Monday, April 02, 2018

My emergency room experience

When I fainted and hit my head, I went to the emergency room at Sunnybrook.

Upon arriving at the emergency room, you swipe your health card in an automated kiosk, select a category into which your complaint falls, and describe it in a few words. The kiosk then issues you a number.

You sit down in the waiting room chairs, and the numbers come up on these big screens above small glassed-off offices. When your number comes up, you go talk to a triage nurse. It took less than 10 minutes (and perhaps even less than 5) for my number to come up.

The triage nurse listens to your problem, asks questions, takes your vitals, takes down all the information, takes your vital signs, and enters everything into the computer so you can be appropriately triaged.  Then I was sent back to the waiting room. Some other patients were sent into the other "zones", which have different waiting rooms, and I don't know what happens to them after that. (You can google Sunnybrook emergency room zones for more information - no point in me trying to explain it here when I don't have any information that hasn't already been put on the internet from more reliable sources.)

Soon after speaking to the triage nurse (maybe 5-10 minutes, definitely under half an hour), the receptionist calls your name, and you check in. They scan your health card, take your information, emergency contact, name of primary care physician, and issue you a wristband.  Then it's back to the waiting room.

What happens next depends on the particulars of the patient's condition. For me, another nurse called my name, and took me into a room (two examining tables/beds divided by a curtain) where he took my blood and took an EKG. This was about an hour after I arrived.  Then I was sent back to the waiting room for the longest wait of the day.  I later learned that this blood work was the primary diagnostic tool in my case, so even though I was sitting around for four hours, my blood work was at the lab.

After four more hours of waiting, they finally called my name and brought me into the "orange zone", where I was seated in another small waiting area. This made me nervous, because a lot of the patients in this area were in beds with machines and/or IVs hooked up to them. I could overhear that one patient had had a stroke, and another patient's family members were crying. It turned out this was a kind of mixed-use area - the people in beds were ER patients who were going to be staying in the hospital overnight, waiting for a bed to open up in the appropriate ward. They were also using this zone for patients who didn't need actual treatment, which is why I was there.

After sitting around in the orange zone waiting area for a bit, a nurse talked to me, asked me to tell my story again, re-took my vitals, and told me that my tests had come back normal so I just had to talk to the doctor and then I'd be discharged.  Then he sent me back to the orange zone waiting area.

After some more time waiting, the doctor called me and took me to a stretcher in the hallway that could be curtained off.  He asked for my story again, asked me questions, talked to me about my test results, did some non-invasive clothed physical exams (including stroke screening and palpating my abdomen). Then he gave me discharge instructions about how to take care of the bump on my head and what signs to seek further medical attention for, answered my questions, and sent me home.

My total time in the orange zone was 1-2 hours, my total time in the ER was about 6 hours. This was on the Saturday afternoon of a long weekend.

***

A bit about the physical environment:

The Sunnybrook ER is on the ground floor. The main entrance is on the first floor (which is one storey higher than the ground floor), so you have to go down a storey if you come in the main entrance. I don't know whether there was another easier way to access the ER.

The waiting room chairs are padded (with a vinyl-like upholstery that appears to be easy to clean) and have high backs. I can't tell you if they're comfortable to lean back on because I had an enormous bump on the back of my head. They were more comfortable than classroom chairs, church pews, or the chairs in my doctor's waiting room. I've previously blogged that ER waiting rooms should be sleepable, so I was surprised to notice that there was one (but only one) recliner-style chair that appeared to be sleepable. I'm not sure if it was there intentionally for sleepability or it was just an extra chair that they put there for more seating. In any case, I didn't try it out since other patients needed it more than me, and I couldn't lean my head back anyway.

The waiting room was very crowded (on the Saturday afternoon of a long weekend), and some patients' family members were sitting on the floor, or standing. I suspect some patients took those wheelchairs by the entrance so they'd have somewhere to sit, and after a while uncomfortable-looking folding chairs started materializing from somewhere.

