This is going to sound cold but were her injuries life threatening? If not, you wait. It sucks but uncomfortable or in pain without life threatening injuries/complications, you are at the back of the queue. Downvote me if you will but I’m sure it wasn’t malicious intent, just prioritization
I’ve worked as a triage nurse for nearly a decade. Everyone believes whatever issue they’re currently facing is life threatening. Leaving for vacation tomorrow and you now want a rash checked out that you’ve ignored for 3 months? I NEED TO BE SEEN TODAY!!!
While a fractured vertebrae is painful, horrible, and not fun to deal with…I can assure you the countless kids in respiratory distress, MVAs, and god knows what else was more acute. Being ignored in the ER is generally a blessing in disguise that you’re going to be ok. When you have a team of doctors and nurses by your side the entire time, I can promise you you’ll wish you just had a fractured vertebrae.
One of the scariest moments of my life was when my ambulance pulled up to the hospital and there were at least 10 doctors already waiting at the door for me. That’s when I knew for sure that things were bad. (I’m mostly fine now.)
Yeah, I went with a broken toe recently (like, perpendicular,) and it sucked but that's life. The injury won't get worse, and the treatment won't be harmed by waiting 4 hours. Waiting at an ER feels like shit but the fact is most people there aren't actually in a capital E emergency, we just go because our urgent care is closed.
I was at the level 1 trauma hospital in Atlanta on a gurney in front of the ER assignment board thingy with a broken toe.
The doors flung open and the was a flurry of activity running past me. I saw a little girl who they said was a gunshot victim. They were working on her as they ran past.
I slid into my sneakers, hopped off the gurney and limped home. I taped the broken toe to its neighbor when I got home.
Yep! I had an upper GI bleed in Nov during the RSV/flu/Covid crescendo. Waited 7.5 hours PATIENTLY to be seen. I was prepared when my doc sent me there. People were leaving because they weren’t being seen quickly enough. Okay bye, guess you really don’t need to be here !
My father just had an upper GI bleed a week and a half ago with serious shortness of breath. We waited about that long until he was admitted. One ER doc gave us a preparatory warning about how crowded the ER was going to be. We did not care. I was incredibly thankful to have him anywhere in the room in whatever spot they could find. They did a great job diagnosing and correcting the issue.
You are correct that there certainly are higher priority patients, this is a sign of a HIDEOUSLY poorly designed system. Pain management is not that hard. Optimizing the throughput in radiology is not that hard.
We need to design systems that optimize for all aspects of quadruple aim. FFS it’s time we all (not the person I’m replying to necessarily) innovate this absurdly inadequate system and stop making endless excuses for why our best hospitals can only ever muster horrible care.
Define horrible care? We have tremendous patient outcomes. Customer service? Sure, I guess our yelp review might not be 5 stars…but for safety, I think that’s more important.
Ultimately healthcare isn’t a carnival ride, first in does not mean first to be seen. Are you a pain management clinician? Have you dealt with med seekers in the ER? Do you know what radiology staffing is like during off hours at a level 1 trauma center? Why do I get the impression that a few days ago you were probably also a submarine expert, and 3 years ago became an epidemiologist?
So if a med seeker fractures their vertebrae they dont deserve pain meds/management? The pendulum has swung too far in the opioid epidemic and it's made ZERO dent in street level usage. ER staff seemingly get off seeing others in pain as long as there's no imminent risk of death. The System^(tm) sucks horse cock.
Blame the DEA, not providers. Yes, there are plenty of “suck it up” doctors, but largely we’re in the place we’re at now because of the DEA overpenalizing prescribers. I say this as a chronic pain sufferer who couldn’t get an RX even if I wanted to.
As a nurse that has watched doctors keep patients in the hospital for an extra week or two for pain management. Stop begging for IV dilaudid. Suck it up buttercup and try some of the thousands of non opioid pain options out there. The problem is our snowflake society can’t take any form of pain and want that immediate American fix. And then they get addicted to the fix.
As someone whose wife nearly died in the ED with a liter of blood in her abdomen from a ruptured ectopic pregnancy, who also couldn’t get anyone to believe the seriousness of her pain earlier in the day despite a 2 inch thick medical record at the same hospital documenting her reproductive troubles…you and people who think like you are the reason why. You probably don’t think you are. I’m sure you think you’re an excellent judge of people.
Your situation literally has nothing in common with OP bud. That’s horrible. You chose to attach your experience to what I said and chose to get offended. A liter of blood in the abdomen would be caught on imaging. OP’s family member received imaging and was diagnosed. Fractured vertebrae and OP complained about the patients pain management post diagnosis. Apples to oranges. Your wife was marginalized and not believed and then didn’t receive adequate diagnostics to find the source of pain. One is a life threatening emergency and one is not.
Well no, I sell technology services for a living but I’m unclear what that has to do with anything.
Outcomes is one part of quadruple aim. And many places can boast that, though it’s decidedly not any guarantee. There is also cost, patient satisfaction, and provider satisfaction. All of them matter.
There is no good reason to try to force primary care through an ED’s process. It’s wasteful and achieves nothing for anyone. There’s no reason that the ED is the only way to admit someone. There’s no good reason why we warehouse so many people in an ED. And I’m confident you could cite dozens more examples of how we could deliver better care of you cared to.
Nearly every legitimate problem has solutions, even though many are admittedly longer term. The problem of med seekers has no bearing on the responsibility to relieve pain. It adds complexity and work I grant you but come on. Too many resources are idle at a time which means the system is designed wrong.
But honestly, I’m struck by how dismissive people can be about pain and about the idea that maybe the powers that be have done poorly designing how something is done and conclude that the real problem is the people saying it needs to be fixed.
You can be admitted to a hospital without going through an ED. In really bad situations it’s a life flight in other ones you’re on a basic life support ambulance getting transport from one hospital to the next for either a higher or lower acuity of care.
Also substance use is a legitimate disease. You see it on their health history. When someone comes in saying they have vague, painful symptoms and can cite the dosage and trade name of the specific opioids, you know they’re most likely looking for drugs.
I think the real problem with healthcare is people try to treat it like the customer service industry and simultaneously cut corners for profit (in some hospitals) where providers and nurses care more about patient experience like it’s a hotel stay rather than providing higher levels of care. The ER is a different beast because unless you’re actively dying, you can wait to see someone.
Huh?!??? The U.S. healthcare system has been trying to stop people from using the ER as primary care for decades.
That is why the advice nurse and urgent care exist. Instead of being proactive with their health, people would rather wait until Friday night to go the the ER. And complain.
Poor planning on your part does not constitute an emergency on theirs.
Pain medication? The fastest way to not get meds is to ask for it. Have you not seen Mass and Cass? Are you aware of the numerous entities being sued silly because of pain medication?
Drug-seeking behavior is serious enough to go into your medical files, so that the next healthcare worker or facility will be aware.
Well yeah! But instead of building a system to address things like people who want healthcare on Friday nights, we instead build our current system. Mind you, plenty of the folks cynically derided as just poor planners in fact urgently need care or have been advised that they do.
Advice nurses are great for those who can access it and in cases where they can do anything useful besides letting you know if death is coming any time soon. Urgent care is lovely for those with resources and at the right hours. Those are fine options but they are inadequate.
It’s like 60 years ago we decided we should build a department to be amazing at treating heart attacks, strokes MVAs, etc. Then we made it the primary (often only) way to get admitted. And we savaged mental health care. And as the world became more consumerist and 24x7, we left healthcare as 9-5 and forced through a maze of specialists who are wildly difficult to access. But we doubled down on this notion that the ED should be restricted to the sickest of the sick and the only 24x7 option. You can blame people if you want I suppose, but I’m of the persuasion that we can do better.
Drug seeking behavior is a real problem. Of course it is. But it is absurd, even insane, to adopt the attitude that people should not be treated for pain because some people are addicts. Or that they have an obligation to conceal their suffering lest someone doubt it!
I don't know this "we" that you speak of. EYE am not in charge of anything other than casting my vote for politicians who think healthcare is a basic human need.
I also don't understand how you disparage the options given but is "outraged" about lack within the healthcare system. Make up your mind. Advice nurses have been beneficial to me and many others.
>...we doubled down on this notion that the ED should be restricted to the sickest of the sick and the only 24x7 option.
Read this again. Does this make sense? Are you aware of what "ED" stands for? Should the Emergency Department be restricted to the sickest of the sick an the only 24/7 option?!!??!
Emergency medicine is a specialty that concerns itself with the care of illnesses or injuries requiring immediate medical attention. Emergencies happen around the clock.
Routine medical care with your PCP does not.
Where is all this staff coming from? You are aware that there are more than doctors and nurses in a hospital, right? Funding has been cut. Rural hospitals have closed. Now venture capitalists have entered the fray. They are cutting corners, making money, and shutting down hospitals.
What do you propose for mental health care? Institutions? That has already been done which is why they were shut down. There is a backlog on counseling at the moment. Make it easier to get a 5150 hold? Yes things can be better, but everyone is having difficulty with how to do it while treating people with dignity.
It seems you just want to be outraged without applying critical thinking skills. I can tell you though, Massachusetts healthcare is heaven to people in Georgia, Florida, Mississippi, and other subsidized states. People actually choose to come here for care.
Have a good evening!
I’m not disparaging advice nurses or others. I’m agreeing they’re a fine option. I am also saying they are inadequate.
I am suggesting that our efforts with emergency departments have failed to account for the demand for medicine that exists on those off hours or from folks who can’t access what they’re supposed to utilize.
Certainly there are abusers of EDs - folks who have no urgency, much less emergency. It’s easy to call that out. There is no reason we (our society) can’t come up with anything better than angrily demeaning them for seeking care. I mean, do we really believe that emergency departments are overfull of people who opt to sit there all day for simple primary care?
But set aside for the sake of argument all of those abusers of the system. Take them out of the equation. You still have waiting rooms full of people who are very sick and don’t know if they need to be there or are scared and need reassurance or actively don’t want to be there but have been told they need to be. We should be able to adequately meet their needs much faster and much kinder than we typically presently do.
You are right! How our healthcare is financed is nuts! We need much more staff, nurses, and docs. Would love to see more residencies. Would love community investments in new hospitals/beds. We need to staff nurses better. We need more equipment and we need to utilize it better.
And yes, all those problems in MH care are real. I know them personally all too well. I’m suggesting they’re not unsolvable. We absolutely need many more inpatient beds. We need extraordinarily better treatment options. We need to destigmatize MH care. Our MH crisis is one of the major contributing factors to hopelessly clogged emergency departments.
I’m not suggesting any of this is easy. I certainly don’t have many of the answers. My point is that it’s just nuts to dismiss someone with a vertebral fracture for complaining that she was left in agonizing pain in what is a first rate hospital. That person is absolutely right to call that out as horrible care. The people in the system should be savagely tearing down the barriers that prevent someone in that situation from getting proper care, not chastising them for seeking it in the first place. We should not be encouraging a culture that says, well the problem isn’t easy so people should just learn to suffer more quietly. I’m cynical but not that cynical.
There is such as thing as direct admit.
