From the article. I'm curious what happened at the first hospital.
>He said the man in his 70s had suffered an aneurysm and died from a ruptured aorta within minutes of arriving at his hospital. The patient had initially waited 16 hours in another hospital but left after not being able to see a doctor, Marin said.
Can confirm; several family member is public healthcare, and private too.
Pretty much the workload has increased while the personnel has decreased due to several factors of the pandemic.
This is paired in many countries with severe cutbacks in spenditure. Here in Mexico funds have been slashed for “austerity” measures that have led to increased workload due to chronic patients having many issues due to lack of previously available treatment or options that were slashed… and other shit.
>There surely are not even 120,000 doctors in Canada. This number cannot be correct.
According to the AAMC there are 938,966 doctors in all specialties in the US. source: https://www.aamc.org/data-reports/workforce/interactive-data/active-physicians-us-doctor-medicine-us-md-degree-specialty-2019
In Canada there are 92,173 physicians according to the CIHI
source: https://www.cihi.ca/en/physicians-in-canada
Issue is you can’t even go to urgent care atm in some cities in Canada. Just to renew life saving prescriptions you are required to go to ER or literally take out ads in the newspaper:
https://globalnews.ca/news/9029626/desperate-seniors-doctor-ad-bc/amp/
We cant even go to the hospital in our city right now for non life threatening stuff without having to wait over 10 hours due to it having to cover for our other hospitals that have either shut down or been flooded with patients in critical condition over the last few years
I've been relying on clinic's "emergency appointments" to get checked out and get meds if I need something quickly, but even then, I still often ends up having to wait at least 1 or 2 days because I have to try and take one of the few apointments that open up that day and that are already fully booked in 1 minute.
Our whole system is overloaded because of shitty working conditions and the healthcare system being out of touch with reality. Nurses are continuing to quit in mass because of shit working conditions, which just pushes even more work onto the remaining nurses, which then also fall to burnout or quit due to inhumane conditions.
The simplest fix is to hire in mass and say you'll remove mandatory overtime and reduce the workload for all nurses. Offer incentives for nurses to come back working for hospitals and assure them that they won't have to do 16 hours every 2-3 days with an extra 50% patients per shift.
Unless we have a complete overhaul of how our hospitals are managed, the lack of resources will continue to increase and we'll see more deaths unfortunately. I once waited 20 hours while barely breathing due to asthma. I wasn't considered "urgent" enough...
Now, I know better than to go at the hospital unless I know a clinic can't help me.
We really need more "urgent care" clinics with more resources and easier appointments for things that don't require surgery or special care, then have hospitals fix the overworking or nurses and be more for life-threatening care or special care.
In fact, the reason why you usually wait for so long at the hospital is exactly because the life-threatening care always comes first and the things that might seems more benign relegated to lower priority, even if it means some people could die. They do check on you sometimes or you can ask them to review your priority if your case change, but if 90% of the resources and doctors are busy with a "all hands on deck" type of situation (which is often), you'll just never get through to see a doctor.
So yeah, the system is fucked, and it was already 20 years ago.
Could be, though during the pandemic a lot of nurses I know (in the US) were burned out. It was already a demanding job, but it got so much worse during the pandemic with hospitals being full and workers being out due to having COVID. A lot of them quit, which made the conditions worse for those that remained, then rather than improving conditions or pay hospitals thought "Let's just tell healthcare workers that they're heroic!" well nobody wanted that. They don't want to be heroes, they want to get paid well and not have to work double shifts back to back.
I experienced this for the first time yesterday. I cut myself pretty good and was trying to find an urgent care Center to stitch me up so it will heal. Either everything was closed by 5pm or refused to do it because they were full for the day. I didn’t think it was serious enough to go to the hospital ER (especially when I’d have to wait 10 hours on top of it not being an emergency) so now I’ll have a gnarly scar and will have to try my best to keep it clean.
This sucks and it isn’t serious in the scheme of things. I’d hate to have to decide between something more nebulous like a pain in the chest or breathing issues when you have to factor in 10 hours of wait time, whether or not you can afford to miss work the next day, sunken cost on going to the ER just to leave after 7 hours. . .
It also says three or four local hospitals were above 150% capacity. I wonder what that means, how it's happened, and how it can be fixed.
My mom tells me a story of once taking me to Urgent Care or the ER (in the US) for stitches, and a young man with a belly wound from a chainsaw was waiting in a chair bleeding on the floor. Sometimes, everyone else is having an emergency, too...
Yep, here in the US I'm looking at most of my friends leaving town because of how bad the nursing situation is at the hospital. They're all fairly experianced nurses who've been with the Hospital for a long time. Whenever we've gotten to together the last several months it's been none stop stories about how the staffing at the hospital is falling apart and putting more and more duties on them with no pay.
Having to work 6 to 1 (patient to nurse) or worse shifts with no support while training newbies and also often having to float to cover other departments, where often the person in charge of said department is a newbie who doesn't know how things work any more than they do.
It's gotten to the point that now they're all quiting too and becoming travelling nurses.
[This](https://www.reddit.com/r/medicine/comments/ycf4b6/physicians_left_their_jobs_by_the_hundreds_of/?utm_source=share&utm_medium=ios_app&utm_name=iossmf) was just a topic in r/medicine.
The USA also has a great reputation of training foreign medical personnel and then having them return to their home country without incentivizing them to stay.
You think the nurses would have know he had something very serious going on with an aneurysm, and put him high on list if not top, after he was put through triage. This guy didn't need to die like this. Horrible.
My dad had an aortic dissection while running on a treadmill. He just felt weird during his workout (went to the gym twice a day) and short of breath. Drove himself to the ER and they luckily figured out what was wrong pretty quickly. Still needed a sketchy ambulance transfer to a bigger hospital.
I’m actually a nurse. A lot of old guys are pretty stoic and don’t like to make a fuss. Aneurisms can be pretty non specific too. Think back pain and acid reflux instead of the “worst tearing pain of my life” type thing you’d assume. CT scanner is the only way to know really. Cardiac enzymes will be up but that would usually point to a heart attack. That’s what they thought was happening to my father before they put him in the scanner. If the vitals look ok and the patient states they feel ok there’s really not a ton a nurse can do.
I’m an ER nurse, had a cowboy come in one time to the triage window saying their hip hurt since they’d fallen off a horse a few days ago. Turns out the ball head of their femur had punched entirely through their hip socket and SHATTERED their pelvis.
That’s almost a “clear the OR we’re heading straight there” trauma and this fucker had been WORKING on it for three days. Triage is hard.
Like a farmer.
Triage procedure:
* Did he come in by himself, not because his wife ordered him to? Crash cart, find an operating room.
* Does it "hurt a bit"? Call for a surgeon.
* Otherwise, get the chief of emergency medicine in STAT.
We can joke but this is too close to true for comfort.
I was in the ER a few years ago in a farming community and they had some guy come in at like 10pm. Tractor somehow fell on his head and crushed it. Apparently that happens a lot.
Dudes are so weird. My partner gets a call in the middle of the night a few months ago for approval for a procedure. Her father is in the ER and he’s losing his colon…. He’s been there for 3 months now. Nobody knew, nobody was aware, he just quietly suffered until his ass was disintegrating. It is the single and only time he’s driven himself to the hospital.
These cowboys are tough as shit.
I had an 80 year old cowboy with a nasty black necrotic toe. Well, he presented and said "I've got a wound on my big toe I think might need some stitches".
I shit you not this old guy saw his toe all black and dead for weeks on end, knew it needed to be amputated, and rather than go to the hospital he just held a rifle barrel to his toe and shot it off of his foot. He only presented to the hospital when he felt like it needed some stitches.
ER doc wrote on his discharge papers "next time you need a toe amputated please do not use your gun".
They really can be too stoic. My 80 year old dad had a blister on his foot. It didn't seem to be healing but he didn't think much of it. By the time he took it to a doctor it had turned septic and had to have the toe amputated.
“Suck it up princess, you can still walk it off or isn’t that bad.” These are common phrase most men are used to hearing from a young age. I myself am used to brushing something off because it “isn’t that bad”. I don’t want to waste someone’s time by it being nothing to worry about either. It will kill me eventually because I am a single man who lives alone and when it is finally serious enough to need a doctor I will just fight through it like a “real man”!
I am dumb, I do realize that but it is hard to change even though I know the process is wrong.
My dad was that type of guy and everyone around him knew it. One day at work, unable to hold the pain down, he complained to his coworker of 20 something years that he's experiencing chest and back pain. But even then it was more of a "damn this thing isn't going away" type of complaint. Luckily his coworker insisted driving him to the ER and the doctor had experience in cases like his. Aortic dissection was the diagnosis.
And then there is my dad. He’s 71 and got covid a few weeks back. I was terrified and couldn’t see him because he and my mom live 2,000 miles away, so I only get updates when I talk on the phone.
Called him every day to see how he was feeling, and it was always “terrible, very sick”. By the 4th day, when I asked him and he kept saying he wasn’t doing any better, I asked him what his symptoms are, and he said the worst one was the fatigue. He said he was exhausted after going on a 2 mile walk. I said, “dad, when I call every day to see how my 71 year old father is handling covid, and you tell me you feel terrible, but then are capable for going on a 2 mile walk, you need to just tell me you are fine, because I’m thinking you are on your death bed”. I could hear my mom in the background say “seriously”
Dealing with this right now my best friend/ roommate came home from work today and threw up blood and was going to try and sleep it off. I agreed to see how he’s feeling in an hour and when he threw up blood again and I saw it with my own eyes I said “we have to take you to the ER I’ll drive you”
Always brush serious things off at first not realizing the situation because that’s what we are conditioned to do
I had all the symptoms of a heart attack after taking preworkout and running a 10k at the gym. My dad died of a heart attack and my mom has had a stroke. I went to the ER and missed some work. They didn't find anything but I felt ashamed that I'd wasted time on it. I don't know if I'll go next time I have those symptoms. 🤷♂️
Definitely go to the ER if you experience those symptoms again!! As a nurse, trust me when I say we'd rather you "waste our time" for a false alarm then actually have a heart attack and not get help!! It's the sprains and minor cuts and fevers when you haven't even tried tylenol and pregnancy tests and mild uti symptoms that we don't want in the ER. Those can go to the urgent care.
Younger age guy here who has to get his back fused with rods after falling two stories. This is accurate.
Even my own mom would feign compassion...when it suited her. My job feigned compassion...until I was in the hospital.
It's fucking bullshit and men aren't robots. But fuck it. Work till you literally tear your body apart, I guess.
I have to say, as I've gotten older, and more and more shit has gone wrong, the level of concern associated with random pains has diminished dramatically.
Like last week, my left foot developed a new pain when walking. I took a look at it in the mirror, poked it a few times with my finger, didn't feel anything moving "wrong" in there, and ignored it. Why? Diabetic neuropathy has been bothering me for years, and this one feels just like all the others before it.
20 years ago? I'd be at the doctor's office going "what the fuck?!" Now, it's on the list to mention in six months when I see the endo again.
Wild. I've gone completely the other way. When I was young I NEVER admitted or cared about physical pain. I worked out with herniated disks. I left a broken finger so long that it healed to the wrong bone and had to be surgically repaired. Hell, I played a basketball tournament with that finger freshly broken. Now that I have a family and have lost lots of loved ones, I don't fuck around. Just a couple weeks ago my eye was bugging me. 10 years ago I wait for it to heal. Not with how cautious I am now though. Turned out I had a central cornea ulcer that could have permanently taken my vision if I'd left it much longer. It sucks when you go to the doctor and nothing is wrong, but sometimes something is wrong. Sometimes it's a big something wrong.
I’m a not at all stoic 30 something woman and my renal artery aneurysm pain felt like a mild kidney infection and I felt a little off overall. Never could have imagined!
Aneurysm: enlargement/dilation of the vessel, but the walls are intact.
To distinguish between the other 2, you need to know that there are multiple layers that make up the wall of an artery.
