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Hosptial waiting rooms

By Jazz - 12 October 2012 30

At a party recently i was discussing the subject of the wait time in hospital waiting rooms with an off duty paramedic. He made an interesting comment that whilst most visitors get exceedingly frustrated at hospital wait times, patients in the waiting room are under constant medical observation.

At the time I thought it a far fetched claim and It seems that i’m not alone in my assumption with this article on ABC describing a 33 hour wait for a terminally ill patient, an experience also shared by others.

If our hospital emergency waiting rooms are indeed an observation room rather than a waiting room perhaps it might be prudent for our incoming government whomever they may be to name it as such? Of course this might require a duty of care rather than the current ‘let me know if you feel unwell’ approach.

Your thoughts?

What’s Your opinion?


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30 Responses to
Hosptial waiting rooms
Girt_Hindrance 8:30 pm 13 Oct 12

“I strongly advise people never to go to Casualty alone if you can possibly help it.”
Damn good advice.
I certainly don’t envy the staff making the prioritisation decisions and it can be very frustrating while waiting for loved ones to be entered into the ward.
Through my experience, I’ve discovered that cuts to the face requiring stitches are further up the ladder than I would have thought. I arrived after a stack and was called in before the Gent in his butchers outfit, clutching a claret soaked towel around his forearm…

Flossie 7:22 pm 13 Oct 12

We took 12 year old junior Flossie to the Calvary ED with a potentially serious post bicycle crash injury a fortnight ago. When describing events and presentation the Triage nurses their eyes widened with concern at the implications. Junior was made a category 2 and we were sent straight to the resuscitation room for immediate assessment.
Doctors were great and respectful and caring, nursing staff had essentially one on one support for the wee bloke. The injury was problematic enough the registrar called the consultant who in turn called the specialist surgical team. Who then also called the paediatric surgery team for assessment and advice. We were ultimately discharged with a paediatric surgery outpatients review booked at TCH for five days time.
Woke up next day to find junior’s presentation had worsened. Called Calvary who advised speaking to TCH. called TCH who advised immediate presentation to ED. So we went. Place was chockers. Spoke to triage, they were great. We were told we would have to wait a bit but they would get to us ASAP. In the forty five minutes or so it took to leave the waiting room and be attended to by a doctor we watched to nurses managing triage and a third nurse doing the rounds of the waiting room taking and recording observations for a number of patients.

I would definitely describe that as monitoring patients. I have had problems with long waits before today,and I am not saying that things are perfect, but the ED system isn’t completely broken.

(junior was fine in the end, hurrah! No surgery!)

knuckles 6:33 pm 13 Oct 12

kakosi said :

Alternatively, if you have an emergency never drive yourself or someone else in, call an ambulance as they tend to take patients straight through into the ward rather than drop you off in the waiting room – having done the triage when they pick the patient up.

This is not correct. Ambulance staff will take timewasters (e.g. non-emergency patients) through the ambulance entry and happily tell the triage nurse that their patient is suitable for the waiting room.

It’s not really that hard. There is a large sign out the front that states EMERGENCY. If your condition is not an emergency you can expect to wait in the waiting area with minimal supervision. If you are not happy with this arrangement, take some responsibility for yourself and see your GP or attend a medical clinic.
Also, coughs, colds, diarrhoea, runny noses and hangovers are not emergencies. They may make you feel like crap, but you will not die from them.

schmeah 1:30 pm 13 Oct 12

Hellno said :

if you anticipate a 5 hour wait and decide to go home for dinner and return later for example).

Please, please don’t tell me people actually register their illness at ED, then go home and get dinner and return to get treated. Honestly, if you’re that functional; driving, organising and eating – you should NOT be at ED .. make an appointment to see your GP for heavens sake.

kakosi 12:38 pm 13 Oct 12

It is true that after initial “triage” most patients in the waiting room won’t see a nurse come out again to check on them unless they are considered to be at higher risk.

A tip for not waiting too long is (if you can) get a doctor to refer the patient to the emergency ward. A call from a doctor to say you’re coming gets you into the ward quicker.

Alternatively, if you have an emergency never drive yourself or someone else in, call an ambulance as they tend to take patients straight through into the ward rather than drop you off in the waiting room – having done the triage when they pick the patient up.

Last tip: if you want to drive in, call both hospitals and ask them which emergency ward is least busy then go to the one that has less of a waiting time.

None of these tips will help you get treated quickly if a) a car accident has occurred and they are trying to cope with one or two serious injuries b) a full ward c) a few druggies are in the ward making a fuss and keeping staff busy.

kakosi 12:24 pm 13 Oct 12

Sorry, quoted the wrong person there… that was in response to Helino.

Cool, should have read the second comment first 🙂

kakosi 12:22 pm 13 Oct 12

I think you are confusing the waiting room with the emergency ward.