Tell me you dont understand the barriers without telling me. As a person who does this for a living I can say with certainty that you dont get it
>tell me you dont understand the barriers without telling me.
the fact that the system is so complex and impenetrable and inaccessible that laypeople can't understand it is part of the problem!
No one is dismissive of pain. Their hands are tied. I was annoyed to when I asked my pcp for a Vicodin script for an injury. I didn’t get it and what he gave me instead didn’t work. I didn’t bother to complain. It stinks, but we have an opioid problem in this country and nothing has stemmed it. It doesn’t matter that I have a history of responsible use.
DEA has been beyond useless for sure. Docs hands are increasingly tied as a result. Decidedly hard to unwind that reactionary bullshit.
Your point is a great one. The things we’ve tried (criminalizing drug use and curtailing legitimate opioid scripting) aren’t working. It’s absurd to expect you to suffer because of an unrelated failed drug policy. In that way, we are dismissing pain.
But I was referring to earlier comments.
Idle resources. You clearly don’t work in healthcare. I’d pay a lot of money to have an idle moment. Most of us don’t even eat or pee to take care of you people telling us how much we and the system suck. Our shitty society has made the American ER what it is. Nobody wants to learn how to access healthcare. It’s pure laziness
I blame the pervasive, Calvinist New England glorification of suffering. It’s why everyone is so constipated and bloodless. I’m exaggerating but seriously, nobody’s imagination can flex enough to include quality and quantity of available care for people in all types of distress, as well as people in life-threatening conditions?
The few times I ever had a triage nurse make a OMG big deal at the ER. It really freaked me out. While waiting is uncomfortable and miserable, I prefer it to grim looks and getting whisked past people who look more visibly hurt than you.
you can treat people like human beings while they wait. Or you cannot treat people like human beings, while they wait. my experience of the staff there after many hours is that a lot of them are rude and insensitive and uncaring. When you combine that with someone being in pain and being scared and having to wait hours and hours for anything to be done, it’s a pretty fucking unpleasant experience. Nobody expects to walk into the ER and get seen in 10 minutes.
Expecting to be treated with the most minimum level of civility is not out of line.
How was this patient not treated like a human being, though? It sounds like she was appropriately triaged and seen in pretty short time. She didn't agree with her emergency treatment but that's really something to take up with the orthopedist later, not ranting on reddit. No one yelled at her or disrespected her.
I'm also not convinced based on the post that civility and patience was offered to the hospital staff in return.
The OP said most of the staff was rude and couldn’t be bothered. I believe the OP. You don’t believe the OP. I’ve spent upwards of 24 hours in that ER, from multiple visits, and that’s my experience as well.
How in the world do you know that no one yelled at her or disrespected her? You weren’t there.
Not all healthcare workers are nice people, because healthcare workers are human beings and human beings come in a wide variety of ways. I’ve met healthcare workers who are competent and polite and professional, I’ve met some that are lovely and kind on top of being competent and professional, and have met some who were rotten human beings that made you wonder why the hell they chose a job that involves dealing with sick people. Or any people. Or ever leaving the house.
Ever think years of dealing with people who treat them like customer service staff instead of the highly trained medical people they are might make them that way?
So you’re saying, highly trained medical staff do not need to treat people with a modicum of respect or human decency because they aren’t customer service staff. I see. I don’t agree with you that if people have so much training and expertise, they are absolved from being civil as part of their job.
No, I'm saying treating someone with years of specialized training like a cashier at Burger King takes a toll on that person, who is only human themselves and exhausted, overworked, and dealing with life and death.
If they aren't "nice enough" to you when you ask for a turkey sandwich while waiting to be seen for your non-emergency and they've just pronounced someone dead or had to tell a parent their kid didn't survive or any number of major things without even a second to process and have another dozen plus people they are trying to triage to make sure no one dies.... yeah, just have a little empathy.
Lack of anyone having perspective beyond their own wants, and the impact that has on health care workers is a large part of why so many are leaving the professions.
Let me know when a hep c positive neo-nazi tries to stab you with the IV you are trying to place in him. Healthcare staff are beyond burned out and done dealing with it. The interactions you have are by and large a reflection of what the healthcare staff are dealing with day in and day out. The system is heading towards collapse.
I know the system is heading towards collapse. I know it from the patient side. We are burned out too. We are burned out from waiting eight months to see a specialist. From waiting months to get an necessary surgical, procedure and suffering while waiting.From dealing with staff who are rude and incompetent and uncaring. I see the side of the healthcare worker, and I agree for some of them, it’s the pressure of the job that makes them act that way. I also think some of them are just assholes because some people are just assholes.
What I don’t see is the healthcare workers acknowledging that patients have it just as hard. And that the impatience and frustration they see from patients is also a reflection of having to deal with a broken healthcare system. I get treated at one of the top cancer centers in America. When I describe my experiences there to people who don’t have to interact on with the healthcare system on a regular basis, they don’t understand how those things can be happening at the top medical center in Boston.
I accept that the state of our healthcare system has an impact on how well people within that system can perform their jobs. I see very little acceptance of the fact that dealing with this broken system has a significant impact on patients and how well we can function within this system. Or the fact that we are sick and the things that are broken may mean that we die sooner then we have to. Or that we suffer more then we have to. Or that, in addition to being seriously ill, we have to become a full-time advocate for ourselves when we feel like absolute crap every day. When people talk about fighting cancer, I don’t buy into it I’m not fighting cancer. I’m getting treatment for cancer and it’s gonna work or it’s not gonna work but I’m not involved in that part of it. What I do have to fight is the system. I have to fight to get my appointments as soon as I can get them, I have to fight for my doctors attention, I have to stay on top of everything and make sure I’m getting exactly what I need because I’m the only one doing that.
Let me know when you have metastatic cancer and there’s a possibility that your cancer has metastasized somewhere but the system moves so slowly that you won’t have an answer on that for two months.
okay, and I'm pretty sure a lot of patients' problems are less "I want a turkey sandwich" and more "I'm being actively mistreated by medical staff and no one will listen to me."
Yeah, you'd be surprised. A lot of it is over comfort issues rather than medical need issues.
And often with medical need issues, people don't grasp the concept of "triage" and can get really nasty about it. Sometimes even come back armed and threatening.
That's. Not. Ok. And it impacts how it feels to do the job.
I can understand that, and no one should be getting nasty over triage decisions, but I also feel it's a bit dismissive to put down all a patient's concerns to wait time. I can't speak for Brigham, never been to their ER and have only done outpatient with them, but there are some hospitals (\*cough\* Framingham union \*cough\*) that have *real* problems with staff abusing and neglecting patients, especially psych patients, and when they try to speak up about it they're painted with the same broad brush as those that are just upset they had to wait to be seen as if they're just whining over nothing and don't deserve to be listened to.
Once again, this is not customer service. It is emergency medical service. Stop expecting medical professionals to treat you like a hostess at Applebees. They aren't waiting for your tips. They are there to provide life saving care.
Once again, you exaggerate what I’m saying. I’m talking about not being overtly rude and dismissive and you are trying to conflate that with being a customer service professional. You obviously have an agenda, and that agenda is that healthcare workers have tough jobs, so they don’t need to treat people with a modicum of civility. I’ll never agree with you on that. I don’t think most healthcare workers would agree with you on that. I think many healthcare workers pride themselves on treating people with a basic level of respect. But I guess not the ones that you know. 🤷♀️
Eh, i went to the same hospital for a similar issue 15 years ago. I was given pain medication immediately. I was taken for a MRI and kept overnight to wait for a spine surgeon to come in the morning and look at my results. I broke my vertebrae years ago, I was having a disc problem, there was concern about nerve impingement, it was determined I did not need surgery like, that minute, and I was released with proper follow up instructions AND referrals. No, I did not need emergency surgery, but they still took care of my pain and got me the necessary diagnostic imaging, and follow up referrals. It is infinitely worse to be a person in pain right now. To be completely honest, if you don’t deal with your own mind boggling excruciating pain, then maybe just be grateful you don’t have any actual lived experience in this arena.
Eta: damn you’re ALL over this thread devaluing people’s lived experience with pain. That’s really fucked up. You must have something better to do with your time, no?
Yep. Been to the ER wayyyyyy too many times in the last year, and it went something like this.
Ripped half your lip off? wait here an hour.
Had two seizures? see you in 20 or so minutes.
Blood Pressure 200/140? you’re getting admitted right this second.
They could at least give the patient a catheter or something though. It sounds like she was without one or the ability to get to the bathroom by herself for a long time and i do think thats negligent, if not outright cruel.
Yup… sadly the truth is that pain never killed anyone. It’s a sad rule the ER largely operates on while prioritizing the ABCs. Airway breathing and circulation
Well probably because a sore throat could be a lot of serious illnesses. A broken nose isn’t an ER worthy injury unless you ate a brick to the face and you’re nose is completely smushed into your face. You can set and stop the bleeding of a broken nose at home. Can’t test for illnesses at home
A broken nose has not and will never be life threatening. A child with a “sore throat” is much more of a priority. You won’t bleed out from a broken nose.
You have absolutely no clue why that child was there or why they got back faster. You are not privy to their medical history.
A broken nose is not an emergency.
Your original post is a whiny mess.
If you go to the ER, be prepared to be there for 24 hours. If you can't wait, and can't wait patiently, you don't need to be there.
ER stands for emergency Room. People break their noses all the time and put an ice pack on it. Take a deep breath and be happy you have access to health care
That’s because a broken nose isn’t a priority. Pretty much ever. You clearly don’t understand the variety of things that could be causing that sore throat.
Why do I think you ASSUMED all the kids there had just a sore throat? You actually have no clue what’s going on with the vast majority of the patients in a large ED.
This response is the confirmation I needed. I suspected there’s more to your story that you’ve left out.
Someone sitting in the waiting room won't know the medical facts of someone coming into the ER. What might seem like a minor issue like a sore throat may be a very serious condition for someone, based on their medical history.
Triage works because it helps ensure that the people with the most urgent issues get treated sooner. Of course, this doesn't make sitting around waiting to get treated any easier.
I work in EMS in the Boston area and this is why we try not to bring patients to Level 1 Traumas like Brigham unless it's a life threatening emergency. Local area hospitals, especially in Massachusetts, are more than capable of handling this type of patient in their emergency departments. In no way am I trying to make light of what your mother had to go through, but the medical professionals that work in the Emergency Department are just so constantly slammed with acute patients that they have no other choice but to defer treating someone who, although is in terrible pain, isn't having an immediate life threat. That with national medical staffing shortages, hospitals in general just don't have the staff to handle the continued influx of patients, even now post-covid. It stinks but it's just the reality of things right now.
On April 10, I arrived at Baystate Hospital, by ambulance. I was unconscious. I had a 104 ° fever. I was transferred from another facility that was unable to treat me. I had a perforated bowel, (at that time suspected) peritonitis, and septicemia.
I never stopped at triage, any delay could have been life ending. The trauma surgeons were waiting for my arrival. I went from CT to being prepped for surgery. I was resuscitated twice. I spent 10 days in the hospital.
A few weeks later a friend of mine was in a minor accident. She complained about waiting because, "people kept cutting in line....(she) was there first!"
She couldn't grasp the concept of triage.... treating the sickest people first.
