"For over a year now we have been boarding 60-80 patients daily in our 80-90 bed ED. Over the summer to now this has ballooned to 100. Most shifts I work I never see a patient in a room anymore unless they are the most critically ill. Our waiting room typically has 30-50 patients waiting six to 12 hours for care. It is common for patients to check in, sit for at least eight hours, decompensate, and then be brought to the critical area of the ED to be cared for. Just last week an elderly woman checked in for weakness, waited nine hours until she slumped over in the waiting room with a blood pressure of 70/40. She was brought to one of our few critical care beds and was found to be in complete renal failure with emergent life threatening metabolic changes. She was admitted to the ICU less than an hour later, but boarded in the critical care bay till the next day.
More people come in, we have no place to see them. If we admit them they don't leave the ED, and often if we discharge them they don't leave either.
We have also recently started to experience a crisis of transportation. We now have no wheelchair, stretcher mobile, or ambulance transport out of the ED at night or on weekends. This leads to prolonged stays in the ED. I had an elderly man from a nursing home slip out of bed and hit his head Friday evening, he was brought to the ED by ambulance, waited eight hours to be seen, had a single CT scan, was discharged back to his nursing facility but had to wait in a chair in the ED until Monday morning >48 hours later to get back to his facility. More people come in, we have no place to see them. If we admit them they don't leave the ED, and often if we discharge them they don't leave either. How are we supposed to safely and efficiently see our 300+ patients per day? It's a tragedy."