Edwin, your recs are solid and helpful. I would add one to your list: recruiting a family member or friend with experience in health care to act as an advocate, particularly if the condition is serious. Even if the illness or injury is not serious or you think it’s unlikely to be, the presence of a true advocate may be the difference between life and death for your loved one.
I worked for 20 years in EM in small, rural hospitals in the US south and decided two years ago, half way through my career, that I could no longer continue to participate in a system that is clearly designed for failure, that ruthlessly exploits the decency, discipline, and tireless, selfless work of all the docs, nurses, and ancillary staff that actually want to provide professional care.
The exodus, during and after Covid, of a huge amount of the nursing intelligence and experience, hard won after years of giving and giving whilst receiving nothing but blatant disrespect, having their basic human needs ignored in favor of protocols and quotas designed by fools who have risen to their highest level of incompetence both within and without their local hospital system, is only hastening the demise of any semblance of professionalism within the ED.
I don’t think the average American understands that some clown in a corporate office who couldn’t find their town on a map is making disastrous staffing decisions for their local ER, happy to hire unqualified buffoons to meet the profit goals of aforementioned multinational companies. Trust me, I have lived it as have thousands and thousands of other tired, despairing souls who just wanted to do honest work for their community; to go home at night and sleep well knowing that we came together and did our damndest to help our neighbors.
If you’re one of the folks, like me, who spent a lifetime striving to achieve excellence because you believe Americans, all Americans, even those in rural areas, deserve professional level healthcare and because you take pride in the quality of your work, there is less and less room for you in this current disaster area.
In addition, with abysmal regularity, the literal possibility of accomplishing what should be a simple, efficient task in the ED is turned into an Orwellian joke. Poorly designed EMR systems, endless charting distractions, bumbling “managers” and a ruthless, exponentially expanding bureaucracy of idiots who never even bothered to become professionals can eventually overwhelm even the most battle hardened decency of dedicated humans.
In the last few years, since my departure from healthcare work, I have been able to accompany multiple family members to “doctor’s” appointments as well as to ER’s and into hospital settings. What I have seen is horrifying.
Nurse practitioners giving potentially lethal recommendations, failing to identify life threatening conditions, nurses who stare at screens like zombies, seemingly unaware of the human being in their care. I have intervened so many times that I can’t count them all.
There seems to be a widespread delusion that the “system”, that is, endless institutionalization or bureaucratization of care can improve or accomplish things that intelligent, competent and sensible humans cannot. This is simply false.
The acceptance of this view is quickly leading to inescapable ruin. A team of professional human beings, highly motivated, working towards a common goal, remains the most sophisticated technology available in the world.
The advocate, therefore, will understand these facts and be highly attuned to the inevitable and often predictable errors and failures bound to emerge in such a system based on false premises, increasingly staffed with untrained place holders instead of professionals, designed to generate profit through “acceptable risk”.
The more fearless, righteously angry, alert and indefatigable your advocate is, the more likely is your survival.
As an advocate for my family and friends, I’m a real son of a bitch, a rabid pitbull that will not let go of whatever I deem worthy of my 10k Newton bite force because I actually want my relatives and friends to survive. And, as I walk into an ER or a clinic with a clear, undeluded mind, I know something that’s becoming less and less of a secret: this system is just as happy to kill you as to heal you and there will be neither justice nor afterthought either way. Institutions and bureaucracies don’t care about you, only humans do.
In short: only humans should draw conclusions; and, there’s no greater technology than a team of human professionals allowed to do their jobs free of the failures of bureaucracy.
I worked in a critical access hospital ER/Urgent Care for 10 years. I left in 2014 before Covid and things got really bad. But I do recall plenty of upset patients or family members who thought they waited too long to be seen for their viral illness that didn’t really need to be seen (or similar minor problem) when we were dealing with a code, trying to get a STEMI transferred out, etc.
This listicle of things to be aware of about going to the #Emergency Room is remarkable for the fact it is as true on the West Coast at #Kaiser as it is in rural hospitals in #Appalachia. Adding a reminder to not use the phrase "I have a high tolerance for #pain" in any conversation, and the pain scale only goes to 10, no bonus points.