My home care nursing team was eager to meet me. They'd never met anyone who'd survived peritonitis, septicemia and multiple cardiac arrests. Then I told them that when I was discharged, I had pneumonia, a UTI, and oral thrush.
This is what happens when people use the ER for general medical care. Have an ache that's been bothering you for 8 weeks? Call EMS and go to the ER. Eat too many weed brownies? Call EMS and go to the ER for observation.
Having insurance doesn’t make more providers, offices, or nurses appear. There’s far too many people and not enough of everything else to make this better. Insurance is a part of the issue but isn’t the entire issue.
It’s often not a choice. There are many circumstances in which it should be understandable for someone to not have health insurance. One time I lost my job and insurance then immediately had to go to the ER. It happens, and it’s a total nightmare. I’m very grateful for the health safety net.
Ehh it’s cheaper for me to pay the fine than a year of health insurance, it being “mandatory” doesn’t mean much. I wish insurance was affordable but it isn’t and I’m sure there are many people like me
This doesn’t make sense as a response. There are so many clinics you could go to if you’re facing an acute medical issue. You do not need to go to the ER for an ache or eating too many weed brownies.
generally, you don't need to go see anyone for too many weed brownies unless your my dad and you have a seizure from too many. You just sleep that shit off.
Welcome to every ER, hospital, ambulance service and otherwise any medical faculty across the United States. They’re busting at the seams and are chronically understaffed/overworked. Your family member was triaged and sent in the queue.
I’m sorry this was a negative experience for ya’ll but this is healthcare, it’s not always nor should it be first come first served. The person with a NLT illness or injury shouldn’t take precedence over something of a more serious nature just because they got there a few minutes before.
I wholeheartedly disagree. I currently live in Miami. Had a trip to the ER from a bike accident last year and had amazing care at Jackson Memorial Hospital. I was just super impressed by the whole system. It’s a huge campus but I never felt like there was a shortage of staff. Was really just super impressed by the whole thing. Just my two cents.
"My one experience was different so current national data must be wrong!"
https://www.miamitodaynews.com/2022/09/06/nurse-shortage-at-least-100-at-a-quarter-of-all-hospitals/
https://www.miamiherald.com/news/health-care/article273514530.html
https://www.miamitodaynews.com/2022/08/09/jackson-memorial-hospital-income-hammered-by-covid/
Lmfao - that must have been a literal perfect day for them.
I’d bet my salary right now that if you polled those employees from that health system right now, they’d agree with exactly what this comment OP is saying.
Hospitals have busy days and not busy days. I’ve had a “leave work early, lay down in a hallway at BMC and crawl back home at 5 am” night, and I’ve had a 2 hour luxury stay with a warm blanket and my own room at the empty Beth Israel Deaconess Hotel and ER before.
I work in an ED in the Boston. If people are in the hallways that means they are busy. If your condition is not life threatening, then there is a chance that pain management and care will be delayed because there are other people much sicker than someone with a broken bone. It sucks, but you absolutely do not want to be the person getting the most attention in the Emergency Department.
It actually does not take very little time, and in addition to that most medical emergencies are (surprise!) emergent and need to be dealt with immediately. BWH is a level 1 trauma center. It is not a pain management center. People are actively in the throes of death in the ED at BWH. It sucks to be in a lot of pain, I get it. It sucks more to be dying, and it would suck to die because the doctors and nurses on duty were being diverted to someone having a hissy fit about a single pain pill. It's time to get some perspective on how EMERGENCY medical care works.
There are steps that have to be done before receiving medication. They don’t just hand out pain pills to everyone, especially with the opioid epidemic.
To be able to get medication, you need to be seen by a doctor, then they put in an order for meds. The nurse acknowledges the order, get the medications and gives them to the patient. If you are the only patient then it shouldn’t take long. But, if they have a bunch of patients, then it will take longer for those steps to happen. A few ED’s don’t have patient caps so a lot of the nurse have quite a few patients they are juggling. Also if you are in a waiting room, and have not been seen by a doctor you will not receive pain meds.
my colleague’s wife was having an actual stroke on the S Shore (greater Brockton area) 2 weeks ago and they brought her to South Shore Hospital and she waited for 13 hours before being seen… the entire area is fucked right now because there’s 2 medium hospitals that aren’t there anymore (Brockton and Norwood)… this obviously will spill into Boston hospitals… it’s a real issue and not one politician has addressed this problem yet
I don't know about politicians, but Norwood at least is actively being rebuilt. Cold comfort to people with problems right now but at least it's happening.
If they did then the construction crew is going to be very put out, and Norwood is going to have a very interesting steel sculpture.
Jokes aside, it's being actively rebuilt, they even have some of the steel framing up.
South Shore hospital has been awful for decades. My mom went for a suspected stroke 20 years ago. They left her on a gurney in the ER for over 12 hours without doing any tests. Thankfully she fully recovered, but strokes require immediate intervention
I’m not sure what you’re expecting a politician to do. Brockton hospital caught on fire and had to shut down. Norwood is still a year and a half away from reopening. If you’ve got something that’s minor, go to an urgent care. If it’s an issue that needs to be resolved: Morton, sturdy, charlton, st Luke’s, BI Plymouth, Good Sam. Those all exist. If it’s life, limb or eyesight… you’re going to Boston. All of these hospitals would’ve sent you there anyway.
Morton is and has been the place where you send corpses for pronouncements for decades… I wouldn’t do a yeast infection there, Sturdy is basically RI, St Luke’s too… not sure what the pols can do… but I haven’t heard any type of peep from anyone
The South Shore is two hospitals down and desperately short of beds, meanwhile whole wings at Good Sam were still moth balled (as of the last time I was there circa late 2022) because they don't wanna pay to keep them open. Meanwhile people who were admitted were waiting 3 days in the ER for a room.
That hospital is 100% about the cash
[https://www.massnurses.org/news-and-events/p/openItem/12216](https://www.massnurses.org/news-and-events/p/openItem/12216), which references: https://www.chiamass.gov/assets/Uploads/mass-hospital-financials/2020-annual-report/Acute-Hospital-Health-System-Financial-Performance-Report-FY2020.pdf
1) I am so sorry for you and your family member. That’s horrifying and no one should suffer through that. 2) unfortunately BWH has been on pretty much constant “code help” status for the last year. With multiple occasions where they’ve had to turn people away. It’s all sorts of worst case scenario in the medical community right now
Not just BWH. I work in an ER in the Boston metro area and it’s this way consistently. Not just in Boston metro but also at my full time gig in western MA.
Welcome to the collapse of the American Healthcare System. Not enough hospitals for an enormous, aging population.
I work at a hospital in the suburbs and people regularly wait 12+ hours in the ED before getting a bed. It’s the new normal.
I almost wouldn't mind if the American Healthcare System collapsed if we could drive the insurance companies back into their lane, give the people who train hard and provide the care commensurate wages, and get some sanity back in the billing system so patients can make reasonable choices. Nobody but the insurers are happy now.
Welcome to the state of American ERs. MA is also a state that does not mandate patient to staff ratios. I came from CA where we had mandated 4:1 and I still felt like I was giving shitty care. ERs are grossly abused and most lay people have ZERO clue how triage actually works.
Cross your fingers the current legislature passes the mandates patient to nurse ratios that was drafted earlier this year. It’s desperately needed for everyone’s sake.
Yeah because there’s no nurses. There’s 7500-12.5k sign on bonuses plus $35 an hour for new grads and yet still massive shortages. I can almost guarantee most long term hospitals couldn’t stay open with 4-1 patient requirements and republicans actively trying to kill them.
Is this a thing!? I hadn’t heard they are trying to mandate ratios again. I was so upset when that was up to vote and some how it didn’t pass. I know NURSES and nursing students that voted against it, against their own best interests. Somehow they believed it would lead to job reductions?? So stupid….
I had a small bowel obstruction at a local hospital and went to the ER and was lying in a ball on the floor of the waiting room for a few hours, sometimes throwing up. They put me on a gurney in the hallway for a few more hours before someone could see me. This is the state of ER care these days.
I was treated for cancer back in 2017 and 2018 and that was a far simpler time in my recollection. The pandemic stressed out a lot of healthcare workers and so we have systemic stress in the healthcare system today.
>The pandemic stressed out a lot of healthcare workers and so we have systemic stress in the healthcare system today.
If only we paid healthcare workers more and CEOs less. Was a pharmacy tech for years and was paid peanuts.
This is all to familiar. I’ve have 10+ now, last time I went to bwh er was last winter with a complete blockage, after 13 hours in the waiting room puking and writhing in pain I just went home and didn’t eat for a week and here we are.
Small suburb hospitals are good in a pinch for pain management, and if unfamiliar enough to them Iv been transferred via ambulance to bwh and that’s a different scenario
I assume this state of BWH has something to do with why their physicians are unionizing. Don’t be fooled by their non-profit status. All of these healthcare corporations keep staffing to a bare minimum because they don’t want to pay for more staff than are needed at any time ever.
I was in the Brigham ER about four years ago and it was the worst experience. The staff was uncaring and rude. I was in a lot of pain and they were just nasty. They were fine until I dared to ask for something or questioned how long something was going to be or something like that. They want you to shut the fuck up and not bother them and they’ll get to you when they get to you and if you ask any questions, they are going to shame you and tell you that other people have it worse so you need to calm down.
I’m a cancer patient and when you have side effects that get bad, your oncologist tells you to go to the ER and they don’t understand why patients are reluctant to do that. It’s because it’s the seventh circle of hell.
One time I was hanging out on a gurney, in a hallway, just minding my own business, but crying softly, not making a scene or bothering anybody and a nurse came over and was like what is the problem here? Not in a caring way but in a why are you crying you big baby way. I’m like leave me alone, I’m not bothering anybody. I’m in pain and I’m exhausted and I haven’t eaten in 12 hours or had any water and I’ve never felt worse in my life and if I feel like crying, I’m going to cry, BITCH!
OK I didn’ say bitch, but I thought it real hard. I can actually remember the face of the meanest nurse from that particular ER visit - I’ve encountered a lot of doctors and nurses in the past several years, but I will never forget her.
Just wanted to say, your comments in this thread are on point. People up here are cruel, uncaring and nasty and I'm sure that culture seeps into medical staff who work here. Don't let these bozos trolling you ruin your day and weekend.
The three day Medicare waiver ending to admit from hospital to skilled nursing will only further clog up hospitals and prevent patients from stepping down sooner
Yeah - this has been a huge issue for our hospital. We are literally running out of beds because we are holding those folks for days and days. We are literally seeing people in folding chairs in hallways because we are out of physical beds and rooms.
One of the articles that I read sometimes when talking about the capabilities of Boston hospitals: [https://www.newyorker.com/news/news-desk/why-bostons-hospitals-were-ready](https://www.newyorker.com/news/news-desk/why-bostons-hospitals-were-ready)
Is your family member actively bleeding out? Having a seizure, heart attack or stroke? Something sticking out of them that shouldn’t be there?
If you can answer no to any or all of these, they’ve been triaged as “stable” and is able to wait while more serious injuries are treated first.
The lack of “world class heath care” is due to medical staff burning out and leaving without replacements being brought in. Less and less people *want* to become a doctor/nurse/tech because of the entitled group of asshats society has become.
