Wednesday, March 9, 2016

Dear patient who went to the Urgent Care..

…because you have had chest pains for days and your doctor told you to go to the ER.

During your stopover the Urgent Care you had an EKG which was proclaimed "fine", whereupon you were instructed to go to the the actual ER (us) "for further testing".  You arrived by private motor conveyance, which by all accounts does not qualify as an ambulance thus indicating that you did not require advanced life support or monitoring.  I understand that this particular urgent care DID offer you an ambulance as a precaution, which you vehemently refused.

Just so we are clear, you are not, at present, having a heart attack, based on the EKG I completed in the triage area.  That is our policy.  An EKG done outside the hospital in a doctor's office or urgent care center we don't trust (pretty much all of them) gets an EKG.  Sorry, policy.  Also, the urgent care should know to tell you (but apparently doesn't) to leave all those little stickers on your chest.  This would be important in order to compare any subsequent EKG's.  But you took the time to take them off, so….moot point.

I fully understand that "chest pain is an emergency!", a fact that  has been ingrained into every cell in my body and seared on what is left of my soul for the last 40 years.  Please understand that head trauma, stroke, and hemorrhage are also emergencies, and the patients who are experiencing them have arrived in an ambulance through the back door in the last 15 minutes.  Please note the onset of their symptoms was not days and days ago.   There are also 4 other chest paineurs ahead of you, as well as several others who are experiencing other serious symptoms that also deserve immediate care.

I will listen politely to your ranting and threats to call my boss, but please refrain from haranguing my front desk clerk.  She is busy assisting other patients and has wasted enough of her time dealing with your nonsense.  Shortly,  I will be happy to check your vital signs again and reassess you.  While you sit in the waiting room until a bed is available in the ER, I will have your blood drawn for cardiac markers, and, following our protocol, and have alerted my resource that you are here.   However, you have arrived at a very busy time.   I can not create a bed where non exists.  I can assure you, based on the assessment of my physician, that you are not presently having a life-threatening emergency, and we will get to you as soon as we possibly can.

As an aside, no, I have no interest in speaking to your doctor, but I know that my charge nurse did.  He most certainly did not tell her to "get you in to a damn room right this minute".  The conversation between your doctor and the charge nurse went thus:

Doc: "Hi, I know that my patient Mr. X is there.  He is calling me from the waiting room, he's a bit of a pain.  Can I tell him that I called and spoke to you?"

Auntie: "Sure.  You can tell him there are 4 chest paineurs ahead of him, plus a trauma and a stroke.  He had a EKG, in fact 2 that are within normal limits.  He has labs pending.  It's gonna be awhile."

Doc: "I know you're busy and will get to him when you can.  Have a nice night, and I'll bring donuts next time I come in".

Auntie: "Sure, thanks for calling".

How I wish I could tell you that.  But, that is my burden to bear.

Now, please just take a deep breath and have a seat.  Waiting sucks, but patient patients are a virtue.
Thanks for your kind attention to this matter.