Thursday, April 9, 2009

Don't Knock on the Glass!

"Don't Knock on the Glass!" That was the sign taped to the emergency room office window. I stared at it for about six hours on Friday. No one knocked on the glass during the whole time I was there. I guess the sign worked.

I saw a lot as I waited for news about my father's condition. He'd had some chest pains earlier in the day and we brought him directly from a doctor's office to the emergency room. He was taken behind the electronic doors into the locked ER exam rooms and hooked up to a heart monitor – while I parked the car in the nearest open parking space – about a half mile away on the other side of the hospital.

My mother stayed in the locked unit with my father and I stayed in the waiting room. There was a second sign, this one taped to the wall by the locked doors, warning, "One visitor per adult patient, two visitors per child patient. You must have a pass to enter exam area." This sign didn't work so well.

During my time in the waiting room, that visitor rule was regularly violated. Once I counted eight visitors for one guy. His wife, three kids in the middle school age range, plus her sister who had a couple of babies hanging on her, plus a mother-in-law, all went into to the unit without a pass. They just waited for someone to exit the unit and then while the doors were still open, went in. The kids came in and out with regularity as they made trips to the vending machines down the hallway and then back into the locked unit. No one ever challenged them.

You can learn a lot just by watching. I sat in a seat where I could see into the unit when the doors opened. Sometimes my mom would appear and give me the thumbs up signal and I would nod at her before the doors would close. One time an anxious forty-something man stood in the doorway with his weeping daughter hovering just to the side. By standing in the doorway, he kept the doors from closing. He stood there, trying to catch a glimpse of his son. Minutes before he'd been talking to the nurses behind the glass about his twenty-four-year-old son who had just been brought in by ambulance.

I know the son was twenty-four because the father's voice carried as he said, "He'd been with his son twenty-four years ago when he was born in this hospital and if he was dying, he wanted to be with him now." Without expression, the nurse behind the glass said the son wasn't in the computer system yet and the man would just have to wait. It would be about twenty minutes. Another nurse in the unit – I could see her through the open door – told the father that the young man was behind curtain twelve. The nurse behind the glass ignored her and repeated to the father that his son wasn't in the system yet and she didn't know where he was. The anxious man turned angry and tried to get the two nurses to talk to each other. No go. All this while the kids with their vending machine loot were going back and forth around the man, through the open doors.

After about five minutes of this, two uniformed city cops appeared (called by the nurse behind the glass). They approached the man, demanding answers. "What's your problem, buddy? Why are you creating a disturbance?"

The father never raised his voice, but he never backed down either. He told them he only wanted to be with his dying son. That he'd done nothing wrong; nothing to warrant the staff calling the police.

I heard one cop say, "They wouldn't have called us, if you'd done nothing."

I wanted to raise my hand and offer supporting testimony, but wisely refrained from getting involved.

Finally, a third nurse came out of the unit and joined the cops and the distraught family. She seemed very annoyed with the demanding father and abruptly dismissed his concerns about his son. She told him and the cops, "He not dying. He's sitting up and alert." She then walked away.

Why in the world that information about the son's condition couldn't have been shared with the family ten minutes earlier is beyond my powers of imagination. For some reason, the nursing staff didn't want this patient's family with him – maybe it was a drug overdose or some other reason they needed time alone with the patient. But instead of telling the family the truth, they blatantly lied and said they didn't know where the patient was. All that angst was so unnecessary.

A family came in with a very frail appearing, elderly woman. She was in a wheelchair, being pushed by her sixty-something Stetson-wearing son and his wife. The elderly woman's husband was beside her, very unsteady on his feet. The son and his mother were admitted beyond the electronic doors, while the rest of the family waited outside. Later the son came out, asked the wife to take his father down to the coffee shop, telling them he'd join them in a few minutes while the mother was receiving some tests. About twenty minutes later the son reappeared and headed down the hallway to the coffee shop.