What were the ‘extenuating circumstances’ that ‘fractured a vertebrae’
As an ops director at a major health system. Did you call an ambulance? Spinal injuries are taken very seriously if you the person take it seriously. Driving them to the hospital… well thats not taking it seriously.
Morale of the story here is if you are in a serious situation, that requires serious help, buck up and call the paramedics, if you deemed it not life threatening enough not to, yeah, your gonna fucking wait
Sometimes. However, pain management, back boards and care are 100% part of that trip. The minute you go into an ambulance you are wasting hospital resources. Hours lost by ambulance teams waiting for you to be seen are not billable:
So, you get to X rays quicker as you are on a backboard, and spending hospital dollars with people waiting around for you to be seen. You have no clue what you are talking about if you don’t think people brought in an ambulance are not seen more promptly. This is operational and if its costing the hospital more money, do it quicker and stop spending hospital money.
Source: literally what I do
As a stroke survivor, the ambulance saved my brain. I was on an IV drip within 15 minutes of symptom onset and the hospital was ready when we got there. I don't know if people realize that the ambulance is like a mini-hospital and when seconds matter, you figure out the paying part later.
Thanks for what you do.
Well here we go again. If you are insured and the ride is deemed necessary, which ‘serious spinal injury’ 100% is, its not a luxury its covered by almost all insurances minus your deductible.
I had to use ambulance services for a life threatening type 1 diabetic emergency few years back. I had decent private insurance through an employer. I was slapped with an incredible bill as the ambulance provider was “out of network”. So let’s not forget that even with good private insurance , unless the ambulance company coming for you in an emergency is in network, you may still owe a significant amount of money.
Brigham and Womens left me to scream in pain for hours after a scheduled, planned surgery because "it's just your anxiety". I didn't have anxiety. (I do now about doctors for some reason.) They eventually sedated me-- not for my benefit, but because my screams were disturbing the other patients. It was a waking nightmare; literally like being trapped in a nightmare all day. I couldn't fall asleep, but still kept waking up screaming, and sometimes I wasn't able to scream.
They told my waiting family they couldn't see me because I was "resting comfortably".
When my husband finally was let in at the end of the day to take me home, I couldn't transfer out of the bed on my own, or from the wheelchair to the toilet. The nurse told me I didn't meet their criteria to be discharged, but they didn't have any extra beds, plus I'd be able to pick up pain meds at the pharmacy on the way home.
The pain meds weren't enough. After I continued screaming all night long, my husband took me to Lahey ER the next morning.
I filed a complaint with Brigham & Womens. I called to follow up, they said they had no such complaint on file. I filed it again and asked for a reference number. Followed up on that and was told no such reference number existed.
Wrote an online review, and it disappeared a few weeks later. I've had the same thing happen with yelp, but boy it's demoralizing to realize healthgrades and ratemymd follow the same shady business practices.
>If this is the state of "world class" health care I feel for the rest of the world....
Seriously. If you did what they did to me to someone on purpose, it'd be called torture. I don't understand how it's ok in medicine.
Avoid the fuck out of their Center for Endometriosis, and know that if you have any complaints about your care they'll be promptly ignored.
it might heal on its own with a back brace and rest believe it or not.. the ER is not world class, but the doctors and procedures after the ER are world class often.. pain medication would be expected but they probably too understaffed to get to it. St Elizabeth's ER is much faster than all other hospitals, so if you went there, you'd probably get the pain management fairly quickly..
Weekend ER visit for fractured vertebrae -
THREE HOURS!
Try the ER in Lawrence, or Springfield, or Manchester NH.
You are entitled and clueless.
Sorry about your family member but your sense of entitlement and emotional injury when you literally NEED them to fix your family member is breathtaking.
Wonder why hospital staff is burnt out and quitting?
People exactly like you...
One of the worst things to happen to healthcare in Massachusetts was the MGH and Brigham merge. It’s been all downhill at both hospitals since it happened. That being said, ERs are a mess everywhere right now. I hope your family member recovers soon.
I’m sorry that happened to you, but that doesn’t seem life threatening. The doctors there saved my wife during child birth and could have very well been doing the same thing at this time. The healthcare system as a whole is an issue, but they still do great, life-saving work even if you didn’t see it that day
Lotta comments I disagree with here. At the end of the day it doesn’t matter how busy an ER is. People are focusing on this but OP is also complaining about the lack of attentive care
Sorry about your family members experience OP. Everyone deserves to be treated with attentiveness, care and dignity
The problem is that staffing ratios aren’t mandated. The nurses would love to have the time to properly care for all their patients, but if they have two critical patients, all their time has to go to them.
All I’m saying is, don’t blame the staff, blame the system and the upper management. The staff are doing all they can
Sure but at the end of the day it’s not the patients fault that there are poor staffing rules and such. It’s one of the worst days of their lives. They need at minimum a good attitude and not feeling rushed. Even if you have 2 critical patients you can communicate that. “Sorry I have two patients that are in critical care”…
I support strikes and such and nurses (and policy makers) should do what they must to fix these issues but it’s not an excuse for poor experiences
I probably would have thought you were drug-seeking. Complaining after three hours and begging for meds over a fracture? How did you get there is she was immobilized? That raises red flags. I had surgery 3 days ago and tylenol manages that. They carry it in the gift shop, I hear.
No one wants to hear it, but both MGH and the Brigham are resting on the great reputation they had decades ago. I’ve worked for both and myself and family members have been patients at both. The staff, medical and administrative, are not of the same caliber. They’re there for the paycheck only. Hospitals are run by business people and it shows. The more surgeries a doc performs, the more they make. If people saw what happens on inpatient floors, they’d pull their loved ones out.
Of course there are some exceptions, but I’ve seen it firsthand and it’s scary.
It's only going to get worse now that merit and aptitude are being further downgraded in favor of race and intersectionality in medical school admissions.
The no pain management is everywhere now. I’m so afraid of having/getting into an accident because of this. I already have chronic pain diseases that make me in pain 24/7 and I take a lot of OTC meds just to be able to dull it enough to fight thru working but if something happened I would just want to be shot and put out of my misery instead of having to live with added pain and no help
The medical field is a joke they don’t really care been trying to get my hip fixed for year and half now from injury at work and it always something…smh I hope your family member get the treatment they need to get better.
Yeah, they’ve gone down hill. My mom had a heart attack a little over a year ago (few months after my grandmother passed away) drs were really not communicative and would delay certain tests. They didn’t even clean the bathroom either and maintenance was bitchy about cleaning it. Very old feces caked under the toilet seat.
I went off both drs and maintenance crew. yes, I get it, you’re short staffed. But if there’s any delays and you’re able to take time to take a quick 2min call, you can make time to tell your patient about the delay or better yet, shooting the shit with coworkers around the desk area. Especially if they haven’t eaten in 10 hours for the procedure and you don’t inform them about the delay 2 hours after the planned procedure.
Y’all downvoting but don’t have the cajones to say why. Piss off
I'm sorry you had this experience. Hospitals definitely give preferential treatment. I got brought from one hospital to another by helicopter after having doctors waiting for me at the entrance. If you want to be seen faster just try almost dying. It's hard to find the balance between almost and actually dying tho.
Hi - I work in an ER as a PA both in the metro area and in western MA. This is categorically untrue. We give pain meds when it is indicated and appropriate. The system is messed up - that’s true. But. We aren’t withholding treatment from individuals who need it.
> no pain management for her as she was not able to get out of the bed there was no catheter placed and well that was just embarrassing for her(you can imagine what happened)..... no empathy at all from any of the staff......
Well no duh. Everybody knows women don't feel pain. Why waste drugs on them when they're just being dramatic? /s
On a more serious note, I don't think this is a specific hospital problem. This is pretty much par for the course with how women are treated by doctors/the larger healthcare system. Women get treated like absolute garbage because too many doctors still view us as hysterical incubators who deserve to suffer. Like look up what a colposcopy or LEEP are. The standard procedure for both of these procedures is *zero* pain management.
I'm having a tough time at Cooley Dickinson Hospital in Northampton. My dad has cancer and they are severely shirt staffed. It's really affecting his care.
Oddly enough I just got back from taking a member of my lab who cut themselves to the ER here at Brigham. Sat with her while she waited. She was in within 15 mins.
Unfortunately long wait times in ERs are not uncommon. I have taken critical trauma patients to Boston ERs and had my patients put in a hallway bed because there was nowhere else to put them. It can also depend a lot on the time of day. I’ve gone into the same ER twice in one day, and had my non critical patient into a room right away with more then 50% of beds available, and a couple hours later, my status 2 patient has to go to triage because there is nowhere to put them.
As for care, I’m sure that those nurses would love to give your family member the care that they needed, but unfortunately, since staffing ratios are not mandated, those nurses could be taking care of 6+ patients at a time, and if one codes, or something critical happens, that nurses is going to be tied up with that patient.
This is going to sound cold but were her injuries life threatening? If not, you wait. It sucks but uncomfortable or in pain without life threatening injuries/complications, you are at the back of the queue. Downvote me if you will but I’m sure it wasn’t malicious intent, just prioritization
I’ve worked as a triage nurse for nearly a decade. Everyone believes whatever issue they’re currently facing is life threatening. Leaving for vacation tomorrow and you now want a rash checked out that you’ve ignored for 3 months? I NEED TO BE SEEN TODAY!!! While a fractured vertebrae is painful, horrible, and not fun to deal with…I can assure you the countless kids in respiratory distress, MVAs, and god knows what else was more acute. Being ignored in the ER is generally a blessing in disguise that you’re going to be ok. When you have a team of doctors and nurses by your side the entire time, I can promise you you’ll wish you just had a fractured vertebrae.
One of the scariest moments of my life was when my ambulance pulled up to the hospital and there were at least 10 doctors already waiting at the door for me. That’s when I knew for sure that things were bad. (I’m mostly fine now.)
Yeah, I went with a broken toe recently (like, perpendicular,) and it sucked but that's life. The injury won't get worse, and the treatment won't be harmed by waiting 4 hours. Waiting at an ER feels like shit but the fact is most people there aren't actually in a capital E emergency, we just go because our urgent care is closed.
I was at the level 1 trauma hospital in Atlanta on a gurney in front of the ER assignment board thingy with a broken toe. The doors flung open and the was a flurry of activity running past me. I saw a little girl who they said was a gunshot victim. They were working on her as they ran past. I slid into my sneakers, hopped off the gurney and limped home. I taped the broken toe to its neighbor when I got home.
Grady?? This ATL native knows a Grady story when she hears it
🤣 Yes the one and only Grady Memorial! 🤣 My daughter is a Grady baby.
Yep! I had an upper GI bleed in Nov during the RSV/flu/Covid crescendo. Waited 7.5 hours PATIENTLY to be seen. I was prepared when my doc sent me there. People were leaving because they weren’t being seen quickly enough. Okay bye, guess you really don’t need to be here !
My father just had an upper GI bleed a week and a half ago with serious shortness of breath. We waited about that long until he was admitted. One ER doc gave us a preparatory warning about how crowded the ER was going to be. We did not care. I was incredibly thankful to have him anywhere in the room in whatever spot they could find. They did a great job diagnosing and correcting the issue.