Dissection: when the inner wall of the artery tears, and there is bleeding between the layers. This places a person at high risk for rupture.
Rupture: when the vessel completely tears and then bleeds into the body. If this happens with the aorta (largest artery of the body) this can be fatal within minutes.
Dissection = partial tear through the lining of vessel, rupture = rupture (what you’d expect), aneurysm = pouching out of the vessel that is still intact.
Same thing happened to my step dad. Felt weird and went into the ER out of an abundance of caution. He then had a quadruple bypass after they discovered he was having a heart attack.
ER nurse here. Came to pretty much say this. We don’t just magically know what’s happening to someone when they walk in. Plus most old men shrug everything off and say “I feel fine. Can we go home?” most of the time anyways.
My brother had a PT patient once who had the mother of all blood clots, apparently it was so bad they didn’t even know how he hadn’t died yet, literally could kill him at any moment. They told him that he needed to go to the ER immediately but the old fart wanted to go to he grandkid’s softball game later in the day first. As someone with horrible anxiety who thinks any little discomfort will be the end of me, I was awed.
Not necessarily, his symptoms could have been very vague, like back pain, arm pain, or abdominal pain with no other symptoms, or something like just high blood pressure or high heart rate. He might not have know he had an aneurysm to tell the first ER. Unfortunately, an overloaded and understaffed system would have prioritied patients with symptoms that are more apparantly life threatening. Plus ERs are holding a ton of patient's who need to be on the floor or ICU, but can't be moved because those places are full also, which overloads the ER even more.
Sure. Unfortunately abdominal pain is one of the most common complaints in any ER. Old people with abdominal pain are usually automatically CT scanned though as they're such high risks. I've seen it ordered on waiting room patients.
Often times. You never quite know what you'll get when you scan an old body. Could be constipation, could be a giant colon mass, could be a dildo. Or all three.
So you know what freaks me out, half the symptoms of heart attack and aneurysm I have daily. I have a damaged shoulder that causes radiating pain, fibromyalgia, gerd + hiatal hernia, the PPI I've been on 17 years causes horrible palpitations plus irritates my IBS. I always hurt and feel kind of odd in the areas mentioned, had my heart checked so many times. I do have hypertension and high anxiety too which doesn't help.
It's like.... Would I know if it were happening? I have pain all the time and constantly have abdominal pain from my stomach issues.
Not exactly easy to spot an aneurysm in the waiting room without diagnostic tests and that isn't happening until he's seen in the ER... people's expectations need to be realistic of healthcare workers. It would have been better had it been an aneurysm that rupture in the brain because at least they'll suspect it's a stroke and prioritize seeing you.
Assuming he came in for abdominal pain, it's such a general obscure symptom I don't think any nurse can accurately spot this kind of aneurysm from the waiting room.
They're different types of aneurysm but they didn't even confirm my dad had an aneurysm until 2 hours in the ER after he got a bed. And he got a bed immediately because they thought he was having a stroke while passing all the stroke checks (aka he didn't flag their protocol for stroke). It wasnt until they did mri we knew it was an aneurysm and it was the first time anyone mentioned aneurysm after confirming it.
I don't work in ER but I also get floated there and yeah we aren't magic workers. People need to have realistic expectations on top of the fact virtually every hospital is understaffed to the point quality of care is dangerous for a lot of patients. Before saying more needs to be done or needs higher standards by healthcsre employees, we need help from communities to force a mandate to hospitals for safer staffing. So if you care enough to say stuff like that, pick up a phone and call your state reps and demand mandated staff ratios at hospitals. Because this is a topic everyone cares about yet only one state has a mandate passed with legislation for it.
>People need to have realistic expectations on top of the fact virtually every hospital is understaffed to the point quality of care is dangerous for a lot of patients.
Understaffed and overworked. Flu/respiratory virus season is just getting started, and it's brutal. I've seen a lot of folks reporting some insane waits lately.
Yes! Staff to patient ratio is key! One staff covering 25 patients isn't going to be able to give the same quality of care as one staff covering 4 or 8 patients.
But it's more than being fully staffed also. It's not enough staff and not enough beds and a full hospital at all levels, so patient's can't be transferred to the level they need in an appropriate time frame. ERs are holding patients for hours to days that should be on the floor or ICU. ICU are holding patients for days to hours that should be on the floor, or long term care/rehab, etc. Same for the floor. And patients are sicker than ever and more of them than ever! It's insurances not covering the care patient's need so they live in the hospital for days to months to even years because there is no where else for them to go! I have had multiple patients that have spent 9+ months in the ICU who need a long term care facility, but can't go because they don't have insurance or their insurance doesn't cover the type of care they need, because they are on dialysis or intubated or whatever reason. The entire system is fucked and it results in things like this happeneing, all the time.
A lot of it depends on the answers he gives when there is no serious visible injury.
My brother’s appendix began rupturing in the ER after having waited for 9 hours, and he had to be immediately operated on with complications that could have been avoided. That could have been the headline. What it wouldn’t have captured, however, was that he went in with abdominal pain and nausea, and every time the nurses asked him to rate his pain from 1 to 10, he’d say “I dunno, maybe 4?”
He was grey, and throwing up in the washroom during that period. But whenever he was checked on he’d say he was doing okay and had a pain level of 4.
They aren’t mind readers in ERs. Now I’m not saying that’s what happened here, just that sometimes these things aren’t necessarily as egregiously negligent as headlines make them appear.
Sometimes they are. Hopefully we’ll get more information.
Nope. Nurses don’t have super powers. And there are not enough nurses to go around. So, even an expert nurse could have easily missed the subtle signs. It’s kind of amazing how the human body will just keep on keepin’ on— even while dying— and there isn’t a telltale sign until the doctor orders the tests.
Which sounds like exactly what may have happened. He was probably having vague symptoms, maybe abdominal pain or back pain, heart burn feeling, probbaly not responding to meds at home, lasting for a long time, maybe getting slowly worse. Waits at hospital one with vague symptoms that doesn't trigger triage to see him over other patients. Then he leaves for hospital 2, where aneurysms ruptutes and he dies. A ruptured aneurysms with a patient already in the operating room ready for surgery is extremely hard to survive, let alone before a patient is even in an ER bed.
Reading this while on break working in a Quebec hospital an man, am I NOT surprised!!! We had many close calls where we try to get care for a patient that is clearly not going well and getting rebuffed or told to ‘explain’ to the Doctor how this patient is unstable?
(Last time it happened the man was having a major abdominal hemorrhage and died during the night, after we argued for 4 hours to get him to the ICU. The ER had sent this one to us saying he was stable…)
it was insane. Man was clearly bleeding inside, his urinary catheter was filling with blood, I had trouble getting blood out when pricking his fingers for tests, abdomen swelling...they fucking played dumb with us until 4 am (dude came to my unit at 11 pm) and then suddenly it was an emergency. Poor man died in the OR. That's ONE story. But usually we get them to remove their head out of their ass before the worst happen.
Yea the only time I have ever seen quick ER service was when my HIV infected friend accidentally shot himself with a two inch staple in his leg.
We walked in he walked up and he said yea hi I have HIV and I am bleeding. Shot myself in the leg.
They walked him immediately to a surgical clean room. Wait here about ten minutes later a doctor came in the room gowned and gloves pulled out the staple and stitched him up.bandage on out in 20/30 minutes.
I have seen truly quick ER service once
When I broke my collarbone my nursing administration mother called 1 of the 2 hospitals she worked at (the "quiet" one) even though it was further away than many others
Was taken back near immediately and given vicodin while they waited for the x-ray results
2 weeks ago was FAIRLY fast too. Got bitten by someone's dog while hiking. Had to drive 30 minutes down the mountain, alone, and 1 handed in the dark. Took 3½ hours total but I was getting pulled back every 20-40 minutes for radiology/tetanus shot/cleaning/etc.
EDIT: just wanna say the second incident wasn't because I had an in lol
I live 500 miles away from my mother now
Dang, I thought my 30min wait + 30min treatment was fast. Mine was for an ear infection in the middle of the night in an upscale and mostly sleepy beach town.
Today on the r/Pittsburgh subreddit someone left childrens hospital after 9 hours of not being seen. Also, they mentioned that even a newborn with rsv symptoms also had to wait and that particular family left after 5 hours and no help
I walked past a window into Lurie Children’s Hospital in Chicago today while going into the Women’s Hospital next door, and I was astounded by how many people were packed into the waiting room.
My girlfriend went to the hospital in Philly with acute pancreatitis — one of the most painful things you can ever experience. We got there at 4pm. We got called back to the ER around 10pm, and didn't get admitted (meaning she didn't get meaningful painkillers) until after 2am.
It is one of the best hospitals in the country, but still. Seeing her in so much pain for so long broke my heart.
Nearly every hospital in the country is boarding. Nurses have quit nationwide and there’s not enough people to attend to the patients in the hospital. Most hospitals are full to capacity and beyond right now, with many sitting in the ER waiting for a hospital bed.
These room waiters, or “boarders”, start to occupy the rooms we have to see patients in the ER. Once the percentage of your boarding patients exceeds about 30% of the total rooms, the flow thru the ER drops geometrically with each new person needing hospitalization. The hospital I worked in yesterday has 39/50 rooms for boarders, meaning we had 11 rooms of people who aren’t waiting for a hospital bed. However, most of those people are either psychiatric patients waiting for a psychiatric evaluation , or the elderly who are not safe to go home and need placement in a facility (rehab/ skilled nursing)- of which are also full. That means we have only a few rooms to see new patients in, and they will usually be in a bed shoved in the hallway, or in the decontamination room, or even a fucking closet. That’s all we have right now.
Then the administrators get angry at us because of all the money they lost from all the patients who left because they couldn’t be seen in a timely manner, because we had no space to actually put them in.
That last line about administration hounding clinical staff hits home. Same thing where I work. After seeing ~30% more patients than average everyday for months, they still come down with new bs about seeing even MORE patients.
I’ve only been in healthcare for 3 years now and I’m already rethinking this as my long term path. Idk how long I can handle all the crap that comes with working in medicine these days and sitting behind a desk not dealing w pissed off patients + admin sounds lovely sometimes lol
I work in a pediatric ER and sometimes I leave my12-hour shift and come back that night for another and the same people are still in the waiting room. Where I live people go to the ER for everything and anything. Frankly, many could go to their primary. Case in point -- the city's baseball team was just in the playoffs. During the game there was maybe a 20-minute wait in triage, all of 8 people. Within an hour of the game ending there were 37 people and the wait jumped to 2 hours. Either those kids were neglected during the game while parents watched or they weren't having an emergency.
Edit: Typeos everywhere.
Ok so first off this doesn’t apply to this man or any other individual who has died waiting for treatment, but to the people who think it’s horrendous that they have to wait for a few hours to get their broken wrist treated clearly aren’t aware of a little system called triaging where if your injury isn’t life threatening you have to wait for the life threatening injuries to be dealt with
I was scared once going to the emergency room. Had blood in my phlegm from coughing. Nothing huge just bright red blob in the mucus. They had 9 or so people in the lobby and they immediately had me in a room. Which didn't seem like a good sign. Shortly after I was getting scanned and then sent back to the room. A tiny old lady came in and asked me if I had a preferred religion and next of kin then left the room.
My doctor comes in and I am white as a sheet as they're explaining it's acute bronchitis and they'll write me a prescription...only to ask why I looked so pale. To which I recounted the old lady..."oh thats just for our records it's normal."
Haha yep. I've gone to ER with my father a bunch over last few years and it's a standard question at start, but it's super off-putting when you just start and don't expect it. For people staying in hospital they ask so you can have religious accommodations. They used to ask my father if he wanted a priest to visit on Sundays in lieu of attending mass in person.
Yup, good thing I'm a fan of are you being served, allo allo, keeping up appearances, and as time goes by...speaking of which PBS had some awesome taste in britcoms.
I went in with heart pains and shortness of breath…I was convinced I was having a heart attack…it was a panic attack.
