Our Hospital Emergency Room Experience

This week my husband was rushed to the hospital with a strangulated hernia.  He is fine and recuperating with the help of his Mother, me and his two blond Labradors.  Today I will share with you my thoughts and feelings about the experience. Hospital waiting rooms are a lot like airports.  Since you must stay there for a certain time, a prisoner of sorts, I always “people watch”.  Also, as a result of my training and education I analyze the processes that are taking place to determine what I would change, what works well.  I cannot help doing this; it’s just something I do naturally after doing so for so many years.  Anyway it passes the time…

We arrived at the Montreal General Hospital which was my choice from previous positive experiences, not easy but positive.  We found Emergency and we were faced with the first thing that stands out.  Because of SARS and H1N1 we had to clean our hands with antibacterial liquid, it is hospital policy to do so when entering or leaving.  There is a Security Guard who will make sure you do.

Then we made our way to Triage which has no numbering system and only 5 chairs.  This has to be explained to every single person who comes in for treatment because there is no clear direction.  Because there are only 5 chairs, people have to sit in the waiting room but because there is no numbering system, people are constantly worried they are losing their turn.  This adds to the stress of the experience unnecessarily.  Maybe the paper numbers are too expensive these days.

After about 45 minutes waiting, the Triage nurse came out and told us that she is on a 16 hour shift.  I assume she told us this to vent a little and to make sure nobody messed with her.  It was effective.  She asked each person what their problem is and takes their Medicare and hospital cards and disappeared again.  Shortly afterward she started calling people in and we were called before some other patients.  Although she had clearly stated patients would be seen by priority of their condition, there was some grumbling.  Of course now that we were securely in the room, we found this mildly amusing.

So we thought we were doing pretty well here, we’d been there an hour and been through triage and waiting to be seen by a doctor which happened within another 30 minutes.  Things were moving along nicely.  My husband was in pain (on a scale of 1 to 10 it was an 8 ) but he looked pretty healthy.  I tell you this because it will be important later.  We were called to an examining room, hung out there for another 40 minutes and then a young doctor came in and read our family doctor’s notes about possible strangulated hernia, he then decided a CT scan was in order to find out what was really going on.  A nice and funny European nurse came in to draw blood and explained that when there is an opening in the CT scan schedule, they will have Marc drink one liter of liquid and then wait 1-2 hours before he will get his CT scan.  Uh Oh!  This was going to take major time so we hunkered down to endure the wait.  Because this was not my first rodeo, we came prepared.  I brought water, playing cards, MP3 player, newspaper and books to read.    I called his Mother which is always a dilemma as we don’t want to worry her, but we needed  the “prayer patrol” to get busy.

Emergency rooms are the great equalizers.  There were a couple of “street” people, young people, old people who had lived too long and their systems are failing, several psychiatric patients, people who were there for minor complaints and ourselves.  When you’re in Emergency nobody cares how much money you make, how big your car or your house is; where you work or your title.  You lose all of these identities and labels once you walk through those doors.

Finally they came with the liquid for Marc to drink for the CT scan; meanwhile we were playing “go fish”.  He’d never played that game which was completely incomprehensible to me.  How can you reach the age of 45 and never play “go fish”?  I love him anyway but it is a definite gap in his education.  We made friends with two nice young men, one of which fell off a roof.  They were jealous of our pack of cards.  We were keeping ourselves busy when a “code white” was called.  We ask the Security Guard to explain what a code white is and he refused.  We found out later that a code white is called when a person is acting dangerously and might hurt himself or someone else.  The doors opened to the Psychiatric holding area and a young woman was being put into restraints.

What I found surprising was that no one was checking to see if the patients waiting were getting worse.  It said on the resolving sign that if you get worse you should check back with the Triage nurse but honestly if you were really worse, that would not be an option.  I have to say Nurse Nancy was gruff but nice and was the only one who really helped us.

Meanwhile Marc was not being called for the CT scan and then this really mean orderly took away his comfortable chair (I guess he looked too healthy).  We are now in hour 7 of our wait.  Finally I went to the Triage nurse after asking various other support people when Marc would be called for the CT scan because we were approaching the two hour window and he would have had difficulty drinking another liter of the contrast liquid.  He was really suffering at this point in addition to fatigue and sitting in a plastic waiting room chair.  He hasn’t eaten in 12 hours because of the possibility of surgery.  The IV the European nurse setup had dried up and after asking 3 people no one came to either take it out or make it active, they just shrugged and walked away.