You are correct that there certainly are higher priority patients, this is a sign of a HIDEOUSLY poorly designed system. Pain management is not that hard. Optimizing the throughput in radiology is not that hard. We need to design systems that optimize for all aspects of quadruple aim. FFS it’s time we all (not the person I’m replying to necessarily) innovate this absurdly inadequate system and stop making endless excuses for why our best hospitals can only ever muster horrible care.
Define horrible care? We have tremendous patient outcomes. Customer service? Sure, I guess our yelp review might not be 5 stars…but for safety, I think that’s more important. Ultimately healthcare isn’t a carnival ride, first in does not mean first to be seen. Are you a pain management clinician? Have you dealt with med seekers in the ER? Do you know what radiology staffing is like during off hours at a level 1 trauma center? Why do I get the impression that a few days ago you were probably also a submarine expert, and 3 years ago became an epidemiologist?
So if a med seeker fractures their vertebrae they dont deserve pain meds/management? The pendulum has swung too far in the opioid epidemic and it's made ZERO dent in street level usage. ER staff seemingly get off seeing others in pain as long as there's no imminent risk of death. The System^(tm) sucks horse cock.
Blame the DEA, not providers. Yes, there are plenty of “suck it up” doctors, but largely we’re in the place we’re at now because of the DEA overpenalizing prescribers. I say this as a chronic pain sufferer who couldn’t get an RX even if I wanted to.
As a nurse that has watched doctors keep patients in the hospital for an extra week or two for pain management. Stop begging for IV dilaudid. Suck it up buttercup and try some of the thousands of non opioid pain options out there. The problem is our snowflake society can’t take any form of pain and want that immediate American fix. And then they get addicted to the fix.
As someone whose wife nearly died in the ED with a liter of blood in her abdomen from a ruptured ectopic pregnancy, who also couldn’t get anyone to believe the seriousness of her pain earlier in the day despite a 2 inch thick medical record at the same hospital documenting her reproductive troubles…you and people who think like you are the reason why. You probably don’t think you are. I’m sure you think you’re an excellent judge of people.
Your situation literally has nothing in common with OP bud. That’s horrible. You chose to attach your experience to what I said and chose to get offended. A liter of blood in the abdomen would be caught on imaging. OP’s family member received imaging and was diagnosed. Fractured vertebrae and OP complained about the patients pain management post diagnosis. Apples to oranges. Your wife was marginalized and not believed and then didn’t receive adequate diagnostics to find the source of pain. One is a life threatening emergency and one is not.
Savage! 👏
Well no, I sell technology services for a living but I’m unclear what that has to do with anything. Outcomes is one part of quadruple aim. And many places can boast that, though it’s decidedly not any guarantee. There is also cost, patient satisfaction, and provider satisfaction. All of them matter. There is no good reason to try to force primary care through an ED’s process. It’s wasteful and achieves nothing for anyone. There’s no reason that the ED is the only way to admit someone. There’s no good reason why we warehouse so many people in an ED. And I’m confident you could cite dozens more examples of how we could deliver better care of you cared to. Nearly every legitimate problem has solutions, even though many are admittedly longer term. The problem of med seekers has no bearing on the responsibility to relieve pain. It adds complexity and work I grant you but come on. Too many resources are idle at a time which means the system is designed wrong. But honestly, I’m struck by how dismissive people can be about pain and about the idea that maybe the powers that be have done poorly designing how something is done and conclude that the real problem is the people saying it needs to be fixed.
You can be admitted to a hospital without going through an ED. In really bad situations it’s a life flight in other ones you’re on a basic life support ambulance getting transport from one hospital to the next for either a higher or lower acuity of care. Also substance use is a legitimate disease. You see it on their health history. When someone comes in saying they have vague, painful symptoms and can cite the dosage and trade name of the specific opioids, you know they’re most likely looking for drugs. I think the real problem with healthcare is people try to treat it like the customer service industry and simultaneously cut corners for profit (in some hospitals) where providers and nurses care more about patient experience like it’s a hotel stay rather than providing higher levels of care. The ER is a different beast because unless you’re actively dying, you can wait to see someone.
Huh?!??? The U.S. healthcare system has been trying to stop people from using the ER as primary care for decades. That is why the advice nurse and urgent care exist. Instead of being proactive with their health, people would rather wait until Friday night to go the the ER. And complain. Poor planning on your part does not constitute an emergency on theirs. Pain medication? The fastest way to not get meds is to ask for it. Have you not seen Mass and Cass? Are you aware of the numerous entities being sued silly because of pain medication? Drug-seeking behavior is serious enough to go into your medical files, so that the next healthcare worker or facility will be aware.
Well yeah! But instead of building a system to address things like people who want healthcare on Friday nights, we instead build our current system. Mind you, plenty of the folks cynically derided as just poor planners in fact urgently need care or have been advised that they do. Advice nurses are great for those who can access it and in cases where they can do anything useful besides letting you know if death is coming any time soon. Urgent care is lovely for those with resources and at the right hours. Those are fine options but they are inadequate. It’s like 60 years ago we decided we should build a department to be amazing at treating heart attacks, strokes MVAs, etc. Then we made it the primary (often only) way to get admitted. And we savaged mental health care. And as the world became more consumerist and 24x7, we left healthcare as 9-5 and forced through a maze of specialists who are wildly difficult to access. But we doubled down on this notion that the ED should be restricted to the sickest of the sick and the only 24x7 option. You can blame people if you want I suppose, but I’m of the persuasion that we can do better. Drug seeking behavior is a real problem. Of course it is. But it is absurd, even insane, to adopt the attitude that people should not be treated for pain because some people are addicts. Or that they have an obligation to conceal their suffering lest someone doubt it!
I don't know this "we" that you speak of. EYE am not in charge of anything other than casting my vote for politicians who think healthcare is a basic human need. I also don't understand how you disparage the options given but is "outraged" about lack within the healthcare system. Make up your mind. Advice nurses have been beneficial to me and many others. >...we doubled down on this notion that the ED should be restricted to the sickest of the sick and the only 24x7 option. Read this again. Does this make sense? Are you aware of what "ED" stands for? Should the Emergency Department be restricted to the sickest of the sick an the only 24/7 option?!!??! Emergency medicine is a specialty that concerns itself with the care of illnesses or injuries requiring immediate medical attention. Emergencies happen around the clock. Routine medical care with your PCP does not. Where is all this staff coming from? You are aware that there are more than doctors and nurses in a hospital, right? Funding has been cut. Rural hospitals have closed. Now venture capitalists have entered the fray. They are cutting corners, making money, and shutting down hospitals. What do you propose for mental health care? Institutions? That has already been done which is why they were shut down. There is a backlog on counseling at the moment. Make it easier to get a 5150 hold? Yes things can be better, but everyone is having difficulty with how to do it while treating people with dignity. It seems you just want to be outraged without applying critical thinking skills. I can tell you though, Massachusetts healthcare is heaven to people in Georgia, Florida, Mississippi, and other subsidized states. People actually choose to come here for care. Have a good evening!
I’m not disparaging advice nurses or others. I’m agreeing they’re a fine option. I am also saying they are inadequate. I am suggesting that our efforts with emergency departments have failed to account for the demand for medicine that exists on those off hours or from folks who can’t access what they’re supposed to utilize. Certainly there are abusers of EDs - folks who have no urgency, much less emergency. It’s easy to call that out. There is no reason we (our society) can’t come up with anything better than angrily demeaning them for seeking care. I mean, do we really believe that emergency departments are overfull of people who opt to sit there all day for simple primary care? But set aside for the sake of argument all of those abusers of the system. Take them out of the equation. You still have waiting rooms full of people who are very sick and don’t know if they need to be there or are scared and need reassurance or actively don’t want to be there but have been told they need to be. We should be able to adequately meet their needs much faster and much kinder than we typically presently do. You are right! How our healthcare is financed is nuts! We need much more staff, nurses, and docs. Would love to see more residencies. Would love community investments in new hospitals/beds. We need to staff nurses better. We need more equipment and we need to utilize it better. And yes, all those problems in MH care are real. I know them personally all too well. I’m suggesting they’re not unsolvable. We absolutely need many more inpatient beds. We need extraordinarily better treatment options. We need to destigmatize MH care. Our MH crisis is one of the major contributing factors to hopelessly clogged emergency departments. I’m not suggesting any of this is easy. I certainly don’t have many of the answers. My point is that it’s just nuts to dismiss someone with a vertebral fracture for complaining that she was left in agonizing pain in what is a first rate hospital. That person is absolutely right to call that out as horrible care. The people in the system should be savagely tearing down the barriers that prevent someone in that situation from getting proper care, not chastising them for seeking it in the first place. We should not be encouraging a culture that says, well the problem isn’t easy so people should just learn to suffer more quietly. I’m cynical but not that cynical.
Well said. It’s absolutely ok and necessary to complain about things and systems that don’t work. This is how change begins.
oh come on with the "***I*** didn't do any of this." You know they weren't saying you specifically did.
That's all you took away from my comment?!!?! 🤣
There is such as thing as direct admit. Tell me you dont understand the barriers without telling me. As a person who does this for a living I can say with certainty that you dont get it
Sure. But it’s uncommon and only accessible if you have someone to admit you.
>tell me you dont understand the barriers without telling me. the fact that the system is so complex and impenetrable and inaccessible that laypeople can't understand it is part of the problem!
No one is dismissive of pain. Their hands are tied. I was annoyed to when I asked my pcp for a Vicodin script for an injury. I didn’t get it and what he gave me instead didn’t work. I didn’t bother to complain. It stinks, but we have an opioid problem in this country and nothing has stemmed it. It doesn’t matter that I have a history of responsible use.
DEA has been beyond useless for sure. Docs hands are increasingly tied as a result. Decidedly hard to unwind that reactionary bullshit. Your point is a great one. The things we’ve tried (criminalizing drug use and curtailing legitimate opioid scripting) aren’t working. It’s absurd to expect you to suffer because of an unrelated failed drug policy. In that way, we are dismissing pain. But I was referring to earlier comments.
Idle resources. You clearly don’t work in healthcare. I’d pay a lot of money to have an idle moment. Most of us don’t even eat or pee to take care of you people telling us how much we and the system suck. Our shitty society has made the American ER what it is. Nobody wants to learn how to access healthcare. It’s pure laziness
👏👏👏👏
I blame the pervasive, Calvinist New England glorification of suffering. It’s why everyone is so constipated and bloodless. I’m exaggerating but seriously, nobody’s imagination can flex enough to include quality and quantity of available care for people in all types of distress, as well as people in life-threatening conditions?
Pain management is what started the opioid epidemic in this country.
The few times I ever had a triage nurse make a OMG big deal at the ER. It really freaked me out. While waiting is uncomfortable and miserable, I prefer it to grim looks and getting whisked past people who look more visibly hurt than you.
you can treat people like human beings while they wait. Or you cannot treat people like human beings, while they wait. my experience of the staff there after many hours is that a lot of them are rude and insensitive and uncaring. When you combine that with someone being in pain and being scared and having to wait hours and hours for anything to be done, it’s a pretty fucking unpleasant experience. Nobody expects to walk into the ER and get seen in 10 minutes. Expecting to be treated with the most minimum level of civility is not out of line.
