"We are a 28 bed pediatric ED, with a catchment area of 2.5 million children. I came onto shift yesterday morning. We had 15 children on psych holds, many of them waiting in the lobby for their 24-72 hours stays so we could use our beds to see medical patients. One of those patients had been in the ED for >150 hours, as their parents had relinquished their rights and DFS was refusing to take the patient back, even though our psychiatry team had cleared them as no longer a danger to self or others.
There are no open PICU beds in our four closest counties, including our own.
We had ten admissions boarding, seven on high-flow oxygen, four of which were PICU level. There are no open PICU beds in our four closest counties, including our own. We had 35 patients in the waiting room in addition to the 20 medical patients being managed by the ED. We had seven transfers pending from outside facilities to the ED, plus more awaiting direct admissions from an outside ED to an inpatient bed whenever a bed became available. One that left another hospital's ED AMA and came to our ED had been waiting three days for transfer. They had an AVM in their brain that needed urgent surgery."