Graveyard Shift

After a few weeks of training on second shift, I'm back to my roots on the graveyard shift. I always have trouble switching from days to nights. After trying everything I could think of, I resorted to taping aluminum foil to the windows to make my East facing bedroom dark.

We had our first real cold snap this weekend. In my experience when it switches from warm to cold, things slow down. That was certainly the case this weekend. Volume was down and there was almost no wait time for the patients. The doctors picked up the pace and got patients in and out.




When I was on the ambulance, I frequently had to take patients to the ER who were not experiencing an emergency. People will call 911 because they have a cold, or the runs. Now that I'm working in the ER, I see how big a problem this is.

I know what some of you are thinking. I know about all the people in the US who don't have insurance or access to a physician. Our hospital has several free clinics, and people do use them, but there is a certain segment of society that uses the ambulance like a taxi and the ER like a pharmacy. They never pay, and they have no intention of paying. This is all part of the free ride they take.

I don't get angry at it, but I have to admit it bothers me. Emergency rooms are for emergencies. If you have a cold, go to the free clinic. That's what it is there for. They're open 17 hours a day. There are four locations. I was working triage the other day and had a patient come in just for a pregnancy test.

All in all I think the patients bill of rights is a good thing. The patients bill of rights makes it so we can not refuse care to someone who asks for it. I want people to get the help they need. But I realize that these occurances are one of the things that drive up the cost of health care.

Let me be clear. If you've been throwing up for days, you might need to come to the ER. If you have a high fever, you might need to come to the ER. If you've been coughing since this morning, you probably don't need to come.

Many drug stores have inexpensive clinics now. If you can't afford that, there are places that will see you for free. I'm not complaining about having to work, I just don't want to have to come to your room so you can ask for a free meal when I need to be putting on a 12 lead on a person who came in with difficulty breathing.

And if folks won't stop coming in, then perhaps they could be polite. We have to see the most serious patients first. Yelling at the greeter because you've been waiting for an hour (thats our average wait time for non emergency, and well above the national average) won't get you back any faster.