Walking into a shift in the emergency department these days feels a bit like entering a disaster zone.
There are 50-odd patients in the waiting room needing to be seen. A number of beds are closed in the emergency department and across the rest of the hospital because of a lack of staffing. We’re holding a half-dozen acute mental health patients who desperately need care, because there’s no room in psychiatric hospitals. A few bed-bound patients are ready to leave but don’t have a ride to wherever they’re going, so they’ll be spending the night with us; there’s no one to drive the ambulances to transport them. And a couple dozen more patients have been waiting on emergency department stretchers for hours after evaluation, until an intensive care unit, medical or surgical bed becomes available. Meanwhile, we can’t use these emergency department staff or beds to care for those sitting in the waiting room with yet-to-be-diagnosed problems. Instead, I’m scanning the waiting room list to try to find the needle in the haystack — someone with a life-threatening illness that we haven’t identified yet.