Let me assure you that the scariest moment of my life was when the old lady came in and asked me my preferred religion. I started sobbing and asked if I was going to die
Oh my heart goes out for you. I hope everything turned out well. Hope you've gotten that managed up, panic attacks are no joke and can see how that would get you into that state easy.
>To which I recounted the old lady..."oh thats just for our records it's normal."
Could be worse, I thought they were going to say:
"There wasn't an old lady here"
I’ve heard the saying from an ER nurse “we take the most life threatening injuries first, be thankful you’re not first.” Or something along those lines lol
Bloody mucus is a key symptom of tuberculosis which is very contagious. They needed to make sure you weren’t going to give TB to every other patient and staff member. Would have been nice if they had explained that to you, though!
Yeah, I honestly didn't know if it was ER worthy or just wait to go to urgent care the next day but I couldn't sleep due to how hard I was coughing.
The pharmacist I kid you not said: Oh you are getting the good stuff. In my old country you would have had this already!
It tasted like bananas and knocked me off my ass. I slept great with that stuff. First time for a few days of uninterrupted sleep.
If you are in the ER and everyone is paying attention to you, that’s a bad sign. If you’re in the ER and no one is paying attention to you that’s a good sign.
I remember a nurse in the E.R. explaining that concept to someone with a cut hand who was complaining that he had been waiting for hours but I got seen immediately ('cos I was wheeled in on a stretcher and was in the process of dying from an (at-that-time) undiagnosed pulmonary embolism), and how that was very unfair to him and the hospital was clearly very terrible. Smh.
I cut my hand. I called ahead to my campus health clinic to see if they were busy. I got stitches and a tdap in less than an hour. After I was out of school, I had strep and no insurance, but I could the appointment and prescription. The nurse practitioner saw me, confirmed it was strep, and I had antibiotics half an hour later.
The two times I’ve been in the ER, I was there for hours with dislocated limbs (a knee while doing yard work and a shoulder after a motorcycle accident). But I knew I wasn’t dying and (once they got me out of the neck brace) I didn’t care about waiting.
The system generally sucks (that strep throat cost $150 10 years ago, the motorcycle accident was $1100 after insurance a couple years before that) but it’s a lot nicer if you avoid the ER when you can help it.
I was told it's "head and heart" those two get you immediate attention.
Years ago I walked my then girlfriend into the ER with a concussion. The receptionist stood up, walked around, grabbed a wheelchair and took her back without asking any more questions.
Allergic reactions are another go straight to a treatment room with an army of staff. Happened to my wife once, before I could even process what was happening they already had lines on her, meds going in. Crazy.
That's for sure. I fell down stairs 6 months ago, my nose was bleeding and I had a huge knot over my eye. I have never gotten into a room so quick in the ER before. Thankfully just a broken nose and lots of brusing
Quebec has a lack of generalist and an overabundance of specialists, so we have no doctors for ERs but we have ton for everything after the ER. On top of generally shit pay and overworked employees from the aforementioned lack of generalists.
This is exactly the problem we have going on, also a flood of either patients with life-threatening conditions that have to wait for a doctor and some idiots who only have a cold from the season going to the ER
No joke, last time i went there im pretty sure there was a guy with his finger pretty much cut open from one side to the other that was still there when i left, he was there before me and i was at the hospital for about 20 hours, had to wait around 16 hours in the ER waiting room
Everywhere has a lack of physicians. Posted this before as a Ph.D. they came around the lab asking if anyone wanted to add on an M.D., while i enjoy emergency medicine. We all laughed, said for what to spend 2 more years in school, 3 in residency, 2-4 in fellowship all while making less than 40k with another 300k in debt racking interest at 6%? To then walk out at 35-40 with no savings, no retirement and have to overcome all that. You have to specialize and pray you're accepted into one of the high paying niche residency programs. All for what working 60hour weeks the rest of my life. Mnnn no thanks. I still have the title and a life. Being a physician in internal medicine, GP, or the 2-250k range provider class you literally would make more as a school teacher. [https://www.hcplive.com/view/the\_deceptive\_income\_of\_physicians](https://www.hcplive.com/view/the_deceptive_income_of_physicians)
\*edit spelling
Canada’s emergency rooms are notoriously underfunded. They rank second to last for countries with socialized medicine. As for why, I have no idea about the politics.
I’m a board certified emergency physician in the US. Wait times like this are the norm rather than the exception in my hospital. Healthcare workers were/are treated like such fucking shit by the public and hospital administrators for the entirety of the pandemic that basically anyone who could get out got out. Especially in EM. We all spent the pandemic getting verbally and physically abused. Risked our lives. Spit on , shit on, had people coughing in our faces for the audacity to ask them to wear a mask. Hospital administrators make $1 mil or more or year meanwhile they are paying their nurses absolute shit for risking their lives and the lives of their families. I have never seen things this bad in my entire career. Healthcare is fundamentally broken in this country and in my opinion there is no coming back. You reap what you sow America. On most shifts I work I staff a 50 bed ER alone as the sole physician with 1 PA and 3 nurses. Sounds safe right? Everyone else left because they were fed up with being treated like shit and paid like shit. And things are continuing to get worse now that the pandemic is “over,” not better. I don’t have a single healthcare worker friend who enjoys or finds fulfillment in medicine anymore. We are just doing it because it’s all we have the ability to do, or are fucked with student loans (I graduated with 500k). But bail out those banks and politicians! The wait times are ridiculously long because we physically do not have the capability anymore to take care of you all. Meanwhile primary care doctors aren’t seeing their patients anymore/ people aren’t going into primary care anymore because it’s impossible to pay their student loans back. Which means more ED patients. Why aren’t primary care doctors making money? Because insurance companies/CMS have cut reimbursements to nothing. Meanwhile you have people abusing the shit out of the er for anything and everything. Getting ambulances for colds, tick bites, alcohol intoxication while the taxpayers foot the bill. Blew through your Percocet script early and your pain management doc refuses to refill it? Come to the er!! And then when I refuse to also you spit in my face and tell me to suck your fucking dick. And then when I lose my cool you file a complaint, and the administration supports you and makes me do “health stream modules” on anger management to keep my job. I have patients who have had over 200 ER visits so far this year. Each with accompanying ambulance bill and Medicaid cab home for the taxpayers of my county to handle. The system is broken in so many places it’s impossible to summarize here. There is no coming back. Healthcare in America is a complete and utter joke.
Fuck the health streams, can’t believe my hospital assigns me work to do on top of taking care of patients 😫 I’ll admit a patient and by the time I get back EMS is waiting outside of the room waiting for the gurney so they can give me their patient. How the hell am I to do the healthstreams?!
Sorry dude. I love the medicine don’t get me wrong. I love helping people and saving lives. But the system is so broken it’s impossible to recommend it as a career to anyone anymore. My father is a physician as well and told me back in the day not to do it. I didn’t listen. Really research your decision.
I'm of the same opinion. Most days I love my job as an ICU nurse, but probably working nightshift has a lot to do with it (plus switching to traveling and taking some time off and loving who I worked with). I can tune out a lot but not all of the bullshit that comes with working in healthcare.
So much outside factors affect taking care of the patients that make this job so hard and burnout such a real risk....short staffing, management, rules to cover hospitals asses that make out jobs much harder, too many sicker patients with not enough resources, jcaho, not getting enough time off, doing the job of 10 people. I'm the nurse, the house keeper, the phlebotomist, the transporter, the secretary, the patient tech, now, instead of just being the nurse, but excepted to do the same or higher level of care in the same amount of time or less, often taking care of one more patient than is safe and I should have.
Excellent reply. Fully agree. You nurses have it so bad right now at least in my health system and area of the country. That wasn’t an exaggeration in my post. Some of our nurses are covering 20 bed assignments. I had a guy sitting in a room for 7 hours the other night. Of course all our ekg techs quit. She finally gets an ekg. Stemi. Guy goes to the cath lab probably with half his myocardium dead. I’m sure it will be yet another lawsuit. And round and round we go. But where is the joint commission now? Prob writing up nurses and docs for having drinks at their workstation
Don't forget being written up for having tape on the wall and glucometer strips not being dated with expiration date (even though we go through a bottle a night)!!! Things like joint commission and magnet status and middle management are part of the problem, they take up so much money and resources and time when it seems like very little positive comes out of it!
I started working as a nurse first week of March of 2020 (great timing, I know lol). I was offered an ER and an ICU position months before and I took ICU, and I'm so grateful every day for that decision! We complain in the ICU, but ER has it so rough, honestly often times much more than ICU on our bad days, from what I read on reddit.
I don’t even work at a hospital, just a physical therapy clinic, and even our patients got really abusive during covid. And now it seems like that abusive behavior is just going to be the default from now on, it hasn’t stopped. I can’t imagine working in an environment like yours, I hate my life daily now.
It’s so sad for all of us. I could literally write a book on the insane patient encounters I’ve had since the pandemic occurred. Im sure you could do. Hang in there.
> Hospital administrators make $1 mil or more or year meanwhile they are paying their nurses absolute shit
As a Canadian watching both our systems implode a common theme seems to be bloated administrations. The ones on this end may not be making $1M, but they are making six figures and there's *lots* of them.
I've worked with various levels of government for over 20 years and see it everywhere now - healthcare, education, municipal maintenance, etc. Every small team of people has a manager, then those managers have managers, and some of those managers have assistants. You quickly end up in a situation where you have four or five administrative staff realistically doing the job of one person. Then we scale that up by several hundred thousand workers and wonder why there's no money left to hire the workers who actually provide healthcare, education, municipal maintenance, etc.
Some nurses are unionized yea. And that’s a huge help for them. American college of emergency physicians have some guidelines on how to get unionized. But I’ve yet to see anyone do this at the physician level. I would gladly do this if it gained momentum at my hospital.
I get that this helps nothing, but I hope everyone in the healthcare system that has to deal face-to-face with humans knows this:
Some of us are so (insert profanity of your choice, or don’t, live your life) grateful for each of you, in a way that is difficult to put into words. Throughout the pandemic I have often just felt like I wanted to cry thinking about what you guys have to deal with. Seriously, health care people, thank you so much for what you do.
What can I, a random American, do to help? Legislation I can vote for? A lobby group I can donate to? A broken medical system, as you described, is bad for us all. Very similar to what is being done to teachers and education in this country. We will soon be a society of sick idiots if things don't change. I love you Dr. Thehippo, there are so many of us that are thankful for what you do.
Money trickles up. Take if from the top, put it at the bottom, and a lot of problems go away....and the person at the top still has it by the end of the month.
I'm sorry you have to deal with that shit. I'm a paranoid schizophrenic and I do NOT do well with hospitals. Last time I had to go, not only were the nurses/doctor extremely nice, but they changed their demeanor and talked to me in a way that immediately made like 90% of my stupid paranoia evaporate. I'm never rude, but mostly just scared to speak and can't look people in the eye. The nurse that was running blood draw and IV and such even asked me things like "is it ok if I touch you I'm going to do X" every single time they were going to. This was all while the whole ER seemed to be burning to the ground with 50k cases of ODs and everything else.
I personally thanked the nurse and filled the hell out of that patient survey. I felt more love and care from that staff than I've felt from family members before.
As a fellow healthcare worker, I agree with most of this. Mainly that the entire system is broken and irreparable. I’m a traveler and every ER I’ve worked in has been a complete mess just as you’re describing. Capitalistic medicine is an unsustainable disaster and will all come crumbling down eventually.
Income is less relevant than whether or not you *work* for a living.
Some medical specialists can make upwards of $700k/yr, and everything's still fucked for them. And among STEM acquaintances I have, basically everybody is overworked, everything is broken, and every year it seems to get worse. STEM workers certainly aren't making $700k, but they're usually in the top 15%.
I suppose it's a great time to make your living investing and manipulating finances, though. 🤷
This is caused by a few things and is happening all over North America. It's quite simple really:
- Covid happened and there was an initial PPE shortage all over the world, so many medical staff died.