Nope – mentioned getting into the emergency ward from the waiting room quickly if it’s an actual life-threatening emergency. I was attempting to put the whole waiting time issue into perspective to show why people can’t get into the emergency ward quickly.

A hell of a lot of people who wait long hours in the waiting room would be better off going to see an after hours locum doctor located just “round the corner” at both the hospitals – but then of course that costs $70 and people don’t seem to either want to pay or aren’t able to pay.

Jethro 10:40 am 13 Oct 12

Jethro said :

kakosi said :

If you have a life-threatening emergency you get from the waiting room to the emergency ward quite quickly…however this doesn’t always guarantee a doctor will see you quickly (unless you’ve stopped breathing or had a heart attack that is).

Getting into a hospital bed from the emergency ward has taken from 7 to 48+ hours for my relatives in past years, and at discharge it’s no less than 8 hours to get out.

You usually do get a much better level of care in the emergency ward. Once you get into a hospital ward you notice everything works a hell of a lot slower…to the point of neglect in some instances.

I think you are confusing the waiting room with the emergency ward.

Sorry, quoted the wrong person there… that was in response to Helino.

Jethro 10:16 am 13 Oct 12

kakosi said :

If you have a life-threatening emergency you get from the waiting room to the emergency ward quite quickly…however this doesn’t always guarantee a doctor will see you quickly (unless you’ve stopped breathing or had a heart attack that is).

Getting into a hospital bed from the emergency ward has taken from 7 to 48+ hours for my relatives in past years, and at discharge it’s no less than 8 hours to get out.

You usually do get a much better level of care in the emergency ward. Once you get into a hospital ward you notice everything works a hell of a lot slower…to the point of neglect in some instances.

I think you are confusing the waiting room with the emergency ward.

miz 9:59 am 13 Oct 12

I’m with Jazz on this one. I have occasionally seen a nurse take obs from the odd patient in the waiting room, but it was obvious from this that it was only because there was nowhere else to accommodate the person (bed block) and not because they do this to all waiters routinely. The triage nurses are constantly dealing with new people who they are triaging ‘out the back’ (who then return to the waiting room). They cannot possibly be in two places at once. Rather, the waiting patient, or more usually their support person, has to go to the counter to tell staff if there is a decline. I strongly advise people never to go to Casualty alone if you can possibly help it.

Jazz 8:40 am 13 Oct 12

You must be going to different waiting rooms than I have Hellno. In the several days worth of time i’ve spent in hospital waiting rooms for either myself, my wife, or son I’ve never seen someone come out to check on us or any other person waiting.

Hellno 11:47 pm 12 Oct 12

“Unless someone is regularly checking on them, like taking temperature, pulse, heart rate etc, they are not under “medical observation”.”
That is exactly what does happen in the waiting room. Triage nurses keep an eye on waiting room patients and will periodically take blood pressure, sats, temp etc in the waiting room, as appropriate for the patient. This is also why if you leave the waiting room and do not return in short period of time you may be removed from the waiting list as the medical staff can no longer observe you and provide care when necessary (in other words if you anticipate a 5 hour wait and decide to go home for dinner and return later for example). Being a waiting room patient is not dissimilar to when you are allocated a bed but do not have a doctor or nurse permanently watching over you, but returning to check on you from time to time. You are a patient whether you are in a bed or a waiting room chair.

kakosi 11:32 pm 12 Oct 12

If you have a life-threatening emergency you get from the waiting room to the emergency ward quite quickly…however this doesn’t always guarantee a doctor will see you quickly (unless you’ve stopped breathing or had a heart attack that is).

Getting into a hospital bed from the emergency ward has taken from 7 to 48+ hours for my relatives in past years, and at discharge it’s no less than 8 hours to get out.

You usually do get a much better level of care in the emergency ward. Once you get into a hospital ward you notice everything works a hell of a lot slower…to the point of neglect in some instances.

virgil99 11:10 pm 12 Oct 12

Patients in the waiting room are observed from the triage desk, plus most of the time there is a nurse speicifically to circulate in the waiting room doing observations as suggested above. Patients waiting for ward beds are not in the waiting room, they are generally in beds inside the main assessment area, or sometimes (as in this reported case) they may be in an internal corridor. Even there,there is a specific nurse allocated to care for the patients.

IrishPete 8:55 pm 12 Oct 12

Unless someone is regularly checking on them, like taking temperature, pulse, heart rate etc, they are not under “medical observation”. While someone might notice if they fall off their chair, if they were lying down and died in their sleep, that would quite likely go unnoticed.

I heard the Chief Minister on the radio this morning commenting on how, as soon as she opens more beds, they all fill up “by lunchtime”. She obviously didn’t understand that what this means is that she didn’t open enough new beds. It’s much cheaper to open 12 new beds at a time, than keep adding 6 then another 6 later.

IP

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