Emergency Department Boarding Stories

"I am a float physician for a health system, at multiple ER’s. I serve rural and suburban facilities. Boarding in the ED is a travesty. I personally have seen bad outcomes due to delay in care. One ED with 15 beds which should be staffed with five nurses and two technicians was staffed by two nurses and one technician. At the same time we had eight boarders and two patients pending transfer to a higher level of care. (On ventilators and vasoactive infusions). We did not have the ability to take care of the folks in the waiting room. People were not able to be triaged. Some unfortunately died in the waiting area.  Many suffered pain and distress while waiting. As many had Covid, and we had a small waiting room, I am sure  we exposed other people to Covid while waiting.

My plea is for rural hospitals to not be forgotten during this time.

I feel that the shortage of nurses, both in the ER and on the Inpatient units were the primary factors. Other contributing factors include centralized care at tertiary centers, which were overwhelmed, and unable to provide the services envisioned by planners who did not foresee the volume of services that this pandemic would demand. In the future, please consider not only the ”average.“ Patient volume, but allow for “excess “ capacity for such events as this, as a matter of public health and safety, as we have shown the need for surge capacity during this time.

I urge both health system managers and governmental officials to reevaluate the need for surge capacity, as a matter of public safety. The cuts in hospital bed capacity and service capabilities over recent years, in the name of efficiency, have left us with an inadequate system for such emergencies. I am sure my colleagues are suffering under similar circumstances. My plea is for  rural hospitals to not be forgotten during this time. Protect the citizens of these areas, and ensure that they have access to adequate care."