Edwin, your recs are solid and helpful. I would add one to your list: recruiting a family member or friend with experience in health care to act as an advocate, particularly if the condition is serious. Even if the illness or injury is not serious or you think it’s unlikely to be, the presence of a true advocate may be the difference between life and death for your loved one.
I worked for 20 years in EM in small, rural hospitals in the US south and decided two years ago, half way through my career, that I could no longer continue to participate in a system that is clearly designed for failure, that ruthlessly exploits the decency, discipline, and tireless, selfless work of all the docs, nurses, and ancillary staff that actually want to provide professional care.
The exodus, during and after Covid, of a huge amount of the nursing intelligence and experience, hard won after years of giving and giving whilst receiving nothing but blatant disrespect, having their basic human needs ignored in favor of protocols and quotas designed by fools who have risen to their highest level of incompetence both within and without their local hospital system, is only hastening the demise of any semblance of professionalism within the ED.
I don’t think the average American understands that some clown in a corporate office who couldn’t find their town on a map is making disastrous staffing decisions for their local ER, happy to hire unqualified buffoons to meet the profit goals of aforementioned multinational companies. Trust me, I have lived it as have thousands and thousands of other tired, despairing souls who just wanted to do honest work for their community; to go home at night and sleep well knowing that we came together and did our damndest to help our neighbors.
If you’re one of the folks, like me, who spent a lifetime striving to achieve excellence because you believe Americans, all Americans, even those in rural areas, deserve professional level healthcare and because you take pride in the quality of your work, there is less and less room for you in this current disaster area.
In addition, with abysmal regularity, the literal possibility of accomplishing what should be a simple, efficient task in the ED is turned into an Orwellian joke. Poorly designed EMR systems, endless charting distractions, bumbling “managers” and a ruthless, exponentially expanding bureaucracy of idiots who never even bothered to become professionals can eventually overwhelm even the most battle hardened decency of dedicated humans.
In the last few years, since my departure from healthcare work, I have been able to accompany multiple family members to “doctor’s” appointments as well as to ER’s and into hospital settings. What I have seen is horrifying.
Nurse practitioners giving potentially lethal recommendations, failing to identify life threatening conditions, nurses who stare at screens like zombies, seemingly unaware of the human being in their care. I have intervened so many times that I can’t count them all.
There seems to be a widespread delusion that the “system”, that is, endless institutionalization or bureaucratization of care can improve or accomplish things that intelligent, competent and sensible humans cannot. This is simply false.
The acceptance of this view is quickly leading to inescapable ruin. A team of professional human beings, highly motivated, working towards a common goal, remains the most sophisticated technology available in the world.
The advocate, therefore, will understand these facts and be highly attuned to the inevitable and often predictable errors and failures bound to emerge in such a system based on false premises, increasingly staffed with untrained place holders instead of professionals, designed to generate profit through “acceptable risk”.
The more fearless, righteously angry, alert and indefatigable your advocate is, the more likely is your survival.
As an advocate for my family and friends, I’m a real son of a bitch, a rabid pitbull that will not let go of whatever I deem worthy of my 10k Newton bite force because I actually want my relatives and friends to survive. And, as I walk into an ER or a clinic with a clear, undeluded mind, I know something that’s becoming less and less of a secret: this system is just as happy to kill you as to heal you and there will be neither justice nor afterthought either way. Institutions and bureaucracies don’t care about you, only humans do.
In short: only humans should draw conclusions; and, there’s no greater technology than a team of human professionals allowed to do their jobs free of the failures of bureaucracy.
Get an advocate and keep praying.
Peace
Excellent advice. I describe the E.R. as the bottom point / fulcrum of an inverted pyramid of all health care. Everything rests on the ER (doc)!
I worked in a critical access hospital ER/Urgent Care for 10 years. I left in 2014 before Covid and things got really bad. But I do recall plenty of upset patients or family members who thought they waited too long to be seen for their viral illness that didn’t really need to be seen (or similar minor problem) when we were dealing with a code, trying to get a STEMI transferred out, etc.
This listicle of things to be aware of about going to the #Emergency Room is remarkable for the fact it is as true on the West Coast at #Kaiser as it is in rural hospitals in #Appalachia. Adding a reminder to not use the phrase "I have a high tolerance for #pain" in any conversation, and the pain scale only goes to 10, no bonus points.