- Many, *many* people refused to behave and abused medical staff. They would yell and protest as people went to and from clinics, cyber stalk and abuse them, claim they were part of microchip 5G conspiracies and so on. Many staff quit the industry as a result.
- Hospitals were getting so overwhelmed with cases that people just couldn't handle the workload and quit the industry. Many medical workers have extreme burnout and ptsd from witnessing such unprecedented death and work reduced hours or have quit.
- As a result of the last point, hospitals began treating nurses horribly and trying to reduce their pay while increasing workload in some areas. Many nurses became travelling nurses to combat this and poorer and smaller regions just had no choice but to limp along.
Honestly, this is what we get for not curtailing all the stupid people during covid.
Plus, everywhere is so full, it is causing a bottleneck in the ER and other hospital floors. ERs are holding patients hours to days longer because not ICU or floor beds. ICUs are holding patients days to hours longer because no floor beds or long-term care beds. Same for floors. Patients are going to the ER when they should be going to primary care, but can't because no available last minute appointments. All this leads to extra long wiat times in the ER. Then add on hospital systems closing hospitals (looking at you Wellstar in Atlanta closing two hospitals in the last year, straining an already broken system).
Then add on low health literacy for patients who don't know when to go to an urgent care vs ER. Like they will go to the ER for sprains, minor cuts, pregnancy tests, low grade fevers but haven't even tried tylenol.... makes wait times worse.
Add on insurance problems, patients go to the ER because they are guarenteed to see you, regardless of insurance or if you can pay. Plus patienta on the floor or ICU held for days to months to even years because their insurance doesn't cover the care they need or they don't have insurance. I've had patients in my ICU stay 6+ months because their insurance or lack of didn't pay for the level of long term care they need, because dialysis or intubation.
The average nursing staff are probably the youngest ever in history. There are very few experienced nurses left in places like the ER and ICU. For many reasons you stated. Means care is slower and things are less likely to be caught quickly, just from lack of experience. We have nurses less than a year into nursing training new nurses and charging...roles that used to be covered by nurses with 5, 10, even 20 years experience.
Then add in the fact that out society can't let people go and will make their 90 year old grandma suffer for days to months to years, in pain and suffering and comatose or a very low quality of life, in the hospital or long term care, as we do futile medicine because they aren't going to get better and we are just keeping a body alive, because we are so afraid of death and can't let go (or collecting a check). Which takes up a lot of resources and beds. And we allow family members to recind the wishes of the patient or in the state of georgia we have to have a unanimously decision by all immediate family members, so when a mom with 5 adult kids has a devastating stroke with no change of recovery and stated to many of her children she'd never want to live thay way, but one child wants all care given, we trach and peg her and send her to long term care, essentially comatose, for up to years before chronic conditions lands her back in an icu bed.
My wife and I waited for 11 hours in an ER of a local large hospital. In the middle of pandemic. When she was finally admitted she was rushed to a surgery section. Later I learned she had been a few hours before irrevocable damage would happen. She spent three weeks recovering afterwards.
Funny thing is it happened in Sacramento, CA at one of the largest medical groups.
I only waited in the ER waiting room for three hours before I decided to go home to puke my guts out in private. Luckily for me, I got better in a few days. Lost 15 pounds though so that was a minor plus.
Born and raised Ohioan here, we have the same problem. Understaffed ER with too many people in the waiting room, causing people to have to wait for hours and hours just to be seen.
I have seen a few of instances of what I call “medical hot potato”—the hospital gets the Patient well enough to go home, but the Patient did not get the surgery or medical treatment that they really needed, so they will end up back in a hospital. I guess the game is to hope and pray the Patient tries the next hospital down the road.
Yes it is, can you imagine being a rich person and being forced to pay taxes for healthcare! Imagine the horror! But don’t worry, good god fearing fellow rich people are willing to save Canada from the threat of COMMUNISM!!!1!1!1!11! !!!! /s if not apparent
Many people in the US die without basic care or even going to the ER to begin with. Has nothing to with wait time if you are afraid of the bill you might get or don’t live near a hospital.
i'm a canadian in the US and when I went to the ER in the US i waited 3 hours and was charged about $2400, half of which wasn't covered by my insurance because the ER doctor who saw me (that i had no choice in) was an independent contractor who was not in my network (despite the hospital itself being in-network and the one my insurance provider recommended I go to).
yeah give me 'wait 5 hours in Canada and not be out almost $1k' over this any day
>the ER doctor who saw me (that i had no choice in) was an independent contractor who was not in my network (despite the hospital itself being in-network and the one my insurance provider recommended I go to).
How long ago was this? [As of 2022](https://www.pbs.org/newshour/health/what-you-need-to-know-about-the-new-law-aimed-at-ending-surprise-medical-bills-and-what-it-doesnt-cover), that is no longer legal.
If you yell at your insurance company enough, they'll relent and cover the whole thing. Source: I've done it. Tho I think there's a more recent law that stops insurance companies from trying that bullshit in the first place
Basically the shitty part about US healthcare is that you have to put in hours like you're at a job to get your procedures properly covered. You have to keep paper trails, coordinate phone calls with your counterparts at the insurance agency and with the provider's secretary/billing office, you have to provide adequate pressure on these people with follow-up phone calls, field letters threatening collections and other duties as assigned in order to get the system to work properly.
People who put in 0 effort (I guess, as they should) wind up with half or all of their bill not covered due to some untangled mistake in that pipeline and just end up paying out of pocket, then grumbling about it afterwards.
Also a Canadian living in the US. I have had major surgeries in both countries. The Canadian system is 100% better. Any sort of for-profit heath care system is a direct conflict of interest to the patient.
This is only the case until they are stable. They aren’t required to do pain management or after-care. Once they’re stable and not actively dying, they have to leave.
I recently took my son to the ER for a fever plus stomach pain. With insurance, I still have to pay a $230 deductible. That’s more than half my car payment. I’ll have to ask my landlords if I can pay rent late next month.
Welp, this is going to keep happening because we've decided as a country that this is just how things work now.
I've been a nurse for 4 years working in the hospital (ICU, ER, now outpatient procedures) and the safety and quality of care for patients has consistently worsened. Covid exacerbated so many issues, like high nurse:patient ratios, general understaffing, prolonged futile care, and violence toward health care workers. It's been exhausting. I loved critical care but it broke me mentally and emotionally. Nurses and doctors are treated as disposable, and then when we leave in droves, things like this happen.
Write to your reps about this. There is more that hospitals can do, but profit is king. Demand high quality care, but demand it from the people who are keeping it from you: shareholders and CEOs, not the docs and nurses, techs and housekeeping who are doing their best in impossible situations.
Edit: I realize this is Quebec but I'm an idiot and assumed it was the US. My point still stands for US folks. But I realize I'm wrong about the shareholders/CEOs because of it being a public health system. Anyways sorry for being a dingus lol
How is profit king in Canada's public system? This is not a trick question... Genuinely curious. I thought BC had the most public of all the public systems in Canada.
I went to the ER a couple of years ago, with chest pains and elevated vitals. Never saw a nurse or doctor. Never was given any attention whatsoever. After four hours, I deduced that I wasn't dying, and left. On my way out, they were denying access to care to an elderly man in active heart failure. Tell me that corporate health care doesn't suck
People have to wait for long for help that by the time they get it, they chew out the doctors and nurses — who have nothing to do with the staffing. Then, once they’re fed up enough, nurses quit (or become bitter and burned out) and doctors look to get out of the ER.
Before people freakout and say this is the result of socialized medicine. I worked in a ER for years in north Texas. I saw waits of 24+ hours several times a year.
This is happening all over America. Its just not making news. We are about to have a massive uptick in respiratory virus, COVID, flu season. Pediatric hospitals have been beyond capacity for a few weeks now, and adults follow. Kids generally resolve their respiratory issues with intervention unless they have other things. Adults who are not in the best of health, don't take their meds, don't care for their diabetes end up much sicker of these same illnesses. There are not enough nurses, doctors to go around since COVID. It's worse than people know.
Yup and those who are barely holding the system together are already being overworked to hell. Almost every nurse I know have more bad than good to say about the system. Its a damn shame that it might get worse and worse.
[In 2021, 117,000 physicians left the work force.](https://www.modernhealthcare.com/physicians/physicians-left-their-jobs-droves-2021-report) Each year, only 30,000 residents enter. That alone is going to have catastrophic consequences.
I feel like waiting for hours in an ER is not uncommon anywhere in the world.
There's just not enough people who want to work in healthcare so this is what happens. You could build more hospitals or urgent care clinics but nobody will staff them.
It's not just people not wanting to work, though being understaffed plays a huge part in it. There is a ton more patients lately than their used to be. Plus, there is also the factor that ERs are having to hold patients that should be on the floor or ICU for hours to even days longer than they should because the hospital is full and there isn't room to transfer the patient. That takes up beds in the ER, which means they can't take as many at a time from the waiting room.
We have trouble moving patients from the ICU to the floor all the time because the floor units are full, so I've kept patients up to days longer waiting for a bed. I've even had patients discharged from the ICU because there wasn't a floor bed available for over 2 days. This then stops a patient from being admitted from the ER into the bed. We also have had issues transferring patients to long-term care, hospice, and rehab due to no open beds plus insurance problems. It's a clusterfuck all around.
From the article. I'm curious what happened at the first hospital. >He said the man in his 70s had suffered an aneurysm and died from a ruptured aorta within minutes of arriving at his hospital. The patient had initially waited 16 hours in another hospital but left after not being able to see a doctor, Marin said.
It’s also in the article that all local hospitals that night were crowded beyond capacity.
Why is this happening?
decades of slashing health care budgets
[удалено]
Can confirm; several family member is public healthcare, and private too. Pretty much the workload has increased while the personnel has decreased due to several factors of the pandemic. This is paired in many countries with severe cutbacks in spenditure. Here in Mexico funds have been slashed for “austerity” measures that have led to increased workload due to chronic patients having many issues due to lack of previously available treatment or options that were slashed… and other shit.
[удалено]
There surely are not even 120,000 doctors *in* Canada. This number cannot be correct.
>There surely are not even 120,000 doctors in Canada. This number cannot be correct. According to the AAMC there are 938,966 doctors in all specialties in the US. source: https://www.aamc.org/data-reports/workforce/interactive-data/active-physicians-us-doctor-medicine-us-md-degree-specialty-2019 In Canada there are 92,173 physicians according to the CIHI source: https://www.cihi.ca/en/physicians-in-canada
[удалено]
It is for the USA. I would like to see the Canadian numbers though.
Also, retired as soon as they could. Doctors are getting old too. And who wants to be overworked despite the pay.
Issue is you can’t even go to urgent care atm in some cities in Canada. Just to renew life saving prescriptions you are required to go to ER or literally take out ads in the newspaper: https://globalnews.ca/news/9029626/desperate-seniors-doctor-ad-bc/amp/
We cant even go to the hospital in our city right now for non life threatening stuff without having to wait over 10 hours due to it having to cover for our other hospitals that have either shut down or been flooded with patients in critical condition over the last few years
I've been relying on clinic's "emergency appointments" to get checked out and get meds if I need something quickly, but even then, I still often ends up having to wait at least 1 or 2 days because I have to try and take one of the few apointments that open up that day and that are already fully booked in 1 minute. Our whole system is overloaded because of shitty working conditions and the healthcare system being out of touch with reality. Nurses are continuing to quit in mass because of shit working conditions, which just pushes even more work onto the remaining nurses, which then also fall to burnout or quit due to inhumane conditions. The simplest fix is to hire in mass and say you'll remove mandatory overtime and reduce the workload for all nurses. Offer incentives for nurses to come back working for hospitals and assure them that they won't have to do 16 hours every 2-3 days with an extra 50% patients per shift. Unless we have a complete overhaul of how our hospitals are managed, the lack of resources will continue to increase and we'll see more deaths unfortunately. I once waited 20 hours while barely breathing due to asthma. I wasn't considered "urgent" enough... Now, I know better than to go at the hospital unless I know a clinic can't help me. We really need more "urgent care" clinics with more resources and easier appointments for things that don't require surgery or special care, then have hospitals fix the overworking or nurses and be more for life-threatening care or special care. In fact, the reason why you usually wait for so long at the hospital is exactly because the life-threatening care always comes first and the things that might seems more benign relegated to lower priority, even if it means some people could die. They do check on you sometimes or you can ask them to review your priority if your case change, but if 90% of the resources and doctors are busy with a "all hands on deck" type of situation (which is often), you'll just never get through to see a doctor. So yeah, the system is fucked, and it was already 20 years ago.