There was no one left to ask so I asked Nurse Nancy about the CT scan, she made a call and escorted us down through the Psych holding area past the girl in restraints.   I asked how long it would take to get the results and I was told 30-45 minutes if no trauma cases came in.  Ninety minutes went by and the original doctor came back to confirm Marc needs surgery (I could have told them that) and that we would have to wait for the surgeon but he was busy and he could not estimate how long we would wait.  It was about midnight at this point and we were done in.  Everyone else we came in with had gone home and we were virtually alone in the waiting room.   We were called to an examination room.  Finally Marc could lie down on a stretcher and a young medical student came in and started asking all the questions we had already answered five times but he was a cute kid and obviously very interested in the case.  He told us the surgical resident would come when he had a chance but we were lucky and he came right away.  He couldn’t decide when the surgery would take place, we’d have to wait for the senior surgical resident and he was in another surgery.  He told us the surgery would happen during the night or in the morning.

At that point because Marc now had a place to sleep, pain medication and a nurse to watch over him, I decided I’d better start my drive home while I could still see straight.  It was 1:30 in the morning by now.  I made him a pillow out of towels and a blanket because all their pillows had been stolen by previous patients.  They decided to put him down the hall where it is dark and he could have a curtain around him.  I could not wait with him there so there was no point in my staying.

I found my way back to the dark parking lot, literally ran to my car, jump inside and lock the door.  I do not like dark parking lots in the middle of the night.  I am completely useless at these parking machines.  My husband always laughs at me because I don’t put the car close enough to the parking ticket machine and my arms are not long enough.  Similarly, I don’t use drive-through banking because it is just too humiliating.  So I pulled up to the machine and my car was too far away.  I turned off the engine but then the window wouldn’t come down.  I turned the engine back on, put the window down but I was too far away from the machine and had to get out anyway.  I put my ticket in and eureka!  The arm goes up and I didn’t pay anything.  My little Scottish heart is racing.  I rush to turn the car back on and off I go into the night without paying.  It’s like my reward for waiting patiently.  I guess if you’re tortured until after midnight you don’t have to pay for parking.   I pulled over to put my seatbelt on and off I went.    Montreal is construction central in the summer.  They say we have two seasons, winter and construction.  Three routes home were blocked, by this time I had tears behind my eyes but the last one worked and I made my way home.

I sat in my bed with 3 squares of chocolate and a glass of wine and my doggies to do my work e-mail.  Marc called at 2:30 to say he was going into surgery.  I prayed that my wonderful husband would not be taken from me, called his Mother and then tried to sleep.  I must have drifted off because at around 6:30 he called to say he had just arrived in his room and he was okay.  All of a sudden everything hurt, my head, my joints everything.  The relief was enormous.  My life was intact.  I called his Mother in Ottawa to let her know and went to sleep for an hour.

I am incredibly blessed with my friend Maryse who offered to come to the hospital even though she had just spent all evening at a funeral for her beloved cousin, Richard and Adriana for taking care of the doggies and Marc’s family for the prayer patrol and support and everyone at work who was so concerned and supportive.  Special thanks to Dr. Nancy Tozer (our General Practitioner) and her nurse Linda who was seeing Marc on an emergency basis and diagnosed his hernia.

So here are my rules for Emergency Room Waits:

1.  Bring things to do and eat, it may be much longer than you anticipate.

2.  Make friends with the other patients because everyone’s stories are interesting on some level and it passes the time.

3.  Don’t look too healthy because a mean orderly will take away your comfortable chair.

4.  Have someone go with you.  Having an advocate is a huge advantage - a real must in today’s environment.

5.  Be nice to the personnel.  It is extremely difficult working in the health care system and if you show them the same level of respect you think you deserve, it would make it easier for everyone.

6.  Accept that this is where you are and make the best of it.  I find this to be true anywhere you have to wait.

7.  Stand up for yourself in an appropriate manner.  Stay calm (you wouldn’t want to become a “Code White”)

Have a good week and stay healthy!

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