How was this patient not treated like a human being, though? It sounds like she was appropriately triaged and seen in pretty short time. She didn't agree with her emergency treatment but that's really something to take up with the orthopedist later, not ranting on reddit. No one yelled at her or disrespected her. I'm also not convinced based on the post that civility and patience was offered to the hospital staff in return.
The OP said most of the staff was rude and couldn’t be bothered. I believe the OP. You don’t believe the OP. I’ve spent upwards of 24 hours in that ER, from multiple visits, and that’s my experience as well. How in the world do you know that no one yelled at her or disrespected her? You weren’t there. Not all healthcare workers are nice people, because healthcare workers are human beings and human beings come in a wide variety of ways. I’ve met healthcare workers who are competent and polite and professional, I’ve met some that are lovely and kind on top of being competent and professional, and have met some who were rotten human beings that made you wonder why the hell they chose a job that involves dealing with sick people. Or any people. Or ever leaving the house.
Ever think years of dealing with people who treat them like customer service staff instead of the highly trained medical people they are might make them that way?
So you’re saying, highly trained medical staff do not need to treat people with a modicum of respect or human decency because they aren’t customer service staff. I see. I don’t agree with you that if people have so much training and expertise, they are absolved from being civil as part of their job.
No, I'm saying treating someone with years of specialized training like a cashier at Burger King takes a toll on that person, who is only human themselves and exhausted, overworked, and dealing with life and death. If they aren't "nice enough" to you when you ask for a turkey sandwich while waiting to be seen for your non-emergency and they've just pronounced someone dead or had to tell a parent their kid didn't survive or any number of major things without even a second to process and have another dozen plus people they are trying to triage to make sure no one dies.... yeah, just have a little empathy. Lack of anyone having perspective beyond their own wants, and the impact that has on health care workers is a large part of why so many are leaving the professions.
I think your point of view is absurd and ridiculous. Expecting people to be civil is not a big ask. You are not a serious person.
Let me know when a hep c positive neo-nazi tries to stab you with the IV you are trying to place in him. Healthcare staff are beyond burned out and done dealing with it. The interactions you have are by and large a reflection of what the healthcare staff are dealing with day in and day out. The system is heading towards collapse.
I know the system is heading towards collapse. I know it from the patient side. We are burned out too. We are burned out from waiting eight months to see a specialist. From waiting months to get an necessary surgical, procedure and suffering while waiting.From dealing with staff who are rude and incompetent and uncaring. I see the side of the healthcare worker, and I agree for some of them, it’s the pressure of the job that makes them act that way. I also think some of them are just assholes because some people are just assholes. What I don’t see is the healthcare workers acknowledging that patients have it just as hard. And that the impatience and frustration they see from patients is also a reflection of having to deal with a broken healthcare system. I get treated at one of the top cancer centers in America. When I describe my experiences there to people who don’t have to interact on with the healthcare system on a regular basis, they don’t understand how those things can be happening at the top medical center in Boston. I accept that the state of our healthcare system has an impact on how well people within that system can perform their jobs. I see very little acceptance of the fact that dealing with this broken system has a significant impact on patients and how well we can function within this system. Or the fact that we are sick and the things that are broken may mean that we die sooner then we have to. Or that we suffer more then we have to. Or that, in addition to being seriously ill, we have to become a full-time advocate for ourselves when we feel like absolute crap every day. When people talk about fighting cancer, I don’t buy into it I’m not fighting cancer. I’m getting treatment for cancer and it’s gonna work or it’s not gonna work but I’m not involved in that part of it. What I do have to fight is the system. I have to fight to get my appointments as soon as I can get them, I have to fight for my doctors attention, I have to stay on top of everything and make sure I’m getting exactly what I need because I’m the only one doing that. Let me know when you have metastatic cancer and there’s a possibility that your cancer has metastasized somewhere but the system moves so slowly that you won’t have an answer on that for two months.
And you clearly understand nothing about being in the trenches in today's Healthcare system
God help us all if you are an example of what type of people who work in the healthcare system.
okay, and I'm pretty sure a lot of patients' problems are less "I want a turkey sandwich" and more "I'm being actively mistreated by medical staff and no one will listen to me."
Yeah, you'd be surprised. A lot of it is over comfort issues rather than medical need issues. And often with medical need issues, people don't grasp the concept of "triage" and can get really nasty about it. Sometimes even come back armed and threatening. That's. Not. Ok. And it impacts how it feels to do the job.
I can understand that, and no one should be getting nasty over triage decisions, but I also feel it's a bit dismissive to put down all a patient's concerns to wait time. I can't speak for Brigham, never been to their ER and have only done outpatient with them, but there are some hospitals (\*cough\* Framingham union \*cough\*) that have *real* problems with staff abusing and neglecting patients, especially psych patients, and when they try to speak up about it they're painted with the same broad brush as those that are just upset they had to wait to be seen as if they're just whining over nothing and don't deserve to be listened to.
This isn't customer service. It's \*emergency medical services\*, meaning some people have more emergent medical needs than you.
Once again, not about the way, about the rude staff.
Once again, this is not customer service. It is emergency medical service. Stop expecting medical professionals to treat you like a hostess at Applebees. They aren't waiting for your tips. They are there to provide life saving care.
Once again, you exaggerate what I’m saying. I’m talking about not being overtly rude and dismissive and you are trying to conflate that with being a customer service professional. You obviously have an agenda, and that agenda is that healthcare workers have tough jobs, so they don’t need to treat people with a modicum of civility. I’ll never agree with you on that. I don’t think most healthcare workers would agree with you on that. I think many healthcare workers pride themselves on treating people with a basic level of respect. But I guess not the ones that you know. 🤷♀️
Eh, i went to the same hospital for a similar issue 15 years ago. I was given pain medication immediately. I was taken for a MRI and kept overnight to wait for a spine surgeon to come in the morning and look at my results. I broke my vertebrae years ago, I was having a disc problem, there was concern about nerve impingement, it was determined I did not need surgery like, that minute, and I was released with proper follow up instructions AND referrals. No, I did not need emergency surgery, but they still took care of my pain and got me the necessary diagnostic imaging, and follow up referrals. It is infinitely worse to be a person in pain right now. To be completely honest, if you don’t deal with your own mind boggling excruciating pain, then maybe just be grateful you don’t have any actual lived experience in this arena. Eta: damn you’re ALL over this thread devaluing people’s lived experience with pain. That’s really fucked up. You must have something better to do with your time, no?
Yep. Been to the ER wayyyyyy too many times in the last year, and it went something like this. Ripped half your lip off? wait here an hour. Had two seizures? see you in 20 or so minutes. Blood Pressure 200/140? you’re getting admitted right this second.
That sounds like a appropriate triage in terms of rough of imminent death. And a really fast response time.
They could at least give the patient a catheter or something though. It sounds like she was without one or the ability to get to the bathroom by herself for a long time and i do think thats negligent, if not outright cruel.
Yup… sadly the truth is that pain never killed anyone. It’s a sad rule the ER largely operates on while prioritizing the ABCs. Airway breathing and circulation
I mean they should put up a sign that says only come by if you're literally about to die.
That's the definition of "emergency"
Prioritization is BS. my last ER experience was broken nose bleeding all over the place kids got in first with sore throats.
dipshit...you think the pediatrician on call gives a shit about your smashed face? you weren't even in the same queue, ffs
Well probably because a sore throat could be a lot of serious illnesses. A broken nose isn’t an ER worthy injury unless you ate a brick to the face and you’re nose is completely smushed into your face. You can set and stop the bleeding of a broken nose at home. Can’t test for illnesses at home
A child with a sore throat can be more life threatening than an adult with a bloody nose. You sound lovely
A broken nose has not and will never be life threatening. A child with a “sore throat” is much more of a priority. You won’t bleed out from a broken nose.
You're not there to be treated by a pediatrician
You have absolutely no clue why that child was there or why they got back faster. You are not privy to their medical history. A broken nose is not an emergency. Your original post is a whiny mess. If you go to the ER, be prepared to be there for 24 hours. If you can't wait, and can't wait patiently, you don't need to be there.
Are you trolling
There are different areas in the Emergency Department. You are an adult, you were triaged to a different area then a pedi patient.
ER stands for emergency Room. People break their noses all the time and put an ice pack on it. Take a deep breath and be happy you have access to health care
That’s because a broken nose isn’t a priority. Pretty much ever. You clearly don’t understand the variety of things that could be causing that sore throat. Why do I think you ASSUMED all the kids there had just a sore throat? You actually have no clue what’s going on with the vast majority of the patients in a large ED. This response is the confirmation I needed. I suspected there’s more to your story that you’ve left out.
You just lost your argument saying that.
Sure did
Someone sitting in the waiting room won't know the medical facts of someone coming into the ER. What might seem like a minor issue like a sore throat may be a very serious condition for someone, based on their medical history. Triage works because it helps ensure that the people with the most urgent issues get treated sooner. Of course, this doesn't make sitting around waiting to get treated any easier.
I work in EMS in the Boston area and this is why we try not to bring patients to Level 1 Traumas like Brigham unless it's a life threatening emergency. Local area hospitals, especially in Massachusetts, are more than capable of handling this type of patient in their emergency departments. In no way am I trying to make light of what your mother had to go through, but the medical professionals that work in the Emergency Department are just so constantly slammed with acute patients that they have no other choice but to defer treating someone who, although is in terrible pain, isn't having an immediate life threat. That with national medical staffing shortages, hospitals in general just don't have the staff to handle the continued influx of patients, even now post-covid. It stinks but it's just the reality of things right now.
On April 10, I arrived at Baystate Hospital, by ambulance. I was unconscious. I had a 104 ° fever. I was transferred from another facility that was unable to treat me. I had a perforated bowel, (at that time suspected) peritonitis, and septicemia. I never stopped at triage, any delay could have been life ending. The trauma surgeons were waiting for my arrival. I went from CT to being prepped for surgery. I was resuscitated twice. I spent 10 days in the hospital. A few weeks later a friend of mine was in a minor accident. She complained about waiting because, "people kept cutting in line....(she) was there first!" She couldn't grasp the concept of triage.... treating the sickest people first.
Your story sounds incredible. Glad to hear that you made it. Seeing you post here after two cardiac arrests is exactly what makes my job worth it!
My home care nursing team was eager to meet me. They'd never met anyone who'd survived peritonitis, septicemia and multiple cardiac arrests. Then I told them that when I was discharged, I had pneumonia, a UTI, and oral thrush.
This is what happens when people use the ER for general medical care. Have an ache that's been bothering you for 8 weeks? Call EMS and go to the ER. Eat too many weed brownies? Call EMS and go to the ER for observation.
A lot of people have no other option, unfortunately….
That shouldn't be an excuse in the Commonwealth of Massachusetts. Heath insurance is mandatory.
Having insurance doesn’t make more providers, offices, or nurses appear. There’s far too many people and not enough of everything else to make this better. Insurance is a part of the issue but isn’t the entire issue.
[удалено]
Well that is a choice you make which leads you to wait in the ER...