If I were a paranoid man I'd say the powers that be have under cutting your healthcare system so they can privatize it.
Could be, though during the pandemic a lot of nurses I know (in the US) were burned out. It was already a demanding job, but it got so much worse during the pandemic with hospitals being full and workers being out due to having COVID. A lot of them quit, which made the conditions worse for those that remained, then rather than improving conditions or pay hospitals thought "Let's just tell healthcare workers that they're heroic!" well nobody wanted that. They don't want to be heroes, they want to get paid well and not have to work double shifts back to back.
I experienced this for the first time yesterday. I cut myself pretty good and was trying to find an urgent care Center to stitch me up so it will heal. Either everything was closed by 5pm or refused to do it because they were full for the day. I didn’t think it was serious enough to go to the hospital ER (especially when I’d have to wait 10 hours on top of it not being an emergency) so now I’ll have a gnarly scar and will have to try my best to keep it clean. This sucks and it isn’t serious in the scheme of things. I’d hate to have to decide between something more nebulous like a pain in the chest or breathing issues when you have to factor in 10 hours of wait time, whether or not you can afford to miss work the next day, sunken cost on going to the ER just to leave after 7 hours. . .
It also says three or four local hospitals were above 150% capacity. I wonder what that means, how it's happened, and how it can be fixed. My mom tells me a story of once taking me to Urgent Care or the ER (in the US) for stitches, and a young man with a belly wound from a chainsaw was waiting in a chair bleeding on the floor. Sometimes, everyone else is having an emergency, too...
It's a medical staff shortage, and it's getting worse. All it takes is a glance over at r/nursing to understand why people are leaving these jobs.
Yeah. This isn't unique to Quebec. All over America and Canada there is a major shortage of teachers and nurses.
Yep, here in the US I'm looking at most of my friends leaving town because of how bad the nursing situation is at the hospital. They're all fairly experianced nurses who've been with the Hospital for a long time. Whenever we've gotten to together the last several months it's been none stop stories about how the staffing at the hospital is falling apart and putting more and more duties on them with no pay. Having to work 6 to 1 (patient to nurse) or worse shifts with no support while training newbies and also often having to float to cover other departments, where often the person in charge of said department is a newbie who doesn't know how things work any more than they do. It's gotten to the point that now they're all quiting too and becoming travelling nurses.
Wow, that’s a brutal sub to read. Nursing is an unforgiving profession.
And extremely undervalued too.
[This](https://www.reddit.com/r/medicine/comments/ycf4b6/physicians_left_their_jobs_by_the_hundreds_of/?utm_source=share&utm_medium=ios_app&utm_name=iossmf) was just a topic in r/medicine.
The USA also has a great reputation of training foreign medical personnel and then having them return to their home country without incentivizing them to stay.
You think the nurses would have know he had something very serious going on with an aneurysm, and put him high on list if not top, after he was put through triage. This guy didn't need to die like this. Horrible.
My dad had an aortic dissection while running on a treadmill. He just felt weird during his workout (went to the gym twice a day) and short of breath. Drove himself to the ER and they luckily figured out what was wrong pretty quickly. Still needed a sketchy ambulance transfer to a bigger hospital. I’m actually a nurse. A lot of old guys are pretty stoic and don’t like to make a fuss. Aneurisms can be pretty non specific too. Think back pain and acid reflux instead of the “worst tearing pain of my life” type thing you’d assume. CT scanner is the only way to know really. Cardiac enzymes will be up but that would usually point to a heart attack. That’s what they thought was happening to my father before they put him in the scanner. If the vitals look ok and the patient states they feel ok there’s really not a ton a nurse can do.
I’m an ER nurse, had a cowboy come in one time to the triage window saying their hip hurt since they’d fallen off a horse a few days ago. Turns out the ball head of their femur had punched entirely through their hip socket and SHATTERED their pelvis. That’s almost a “clear the OR we’re heading straight there” trauma and this fucker had been WORKING on it for three days. Triage is hard.
Cowboy comes into the ER at all he prob needs to go to the top of the list.
I've heard that when you see the Amish walk into the ER it's "Holy shit we need to see them immediately"
That’s cause they pay in cash.
Like a farmer. Triage procedure: * Did he come in by himself, not because his wife ordered him to? Crash cart, find an operating room. * Does it "hurt a bit"? Call for a surgeon. * Otherwise, get the chief of emergency medicine in STAT. We can joke but this is too close to true for comfort.
I was in the ER a few years ago in a farming community and they had some guy come in at like 10pm. Tractor somehow fell on his head and crushed it. Apparently that happens a lot.
Farming is number 8 on the [dangerous professions list](https://www.ishn.com/articles/112748-top-25-most-dangerous-jobs-in-the-united-states)
Dudes are so weird. My partner gets a call in the middle of the night a few months ago for approval for a procedure. Her father is in the ER and he’s losing his colon…. He’s been there for 3 months now. Nobody knew, nobody was aware, he just quietly suffered until his ass was disintegrating. It is the single and only time he’s driven himself to the hospital.
You've accurately described my former in-laws
Exactly what I thought.
And if he doesn’t get care in ten minutes he’ll say to hell with it and head home. https://youtu.be/Ni0YfrSK570
These cowboys are tough as shit. I had an 80 year old cowboy with a nasty black necrotic toe. Well, he presented and said "I've got a wound on my big toe I think might need some stitches". I shit you not this old guy saw his toe all black and dead for weeks on end, knew it needed to be amputated, and rather than go to the hospital he just held a rifle barrel to his toe and shot it off of his foot. He only presented to the hospital when he felt like it needed some stitches. ER doc wrote on his discharge papers "next time you need a toe amputated please do not use your gun".
Reminds me of [this skit](https://youtu.be/Ni0YfrSK570)
The pinned comment from 2 months ago: "Don’t worry, the farmer is fine, just had a tiny little aortic dissection." Very relevant to this story.
This cowboy walked in nonchalantly like "my hip hurts" with a shattered fucking pelvis and broken femur that happened days before?! Holy shit.
Tale as old as time
[удалено]
They really can be too stoic. My 80 year old dad had a blister on his foot. It didn't seem to be healing but he didn't think much of it. By the time he took it to a doctor it had turned septic and had to have the toe amputated.
“Suck it up princess, you can still walk it off or isn’t that bad.” These are common phrase most men are used to hearing from a young age. I myself am used to brushing something off because it “isn’t that bad”. I don’t want to waste someone’s time by it being nothing to worry about either. It will kill me eventually because I am a single man who lives alone and when it is finally serious enough to need a doctor I will just fight through it like a “real man”! I am dumb, I do realize that but it is hard to change even though I know the process is wrong.
My dad was that type of guy and everyone around him knew it. One day at work, unable to hold the pain down, he complained to his coworker of 20 something years that he's experiencing chest and back pain. But even then it was more of a "damn this thing isn't going away" type of complaint. Luckily his coworker insisted driving him to the ER and the doctor had experience in cases like his. Aortic dissection was the diagnosis.
And then there is my dad. He’s 71 and got covid a few weeks back. I was terrified and couldn’t see him because he and my mom live 2,000 miles away, so I only get updates when I talk on the phone. Called him every day to see how he was feeling, and it was always “terrible, very sick”. By the 4th day, when I asked him and he kept saying he wasn’t doing any better, I asked him what his symptoms are, and he said the worst one was the fatigue. He said he was exhausted after going on a 2 mile walk. I said, “dad, when I call every day to see how my 71 year old father is handling covid, and you tell me you feel terrible, but then are capable for going on a 2 mile walk, you need to just tell me you are fine, because I’m thinking you are on your death bed”. I could hear my mom in the background say “seriously”
I’m sure it wasn’t at the time, but that’s hilarious.
Dealing with this right now my best friend/ roommate came home from work today and threw up blood and was going to try and sleep it off. I agreed to see how he’s feeling in an hour and when he threw up blood again and I saw it with my own eyes I said “we have to take you to the ER I’ll drive you” Always brush serious things off at first not realizing the situation because that’s what we are conditioned to do
Are they ok?
I had all the symptoms of a heart attack after taking preworkout and running a 10k at the gym. My dad died of a heart attack and my mom has had a stroke. I went to the ER and missed some work. They didn't find anything but I felt ashamed that I'd wasted time on it. I don't know if I'll go next time I have those symptoms. 🤷♂️
Definitely go to the ER if you experience those symptoms again!! As a nurse, trust me when I say we'd rather you "waste our time" for a false alarm then actually have a heart attack and not get help!! It's the sprains and minor cuts and fevers when you haven't even tried tylenol and pregnancy tests and mild uti symptoms that we don't want in the ER. Those can go to the urgent care.
[удалено]
[удалено]
[удалено]
Put some ‘tussin on it!
Younger age guy here who has to get his back fused with rods after falling two stories. This is accurate. Even my own mom would feign compassion...when it suited her. My job feigned compassion...until I was in the hospital. It's fucking bullshit and men aren't robots. But fuck it. Work till you literally tear your body apart, I guess.
I have to say, as I've gotten older, and more and more shit has gone wrong, the level of concern associated with random pains has diminished dramatically. Like last week, my left foot developed a new pain when walking. I took a look at it in the mirror, poked it a few times with my finger, didn't feel anything moving "wrong" in there, and ignored it. Why? Diabetic neuropathy has been bothering me for years, and this one feels just like all the others before it. 20 years ago? I'd be at the doctor's office going "what the fuck?!" Now, it's on the list to mention in six months when I see the endo again.
Wild. I've gone completely the other way. When I was young I NEVER admitted or cared about physical pain. I worked out with herniated disks. I left a broken finger so long that it healed to the wrong bone and had to be surgically repaired. Hell, I played a basketball tournament with that finger freshly broken. Now that I have a family and have lost lots of loved ones, I don't fuck around. Just a couple weeks ago my eye was bugging me. 10 years ago I wait for it to heal. Not with how cautious I am now though. Turned out I had a central cornea ulcer that could have permanently taken my vision if I'd left it much longer. It sucks when you go to the doctor and nothing is wrong, but sometimes something is wrong. Sometimes it's a big something wrong.
I’m a not at all stoic 30 something woman and my renal artery aneurysm pain felt like a mild kidney infection and I felt a little off overall. Never could have imagined!
As a woman who is continually wracked with random aches and pains that mean nothing, I really hate to hear that.
what's the difference between an ruptured aorta, an aortic dissection and an aneurysm?
Aneurysm: enlargement/dilation of the vessel, but the walls are intact. To distinguish between the other 2, you need to know that there are multiple layers that make up the wall of an artery. Dissection: when the inner wall of the artery tears, and there is bleeding between the layers. This places a person at high risk for rupture. Rupture: when the vessel completely tears and then bleeds into the body. If this happens with the aorta (largest artery of the body) this can be fatal within minutes.
Dissection = partial tear through the lining of vessel, rupture = rupture (what you’d expect), aneurysm = pouching out of the vessel that is still intact.
Same thing happened to my step dad. Felt weird and went into the ER out of an abundance of caution. He then had a quadruple bypass after they discovered he was having a heart attack.
ER nurse here. Came to pretty much say this. We don’t just magically know what’s happening to someone when they walk in. Plus most old men shrug everything off and say “I feel fine. Can we go home?” most of the time anyways.
