Wednesday, May 20, 2015

When is the Emergency Room not an Emergency Room?

 I am very happy our day at Children’s Emergency is over.  Thinking back at our 5 hours we spent waiting for treatment I observed a lot of good things and staff making their best efforts.  In terms of obtaining care I probably don’t have a lot to complain about.  We went in with a problem and we’ve been told it’s been addressed.  So why am I so frustrated?

The whole adventure started yesterday morning with a call from our school principal.  She informed us that a student in our school had a case of chicken pox.  This was the second case in two weeks.  With Russell being immune-compromised this is an issue.  Fortunately, this was not Russell’s day to be at school.  And he had not been at school since last Wednesday.  Unlikely that he had been exposed.  Good news.

I proceeded to make the call I don’t enjoy making.  I called Russell’s Cardiology clinic to let them know about the situation.  I get the impression they are more protective of Russell than we are.  I guess that is why we love them.  I gave them as much information as I could.  They agreed that Russell’s odds of being exposed to the Chicken Pox was not likely but with a second case being reported in the school they were concerned that the virus was “in the community.”  They made a compelling case that we should take some preventative action.  They consulted with Infectious Diseases who agreed.  We were given two clear options.  We could take an oral medication for about 10 days which would give him some immunity for the 10 days he is on the med or we could come into the hospital and take an IV medication that would protect Russell for about a month.   The logic was that in about a month, hopefully the virus would have come and gone through the community and Russell would no longer be at risk.  We chose to come into the hospital and give up 4 hours of our lives (the time it would take the IV to run) and try to protect Russell for a month.

Our Cardiologist made arrangements last night with the Emergency Room to make the necessary arrangements.  We would come into Emerg to start the IV at 8:00 this morning.

Like good parents we packed up this morning and headed to the hospital. We arrived at the triage desk at Children’s Hospital.  Upon hearing the word “chicken pox” we were immediately taken to an isolation room where we complete the rest of the registration process.  This was a good start; things went south quickly.  We were then informed that no one knew why we were there and no arrangements had been made.  They were now trying to reach our cardiologist to figure out a plan.  So awesome.

You have to keep in mind that I am assuming at this point that we have now entered the ER triage process.  In other words, the ER Doctor cannot see us (by policy) until other more urgent patients are seen.  Russell, to our knowledge, does not have chicken pox.  The only risk he might present is that he possibly could be carrying.  Because we are in an isolation room; we pose no risk and there is absolutely no urgency by the hospital to do anything with us until all other more urgent cases are seen.  Is  this irritating and frustrating; yes.  Is the hospital following policy; yes.

After waiting 2 ½ hours we saw the ER Doctor.  A quick exam and she ordered the med we needed.  Yes, the med our Doctor had requested the night before that should have been waiting for us.  The med we required is a blood product and has to be requested from Canadian Blood Services.  Just another little wrinkle that slows the process down.  After 4 hours of waiting my wife was informed that they did not have any medication on hand and they were now looking for other sources.  So, now it was looking like our trip may have all been a waste of time.  At this point I was noticeably irritated. 

Shortly after, our nurse contacted my wife again and said that they had located the medication and that it was not administered by an IV but by a simple injection.  A 3 second injection!  The nurse went on to say that they were in the process of preparing the injection and that we would be ready to go in a few minutes.

Don’t get me wrong.  Not having to wait around for an IV to run was fantastic news but what about all of the other information we were given.  This really didn't add up.

We checked the data on the medication (which we requested) for and it seemed to be the correct thing.  Russell got his medication, we waited for 20 mins and went home.  We waited around 5 hours to get a simple single injection.  The frustrating part to me was that I could find no fault in what we went through.  Yes, there was some communication issues but this is what our health care system calls quality health care.  From my point of view if this is an example of the system working then this simply is not good enough.  

From the beginning of the process no one considers our schedule and the inconvenience to us.  I had to take time off work for this.  My wife had to use up one of her valued days off.  Russell missed a day of school.  This is never considered when building these processes. 

Patients need to start demanding more and better service.  If this is public health care, the public must speak up and be heard.

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