A back up in he ED usually reflects not only the state of the hospital, but many times, of the community. Depending on what level of trama they are certified at, they may be mandated to hold so many beds available for an actual emergency, especially if other area hospitals are on divert. Another scenario is that all in-patient beds are full. It wasn't uncommon at our hospital that the full work-up was done in the ED and the patient was admitted and discharged right from the emergency room. Another factor is the number of nurses staffing the beds. There might be beds open, but if there's no one to staff them, no patient gets them. A 5 hour wait to me seems pretty average.
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