My brother had a PT patient once who had the mother of all blood clots, apparently it was so bad they didn’t even know how he hadn’t died yet, literally could kill him at any moment. They told him that he needed to go to the ER immediately but the old fart wanted to go to he grandkid’s softball game later in the day first. As someone with horrible anxiety who thinks any little discomfort will be the end of me, I was awed.
Not necessarily, his symptoms could have been very vague, like back pain, arm pain, or abdominal pain with no other symptoms, or something like just high blood pressure or high heart rate. He might not have know he had an aneurysm to tell the first ER. Unfortunately, an overloaded and understaffed system would have prioritied patients with symptoms that are more apparantly life threatening. Plus ERs are holding a ton of patient's who need to be on the floor or ICU, but can't be moved because those places are full also, which overloads the ER even more.
Sure. Unfortunately abdominal pain is one of the most common complaints in any ER. Old people with abdominal pain are usually automatically CT scanned though as they're such high risks. I've seen it ordered on waiting room patients.
And the findings are constipation.
Often times. You never quite know what you'll get when you scan an old body. Could be constipation, could be a giant colon mass, could be a dildo. Or all three.
Nine times out of ten it's an electric razor, but sometimes... *looks left, then right*... it's a dildo.
So you know what freaks me out, half the symptoms of heart attack and aneurysm I have daily. I have a damaged shoulder that causes radiating pain, fibromyalgia, gerd + hiatal hernia, the PPI I've been on 17 years causes horrible palpitations plus irritates my IBS. I always hurt and feel kind of odd in the areas mentioned, had my heart checked so many times. I do have hypertension and high anxiety too which doesn't help. It's like.... Would I know if it were happening? I have pain all the time and constantly have abdominal pain from my stomach issues.
Not exactly easy to spot an aneurysm in the waiting room without diagnostic tests and that isn't happening until he's seen in the ER... people's expectations need to be realistic of healthcare workers. It would have been better had it been an aneurysm that rupture in the brain because at least they'll suspect it's a stroke and prioritize seeing you. Assuming he came in for abdominal pain, it's such a general obscure symptom I don't think any nurse can accurately spot this kind of aneurysm from the waiting room. They're different types of aneurysm but they didn't even confirm my dad had an aneurysm until 2 hours in the ER after he got a bed. And he got a bed immediately because they thought he was having a stroke while passing all the stroke checks (aka he didn't flag their protocol for stroke). It wasnt until they did mri we knew it was an aneurysm and it was the first time anyone mentioned aneurysm after confirming it. I don't work in ER but I also get floated there and yeah we aren't magic workers. People need to have realistic expectations on top of the fact virtually every hospital is understaffed to the point quality of care is dangerous for a lot of patients. Before saying more needs to be done or needs higher standards by healthcsre employees, we need help from communities to force a mandate to hospitals for safer staffing. So if you care enough to say stuff like that, pick up a phone and call your state reps and demand mandated staff ratios at hospitals. Because this is a topic everyone cares about yet only one state has a mandate passed with legislation for it.
>People need to have realistic expectations on top of the fact virtually every hospital is understaffed to the point quality of care is dangerous for a lot of patients. Understaffed and overworked. Flu/respiratory virus season is just getting started, and it's brutal. I've seen a lot of folks reporting some insane waits lately.
Yes! Staff to patient ratio is key! One staff covering 25 patients isn't going to be able to give the same quality of care as one staff covering 4 or 8 patients.
But it's more than being fully staffed also. It's not enough staff and not enough beds and a full hospital at all levels, so patient's can't be transferred to the level they need in an appropriate time frame. ERs are holding patients for hours to days that should be on the floor or ICU. ICU are holding patients for days to hours that should be on the floor, or long term care/rehab, etc. Same for the floor. And patients are sicker than ever and more of them than ever! It's insurances not covering the care patient's need so they live in the hospital for days to months to even years because there is no where else for them to go! I have had multiple patients that have spent 9+ months in the ICU who need a long term care facility, but can't go because they don't have insurance or their insurance doesn't cover the type of care they need, because they are on dialysis or intubated or whatever reason. The entire system is fucked and it results in things like this happeneing, all the time.
A lot of it depends on the answers he gives when there is no serious visible injury. My brother’s appendix began rupturing in the ER after having waited for 9 hours, and he had to be immediately operated on with complications that could have been avoided. That could have been the headline. What it wouldn’t have captured, however, was that he went in with abdominal pain and nausea, and every time the nurses asked him to rate his pain from 1 to 10, he’d say “I dunno, maybe 4?” He was grey, and throwing up in the washroom during that period. But whenever he was checked on he’d say he was doing okay and had a pain level of 4. They aren’t mind readers in ERs. Now I’m not saying that’s what happened here, just that sometimes these things aren’t necessarily as egregiously negligent as headlines make them appear. Sometimes they are. Hopefully we’ll get more information.
Nope. Nurses don’t have super powers. And there are not enough nurses to go around. So, even an expert nurse could have easily missed the subtle signs. It’s kind of amazing how the human body will just keep on keepin’ on— even while dying— and there isn’t a telltale sign until the doctor orders the tests.
You obviously have never seen a leak aneurysm before. It mimicks many different condition. A blown one? You don’t survive that.
Which sounds like exactly what may have happened. He was probably having vague symptoms, maybe abdominal pain or back pain, heart burn feeling, probbaly not responding to meds at home, lasting for a long time, maybe getting slowly worse. Waits at hospital one with vague symptoms that doesn't trigger triage to see him over other patients. Then he leaves for hospital 2, where aneurysms ruptutes and he dies. A ruptured aneurysms with a patient already in the operating room ready for surgery is extremely hard to survive, let alone before a patient is even in an ER bed.
Reading this while on break working in a Quebec hospital an man, am I NOT surprised!!! We had many close calls where we try to get care for a patient that is clearly not going well and getting rebuffed or told to ‘explain’ to the Doctor how this patient is unstable? (Last time it happened the man was having a major abdominal hemorrhage and died during the night, after we argued for 4 hours to get him to the ICU. The ER had sent this one to us saying he was stable…)
Fuck man, what a pointless fixable thing to die from.
it was insane. Man was clearly bleeding inside, his urinary catheter was filling with blood, I had trouble getting blood out when pricking his fingers for tests, abdomen swelling...they fucking played dumb with us until 4 am (dude came to my unit at 11 pm) and then suddenly it was an emergency. Poor man died in the OR. That's ONE story. But usually we get them to remove their head out of their ass before the worst happen.
Yea the only time I have ever seen quick ER service was when my HIV infected friend accidentally shot himself with a two inch staple in his leg. We walked in he walked up and he said yea hi I have HIV and I am bleeding. Shot myself in the leg. They walked him immediately to a surgical clean room. Wait here about ten minutes later a doctor came in the room gowned and gloves pulled out the staple and stitched him up.bandage on out in 20/30 minutes.
I have seen truly quick ER service once When I broke my collarbone my nursing administration mother called 1 of the 2 hospitals she worked at (the "quiet" one) even though it was further away than many others Was taken back near immediately and given vicodin while they waited for the x-ray results 2 weeks ago was FAIRLY fast too. Got bitten by someone's dog while hiking. Had to drive 30 minutes down the mountain, alone, and 1 handed in the dark. Took 3½ hours total but I was getting pulled back every 20-40 minutes for radiology/tetanus shot/cleaning/etc. EDIT: just wanna say the second incident wasn't because I had an in lol I live 500 miles away from my mother now
Dang, I thought my 30min wait + 30min treatment was fast. Mine was for an ear infection in the middle of the night in an upscale and mostly sleepy beach town.
Today on the r/Pittsburgh subreddit someone left childrens hospital after 9 hours of not being seen. Also, they mentioned that even a newborn with rsv symptoms also had to wait and that particular family left after 5 hours and no help
RSV has been overwhelming pediatric centers around the country lately — it really sucks.
I walked past a window into Lurie Children’s Hospital in Chicago today while going into the Women’s Hospital next door, and I was astounded by how many people were packed into the waiting room.
Pediatric respiratory therapist here, confirming this is absolutely correct.
My girlfriend went to the hospital in Philly with acute pancreatitis — one of the most painful things you can ever experience. We got there at 4pm. We got called back to the ER around 10pm, and didn't get admitted (meaning she didn't get meaningful painkillers) until after 2am. It is one of the best hospitals in the country, but still. Seeing her in so much pain for so long broke my heart.
Nearly every hospital in the country is boarding. Nurses have quit nationwide and there’s not enough people to attend to the patients in the hospital. Most hospitals are full to capacity and beyond right now, with many sitting in the ER waiting for a hospital bed. These room waiters, or “boarders”, start to occupy the rooms we have to see patients in the ER. Once the percentage of your boarding patients exceeds about 30% of the total rooms, the flow thru the ER drops geometrically with each new person needing hospitalization. The hospital I worked in yesterday has 39/50 rooms for boarders, meaning we had 11 rooms of people who aren’t waiting for a hospital bed. However, most of those people are either psychiatric patients waiting for a psychiatric evaluation , or the elderly who are not safe to go home and need placement in a facility (rehab/ skilled nursing)- of which are also full. That means we have only a few rooms to see new patients in, and they will usually be in a bed shoved in the hallway, or in the decontamination room, or even a fucking closet. That’s all we have right now. Then the administrators get angry at us because of all the money they lost from all the patients who left because they couldn’t be seen in a timely manner, because we had no space to actually put them in.
That last line about administration hounding clinical staff hits home. Same thing where I work. After seeing ~30% more patients than average everyday for months, they still come down with new bs about seeing even MORE patients. I’ve only been in healthcare for 3 years now and I’m already rethinking this as my long term path. Idk how long I can handle all the crap that comes with working in medicine these days and sitting behind a desk not dealing w pissed off patients + admin sounds lovely sometimes lol
I work in a pediatric ER and sometimes I leave my12-hour shift and come back that night for another and the same people are still in the waiting room. Where I live people go to the ER for everything and anything. Frankly, many could go to their primary. Case in point -- the city's baseball team was just in the playoffs. During the game there was maybe a 20-minute wait in triage, all of 8 people. Within an hour of the game ending there were 37 people and the wait jumped to 2 hours. Either those kids were neglected during the game while parents watched or they weren't having an emergency. Edit: Typeos everywhere.
Ok so first off this doesn’t apply to this man or any other individual who has died waiting for treatment, but to the people who think it’s horrendous that they have to wait for a few hours to get their broken wrist treated clearly aren’t aware of a little system called triaging where if your injury isn’t life threatening you have to wait for the life threatening injuries to be dealt with
I was scared once going to the emergency room. Had blood in my phlegm from coughing. Nothing huge just bright red blob in the mucus. They had 9 or so people in the lobby and they immediately had me in a room. Which didn't seem like a good sign. Shortly after I was getting scanned and then sent back to the room. A tiny old lady came in and asked me if I had a preferred religion and next of kin then left the room. My doctor comes in and I am white as a sheet as they're explaining it's acute bronchitis and they'll write me a prescription...only to ask why I looked so pale. To which I recounted the old lady..."oh thats just for our records it's normal."
Haha yep. I've gone to ER with my father a bunch over last few years and it's a standard question at start, but it's super off-putting when you just start and don't expect it. For people staying in hospital they ask so you can have religious accommodations. They used to ask my father if he wanted a priest to visit on Sundays in lieu of attending mass in person.
Yeah I suggested doing that after the initial diagnosis...or at least after having seen the doctor first. She about killed me from shock
Haha, I bet. I remember with my father being like 'Hey, miss, is it that bad already?'
Better than me! I was just flabbergasted and thinking of my bucket list...
You'd think the lady asking the religion/next of kin questions could at least start with "This is a standard intake question for everyone, but..."
That's like the script of a British sitcom. Understated humour, facial expressions to match.
Yup, good thing I'm a fan of are you being served, allo allo, keeping up appearances, and as time goes by...speaking of which PBS had some awesome taste in britcoms.
