On a Sunday evening, 14-year-old John DeTone was in-line skating with friends on his driveway when he tripped and fell on his arm. Half an hour later, his wrist started hurting. John’s dad phoned the emergency room (ER), and a nurse advised him to bring his son in. John, a fan of TV shows like “ER” and “Rescue” 911,” was a little nervous about going to the ER. “I wasn’t worried about my wrist–it was either broken, sprained, or just sore–but I was scared about what I might see at the hospital, like people who were bleeding or all banged up.”
In the Waiting Room
Though the ER was crowded with people, from little kids to elderly folks, John was relieved that there was no blood or gore. “We spent most of the time in the waiting room, where people were sitting around watching TV.” When he was called into the treatment area behind the nurses’ station, he did see a man asleep in the next cubicle, but nothing gross or scary.
“In most hospitals,” explains Dr. Toni Mitchell, an ER doctor at Tampa General Hospital’s Trauma Center in Florida, “there are separate entrances for people who walk in and for those with major injuries, called traumas, usually brought by ambulance. And certain beds or areas are allocated for particular problems, such as a separate trauma room.” Most ERs provide private cubicles for patients, separated by curtains.
People visit the emergency room for reasons ranging from non-life-threatening emergencies like a bone fracture, as in John’s case, to serious injuries or illnesses, such as head injuries, severe bleeding, and asthma. In fact, the reason for being, there often determines how long the wait. A person may be there an hour or less, or several hours, even for a non-life-threatening emergency.
“It’s not like a bakery, where you take a number and get served in that order,” says Dr. Mitchell. “The sickest people are always treated first.”
One common and unnecessary delay for kids under 1 8, who can’t be treated without a parent’s permission except in life-threatening emergencies, is forgetting to bring a phone number where a parent can be reached. Having the number with you can save a lot of time.
In major metropolitan areas, such as Los Angeles or New York City, ER wait times may be longer because they serve large populations. Also, ERs are typically more crowded on weekends and holidays, when more traumas and other emergencies occur. Many ERs try to handle the greater flow by increasing their staff at these times.
The severity of your problem is the most important factor in how long you’ll be there. “You could be first in line with a painful hairline bone fracture,” says Ann Simmons, M.S.N., administrative nursing coordinator at Montefiore Medical Center in New York City. “But if a heart attack and an asthma case come in right after you, they’ll be seen first.”
Take the case of 13-year-old Patrick O’Connor, whose mom took him to an ER after he hit his head during a basketball game. “I remember my coach coming over, and then being back on the bench, but nothing in between.” Because Patrick wasn’t making sense when his coach spoke to him, he and Patrick’s mom knew he should, literally, have his head examined. Patrick had a concussion (a head injury that causes an interruption of neural activity in the brain, ranging from minor to serious). Unlike John, who wasn’t called for about an hour and a half, Patrick was brought from the waiting room into the ER in less than five minutes.
Both boys, however, had to fill out a form with basic questions (e.g., name, address, height, weight), and each saw the triage (tre’-azh) nurse, whose job is to speak with you, take your “vital signs” (temperature pulse, etc.), and determine the urgency of your problem. (The word triage is French, meaning “to sort out.” Unless you come in by ambulance or with a dire emergency, you’ll see the triage nurse first.
A Lot of Tests
While the sign-in and waiting areas are ones you don’t usually see on TV, even the treatment area isn’t always as frantic in real life. “In shows like `ER,’ doctors are constantly racing around, barking out orders, and test results are always back immediately,” says ER nurse Al Moncada. “In reality, you’ll need to wait awhile for routine test results, such as X-rays. And not all cases require such dramatic and immediate care. There are life-and-death emergencies, but also a lot of lulls.” Also, unlike the TV show, you’ll probably see more nurses than doctors in the ER.
The Value of “ER”
Despite its exaggeration of real life, many health professionals think the show “ER” is beneficial because it increases awareness of the valuable service emergency medicine provides.
“The best part [about the show], in my opinion,” adds Dr. Mitchell, “is the important message it brings across about ERs week after week: We’re there for you, and we care.”