And its also not based on time you have been there. It's based on severity of injury or illness. So you could be about to get seen but if other people come in that are more urgent than you get booted back. So that being said it all depends on what you need to be treated for and how long you wait. It's not too unusual for normal civilian hospitals to make you wait 4 hours for extreme migraine or something like that.

Response by SSG Drew Cook made Aug 10 at 2016 1:39 AM

SSG Drew Cook — Wed, 10 Aug 2016 01:39:00 -0400

Don't go to the ER for a non-emergency, and you won't have to wait as long.

Response by Capt Michael Greene made Aug 10 at 2016 2:13 AM

Capt Michael Greene — Wed, 10 Aug 2016 02:13:45 -0400

The specific question has been answered. The general question is Why Does The US Have Very Poor Healthcare, the worst of the Richest 30 Countries, while at the same time, paying waay, waay more for healthcare than any of those nations?

Answer: Our healthcare "system," if this hodgepodge can be called that, is driven by profit. Other countries' healthcare systems are designed to take care of the health of the nation.

Our system is designed to produce maximum profit while providing the average person the least acceptable level of health.

Response by PO1 Tony Holland made Aug 10 at 2016 2:19 AM

PO1 Tony Holland — Wed, 10 Aug 2016 02:19:07 -0400

You didn't mention whether you went to military facility or not. I worked triage for a year as an ambulatory patient at the Submarine Medical Facility in New London in 1970. The majority of patients were walk-ins screened by me to be seen by corpsmen or by physicians depending on the symptoms. In addition, the hospital had a separate emergency department. Sick call was for normal hours only.

Response by SGT Tim Soyars made Aug 10 at 2016 4:25 AM

SGT Tim Soyars — Wed, 10 Aug 2016 04:25:04 -0400

When you condition deteriorates to the point you or yours ARE now a real emergency dept. patient. Triage nurse: "How long has your child had a fever? It's 104 now." Mom: "All day." Nurse: "You checked him in as, "Sick". You should have told us then. Have you given him any Tylenol or Motrin?" Mom: "No! I wanted you to see that he really has a fever!" (At which point the child starts to seize.)

Response by SPC James Gromley made Aug 10 at 2016 5:36 AM

SPC James Gromley — Wed, 10 Aug 2016 05:36:22 -0400

Sorry to hear about your wait but ER's are set up to treat those who have the worst problems first, just like on the field of battle. someone with a flash wound that is in a lot of pain will be pass over for some one who is not talking barely breathing and bleeding slowly from a open hole in their chest or abdomen, it is called triage and was actually develop on the battlefield during WWI and perfected throught out history with every war we have been in sense then. I do see what you mean having been there myself. I once was in a ER and was waiting on the doctors to decied if they would fly me or a 5 year old boy to another hospital, he got the flight when the X-Rays showed his skull fracture. I had to ride 2 hours in a medic unit with peritonitis, the unit was being driven by a medic who was not happy because she had to cancel a hot date to make the trip. So I can see your point, it can suck at itmes but worst case are treadted first.

Response by SSG Private RallyPoint Member made Aug 10 at 2016 7:35 AM

SSG Private RallyPoint Member — Wed, 10 Aug 2016 07:35:37 -0400

If an hour goes by without hearing from someone go to the nurses station/desk and ask if they forgot about you. It happens more than you want to believe.

Response by SSgt Rick Glime made Aug 11 at 2016 1:59 PM

SSgt Rick Glime — Thu, 11 Aug 2016 13:59:32 -0400

People go to the E.R. because something is wrong and they don't know what. If you've waited more than 45 minutes, that's too long, and that's being generous. If everyone had medical knowledge, we wouldn't need doctors. I do understand that a lot of BS comes through the doors, but that's what your triage nurse is for. If you brought your baby to my emergency room at 3 in the morning for a runny nose, then you're going to wait until the pediatric clinic opened at 7:30!

Response by PO3 Sherry Thornburg made Aug 11 at 2016 4:39 PM

PO3 Sherry Thornburg — Thu, 11 Aug 2016 16:39:17 -0400

I figure anything over three hours. I have walked out and refused to pay for services billed, which I did not receive. Main take away. Don't use emergency rooms at hospitals. Go to an urgent care clinic or see your own doctor unless it is life threatening and you need an ambulance. That's my policy these days.

Response by MAJ Private RallyPoint Member made Aug 22 at 2016 12:02 PM

MAJ Private RallyPoint Member — Mon, 22 Aug 2016 12:02:24 -0400

The best thing is to remember that ER is short for "EMERGENCY" Room. If it's not a threat to life-limb-eyesight, then you should be utilizing your sick call/appointment line. A cough for a week or back pain for several months does not constitute an emergency. Another point is it is estimated that an ER visit costs 5 times more than the same visit at your Primary Care Clinic. While that may seem insignificant to an individual, when you take into consideration the number of inappropriate ER visits throughout the military and the US, it adds up.

Response by Sgt Kelli Mays made Aug 30 at 2016 10:31 PM

Sgt Kelli Mays — Tue, 30 Aug 2016 22:31:38 -0400

Being married to an ER physician, I understand how the system works...they will take and treat those who are in need of care first...the most urgent cases will go first...you should be at least checked in and vitals taken in a reasonable amount of time, then you'll have to wait...and may even be bumped once or twice if a more urgent case comes in...You will be seen in order of relevance. Putting a time limit on your visit to an ER or ED is something you cannot do because there is no way to determine the time of being seen.

Response by 2LT Ronald Reimer made Apr 12 at 2018 7:26 AM

2LT Ronald Reimer — Thu, 12 Apr 2018 07:26:23 -0400

When your pulse stops and you become unconscious. ER’s are for emergencies. An emergency is defined as “an emergent medical condition that, if not treated within 24 hours, will likely lead to death, significant disability, loss of an extremity or eyesight.” If you have one of these, by all means, go to the ER. ER’s are full of sore throats, rashes, scratches, minor burns, constipation, ear aches, pink eye, sprains, strains and sunburns. Those all result in longer waiting times for everyone else.

Response by MSgt John McGowan made Apr 12 at 2018 8:40 AM

MSgt John McGowan — Thu, 12 Apr 2018 08:40:26 -0400

PO1 George Martin ----- Been to the ER a couple of times. Now you will see them move if it is anything with the heart. I didn't even check in before I was taken to a room and wife checked me in. About a 100 people passed thru or came to the room, all were ER personnel. I was also put in the hallway once when they were busy. Hard call to make on what is to long. My suggestion, learn to sleep those waits out.

Response by COL Private RallyPoint Member made Apr 12 at 2018 9:17 AM

COL Private RallyPoint Member — Thu, 12 Apr 2018 09:17:37 -0400

At the point that you pass away.

Response by SPC David Willis made Apr 12 at 2018 10:18 AM

SPC David Willis — Thu, 12 Apr 2018 10:18:37 -0400

By no means is this an awful wound, but it was bad enough to where I had to change the dressing twice in the waiting room of Ft. Hood's hospital. It was funny watching soldiers with the sniffles getting in a head of me and when the doc was stitching me up he said the nurses needed to learn how to prioritize.

Response by PVT Roger Delgadillo made Jul 6 at 2022 11:25 PM

PVT Roger Delgadillo — Wed, 06 Jul 2022 23:25:30 -0400

When you are I severe pain or having trouble breathing