Maybe ten minutes after that the elderly woman was wheeled out by a nurse and parked in front of a television. I guess they needed the space in the locked unit, and decided to leave her to wait for her tests in the waiting room. But her family wasn't there anymore. The woman got up from her wheelchair and shuffled two steps forward. I just knew she was going to fall. Before I could intervene, a middle-aged woman and her preteen son, who appeared to be leaving the hospital, stopped in front of the woman. I think the elderly woman had asked them where the ladies room was. I heard the middle-aged woman say it was quite a distance, down the hallway and around the corner. The old woman looked desperate. Before either woman could say anything else, the young boy, without any prompting, offered to wheel the elderly woman's chair to the restroom door. The elderly woman gratefully accepted his help. His mother smiled and went with them. The kid couldn't have been more than twelve or thirteen, but he got my hero of the day award!

You can see a lot when you sit in a emergency room for hours and watch the people. One woman was wheeled into the emergency room by paramedics. She was curled up in a wheelchair, sitting on her feet, doubled over in pain. She was probably in her early 40s. She was yelling about her chest hurting. The paramedics parked her outside the glassed-in office and left. The nurse behind the glass was not impressed. After about ten minutes of the woman wailing about her chest hurting – instead of answering the nurse's admittance questions – the woman was moved into the locked exam room area. Ten minutes later, she was wheeled out and left in the waiting room. She continued to vocalize her distress, sometimes screaming, sometime moaning, but always doubled-over in her chair. This went on and on. Everyone in the waiting room was watching the woman; pregnant women with scared toddlers, elderly people fearful of what was to come, and family members wondering how "their" loved one was being treated.

I'm guessing the screaming woman was a frequent flyer and maybe she was in some stage of withdrawal. Or maybe she was in need of mental health treatment. Either way, I was shocked that the staff would leave her in the waiting room. Numerous doctors, nurses, and aides walked by the woman but never slowed. I wondered what would happen if I called 911 on my cell phone and reported there was a woman in distress. Probably nothing since the paramedics were the ones to transport her to the hospital in the first place.

The kids made another trip for soda pop and candy.

I'd had enough. I went and stood in front of the nurses' station and stared at the employees behind the glass.

I didn't knock.

I waited until they acknowledged my existence. Took at least five minutes.

When they asked me what I needed, I told them I'd like an update on my father's condition – that he'd been there a couple of hours and I was sure he was in their system.

The nurse-in-charge smiled and handed me a pass.

Evelyn David

P.S. The standard of care in the emergency room was matched by the rest of the hospital. Four long days later my father checked himself out of the hospital. He'd been observed, monitored, and stress tested. His blood was tested. He saw his assigned hospital staff doctor twice in the four days. Once when he was first checked into his hospital room and once more on day two for about five minutes. The last day, after waiting for more than eight hours for his doctor to appear and discuss his test results, he'd had enough too. He went home.


  1. Emergency rooms certainly aren't like the one depicted on TV on ER.

    Right now the emergency room at our local hospital has it's parking lot torn up--and the other parking lot is always full. Hope I don't have to go anytime soon.

    I've been to ours a lot over the years, dad, mom, grandson more than once for all of them. Frankly, it was much better than what you experienced and everyone complains about ours.

    a.k.a. F.M. Meredith

  2. On TV the doctors and nurses actually care about the patients. I have seen that happen only rarely in a real hospital. On TV, you will see two or three doctors and a whole gang of nurses attending a single patient. I have never, ever, ever seen that in a real hospital. The main thing in hospitals is that you always have to wait a long, long time for anything, whether it is pain medication, food, or a visit from the doctor. The nurses are all sitting at computers, doing who knows what. But they are not observing or assisting the patients. In the meantime, if your family member cannot feed himself, you must make sure to be there at meal times, because the nurses will not feed him. They leave the food for a few hours and then take it away. And this is in a "good" hospital.