Call it a sign of the times or whatever you like, but I call it despicable.
I am talking about how bad hospital emergency departments have become. Now, I know I’m painting with a broad brush here, but hear me out. I can only discuss opinions based on my own experiences. And my experiences with our local hospitals has, at times, been appalling.
Of course there are some very good, professional, caring folks in these EDs. There are people there who really care about their patients and do their best to make your visit and care as good as it can be.
But there is a growing amount of discontent and piss poor attitudes from emergency room personnel. Did you hear the story of the women who bled to death while laying on the floor of a Los Angels emergency room? Of course this incident is an extreme, but it’s where we are all headed if attitudes do not change soon.
I don’t know exactly why this failure to care is occurring, but I have some theories. Some folks may point to issues like an overwhelmed system of emergency medicine. A lot of EDs are being used today as an alternative to using a private family physician. People show up to an emergency care facility with sniffles, fevers and other common symptoms and ailments that do not need specialized emergency care. The result is that these facilities and the people who work in them become overworked and burned out.
Or it could be due to the current nursing shortage that the industry faces. There is such a shortage of nurses right now that experts are convinced we will never dig ourselves out of it. Yes, every nursing school is full to the brim right now with students and yes, there are waiting lists years long to get into these same programs. But the issue is that the shortage has gone on for so long that there are not enough teachers and instructors to produce enough graduates. This issue is made worse by adding in the baby-boomers who are now getting to the ripe older ages and need more and more medical care. All this together suggest that society will never catch up with the demands of medical care. The failure to care issue is worsened due to the shortage. A good portion of candidates who are now allowed to enter and complete nursing programs are getting in to the profession for the wrong reasons and lack the compassion required to really nurse.
Even though I agree that the above mentioned items are all factors, I choose to point to a different culprit. From my perspective as a pre-hospital emergency care provider, the reasons that so many ED staff members have lost site of compassion and care is that the hospitals themselves have changed their focus on why they exist. Specifically, what is hurting most emergency departments today is the fact that they have become for-profit organizations.
The corporations and their fat, cigar smoking executives, who now run most of our hospitals don’t care one bit about compassion. All they care about is their financial bottom-line. Of course, that is their job. They have been groomed and designed to penny pinch, set unrealistic profit margins and bring in as much cash out of our pockets as they possibly can. But this is not how people who are supposed to deliver patient care are wired. Care givers are created differently. They are designed to be compassionate, caring and nurturing. But when the folks at the top of these now for-profit corporations send down the message that money is what we are really about, it clouds, confuses and distorts those care givers.
I see the affects of this profiteering everyday in my work as a Paramedic. It begins as soon as I enter the ED with a patient. The eyes roll and nearly every nurse and doctor in the room tries to ignore and dismiss our presence. I guess they think if they don’t make eye contact with us or acknowledge us then maybe we’ll go away. There is an air that you can cut with a scalpel towards our arrival as if we were purposely bringing to their emergency department another patient just to make their life miserable and their work-load even greater. Oh, excuse me! I did not call 911 and ask for an emergency, advanced life support crew to come into my life, treat me so that I am stable and then transport me to the closest hospital. When 911 is called, for any reason, we respond. That is how the system works. If our patient wants to go to the hospital then we transport them. We do not have a choice.
And this attitude affects the relationship between EMS crews and hospital staffs. When I walk into an ED, I can feel the negative and arrogant vibes. There is a prevailing attitude that the folks in the emergency departments are superior to any care provider who practices outside of the hospital. This negativity has affected, and this is the most important point I am trying to make, the hospital’s ability to deliver quality, emergency patient care.
Just ask the patient I treated, stabilized and delivered to one our local medical facilities recently who was having the big one, the widow maker of a heart attack. This guy had all the classic symptoms and a 12-lead ECG that showed classic signs that his heart was dieing. When I have a patient this critical, I transmit the ECG to the hospital while we are on our way to their facility. I do this so that the ED staff can see what I am seeing and activate their cardiac catherization lab. We are trained that, in heart attacks, time is muscle. Anything that can speed up the process to get the patient to definitive care (cath lab in this case) is considered good and proper.
The nurse who answered my call to the hospital in this case has particularly strong negative feelings towards EMS for reasons only God knows. Long story short, he coped an attitude during our phone conversation because I had the nerve to suggest that my patient needed the services of their cath lab. As I walked in the ED I expected an easy-pass right to the cardiac lab. Get this guy where he needed to go to save his heart and his life. Instead what I received was a wave from this nurse who stated across the department that my patients ECG was “alright” and we could place him is room 5. I insisted that my patient needed a cardiac catherization pronto which of course made the nurse even more incensed. How dare a lowly Paramedic tell a nurse with a two year Associate degree how to treat a patient. So the nurse proceeded to make this about turf and power which meant that my patient did not receive the treatment he should have had immediately. Instead, it was an hour before the decision was made by someone at the hospital that this patient did need a catherization.
Even though the outcome for this one patient was positive (no thanks to this nurse), it could have ended very differently. I ask why? Just to feed the ego of a nurse, or worse yet, an entire hospital emergency department? What was the bottom-line here? Were they trying to save a few bucks by not activating the cath lab until it was absolutely necessary?
I don’t know the answer but I do know my patient did not receive the care he should have. He did not die, bleeding on the floor of this ED like the women in LA did. But if the hospital corporations do not change their attitudes and send a strong message down to all of their staffs that patient care is rule number one, it’s only a matter of time before your loved one will.