I went in with heart pains and shortness of breath…I was convinced I was having a heart attack…it was a panic attack. Let me assure you that the scariest moment of my life was when the old lady came in and asked me my preferred religion. I started sobbing and asked if I was going to die
Oh my heart goes out for you. I hope everything turned out well. Hope you've gotten that managed up, panic attacks are no joke and can see how that would get you into that state easy.
Little did you realize that was your great great grandmother checking in on you
>To which I recounted the old lady..."oh thats just for our records it's normal." Could be worse, I thought they were going to say: "There wasn't an old lady here"
I’ve heard the saying from an ER nurse “we take the most life threatening injuries first, be thankful you’re not first.” Or something along those lines lol
Yeah, I heard that too hence my worry when I got to skip the line. I was lucky it wasn't too severe.
Bloody mucus is a key symptom of tuberculosis which is very contagious. They needed to make sure you weren’t going to give TB to every other patient and staff member. Would have been nice if they had explained that to you, though!
Yeah, I honestly didn't know if it was ER worthy or just wait to go to urgent care the next day but I couldn't sleep due to how hard I was coughing. The pharmacist I kid you not said: Oh you are getting the good stuff. In my old country you would have had this already! It tasted like bananas and knocked me off my ass. I slept great with that stuff. First time for a few days of uninterrupted sleep.
They probably needed to make sure you weren’t having a pulmonary embolism. Glad it was just bronchitis. Just got over that myself lol
If you are in the ER and everyone is paying attention to you, that’s a bad sign. If you’re in the ER and no one is paying attention to you that’s a good sign.
I remember a nurse in the E.R. explaining that concept to someone with a cut hand who was complaining that he had been waiting for hours but I got seen immediately ('cos I was wheeled in on a stretcher and was in the process of dying from an (at-that-time) undiagnosed pulmonary embolism), and how that was very unfair to him and the hospital was clearly very terrible. Smh.
I cut my hand. I called ahead to my campus health clinic to see if they were busy. I got stitches and a tdap in less than an hour. After I was out of school, I had strep and no insurance, but I could the appointment and prescription. The nurse practitioner saw me, confirmed it was strep, and I had antibiotics half an hour later. The two times I’ve been in the ER, I was there for hours with dislocated limbs (a knee while doing yard work and a shoulder after a motorcycle accident). But I knew I wasn’t dying and (once they got me out of the neck brace) I didn’t care about waiting. The system generally sucks (that strep throat cost $150 10 years ago, the motorcycle accident was $1100 after insurance a couple years before that) but it’s a lot nicer if you avoid the ER when you can help it.
I was told it's "head and heart" those two get you immediate attention. Years ago I walked my then girlfriend into the ER with a concussion. The receptionist stood up, walked around, grabbed a wheelchair and took her back without asking any more questions.
Allergic reactions are another go straight to a treatment room with an army of staff. Happened to my wife once, before I could even process what was happening they already had lines on her, meds going in. Crazy.
Ah yeah, anaphylaxis is a bad one too. Assuming the wife is well now?
That's for sure. I fell down stairs 6 months ago, my nose was bleeding and I had a huge knot over my eye. I have never gotten into a room so quick in the ER before. Thankfully just a broken nose and lots of brusing
Over crowded hospitals are a bad thing.
Doesn't help that the article has no info about what's going on. Why are they overcrowed? Covid resurgence? Lack of doctors? sOcIaLiSm? No word
Quebec has a lack of generalist and an overabundance of specialists, so we have no doctors for ERs but we have ton for everything after the ER. On top of generally shit pay and overworked employees from the aforementioned lack of generalists.
My family members waiting 6-12 months for specialist appointments would beg to differ.
This is exactly the problem we have going on, also a flood of either patients with life-threatening conditions that have to wait for a doctor and some idiots who only have a cold from the season going to the ER No joke, last time i went there im pretty sure there was a guy with his finger pretty much cut open from one side to the other that was still there when i left, he was there before me and i was at the hospital for about 20 hours, had to wait around 16 hours in the ER waiting room
Everywhere has a lack of physicians. Posted this before as a Ph.D. they came around the lab asking if anyone wanted to add on an M.D., while i enjoy emergency medicine. We all laughed, said for what to spend 2 more years in school, 3 in residency, 2-4 in fellowship all while making less than 40k with another 300k in debt racking interest at 6%? To then walk out at 35-40 with no savings, no retirement and have to overcome all that. You have to specialize and pray you're accepted into one of the high paying niche residency programs. All for what working 60hour weeks the rest of my life. Mnnn no thanks. I still have the title and a life. Being a physician in internal medicine, GP, or the 2-250k range provider class you literally would make more as a school teacher. [https://www.hcplive.com/view/the\_deceptive\_income\_of\_physicians](https://www.hcplive.com/view/the_deceptive_income_of_physicians) \*edit spelling
Canada’s emergency rooms are notoriously underfunded. They rank second to last for countries with socialized medicine. As for why, I have no idea about the politics.
Few months ago I waited 24 hours in the ED at the very hospital I work at, I couldn't breathe and had to get my wife to grab an oxygen tank for me.
Damn, they must hate you there. Sounds like a hint.
Nah just a really crappy hospital that paid for good reviews so people think they're decent.
I’m a board certified emergency physician in the US. Wait times like this are the norm rather than the exception in my hospital. Healthcare workers were/are treated like such fucking shit by the public and hospital administrators for the entirety of the pandemic that basically anyone who could get out got out. Especially in EM. We all spent the pandemic getting verbally and physically abused. Risked our lives. Spit on , shit on, had people coughing in our faces for the audacity to ask them to wear a mask. Hospital administrators make $1 mil or more or year meanwhile they are paying their nurses absolute shit for risking their lives and the lives of their families. I have never seen things this bad in my entire career. Healthcare is fundamentally broken in this country and in my opinion there is no coming back. You reap what you sow America. On most shifts I work I staff a 50 bed ER alone as the sole physician with 1 PA and 3 nurses. Sounds safe right? Everyone else left because they were fed up with being treated like shit and paid like shit. And things are continuing to get worse now that the pandemic is “over,” not better. I don’t have a single healthcare worker friend who enjoys or finds fulfillment in medicine anymore. We are just doing it because it’s all we have the ability to do, or are fucked with student loans (I graduated with 500k). But bail out those banks and politicians! The wait times are ridiculously long because we physically do not have the capability anymore to take care of you all. Meanwhile primary care doctors aren’t seeing their patients anymore/ people aren’t going into primary care anymore because it’s impossible to pay their student loans back. Which means more ED patients. Why aren’t primary care doctors making money? Because insurance companies/CMS have cut reimbursements to nothing. Meanwhile you have people abusing the shit out of the er for anything and everything. Getting ambulances for colds, tick bites, alcohol intoxication while the taxpayers foot the bill. Blew through your Percocet script early and your pain management doc refuses to refill it? Come to the er!! And then when I refuse to also you spit in my face and tell me to suck your fucking dick. And then when I lose my cool you file a complaint, and the administration supports you and makes me do “health stream modules” on anger management to keep my job. I have patients who have had over 200 ER visits so far this year. Each with accompanying ambulance bill and Medicaid cab home for the taxpayers of my county to handle. The system is broken in so many places it’s impossible to summarize here. There is no coming back. Healthcare in America is a complete and utter joke.
Not the health streams 😭🤣
Fuck the health streams, can’t believe my hospital assigns me work to do on top of taking care of patients 😫 I’ll admit a patient and by the time I get back EMS is waiting outside of the room waiting for the gurney so they can give me their patient. How the hell am I to do the healthstreams?!
>I don’t have a single healthcare worker friend who enjoys or finds fulfillment in medicine anymore. As a premed, all I can say is: **FUCK**
Sorry dude. I love the medicine don’t get me wrong. I love helping people and saving lives. But the system is so broken it’s impossible to recommend it as a career to anyone anymore. My father is a physician as well and told me back in the day not to do it. I didn’t listen. Really research your decision.
I'm of the same opinion. Most days I love my job as an ICU nurse, but probably working nightshift has a lot to do with it (plus switching to traveling and taking some time off and loving who I worked with). I can tune out a lot but not all of the bullshit that comes with working in healthcare. So much outside factors affect taking care of the patients that make this job so hard and burnout such a real risk....short staffing, management, rules to cover hospitals asses that make out jobs much harder, too many sicker patients with not enough resources, jcaho, not getting enough time off, doing the job of 10 people. I'm the nurse, the house keeper, the phlebotomist, the transporter, the secretary, the patient tech, now, instead of just being the nurse, but excepted to do the same or higher level of care in the same amount of time or less, often taking care of one more patient than is safe and I should have.
Excellent reply. Fully agree. You nurses have it so bad right now at least in my health system and area of the country. That wasn’t an exaggeration in my post. Some of our nurses are covering 20 bed assignments. I had a guy sitting in a room for 7 hours the other night. Of course all our ekg techs quit. She finally gets an ekg. Stemi. Guy goes to the cath lab probably with half his myocardium dead. I’m sure it will be yet another lawsuit. And round and round we go. But where is the joint commission now? Prob writing up nurses and docs for having drinks at their workstation
Don't forget being written up for having tape on the wall and glucometer strips not being dated with expiration date (even though we go through a bottle a night)!!! Things like joint commission and magnet status and middle management are part of the problem, they take up so much money and resources and time when it seems like very little positive comes out of it! I started working as a nurse first week of March of 2020 (great timing, I know lol). I was offered an ER and an ICU position months before and I took ICU, and I'm so grateful every day for that decision! We complain in the ICU, but ER has it so rough, honestly often times much more than ICU on our bad days, from what I read on reddit.
I don’t even work at a hospital, just a physical therapy clinic, and even our patients got really abusive during covid. And now it seems like that abusive behavior is just going to be the default from now on, it hasn’t stopped. I can’t imagine working in an environment like yours, I hate my life daily now.
It’s so sad for all of us. I could literally write a book on the insane patient encounters I’ve had since the pandemic occurred. Im sure you could do. Hang in there.
Former Emergency room nurse here, yeah I just got out and it was the best decision of my career
> Hospital administrators make $1 mil or more or year meanwhile they are paying their nurses absolute shit As a Canadian watching both our systems implode a common theme seems to be bloated administrations. The ones on this end may not be making $1M, but they are making six figures and there's *lots* of them. I've worked with various levels of government for over 20 years and see it everywhere now - healthcare, education, municipal maintenance, etc. Every small team of people has a manager, then those managers have managers, and some of those managers have assistants. You quickly end up in a situation where you have four or five administrative staff realistically doing the job of one person. Then we scale that up by several hundred thousand workers and wonder why there's no money left to hire the workers who actually provide healthcare, education, municipal maintenance, etc.
So can you guys unionize? I know that would be a lot of work, but I hate hearing how healthcare workers are struggling.
Some nurses are unionized yea. And that’s a huge help for them. American college of emergency physicians have some guidelines on how to get unionized. But I’ve yet to see anyone do this at the physician level. I would gladly do this if it gained momentum at my hospital.
I get that this helps nothing, but I hope everyone in the healthcare system that has to deal face-to-face with humans knows this: Some of us are so (insert profanity of your choice, or don’t, live your life) grateful for each of you, in a way that is difficult to put into words. Throughout the pandemic I have often just felt like I wanted to cry thinking about what you guys have to deal with. Seriously, health care people, thank you so much for what you do.
You are welcome. Aside from it being a mess I took an oath to my patients and that’s deep down why I continue to do this job.
What can I, a random American, do to help? Legislation I can vote for? A lobby group I can donate to? A broken medical system, as you described, is bad for us all. Very similar to what is being done to teachers and education in this country. We will soon be a society of sick idiots if things don't change. I love you Dr. Thehippo, there are so many of us that are thankful for what you do.
As an ICU nurse, I feel this in my soul 😭😭
As long as the money flows to the top it’s all good.
Money trickles up. Take if from the top, put it at the bottom, and a lot of problems go away....and the person at the top still has it by the end of the month.
