As with many hospitals around Australia, Rurality General Hospital occasionally (or slightly more regularly than that) becomes full. No room at the inn. No vacancy. Standing room only. So what does that mean when patients still present to Emergency? While a large number of patients can be turfed (er, treated and discharged with CLEAR communication sent to the GP), and a minority DNW (do not wait), after they have been through both the triage and emergency physician filter, some will need to be admitted. If there are no beds? They stay in emergency.
Which leads to patients being seen in chairs, sharing cubicles, trolleys in hallways (and rather stressed out nurses, medical registrars who fear to answer a summons to emergency to see a patient because they will be asked why they have not turfed some of their patients to make room for new ones, general chaos, fun and games).
I've heard of hospitals where the trolleys in hallways or chairs used to see (not critically ill) patients have been named after the health minister, prime minister/head of state or treasurer of that particular state/territory/country.
Games of musical chairs then ensue. As soon as one patient goes off to radiology or to the bathroom, their cubicle and bed may be considered fair game by some, only to be negotiated back once they return.
Some of the doctors and nurses joke about how close they become to some of the long stayers. I have even heard someone say "I don't bake my patients muffins unless they have been there for at least 72 hours".
I can't help but wonder when patients share cubicles how close they get to each other. Close enough to observe the catheter being changed, close enough to count their pills, close enough to take part in their discussion with the rounding medical or surgical team (and make confidentiality a foreign concept), close enough to argue or compete to be the "favourite" of the pretty young nurse, close enough to chat to visiting friends and family. If any of them think "gosh, statistically one of us has to shuffle off this jelco coil, wonder which one it will be?" I wonder if any of them even keep in touch after being discharged (alive that is).
5 year reunions? Facebook groups? ("All those who waited 72 hours or more for a bed in the medical ward", "the 24 hour ED alumni" ) Anniversary celebrations? They could sign each others casts, swap pickled appendices, check their heart failure medications against each other... I know that women roomed together in maternity wards often keep in contact, and the same with people in oncology wards or units. I've seen people in day units great each other happily as they are hooked up to their Intragam, chemo or antibiotics.
Hey, this choleycystitis could be the beginning of a beautiful friendship.
1 comentarios:
Oh, don't even get me started. In the meantime, the hospital I'm at is building a new building for inpatient, but there are rooms with four people - one in each corner - with only curtains between them. This is inpatient, not ER. Horrific. Imagine rounding in that.
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