On the word Emergency
I am very slow to anger. Indeed, I can't recall the last time I was in an angry mood. However, I do get pissed off, and I'm sure that if I enrolled in a Pissed Off Management course, one of the things that I would hear would be "Get it off your chest". Well, here goes.Â
Standing in line to be questioned by the triage person at the doorway of the hospital Emergency (ER is an abbreviation of Emergency Room), all I was waiting to say was that I wished to visit a friend who, though formally admitted to the hospital, was being held in an Emergency bed until a bed became available in the hospital surgical wards.Â
The person in front of me, on being questioned as to why he was here, stated loudly that his big toe was sore and he thought it might be a touch of gout.Â
I had the sudden urge to shout "Get the hell out of here. This is not a walk-in clinic. This is an Emergency Room, so bugger off and go to one of the walk-in clinics available in the city."
To me, a key reason why our ER Unit has an often full waiting room, and, inside the doors, gurneys line the corridors and every seat has someone waiting in it, engrossed in their phones, is that our devolving culture seems to have lost the understanding of the specific meaning of many words in our language.Â
Nobody has headaches these days; they have migraines (laughably solved by taking an Advil, according to the ads). Nobody suffers an intolerance or sensitivity to certain substances; they are, it seems, allergic to a whole host of things, regardless of the fact that no serious immune response is associated. This is part of a general and steady decline in the breadth of the average person's vocabulary, such that, now, one word is over used, though there are perhaps numerous words in our lexicon that are available to describe nuances of meaning that would convey greater precision.Â
So, let's define our terms. The word Emergency is defined as "A sudden unforeseen crisis (usually involving danger) that requires immediate action."
With respect to medical emergency care, the definition clarifies that this is "The branch of medicine concerned with the prompt diagnosis and treatment of injuries or trauma or sudden illness."
Sorry, the simple fact is, a sore toe does not qualify as requiring Emergency medical treatment.Â
Other than this widespread lack of understanding as to the meaning of the word Emergency, another facet of the problem is that Ontario Emergency Departments are obliged to treat whomever walks through the door. They are not permitted to turn people away.Â
This has to change. You can call me all kinds of names, over-authoritative, lacking in compassion, intolerant or whatever comes to mind, it matters not to me.Â
For a start, the entrance doors should bear a sign that makes it very clear of what comprises an Emergency and states emphatically that the ER only deals with "the prompt diagnosis and treatment of injuries or trauma or sudden illness."
In addition, those at the triage desk should be granted the power of refusal to those with issues that clearly do not constitute an emergency. A list of available walk in clinics should be handed to such people and they should politely be shown out of the door by the usually bored security guard.
A recent letter to the editor of the local newspaper suggested that a fee applied to non-emergency cases would put a dent in the habit of using the Emergency Unit as a walk-in clinic. My twist on this would be to suggest that if a person insisted on not leaving, their option would be to be asked to sign a statement and hand over their credit card or cash to pay a "fee for service", on the understanding that they would still have to wait until all true emergencies had been dealt with before being attended to.Â
These relatively simple changes in procedure would assure that staff, both doctors and nurses, highly trained in dealing with trauma, could practice their skills efficiently and effectively, as was initially intended. It would also assure that genuine emergency patients brought to the unit in ambulances would not have to wait for hours outside the doors until a corridor space can be found. Currently, at any one time, both ambulances and their first response medics are kept tied up for hours, making them unavailable to answer new emergency calls.Â
If a system is not working, then it needs to be fixed, and fixed promptly. The ER doctors and nurses are painfully aware of the crisis and the need for reform. The greatest obstacle is the ineptitude of medical administrators (whom, I suspect, rarely leave the rarified air of their offices) and the heel-dragging slothfulness of politicians unwilling to do anything that might upset those who voted them into power and might keep them there.Â
It is no use wringing one's hands and complaining. Action requires both the cooperation and resolve of grass roots organizations. Things need to be said, loudly, firmly and repeatedly, and various asses need to be kicked into gear or out of office.Â
Canadians have a reputation for politeness and always saying "sorry" for things that are not their fault. However, the intolerable condition of our health system should not have to be tolerated. The greatest risk is that the current turmoil will be used as an ideal excuse for wide privatization,
leaving quality health care the domain of those who can afford it, siphoning off the best doctors and nurses with better pay and working conditions and leaving the quality of health care for the great majority a mediocre one at best.Â
senior70
August 2023
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