Quote:
Originally Posted by bonrich
As a former Director of Nursing at a hospital in NYS, I find it extremely unsettling that your husband had to wait in the ER hallway for 9 hours. The Standard of Practice for ER's across the US is approximately 3-4 hours, either discharged to home or admitted to a bed in the hospital. I am questioning whether hospital personnel gave your husband the "clot buster" to dissolve clots that occur during a stroke as he appeared to have symptoms indicative of a stroke. I am unclear as to whether this hospital administers the "clot buster" in appropriate instances as there must be a neurologist available 24/7. It is important to be aware of other hospitals within a reasonable radius of TV that can provide the necessary care that one needs.
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TVRH is a stroke center (so we do have a neurologist available 24/7) and our protocol is to immediately obtain a CT of the head and make the right choice to give "clot busters" if the patient meets that criteria. There are many times that the patient does not meet that criteria and it would be life threatening to give certain medications. Just because a patient appears to have a stroke doesn't mean they are having one, there are many illness that cause the same symptoms...you do not treat a TIA as they resolve on their own. You do not treat Transient Global Amnesia as it will also resolve. Myasthenia Gravis has stroke like symptoms but isn't a stroke at all and needs entirely different care. All these types of sudden onset stroke-like symptoms are scary but not a STROKE and do not require "clot buster" meds.
The Standard of Care "might be" 3-4 hours for admission but that doesn't mean a bed is available for that patient to be admitted to...we admit within those parameters all the time and while those patients are in the hallway they are still being cared for by the ER RN using the admission orders until a hospital bed becomes available.
Which brings us to another issue and that is the bottlenecking or holding of patients in the ER while trying to manage the influx of patients who walk in and/or come by ambulance and not have an endless wait time either in the waiting room or waiting to be seen once they are brought back to a treatment area. If you can't move your patient upstairs or to the ICU you have no place to treat incoming patients. ICU nurses have 1-2 patients at any given time, ER nurses are still caring for the ICU patient and 3-4 other patients at the same time. So it's understandable when a stable patient who has been admitted has to wait in the hallway for their hospital room to become available to make space for a critical patient needing a treatment room. It doesn't make it easier for the waiting patient nor the ER RN taking care of those patients to have them in the hall-floor nursing has it's own way of doing things and the ER isn't set up for that. We much prefer to follow through and get the patient to their room within the hospital.
TVRH has 223 hospital beds and 25 ER beds and there are over 85,000 people with a projected build out of 110,00 people, serving the tri-county area, and the non-emergent issues that could easily go to an Urgent Care (and there are many UC's in the area) something has to give and what that relates to is long wait times for everything.