An American Emergency Room

I spent eight hours in the emergency room last night and the early hours of this morning. It was by far one of the worst experiences I’ve ever had at an emergency room. This is saying a lot since I have a lot of experience with emergency rooms due to my chronic health conditions. Usually when I go to an emergency room it is because I need fluids or antinausea meds and sometimes even pain medication.

It started Friday morning. I went to the bathroom and my urine was the color of tea. Obviously, your urine shouldn’t be this color. Anyway, about an hour or two later I started experiencing stomach pain. Because of my gastroparesis this isn’t something I thought I much about. Stomach pain is just something that I deal with every day. A little while later though the pain started to wrap around into my upper back. Then I got nauseous. Couple all these things together and I was pretty certain that I had another kidney infection. This is something that happens with scleroderma. I knew that if my doctor couldn’t see me this was going to mean a trip to the emergency room for fluids and antibiotics. Such is my life. I called my doctor and she referred me to the emergency room.

It was dead when I arrived. I was so grateful for this. They took me right back and started it work up. The doctor came in to talk to me. He was a complete ass. (sigh) Unfortunately this is something I also have a lot of experience with. I knew this meant nausea meds but nothing for pain and not to mention it because then Im drug seeking. Thanks, pillheads. Whatever. I would wait for the test results and go from there.

Turns out it wasn’t my kidneys. He said it was my liver and that I needed an ultrasound. Anytime you think a new organ has begin being compromised by scleroderma it hits you really hard. My brain function became compromised. He began telling me that because I was at a satellite emergency room from the main hospital, that their ultrasound tech had gone home for the evening and I would need to go downtown to have the test completed. He wanted to send me by ambulance which I was not down for. He told me he would call ahead and let them know that I was on my way. The nurse came in with my discharge papers and started to remove my IV. I inquired if I was going to need it again when I arrive downtown. She wasn’t for sure but said that if I wanted to keep the IV I would have to take an ambulance. Say what? Is it just me or does this make no sense?

When I arrived downtown I was sure that it was a full moon even though I had paid no attention on the drive because the emergency room was packed full. There were people sitting in wheelchairs with obvious broken bones, people throwing up into plastic bags, a woman in a chair who I wasn’t even certain was alive anymore, it was plain crazy. People were getting Jimmy Johns delivered. They took me right back to be triaged by a nurse. I thought that maybe I was getting to bypass the crowd. But no such luck. The only people who were bypassing the immediate waiting room were women who were in labor. Eavesdropping on some conversations I found out that people had been waiting there in excess of six hours. What on earth is the point of having satellite ERs if you don’t staff them to the point that avoid sending people to the main campus and over extending the staff?

I waited nearly 2 hours to be taken to have the ultrasound. Then I was taken back to the waiting room. I started to entertain myself by guessing what people were coming in for as they arrived and brainstorming their diagnosis by listening in on the symptoms they would report. I can tell you this much, I have been watching way too much “House” on Netflix.

Two hours later a nurse came out with a file and called my name. She led me and a man I was sure was homeless and just looking for a place to crash for the night back into the elusive exam areas. She didn’t even attempt to settle me into my designated area. She more or less pointed and then mumbled the number 13. At last I had a bed. I wasnt given a gown. I did not have a blanket. I did not have a pillow. Hell, I did not have a way to contact a nurse should I need one. I just curled up in a ball and waited. And waited. And waited…

Eventually, my mother, the sweetest and most reserved person I know, became so agitated she walked to the nurses station to ask exactly what it was we were waiting for. She inquired why if the test was done and I didn’t need to see a doctor would they bother keeping me there, occupying a needed bed and also if it was important, how they could let someone with a liver complication wait so long to be seen. They told her that the doctor had my file in her hand and would be in ASAP.

An hour later the resident doctor came in and started to talk to me about the findings on my ultrasound. She used a big fancy word and then started to talk about my gallbladder. I don’t have a gallbladder. I had it removed in 2001. I had told the doctor at the first emergency room this. I had told the ultrasound tech this. And now I was explaining to a third person the same thing. She apologized, saying it had been a very overwhelming night. She said that she would need to review my file with her supervising doctor and he would be in to see me.

The supervising doctor comes in and tells me that my ultrasound revealed that I had a “fatty liver intrusion”. He explained that this was a chronic condition for which I would need to see a gastroenterologist. In summary, not an emergency. I am stupefied at this point. I’m tired. I’m nauseous. Im still in pain. Im frustrated. So I asked him why if this was a chronic condition had it never showed up on any blood work before and would the symptoms show up in an acute manner. He said that someone had probably messed up. I assured him that with my conditions, constantly getting bloodwork, and having the ability to read the results online, I had never seen elevated liver enzymes and was concerned that this was a complication of my scleroderma. Question ignored. He told me that he would get me medication for the nausea and pain I was experiencing. Then he inquired what I wanted for the pain.

Excuse me? Is this man not the doctor? Isn’t he supposed to make this decision? What am I supposed to say to this? I just stare at him. My mother says that usually the doctors treat me with dilaudid in the emergency room. He tells us that he is limited on what they can write a prescription for. He says he will write a script for Percocet and prepare my discharge paperwork.

I’m allergic to Percocet. All this information is not only in my file but has also been repeated to numerous people at this point. After eight hours all I have to show for my time is an ultrasound, that apparently didn’t even reveal the absence of my gallbladder, the promise of a prescription that I have an allergy to and have been shuffled off to another doctor so THIS doctor doesn’t have to practice medicine. Not to mention that my psyche is now completely twisted.

At that point I put my coat on, grab my bag and tell my mom we’re leaving. I didn’t wait for discharge papers. I just left.

That’s all I have to say about that.

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5 thoughts on “An American Emergency Room

      • yes that is becoming the trend. Short staffing is the rule. I got to the point that I could not bear walking by rooms with the patients hollering “Nurse! Nurse!” knowing I just could not meet all the needs – there were just not enough nurses and aides to take care of them! I ended up leaving nursing out of severe symptoms – anxiety, depression, and mania at times… 😦 Much better now but I still regret, that’s one less nurse who cares about them 😦

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