There are washrooms right in the ER waiting room - two accessible family-style washrooms (i.e. with the toilet and sink behind the same door). They weren't always perfectly clean - sometimes there were puddles of water or bits of paper towel on the floor - but they were always well-stocked with toilet paper, soap, paper towels, sanitizer, etc. so our washroom experience could be as hygienic as possible. Despite the crowded waiting room, I never noticed a line for the washrooms. There is also sanitizer available in the waiting area.

There are vending machines selling water, juice and pop (just inside the doors of the ambulance entrance, by the security booth). I didn't notice anywhere where you could get food within the immediate vicinity of the ER waiting room, but I didn't ask either. There is a food court on the main floor between the main entrance and the elevators, and Google suggests that there are other sources of food elsewhere in the hospital, although I didn't investigate. Some patients' family members went and fetched food from the food court, and I suspect one person somehow had food delivered.

There are multiple password-protected wifi networks with "Sunnybrook" in the name, and no open networks. I didn't inquire about whether we were allowed to use any of them, or try to guess any of the passwords. I googled around the idea after the fact and the internet suggests that one is intended for patients and visitors, but I have no firsthand information.

There are a few wall outlets in the waiting room, but the waiting room was not designed with the assumption that everyone will have a device to charge.

I saw the triage nurses give a basin-like thing to one patient who thought he might vomit, and a blanket to another patient who was shivering, so it's possible other items for the patient's comfort might be available upon request.  No one gave me ice for my head bump, but I didn't ask either.

***

The best thing about this ER visit is that every single person I dealt with had outstanding bedside manner.

The triage nurse, young enough to see me as non-young, who squeezed my hand reassuringly when I confided that I had never been in a hospital before and was frightened, even though she's in a hospital every day and, I'm sure, sees hundreds of people with more cause to be frightened than I have.

The nurse who did my blood work and EKG, diligently requiring me to remove only the minimum clothing necessary and exposing only the minimum skin necessary (and covering exposed skin up as soon as the procedure permitted, even when the body part in question was just my calf), despite the fact that we were behind a curtain and my style of dress makes it apparent that I don't come from a more-modest-than-average cultural tradition.

The orange zone nurse, who patiently answered all my questions about what test result numbers mean even though they were normal and I didn't have to worry about them, and took the time to explain to me why I was in this section with stroke patients and people on tubes and machines.

The doctor, who sat down with me, looked me in the eye as though I had his full attention, and patiently answered every single question about what might have happened and what do I do next and how fainting works and how head lumps work and what they tested for and how they ruled out certain things, even though he was also in charge of all the stroke patients and people on tubes and machines - and even took the time to reassure me that I had done the right thing by coming to the hospital and when I should go to the hospital under similar circumstances, even though we could both see that I was the least important patient he was treating that day.

Even the security guards, who were kindly and patiently giving people directions and answering questions about where you can get food and drink and bathrooms and how the sign-in kiosks work, in between actual security guard emergencies.

Several years ago, I fell down an internet rabbit hole of reading ER nurse blogs, and I found that some of them were kind of . . . contemptuous, I suppose, of their patients. On their blogs, they dissed patients for being frightened when their condition wasn't serious, or for coming to the ER for something that isn't an emergency, or for bringing their mother even though they're a grown-ass adult. As someone who met these criteria (I didn't bring my mother, but I was considering calling her because sometimes I want my mommy when things are scary), I was kind of worried about how I might be treated in the ER. So I am quite pleased that every single person I dealt with at Sunnybrook was outstandingly kind and caring. This makes me feel far safer and more confident for next time I need hospital care.

And I sincerely hope there isn't ever a next time.

3 comments:

laura k said...

Thanks for sharing this! I never thought to do this with my ER experiences.

I'm concerned that you are online while you're recovering from a concussion. But maybe the no-screen period is over. I hope so.

impudent strumpet said...

That's where Mr. Schroedinger comes in - I'm not officially recovering from a concussion. I was never diagnosed with a concussion because I don't perceive myself to be experiencing any of the symptoms that are diagnostic criteria, so I'm not under any actual no-screen order. I started doing brain rest solely on my own initiative based on medical advice I read on the internet - if I wasn't listening to Dr. Google I wouldn't even be doing that.

laura k said...

Oh right. I knew that!