Visiting the Emergency Room: It wouldn’t always go as you wish

Jun 16, 2024 News

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Dr. Zulfikar Bux
Emergency Medicine Specialist

Kaieteur News – Last night, a social media post was shared with me and the author was falsely depicting a scenario that occurred at the GPHC Emergency Department. To be honest, it disturbed me as an image of a patient lying on the floor was posted and the author claimed that the patient was having a seizure and left to lie on the floor. There are two sides to a story and an image on social media, while it can appear explicit, it can never tell the full story. The patient was being attended to by a nurse and went off the chair next to the nurse and ended up on the ground displaying “seizure-like activity”. The nurse hastily called for help but was bombarded by expletives and abuse from persons around because she was not trying to lift the patient off from the floor; it must be noted that a seizing patient should be placed in a lying position and allowed to remain that way until the seizure stops either by itself or with medications. Trying to move a patient while they are seizing often causes more harm than good since it can affect the patient’s airway or cause numerous bodily harm to the patient and or provider. While I empathize with the patient, it is not fair for the nurse to go through the abuse she went through and the unnecessary pressure she was placed under. If a video was posted, it would have told a different story. Thankfully, there was a good outcome for the patient but it has stimulated me to share with you today the reality of how an emergency room visit may go.

You cannot get to visit patients as you wish

It’s never good news to hear that a relative or a friend is a patient of the emergency room. A patient visit to the emergency room usually means that the patient’s condition is grave enough to warrant tension and anxiety amongst friends and relatives. This triggers the phenomena of everyone wanting to see the patient to ease their anxiety and can cause an influx of friends and relatives to the emergency room (ER). The will to see a sick relative and to know of their condition is strong but is also a normal human reaction during such stressful times. This usually puts relatives into a collision path with emergency room staff whose first instinct is to protect the interest of all the patients.

On the wards, patients are generally more stable, have known conditions and have better access to privacy. In the emergency room, there are unstable patients with undifferentiated medical conditions and less access to privacy.  There can never be scheduled patient visiting times here; neither can patient’s visit times be prolonged. As much as we wish to ensure everyone is fully happy, it is not a reality given the nature of our patients and how they present. We always have to be prepared for the constant fact— incoming patient with an unknown condition that has the potential to die very fast. Time is always against the staff in an ER. There are never moments where we can down tools because there is nothing to do. As much as time for patient care is never enough, it is important to ensure that relatives and friends of patients have some of our time too.

We wish there was time to talk to everyone

The reality is that we cannot speak to every relative nor can we allow everyone to see a patient in the emergency room. The ER physician is expected to inform the closest relatives of the patient’s condition and facilitate a short visit to the patient. The time spent with relatives varies according to the patient’s situation but should not hamper patient care. This balance can never be perfect and the ER physician should always err on the side of patient care whenever in doubt. Multiple patients are being taken care of in the same space of time in an ER and it’s important that every patient has similar access to care and privacy. Once the ER physician feels that this is adhered to, then he/she should allow time for relatives of the patient.

Time spent with relatives of patients is time lost away from direct patient care. Patients and their relatives will always need our attention. An ER physician should always prioritize his/her time to ensure patient care is not compromised, but should also find a moment to appease the anxious awaiting relative.

Help us to help you

Working in the ER is one of the toughest jobs in Guyana; it’s a constant battle to save lives, mostly against odds, and the expectations and pressure are real. At the GPHC Accident and Emergency Department, staff constantly sacrifices their wellbeing to help others. While we are human and we are not perfect, know that it is a team-based environment and there is a systematic approach to patient care that mitigates human errors. For the most part, we try our best and the system we have created saves lives. While you may not always be happy, know that our primary goal is to preserve life first and foremost. Sometimes, in the process of doing this, it may come over as insensitive, but I do not think that anyone in the ER wakes up to come to work to deliberately make patients’ lives more difficult than it already is. Please understand this and help us to help you by doing your part to create a pleasant environment.

As emergency physicians, we see daily what others get to experience maybe once in their life. I have seen lives lost in moments of agony but have also seen many lives snatched from the jaws of death. Fighting to save a life against the odds with the expectation of success is what we do.

These constant lifesaving acts that do occur is for the medical staff to experience and out of respect for our patients, it will not be heard in public ears. Do not be deterred by a negative social media post; by the time you’re finished perusing that post, the odds are, a life would have been saved at the GPHC Emergency Department. It is the place where what we do matters, and what matters is what we will always do for you.

 

 

 

 

 

 

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• GPHC Emergency Department, patients, The ER physician

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