The Best Medicine For A Time-Waster

I work as an admissions clerk at a small rural hospital. Being small and rural, you can actually get checked into the emergency room pretty quickly most of the time without being at risk of death. Genuinely, the majority of the time, patients get called back in under ten minutes, maybe fifteen tops if the nurses are wrapping something else up.

Unfortunately, the general attitude of a lot of the regulars is that the ER is for when you just want to pop in and out quickly, and they act like we’re trying to spite them when they do have a long wait. The truth is that we only have five standard rooms and two trauma rooms, and if someone is actively dying then all manpower goes to stopping that.

I was working one afternoon that was the rare occasion where seemingly everybody decided it was a good day to be sick. The ER was full enough that the nurses were triaging people and sending them back out to the waiting area. That’s when one of the regulars came up to the window, very obviously looking around at the very full waiting area. I started to register her, and during that process, she asked about the wait more than she answered any questions. When I tried to ask why she was seeing the ER, she instead pushed about how long the wait would be. I had a million other things to do, so I told her the next person in the queue had been there for over an hour.

At that point, she finally answered my question:

Regular: “Oh, well, in that case, I have chest pains.”

She stood there in absolutely no distress and frankly not even making a token effort to pretend like she wasn’t blatantly lying to get seen faster. Unfortunately, I can’t call people on stuff like that, so I just finished registering her. It’s also policy that we call the nurses any time someone states that they’re having chest pains. So, following policy, I called back and let them know our regular had stated she had chest pains after finding out there was over an hour’s wait.

[Regular] didn’t get brought back immediately, but the nurses were hustling to see to everybody, so she at least got called for triage after about fifteen or twenty minutes. The nurse obviously asked about the chest pains.

Regular: “Oh, my chest isn’t that bad. Actually, what’s really bothering me is my leg.”

Time to note that I’m calling her a regular because during this time she was there at least once a week about arthritis in that leg. We kind of already knew why she was there. Well, she got sent back out and got to spend more time in the waiting area.

Finally, she got into a room. Unfortunately, our most no-nonsense doctor was working that day, and everything had been relayed to him.

Doctor: “So, I see you’re having chest pains.”

She tried to go, “Well, actually…” again, but [Doctor] insisted that they had to treat the issue she was actually registered for and proceeded to do so.

He didn’t order any bill-padding tests, but he did enough to cover the hospital’s butt to be sure that there were no signs of cardiac or breathing issues. After [Regular] had spent a good amount of time stuck in the ER room, [Doctor] happily informed her that they hadn’t found any issues and she was free to go. Oh, and she could take some over-the-counter painkillers for her leg, and she should make a clinic appointment for long-term pain management — something she had been told before and would be covered by her insurance.

Here’s a small public service announcement because I’ve heard enough comments indicating this isn’t that well-known. The emergency room is for emergencies, but what that means is that the ER is just not set up for dealing with anything else. A better way to say it is that the ER is only equipped to deal with right-now issues. If you have high blood pressure or something, then the ER will happily get those readings back down to normal… for today. Making sure they stay down three days from now or next week is just not something the ER can help with.

And if you have some issue that just cannot be diagnosed within a few hours but is also not in any danger of killing you, well, the ER might not help you at all. Many an issue requires long-term monitoring or specialized tests, so you really need to get with a clinician for those things.

I just see people who waste weeks and weeks regularly coming to the ER and then leaving, complaining that they’re not getting the help they need. And they’re right, but it’s because we’re not the correct facility. There are genuinely things a clinician can do that the doctor in the ER can’t.