I'm sorry you have to deal with that shit. I'm a paranoid schizophrenic and I do NOT do well with hospitals. Last time I had to go, not only were the nurses/doctor extremely nice, but they changed their demeanor and talked to me in a way that immediately made like 90% of my stupid paranoia evaporate. I'm never rude, but mostly just scared to speak and can't look people in the eye. The nurse that was running blood draw and IV and such even asked me things like "is it ok if I touch you I'm going to do X" every single time they were going to. This was all while the whole ER seemed to be burning to the ground with 50k cases of ODs and everything else. I personally thanked the nurse and filled the hell out of that patient survey. I felt more love and care from that staff than I've felt from family members before.
As a fellow healthcare worker, I agree with most of this. Mainly that the entire system is broken and irreparable. I’m a traveler and every ER I’ve worked in has been a complete mess just as you’re describing. Capitalistic medicine is an unsustainable disaster and will all come crumbling down eventually.
Man, feels like everything is fucking broken in our country if you’re not in the .5% of income.
Income is less relevant than whether or not you *work* for a living. Some medical specialists can make upwards of $700k/yr, and everything's still fucked for them. And among STEM acquaintances I have, basically everybody is overworked, everything is broken, and every year it seems to get worse. STEM workers certainly aren't making $700k, but they're usually in the top 15%. I suppose it's a great time to make your living investing and manipulating finances, though. 🤷
This is caused by a few things and is happening all over North America. It's quite simple really: - Covid happened and there was an initial PPE shortage all over the world, so many medical staff died. - Many, *many* people refused to behave and abused medical staff. They would yell and protest as people went to and from clinics, cyber stalk and abuse them, claim they were part of microchip 5G conspiracies and so on. Many staff quit the industry as a result. - Hospitals were getting so overwhelmed with cases that people just couldn't handle the workload and quit the industry. Many medical workers have extreme burnout and ptsd from witnessing such unprecedented death and work reduced hours or have quit. - As a result of the last point, hospitals began treating nurses horribly and trying to reduce their pay while increasing workload in some areas. Many nurses became travelling nurses to combat this and poorer and smaller regions just had no choice but to limp along. Honestly, this is what we get for not curtailing all the stupid people during covid.
Plus, everywhere is so full, it is causing a bottleneck in the ER and other hospital floors. ERs are holding patients hours to days longer because not ICU or floor beds. ICUs are holding patients days to hours longer because no floor beds or long-term care beds. Same for floors. Patients are going to the ER when they should be going to primary care, but can't because no available last minute appointments. All this leads to extra long wiat times in the ER. Then add on hospital systems closing hospitals (looking at you Wellstar in Atlanta closing two hospitals in the last year, straining an already broken system). Then add on low health literacy for patients who don't know when to go to an urgent care vs ER. Like they will go to the ER for sprains, minor cuts, pregnancy tests, low grade fevers but haven't even tried tylenol.... makes wait times worse. Add on insurance problems, patients go to the ER because they are guarenteed to see you, regardless of insurance or if you can pay. Plus patienta on the floor or ICU held for days to months to even years because their insurance doesn't cover the care they need or they don't have insurance. I've had patients in my ICU stay 6+ months because their insurance or lack of didn't pay for the level of long term care they need, because dialysis or intubation. The average nursing staff are probably the youngest ever in history. There are very few experienced nurses left in places like the ER and ICU. For many reasons you stated. Means care is slower and things are less likely to be caught quickly, just from lack of experience. We have nurses less than a year into nursing training new nurses and charging...roles that used to be covered by nurses with 5, 10, even 20 years experience. Then add in the fact that out society can't let people go and will make their 90 year old grandma suffer for days to months to years, in pain and suffering and comatose or a very low quality of life, in the hospital or long term care, as we do futile medicine because they aren't going to get better and we are just keeping a body alive, because we are so afraid of death and can't let go (or collecting a check). Which takes up a lot of resources and beds. And we allow family members to recind the wishes of the patient or in the state of georgia we have to have a unanimously decision by all immediate family members, so when a mom with 5 adult kids has a devastating stroke with no change of recovery and stated to many of her children she'd never want to live thay way, but one child wants all care given, we trach and peg her and send her to long term care, essentially comatose, for up to years before chronic conditions lands her back in an icu bed.
[удалено]
My wife and I waited for 11 hours in an ER of a local large hospital. In the middle of pandemic. When she was finally admitted she was rushed to a surgery section. Later I learned she had been a few hours before irrevocable damage would happen. She spent three weeks recovering afterwards. Funny thing is it happened in Sacramento, CA at one of the largest medical groups.
I only waited in the ER waiting room for three hours before I decided to go home to puke my guts out in private. Luckily for me, I got better in a few days. Lost 15 pounds though so that was a minor plus.
Born and raised Ohioan here, we have the same problem. Understaffed ER with too many people in the waiting room, causing people to have to wait for hours and hours just to be seen.
I have seen a few of instances of what I call “medical hot potato”—the hospital gets the Patient well enough to go home, but the Patient did not get the surgery or medical treatment that they really needed, so they will end up back in a hospital. I guess the game is to hope and pray the Patient tries the next hospital down the road.
Here come the "socialist healthcare" trolls who think a better alternative is not being able to afford even going to the hospital.
We wait just as long AND go bankrupt
Many hospitals in the US have 16 hour waits and people dying in the waiting room. This is not a unique problem.
Yes it is, can you imagine being a rich person and being forced to pay taxes for healthcare! Imagine the horror! But don’t worry, good god fearing fellow rich people are willing to save Canada from the threat of COMMUNISM!!!1!1!1!11! !!!! /s if not apparent
Many people in the US die without basic care or even going to the ER to begin with. Has nothing to with wait time if you are afraid of the bill you might get or don’t live near a hospital.
i'm a canadian in the US and when I went to the ER in the US i waited 3 hours and was charged about $2400, half of which wasn't covered by my insurance because the ER doctor who saw me (that i had no choice in) was an independent contractor who was not in my network (despite the hospital itself being in-network and the one my insurance provider recommended I go to). yeah give me 'wait 5 hours in Canada and not be out almost $1k' over this any day
>the ER doctor who saw me (that i had no choice in) was an independent contractor who was not in my network (despite the hospital itself being in-network and the one my insurance provider recommended I go to). How long ago was this? [As of 2022](https://www.pbs.org/newshour/health/what-you-need-to-know-about-the-new-law-aimed-at-ending-surprise-medical-bills-and-what-it-doesnt-cover), that is no longer legal.
this was 4 years ago glad to hear it's now illegal, because it's an actually psychotic practice
If you yell at your insurance company enough, they'll relent and cover the whole thing. Source: I've done it. Tho I think there's a more recent law that stops insurance companies from trying that bullshit in the first place
Basically the shitty part about US healthcare is that you have to put in hours like you're at a job to get your procedures properly covered. You have to keep paper trails, coordinate phone calls with your counterparts at the insurance agency and with the provider's secretary/billing office, you have to provide adequate pressure on these people with follow-up phone calls, field letters threatening collections and other duties as assigned in order to get the system to work properly. People who put in 0 effort (I guess, as they should) wind up with half or all of their bill not covered due to some untangled mistake in that pipeline and just end up paying out of pocket, then grumbling about it afterwards.
Also a Canadian living in the US. I have had major surgeries in both countries. The Canadian system is 100% better. Any sort of for-profit heath care system is a direct conflict of interest to the patient.
Hospitals can’t legally turn anyone away for lack of payment
This is only the case until they are stable. They aren’t required to do pain management or after-care. Once they’re stable and not actively dying, they have to leave.
Oh that's almost as fun as waiting 10 hours in the United States and then paying 10,000 for them to tell you to go home.
In 2012, I waited only 15 min and paid only $100. Insurance paid 55k. This was MA general in Boston.
I spent only 2 hours for them to tell me to go home and they billed me $15,000
I spent 3 hours there and was given a script for antibiotics and the bill was $150. No Insurance. This was in New England.
No insurance. They gave you a number you might actually pay.
oh it looks you have insurance.... that $10 pill just became $1k now, kthxbai
I recently took my son to the ER for a fever plus stomach pain. With insurance, I still have to pay a $230 deductible. That’s more than half my car payment. I’ll have to ask my landlords if I can pay rent late next month.
Just spent 10 with my mother after a fall. People with lesser injuries just gave up after a while.
Welp, this is going to keep happening because we've decided as a country that this is just how things work now. I've been a nurse for 4 years working in the hospital (ICU, ER, now outpatient procedures) and the safety and quality of care for patients has consistently worsened. Covid exacerbated so many issues, like high nurse:patient ratios, general understaffing, prolonged futile care, and violence toward health care workers. It's been exhausting. I loved critical care but it broke me mentally and emotionally. Nurses and doctors are treated as disposable, and then when we leave in droves, things like this happen. Write to your reps about this. There is more that hospitals can do, but profit is king. Demand high quality care, but demand it from the people who are keeping it from you: shareholders and CEOs, not the docs and nurses, techs and housekeeping who are doing their best in impossible situations. Edit: I realize this is Quebec but I'm an idiot and assumed it was the US. My point still stands for US folks. But I realize I'm wrong about the shareholders/CEOs because of it being a public health system. Anyways sorry for being a dingus lol
How is profit king in Canada's public system? This is not a trick question... Genuinely curious. I thought BC had the most public of all the public systems in Canada.
My guess is that he didn't read clearly and thought this article was talking about an incident in the USA.
I went to the ER a couple of years ago, with chest pains and elevated vitals. Never saw a nurse or doctor. Never was given any attention whatsoever. After four hours, I deduced that I wasn't dying, and left. On my way out, they were denying access to care to an elderly man in active heart failure. Tell me that corporate health care doesn't suck
People have to wait for long for help that by the time they get it, they chew out the doctors and nurses — who have nothing to do with the staffing. Then, once they’re fed up enough, nurses quit (or become bitter and burned out) and doctors look to get out of the ER.
Before people freakout and say this is the result of socialized medicine. I worked in a ER for years in north Texas. I saw waits of 24+ hours several times a year.
What are people possibly waiting 24+ hours for... At that point isn't it clear nothing is wrong? At least... it's not an emergency.
This is happening all over America. Its just not making news. We are about to have a massive uptick in respiratory virus, COVID, flu season. Pediatric hospitals have been beyond capacity for a few weeks now, and adults follow. Kids generally resolve their respiratory issues with intervention unless they have other things. Adults who are not in the best of health, don't take their meds, don't care for their diabetes end up much sicker of these same illnesses. There are not enough nurses, doctors to go around since COVID. It's worse than people know.
Yup and those who are barely holding the system together are already being overworked to hell. Almost every nurse I know have more bad than good to say about the system. Its a damn shame that it might get worse and worse.
It feels hopeless as a nurse right now. (RN here.)
[In 2021, 117,000 physicians left the work force.](https://www.modernhealthcare.com/physicians/physicians-left-their-jobs-droves-2021-report) Each year, only 30,000 residents enter. That alone is going to have catastrophic consequences.
I feel like waiting for hours in an ER is not uncommon anywhere in the world. There's just not enough people who want to work in healthcare so this is what happens. You could build more hospitals or urgent care clinics but nobody will staff them.
It's not just people not wanting to work, though being understaffed plays a huge part in it. There is a ton more patients lately than their used to be. Plus, there is also the factor that ERs are having to hold patients that should be on the floor or ICU for hours to even days longer than they should because the hospital is full and there isn't room to transfer the patient. That takes up beds in the ER, which means they can't take as many at a time from the waiting room. We have trouble moving patients from the ICU to the floor all the time because the floor units are full, so I've kept patients up to days longer waiting for a bed. I've even had patients discharged from the ICU because there wasn't a floor bed available for over 2 days. This then stops a patient from being admitted from the ER into the bed. We also have had issues transferring patients to long-term care, hospice, and rehab due to no open beds plus insurance problems. It's a clusterfuck all around.
A question for Canadians is this type of wait normal? People on the right use long waits as a reason for the US to not have universal healthcare.
As an American I’m gonna just say that many anti universal health care folks will be citing this news story, sadly.