Friday, September 28, 2007

I hate the ER.

I hate the ER.

I am a week out of my last ER visit. It was my second one in as many days, which makes it that much worse. Nothing like going to the hospital on a Thursday & finding out your baby is dead, then having to go back Friday because of being in excruciating pain. That was the only time I have ever been admitted to the hospital from the ER.

Now, I know that I don't have any knowledge of the inner workings of an ED, nor of what else was going on when I was there. But I am going to bitch anyway. And identify the hospital--Northeast Baptist, in San Antonio.

As I alluded to, I miscarried. I had bleeding Thursday and because the Navy trained me not to make OB appointments in the first trimester (they don't want to waste their money on you if you're going to miscarry, I guess), I didn't have a doctor of my own to go to, & so no choice but to go to the hospital. That was another in the Baptist network; Baptist Medical Center. I went because a) they take my insurance, & b) they were less than a block from where I was when I realized the bleeding had returned. I wasn't too upset with anything from that visit apart from realizing I'd already been assigned a priority (5--non-urgent) before being triaged. Silly me, I thought that was the entire purpose of being triaged. (Another note: it took an hour to be triaged. I've been triaged faster than that in the crowded ER of a Level III trauma center with several trauma cases incoming.) But they took my blood and did an ultrasound and told me that my baby had been dead a week. Return to the ER for increased abdominal pain or very heavy bleeding.

Friday afternoon, I called up my now-estranged husband (yep, that's the family troubles that have caused my break) and told him I was in so much pain I couldn't take it and I needed him to take me to the hospital. Which he did. (You think that's odd? You don't know the half of it, but it's not something I'm going to explain in public.)

Anyhow, that visit blew a couple of my former ER beliefs all to hell. To wit:

One would think that bleeding heavily on the floor of the ER waiting room would get you seen a little faster. One would be wrong. It doesn't even get you triaged faster. They brought me a wheelchair. And an OB pad. I kid you not.

One might also think that being literally hunched over, crying & moaning in pain, would get an offer of pain medication. Again, one would be wrong. (Now, I don't expect to be offered something until a doctor sees me, but damn. A little ibuprofen would have been nice--and all I'd have either asked for or accepted. I recovered from two c-sections on ibuprofen.) By the time I was offered a painkiller, upon being taken up to my room, I really didn't need it anymore, because the spikes in pain had spaced themselves out from every minute or two to every 30 minutes or so.

The only good thing I can say about anything that went on in that ER was the nurse who took me to the bathroom (after I'd had Robert go tell them a second time that I really, really needed to go) took one look at the blood that was everywhere and brought me rags to clean myself with. Perhaps after a while of working in the ER, the concept of human dignity escapes you, but rest assured it does not escape the patients. If I'd seen her name tag (I wasn't wearing my glasses), I'd write the hospital a letter of thanks. I cannot fully express the horror of having blood on you when you know it means the death of your unborn child. (And yeah, a big crude FUCK YOU to the pro-choice idiots who refuse to admit that a 10-weeks gestation fetus is a child.) She helped me get clean.

I was mostly ignored in the room they put me in, save a quick pelvic exam (and as someone who normally showers & shaves her legs right before a GYN appointment, my apologies to the doctor who did it, especially as he was not a GYN) and in-room sonogram to see what would need to be done. I saw my nurse twice. She seemed very surprised to learn that no one had told me they'd decided I be admitted for surgery first thing in the morning. It apparently never occurred to her to tell me.

Gah, I am almost out of time (library computer)!

I will say, I give a lot of leeway for this having been on a Friday evening. But damn. Keep the patient informed, OK?

And I have a couple of final points to cram in:

I don't care what the actual medical term is. Never, ever, EVER refer to a woman's miscarriage as an abortion. And if you do, and she punches you (like I wanted to, but was too weak to), you deserve it.

Also:

I don't care how much easier it is for staff. Putting a miscarrying woman in the postpartum wing is just fucking cruel.

8 comments:

Mark said...

Sabra, I'm praying for you and your family send me an e-mail if you feel the need to talk about it.

Mark

Murphy said...

damn...

Dave said...

I'm sorry for your loss.

SpeakerTweaker said...

Wow. I had no idea that things had gone rodeo so hard. Now I really wish I could do something to help.

If it helps any, I've had decent luck (if you can call it that) at Methodist Medical Center's ER. They've got a good staff and seem to have their shit together. I've had a couple of clients that were ER Docs there and are good guys. A close friend of mine is also an RN in the hospital.

Take care, and I wish you all the best. I hope you are delivered from your strife.



tweaker

Byron said...

Sabra,

God bless and keep you.

I'm an ED RN. The delay in triage is sub standard according to the standards of care. However, only three or four major medical centers can fulfill all published standards of care. The resources simply aren't there.

Until a doctor examines you and orders it, no nurse can give you even so much as ibuprofen...nor offer it.

Spontaneous abortion is the appropriate medical term. I agree that it would be best not to use the term around women who have miscarried today.

I've seen days in a Level III trauma center where I had a little old lacy whose forearm veered about forty five degrees from true. I had put a sling on it several hours before and came out to refresh the ice pack from time to time as well as to check the circulation and neurological integrity of that broken arm arm. She piteously asked when she would be seen. Every trauma bed had been filled by gunshot wounds and knife wounds since before she had arrived. Major gangfight. Ambulances still arriving with the wounded. Seven hospitals in that metro area. The ED's of all seven were filled with gunshot wounds and knife wounds.

She piteously asked when she would be seen. I told her the truth which was this:"Ma'am as long as ambulances continue to arrive with people who have sustained critical gunshot wounds and knife wounds, you won't be seen."

Good luck.

God bless.

Byron said...

I meant to say that only three or four medical centers in most states can meet all standards of care. These standards are apparently developed by people who have never seen a rural county hospital in west Texas, for example.

One standard of care is that all pregnant women who are being transferred to another hospital should be transferred by EMS in an ambulance. The promulgators of this standard apparently don't realize there are places liked Brewster County, Texas that are 120 miles north to south, 100 miles east to west,and have a grand total of three EMS crews-only one of which is on duty at a given time. The standard of care for loss of consciousness is a CT scan. There are places out west where the nearest CT scanner is hundreds of miles away.

muse said...

I've been to that ER before because it was the closest in proximity from my parents' house. I walked out AMA and drove all the way across town for someone else to reattach my little finger.

There is a lack of care and caring there. Whatever happened to a consumer driven service industry?

I'm so sorry for your traumatic loss.

William the Coroner said...

Unfortunately, the medical term for a miscarriage is abortion, or spontaneous abortion. The one everyone gets their knickers in a twist about is "elective abortion" aka "therapeutic abortion". No judgements are implied by the lingo.

And, really, that just sucks. I'm sorry.