ER - the series - began running 20 years ago - 1994.

[hedgehog]

I challenge anyone to watch some of those early episodes and tell me how emergency rooms have changed since then. Some of the equipment is different, but they are still understaffed and IMO, chaotic and poorly managed. I am also of the firm belief that hospitals use ER charges as a profit center. Any hospital bill is full of incongruous and random charges, but ER bills take the cake. Why else would the bills for simple services be so outlandishly high?

We still have lousy experiences in Emergency Rooms because there is no real pressure for hospitals to change the way they are run. Any manager of a grocery store quickly learns that there better be some extra cash registers open on pay day. How is it that a visit to an ER still means hours of waiting with no information? It's what I went through back when my infant son had asthma attacks. It was what I went through last winter after a serious auto accident. (I'd also note that I saw several violations of infection control protocols with poor management of facilities as a root cause.)

[Dreamer Tatum]

1. In the world I inhabit, ER was a fictional television program

not a documentary.

In the few times I've required an ER, they've been quiet, efficient, attentive, and nothing like
what was portrayed on television.

[nclib]

3. It probably depends on where the hospital is.

Several years back my sister-in-law and I were watching ER. She is a nurse and has worked in an ER and well as other areas of the hospital. I asked her how accurate ER was and she said it was pretty accurate. It did surprise me because, like you, I thought they'd be quieter. This past summer my husband's nephew got married. He married a nurse who works in an ER. She works the night shift and said it can be very chaotic. Almost every night gunshot victims come in. They live near Chicago so location could be a factor.

[Blue_Tires]

5. My dad was a doctor, and wouldn't watch a minute of "ER" with a gun to his head

Even during the time when the whole country was watching it every week

[Ilsa]

14. Depends on private vs county hospital.

The private hospital I last went to got me in right away for a sprained ankle. The county hospital my in-laws went to after a car accident was big, noisy, dirty, no personal privacy, hectic, and chaotic.

Location and whether people have access to doctors for non - emergency issues make a big difference in the conditions in an ER.

[Dreamer Tatum]

15. True. If it was "Country ER," it would have been canceled after three episodes. nt

[MineralMan]

2. Each ER is it's own unique environment.

Last edited Sat Oct 4, 2014, 11:53 AM - Edit history (1)

It's pretty hard to make general characterizations of them. They're also different depending on time of day and day of the week. Location matters a great deal, as well.

In just a few minutes, any ER can go from a quiet, efficient health service location to chaos. Then, an hour later, it can go back to being quiet and efficient.

ERs in the heart of any city tend to be raucous places. It's the nature of the beast. Suburban ERs are often relatively empty of patients. They're also often empty of really well-qualified people if you show up there in an emergency.

They're all different.

[Dreamer Tatum]

6. Serious, big time +1 on this nugget of truth nt

[hedgehog]

8. Why are suburban hosptial ERs empty, while the city ERs are full -

often even when they are branches of the same hospital group?

It's a deep fault in our health care system that good care tends to follow the money.

[MineralMan]

10. Location, population density and demographics, mostly.

It's a matter of who uses ERs, how many people live near the hospital, and how many of those people rely on ERs for even minor issues. In the suburbs, population is less dense and a higher percentage of people are insured. In the city core, the reverse is true.

Also, in suburban areas, you'll find the most urgent care and regular medical clinics. In city cores, you won't find many of either, so the ER tends to be the facility that is the nearest and most convenient. When a medical need is more or less urgent, people tend to go to the nearest facility. In addition, cities usually have public transit and hospitals are on a transit route.

Out in the suburbs, if you're insured, you can go to the urgent care after hours or your regular doctor or clinic during the daytime. Where I am, I can get a same day appointment at my multi-specialty clinic if I feel the need. I actually live in the City of St. Paul, MN, but am close to a suburb, which is where my clinic is located. In my case, that clinic is also an urgent care facility after hours, so I'd go to the same place anyhow. There's also a good suburban hospital in that suburb that is actually closer to me than the downtown hospitals in St. Paul, and it's in my network. Since I have Medicare and a supplement, I go where it's convenient for me to go and where it's not crowded. I'm lucky and have privilege that is not available to everyone.

For many people in St. Paul, though, insurance still isn't something they have. In addition, the only facilities on the public transit routes are located in the heart of the city. Their locations are familiar, too, so that's where people go, mostly, who don't have better options available to them. There's no convenient bus, for example, that goes to my clinic or the nearby hospital. There is a bus, but it would take several transfers to use it.

There's not much motivation for the private health care industry to develop additional clinics and other facilities within the city, I'm afraid, and that's a problem with our healthcare system. Clinics and urgent care facilities go where the people who have insurance live. St. Paul has three major hospitals, all within walking distance of each other and in the heart of the city. Every neighborhood has buses that go downtown. So, downtown is where people go.

[hedgehog]

11. When my daughter cut her foot open after dropping a glass bottle of milk,

her husband drove her past the city branch 10 miles out to the suburban branch of the same hospital to ensure she got good care. Generally, the city branch was overwhelmed, but the suburban branch was mostly empty. Oddly enough, that hospital has since closed its city unit.

[MineralMan]

13. A good decision on your husband's part.

I'd have done the same.

One other note: If something is a dire emergency or is life-threatening, don't drive to the ER. Call 911 and be transported to the ER in an ambulance. Ambulance cases are handled differently from walk-in cases, almost always. I've noticed that with my wife's parents. Both have been ill enough for a 911 call, and treatment began the moment they arrived at the ambulance entrance, even when the ER was very busy in the waiting room.

[Initech]

4. My brother is an ER doctor.

These doctors definitely earn their pay. The hospitals are under staffed and the doctors are over worked. My brother will often work like 18 hour shifts at a time. I really wonder what things would be like if we had single payer.

[hedgehog]

7. I've worked long hours myself, and I can tell you that anyone who works

18 hours is not working at their best. It's not to knock your brother, it's just to state the truth. His employer is at fault for expecting one person to do the work of 3!

[Initech]

9. Oh believe me I could not do what he does.

He loves his job and he's good at what he does (not to mention there's never a dull moment), but he says the hours do suck and when you're on call for that long it does wear on you. I do know what it's like doing three-four jobs at once though!

[gvstn]

12. I wonder what it would be like

If we as a country helped caring, conscientious people go to medical school? Do away with the old boy's school of artificially limiting the number of doctors who are graduated each year. We might then have a sufficient pool of available doctors. OF course they would not make as much money but there are plenty of people who would be happy to help people all day and earn $100-250,000 a year. Nowhere is it written that doctors have to be rich, financially comfortable should suffice.