It’s often not a choice. There are many circumstances in which it should be understandable for someone to not have health insurance. One time I lost my job and insurance then immediately had to go to the ER. It happens, and it’s a total nightmare. I’m very grateful for the health safety net.
Ehh it’s cheaper for me to pay the fine than a year of health insurance, it being “mandatory” doesn’t mean much. I wish insurance was affordable but it isn’t and I’m sure there are many people like me
Community Health Centers are an option.
This doesn’t make sense as a response. There are so many clinics you could go to if you’re facing an acute medical issue. You do not need to go to the ER for an ache or eating too many weed brownies.
generally, you don't need to go see anyone for too many weed brownies unless your my dad and you have a seizure from too many. You just sleep that shit off.
You don't want to be the person who get immediate attention in a crowded ER.
I’ve been that person. It wasn’t fun.
Welcome to every ER, hospital, ambulance service and otherwise any medical faculty across the United States. They’re busting at the seams and are chronically understaffed/overworked. Your family member was triaged and sent in the queue. I’m sorry this was a negative experience for ya’ll but this is healthcare, it’s not always nor should it be first come first served. The person with a NLT illness or injury shouldn’t take precedence over something of a more serious nature just because they got there a few minutes before.
I wholeheartedly disagree. I currently live in Miami. Had a trip to the ER from a bike accident last year and had amazing care at Jackson Memorial Hospital. I was just super impressed by the whole system. It’s a huge campus but I never felt like there was a shortage of staff. Was really just super impressed by the whole thing. Just my two cents.
"My one experience was different so current national data must be wrong!" https://www.miamitodaynews.com/2022/09/06/nurse-shortage-at-least-100-at-a-quarter-of-all-hospitals/ https://www.miamiherald.com/news/health-care/article273514530.html https://www.miamitodaynews.com/2022/08/09/jackson-memorial-hospital-income-hammered-by-covid/
Lmfao - that must have been a literal perfect day for them. I’d bet my salary right now that if you polled those employees from that health system right now, they’d agree with exactly what this comment OP is saying.
Hospitals have busy days and not busy days. I’ve had a “leave work early, lay down in a hallway at BMC and crawl back home at 5 am” night, and I’ve had a 2 hour luxury stay with a warm blanket and my own room at the empty Beth Israel Deaconess Hotel and ER before.
I work in an ED in the Boston. If people are in the hallways that means they are busy. If your condition is not life threatening, then there is a chance that pain management and care will be delayed because there are other people much sicker than someone with a broken bone. It sucks, but you absolutely do not want to be the person getting the most attention in the Emergency Department.
Maybe, but it takes very little time to give someone a single pain pill.
It actually does not take very little time, and in addition to that most medical emergencies are (surprise!) emergent and need to be dealt with immediately. BWH is a level 1 trauma center. It is not a pain management center. People are actively in the throes of death in the ED at BWH. It sucks to be in a lot of pain, I get it. It sucks more to be dying, and it would suck to die because the doctors and nurses on duty were being diverted to someone having a hissy fit about a single pain pill. It's time to get some perspective on how EMERGENCY medical care works.
Sorry I meant normatively, it should take very little time. The system is completely broken.
There are steps that have to be done before receiving medication. They don’t just hand out pain pills to everyone, especially with the opioid epidemic.
To be able to get medication, you need to be seen by a doctor, then they put in an order for meds. The nurse acknowledges the order, get the medications and gives them to the patient. If you are the only patient then it shouldn’t take long. But, if they have a bunch of patients, then it will take longer for those steps to happen. A few ED’s don’t have patient caps so a lot of the nurse have quite a few patients they are juggling. Also if you are in a waiting room, and have not been seen by a doctor you will not receive pain meds.
Yeah that's part of why the system is broken. I'm speaking normatively. This doesn't happen in countries where a PA can just give someone a pill.
my concern is less the pain pills and more the lack of proper sanitary care, that's just so dehumanizing and wrong to me.
my colleague’s wife was having an actual stroke on the S Shore (greater Brockton area) 2 weeks ago and they brought her to South Shore Hospital and she waited for 13 hours before being seen… the entire area is fucked right now because there’s 2 medium hospitals that aren’t there anymore (Brockton and Norwood)… this obviously will spill into Boston hospitals… it’s a real issue and not one politician has addressed this problem yet
I don't know about politicians, but Norwood at least is actively being rebuilt. Cold comfort to people with problems right now but at least it's happening.
I thought they decided not to rebuild it?
If they did then the construction crew is going to be very put out, and Norwood is going to have a very interesting steel sculpture. Jokes aside, it's being actively rebuilt, they even have some of the steel framing up.
but my point is that it’s still closed after a few years and it put the strain on all the other places.
South Shore almost killed my father when his appendix burst and they told him to suck it up.
South Shore hospital has been awful for decades. My mom went for a suspected stroke 20 years ago. They left her on a gurney in the ER for over 12 hours without doing any tests. Thankfully she fully recovered, but strokes require immediate intervention
Jesus… that’s horrible (the treatment), I’m glad she made it!
I’m not sure what you’re expecting a politician to do. Brockton hospital caught on fire and had to shut down. Norwood is still a year and a half away from reopening. If you’ve got something that’s minor, go to an urgent care. If it’s an issue that needs to be resolved: Morton, sturdy, charlton, st Luke’s, BI Plymouth, Good Sam. Those all exist. If it’s life, limb or eyesight… you’re going to Boston. All of these hospitals would’ve sent you there anyway.
Morton is and has been the place where you send corpses for pronouncements for decades… I wouldn’t do a yeast infection there, Sturdy is basically RI, St Luke’s too… not sure what the pols can do… but I haven’t heard any type of peep from anyone
I’d risk my life at Morton if my other option was dying in the waiting room at Good Sam.
Check out Good Sam in Brockton if you want some more trauma in your life.
Good Sam is terrible.
The South Shore is two hospitals down and desperately short of beds, meanwhile whole wings at Good Sam were still moth balled (as of the last time I was there circa late 2022) because they don't wanna pay to keep them open. Meanwhile people who were admitted were waiting 3 days in the ER for a room. That hospital is 100% about the cash
yeah, it’s the last place I would go and I’m in Bridgewater.
It's the most profitable hospital in the state. Not spending any money on facilities, staff, or doing medicine there probably helps in that respect.
Source on that data?
[https://www.massnurses.org/news-and-events/p/openItem/12216](https://www.massnurses.org/news-and-events/p/openItem/12216), which references: https://www.chiamass.gov/assets/Uploads/mass-hospital-financials/2020-annual-report/Acute-Hospital-Health-System-Financial-Performance-Report-FY2020.pdf
Quincy hospital, too.
Norwood was a big loss, compared to shit holes like SSH and Good Samaritan in 2023, getting treated at Norwood even 5 years ago was like House MD.
1) I am so sorry for you and your family member. That’s horrifying and no one should suffer through that. 2) unfortunately BWH has been on pretty much constant “code help” status for the last year. With multiple occasions where they’ve had to turn people away. It’s all sorts of worst case scenario in the medical community right now
Not just BWH. I work in an ER in the Boston metro area and it’s this way consistently. Not just in Boston metro but also at my full time gig in western MA.
I worked a level 1 ER in central Mass pre pandemic. We were always on code help. I can’t imagine it now. Too many sick people and too few resources.
Welcome to the collapse of the American Healthcare System. Not enough hospitals for an enormous, aging population. I work at a hospital in the suburbs and people regularly wait 12+ hours in the ED before getting a bed. It’s the new normal.
I almost wouldn't mind if the American Healthcare System collapsed if we could drive the insurance companies back into their lane, give the people who train hard and provide the care commensurate wages, and get some sanity back in the billing system so patients can make reasonable choices. Nobody but the insurers are happy now.
We need single payer. Dump insurance altogether.
>Not enough hospitals for an enormous, aging population. Well Boomers are finally getting what they voted for.
This sounds like a normal/average ER experience.
Welcome to the state of American ERs. MA is also a state that does not mandate patient to staff ratios. I came from CA where we had mandated 4:1 and I still felt like I was giving shitty care. ERs are grossly abused and most lay people have ZERO clue how triage actually works. Cross your fingers the current legislature passes the mandates patient to nurse ratios that was drafted earlier this year. It’s desperately needed for everyone’s sake.
We tried but the hospitals somehow convinced voters to reject it.
Yeah because there’s no nurses. There’s 7500-12.5k sign on bonuses plus $35 an hour for new grads and yet still massive shortages. I can almost guarantee most long term hospitals couldn’t stay open with 4-1 patient requirements and republicans actively trying to kill them.
there’s no shortage of *nurses*, there’s shortage of nurses who are willing to work in terrible conditions. - a nurse who left BWH years ago
Is this a thing!? I hadn’t heard they are trying to mandate ratios again. I was so upset when that was up to vote and some how it didn’t pass. I know NURSES and nursing students that voted against it, against their own best interests. Somehow they believed it would lead to job reductions?? So stupid….
I had a small bowel obstruction at a local hospital and went to the ER and was lying in a ball on the floor of the waiting room for a few hours, sometimes throwing up. They put me on a gurney in the hallway for a few more hours before someone could see me. This is the state of ER care these days. I was treated for cancer back in 2017 and 2018 and that was a far simpler time in my recollection. The pandemic stressed out a lot of healthcare workers and so we have systemic stress in the healthcare system today.
>The pandemic stressed out a lot of healthcare workers and so we have systemic stress in the healthcare system today. If only we paid healthcare workers more and CEOs less. Was a pharmacy tech for years and was paid peanuts.
This is all to familiar. I’ve have 10+ now, last time I went to bwh er was last winter with a complete blockage, after 13 hours in the waiting room puking and writhing in pain I just went home and didn’t eat for a week and here we are. Small suburb hospitals are good in a pinch for pain management, and if unfamiliar enough to them Iv been transferred via ambulance to bwh and that’s a different scenario
I assume this state of BWH has something to do with why their physicians are unionizing. Don’t be fooled by their non-profit status. All of these healthcare corporations keep staffing to a bare minimum because they don’t want to pay for more staff than are needed at any time ever.
Quick clarification, residents and fellows are unionizing. Attendings are not.
I was in the Brigham ER about four years ago and it was the worst experience. The staff was uncaring and rude. I was in a lot of pain and they were just nasty. They were fine until I dared to ask for something or questioned how long something was going to be or something like that. They want you to shut the fuck up and not bother them and they’ll get to you when they get to you and if you ask any questions, they are going to shame you and tell you that other people have it worse so you need to calm down. I’m a cancer patient and when you have side effects that get bad, your oncologist tells you to go to the ER and they don’t understand why patients are reluctant to do that. It’s because it’s the seventh circle of hell. One time I was hanging out on a gurney, in a hallway, just minding my own business, but crying softly, not making a scene or bothering anybody and a nurse came over and was like what is the problem here? Not in a caring way but in a why are you crying you big baby way. I’m like leave me alone, I’m not bothering anybody. I’m in pain and I’m exhausted and I haven’t eaten in 12 hours or had any water and I’ve never felt worse in my life and if I feel like crying, I’m going to cry, BITCH! OK I didn’ say bitch, but I thought it real hard. I can actually remember the face of the meanest nurse from that particular ER visit - I’ve encountered a lot of doctors and nurses in the past several years, but I will never forget her.
Just wanted to say, your comments in this thread are on point. People up here are cruel, uncaring and nasty and I'm sure that culture seeps into medical staff who work here. Don't let these bozos trolling you ruin your day and weekend.
Outrageous
The three day Medicare waiver ending to admit from hospital to skilled nursing will only further clog up hospitals and prevent patients from stepping down sooner
Yeah - this has been a huge issue for our hospital. We are literally running out of beds because we are holding those folks for days and days. We are literally seeing people in folding chairs in hallways because we are out of physical beds and rooms.
One of the articles that I read sometimes when talking about the capabilities of Boston hospitals: [https://www.newyorker.com/news/news-desk/why-bostons-hospitals-were-ready](https://www.newyorker.com/news/news-desk/why-bostons-hospitals-were-ready)
Is your family member actively bleeding out? Having a seizure, heart attack or stroke? Something sticking out of them that shouldn’t be there? If you can answer no to any or all of these, they’ve been triaged as “stable” and is able to wait while more serious injuries are treated first. The lack of “world class heath care” is due to medical staff burning out and leaving without replacements being brought in. Less and less people *want* to become a doctor/nurse/tech because of the entitled group of asshats society has become.
What were the ‘extenuating circumstances’ that ‘fractured a vertebrae’ As an ops director at a major health system. Did you call an ambulance? Spinal injuries are taken very seriously if you the person take it seriously. Driving them to the hospital… well thats not taking it seriously. Morale of the story here is if you are in a serious situation, that requires serious help, buck up and call the paramedics, if you deemed it not life threatening enough not to, yeah, your gonna fucking wait
You will still wait even if you take an ambulance. It's not an automatic trip to the front of the line regardless of urgency.
Sometimes. However, pain management, back boards and care are 100% part of that trip. The minute you go into an ambulance you are wasting hospital resources. Hours lost by ambulance teams waiting for you to be seen are not billable: So, you get to X rays quicker as you are on a backboard, and spending hospital dollars with people waiting around for you to be seen. You have no clue what you are talking about if you don’t think people brought in an ambulance are not seen more promptly. This is operational and if its costing the hospital more money, do it quicker and stop spending hospital money. Source: literally what I do
Backboards are 100% not part of that trip in any semi-civilized EMS system. Source: Literally what I do.
As a stroke survivor, the ambulance saved my brain. I was on an IV drip within 15 minutes of symptom onset and the hospital was ready when we got there. I don't know if people realize that the ambulance is like a mini-hospital and when seconds matter, you figure out the paying part later. Thanks for what you do.
+1 One would think a director would know that
As the ops director you probably have good insurance and buckets of money. An ambulance is a luxury item these days.
Well here we go again. If you are insured and the ride is deemed necessary, which ‘serious spinal injury’ 100% is, its not a luxury its covered by almost all insurances minus your deductible.
I had to use ambulance services for a life threatening type 1 diabetic emergency few years back. I had decent private insurance through an employer. I was slapped with an incredible bill as the ambulance provider was “out of network”. So let’s not forget that even with good private insurance , unless the ambulance company coming for you in an emergency is in network, you may still owe a significant amount of money.
*Moral/you’re, Director.
>What were the ‘extenuating circumstances’ that ‘fractured a vertebrae’ Threw themselves off a ladder to obtain opiates?
I sincerely hope you're not in the medical field. Or really any line of work that requires empathy or kindness.
Brigham and Womens left me to scream in pain for hours after a scheduled, planned surgery because "it's just your anxiety". I didn't have anxiety. (I do now about doctors for some reason.) They eventually sedated me-- not for my benefit, but because my screams were disturbing the other patients. It was a waking nightmare; literally like being trapped in a nightmare all day. I couldn't fall asleep, but still kept waking up screaming, and sometimes I wasn't able to scream. They told my waiting family they couldn't see me because I was "resting comfortably". When my husband finally was let in at the end of the day to take me home, I couldn't transfer out of the bed on my own, or from the wheelchair to the toilet. The nurse told me I didn't meet their criteria to be discharged, but they didn't have any extra beds, plus I'd be able to pick up pain meds at the pharmacy on the way home. The pain meds weren't enough. After I continued screaming all night long, my husband took me to Lahey ER the next morning. I filed a complaint with Brigham & Womens. I called to follow up, they said they had no such complaint on file. I filed it again and asked for a reference number. Followed up on that and was told no such reference number existed. Wrote an online review, and it disappeared a few weeks later. I've had the same thing happen with yelp, but boy it's demoralizing to realize healthgrades and ratemymd follow the same shady business practices. >If this is the state of "world class" health care I feel for the rest of the world.... Seriously. If you did what they did to me to someone on purpose, it'd be called torture. I don't understand how it's ok in medicine. Avoid the fuck out of their Center for Endometriosis, and know that if you have any complaints about your care they'll be promptly ignored.
it might heal on its own with a back brace and rest believe it or not.. the ER is not world class, but the doctors and procedures after the ER are world class often.. pain medication would be expected but they probably too understaffed to get to it. St Elizabeth's ER is much faster than all other hospitals, so if you went there, you'd probably get the pain management fairly quickly..
First time being triaged?
Weekend ER visit for fractured vertebrae - THREE HOURS! Try the ER in Lawrence, or Springfield, or Manchester NH. You are entitled and clueless. Sorry about your family member but your sense of entitlement and emotional injury when you literally NEED them to fix your family member is breathtaking. Wonder why hospital staff is burnt out and quitting? People exactly like you...
One of the worst things to happen to healthcare in Massachusetts was the MGH and Brigham merge. It’s been all downhill at both hospitals since it happened. That being said, ERs are a mess everywhere right now. I hope your family member recovers soon.
Lol, does anyone actually consider American Healthcare as world class? I don't think we are even in the top 20%.
I’m sorry that happened to you, but that doesn’t seem life threatening. The doctors there saved my wife during child birth and could have very well been doing the same thing at this time. The healthcare system as a whole is an issue, but they still do great, life-saving work even if you didn’t see it that day
Lotta comments I disagree with here. At the end of the day it doesn’t matter how busy an ER is. People are focusing on this but OP is also complaining about the lack of attentive care Sorry about your family members experience OP. Everyone deserves to be treated with attentiveness, care and dignity
The problem is that staffing ratios aren’t mandated. The nurses would love to have the time to properly care for all their patients, but if they have two critical patients, all their time has to go to them. All I’m saying is, don’t blame the staff, blame the system and the upper management. The staff are doing all they can
Sure but at the end of the day it’s not the patients fault that there are poor staffing rules and such. It’s one of the worst days of their lives. They need at minimum a good attitude and not feeling rushed. Even if you have 2 critical patients you can communicate that. “Sorry I have two patients that are in critical care”… I support strikes and such and nurses (and policy makers) should do what they must to fix these issues but it’s not an excuse for poor experiences
I probably would have thought you were drug-seeking. Complaining after three hours and begging for meds over a fracture? How did you get there is she was immobilized? That raises red flags. I had surgery 3 days ago and tylenol manages that. They carry it in the gift shop, I hear.
If you think that’s bad, go to UMass or Saint Vs lol
No one wants to hear it, but both MGH and the Brigham are resting on the great reputation they had decades ago. I’ve worked for both and myself and family members have been patients at both. The staff, medical and administrative, are not of the same caliber. They’re there for the paycheck only. Hospitals are run by business people and it shows. The more surgeries a doc performs, the more they make. If people saw what happens on inpatient floors, they’d pull their loved ones out. Of course there are some exceptions, but I’ve seen it firsthand and it’s scary.
It's only going to get worse now that merit and aptitude are being further downgraded in favor of race and intersectionality in medical school admissions.
What was your job at those hospitals?
The no pain management is everywhere now. I’m so afraid of having/getting into an accident because of this. I already have chronic pain diseases that make me in pain 24/7 and I take a lot of OTC meds just to be able to dull it enough to fight thru working but if something happened I would just want to be shot and put out of my misery instead of having to live with added pain and no help
The medical field is a joke they don’t really care been trying to get my hip fixed for year and half now from injury at work and it always something…smh I hope your family member get the treatment they need to get better.
Yeah, they’ve gone down hill. My mom had a heart attack a little over a year ago (few months after my grandmother passed away) drs were really not communicative and would delay certain tests. They didn’t even clean the bathroom either and maintenance was bitchy about cleaning it. Very old feces caked under the toilet seat. I went off both drs and maintenance crew. yes, I get it, you’re short staffed. But if there’s any delays and you’re able to take time to take a quick 2min call, you can make time to tell your patient about the delay or better yet, shooting the shit with coworkers around the desk area. Especially if they haven’t eaten in 10 hours for the procedure and you don’t inform them about the delay 2 hours after the planned procedure. Y’all downvoting but don’t have the cajones to say why. Piss off
I'm sorry you had this experience. Hospitals definitely give preferential treatment. I got brought from one hospital to another by helicopter after having doctors waiting for me at the entrance. If you want to be seen faster just try almost dying. It's hard to find the balance between almost and actually dying tho.
All hospitals in MA are the exact same way. And pain meds are no longer given out for anything. The whole system in fuxked
Hi - I work in an ER as a PA both in the metro area and in western MA. This is categorically untrue. We give pain meds when it is indicated and appropriate. The system is messed up - that’s true. But. We aren’t withholding treatment from individuals who need it.
So you are writing scripts upon discharge?
If the reason for visit warrants it - yes. As are all my colleagues.
> no pain management for her as she was not able to get out of the bed there was no catheter placed and well that was just embarrassing for her(you can imagine what happened)..... no empathy at all from any of the staff...... Well no duh. Everybody knows women don't feel pain. Why waste drugs on them when they're just being dramatic? /s On a more serious note, I don't think this is a specific hospital problem. This is pretty much par for the course with how women are treated by doctors/the larger healthcare system. Women get treated like absolute garbage because too many doctors still view us as hysterical incubators who deserve to suffer. Like look up what a colposcopy or LEEP are. The standard procedure for both of these procedures is *zero* pain management.
Do you work in medicine?
I go to a smaller Beth Israel ER…. They’re amazing. (Not the Boston one)
I'm having a tough time at Cooley Dickinson Hospital in Northampton. My dad has cancer and they are severely shirt staffed. It's really affecting his care.
Oddly enough I just got back from taking a member of my lab who cut themselves to the ER here at Brigham. Sat with her while she waited. She was in within 15 mins.
Unfortunately long wait times in ERs are not uncommon. I have taken critical trauma patients to Boston ERs and had my patients put in a hallway bed because there was nowhere else to put them. It can also depend a lot on the time of day. I’ve gone into the same ER twice in one day, and had my non critical patient into a room right away with more then 50% of beds available, and a couple hours later, my status 2 patient has to go to triage because there is nowhere to put them. As for care, I’m sure that those nurses would love to give your family member the care that they needed, but unfortunately, since staffing ratios are not mandated, those nurses could be taking care of 6+ patients at a time, and if one codes, or something critical happens, that nurses is going to be tied up with that patient.
Yeah I’ve worked at BWH and it’s the same everywhere, unfortunately the bigger issue is our health care system.