To the Emergency Department Management Team:
I want you to know that I came to the Emergency Department because I desperately need a diagnosis to explain my extreme fatigue. I have fibromyalgia and I am experienced with exhaustion, how it happens and how to prevent it. Since February I have had overwhelming fatigue that has reduced my daily usable time to 4 hours. When I am awake, I don’t feel well. It’s hurting my brain too! I can’t think and can’t remember anything. Sad fact, the last two weeks, that fatigue increased again, I am sleeping or in bed for up to 20 hours daily.
I have been to several doctors: hematologist, rheumatologist, immunologist, neurologist and of course, started it all with the PCP.
No diagnosis that will explain this debilitating fatigue. I have breathlessness as well. Yes, I have COPD, but the out of breath is worse!
I can’t exercise and it has gotten so bad that going to the pool is too much for my body.
In the meantime, I keep getting weirdly scary blood results and everyone tells me that they don’t matter.
VITAMIN B12 1190 H: Reference Range: 200-1100 pg/mL
Google Search: High levels of vitamin B12 in the blood, above 800 pg/mL, can be a sign of a serious or life-threatening disease. Some possible causes include: Liver disease, such as hepatitis or cirrhosis or- Myeloproliferative disorders, such as chronic myelogenous leukemia or polycythemia vera
This is scary!
Follow up Appointment Renal Mag 3 Nuclear Medicine
In any case, this made me tearful at my follow up appointment with my provider. Believe it or not my husband and I were hoping that the horrible results from my Kidney Mag 3 would explain everything. In other words, we were happy with a bad test result, if it could be fixed, I will feel better. But when I was told that the test is meaningless because my creatinine and other blood tests are perfect! I was very upset, another stone wall, I started bawling. She said that I should go to ED and see if I could get some answers for my fatigue.
Emergency Department
I presented at your ED and told them all about the extreme fatigue and shortness of breath. I emphasized that I was there to get answers for my fatigue.
I apologize for getting short with your physician. Please let him know. I am just so tired of it!
BTW: I’ve been tested for Hep C twice in the last 3 months. If either had asked me, I would have told them unnecessary. I don’t have it and I live a life now where the chance of getting it is close to zero. Because it’s a popular illness for the over 65 set, everyone is testing for it. They need to ask us, the patient. Hello!
Okay, move on.
The purpose of my visit explained, here is where everything broke down:
Breakdown
I was told that I could be admitted so that they could continue testing. Is it possible that it is my heart? Could it be pulmonary in nature? Very good. Husband and I were committed to finding answers and it just hadn’t happened yet. We were so hopeful.
Guess what? I was admitted to “the back hall”. That fact was not explained to me. We felt manipulated. Why do people withhold information? To control the response of the person they are lying to. Why would you tell me that I am being admitted and then put me in the hallway of the ED?
Listen, I survived and so did hubby. (My 72 year old husband sat in a chair from 3:00pm until 11:00am, at that point in time, we were up and awake for most of 24 hours.) I want you to know that it was an awful hardship. But more importantly:
What are you doing? YOU HAVE NORMALIZED TREATING PEOPLE INHUMANELY.
Not to mention what you are doing with your spectacular staff. Your staff is incredibly patient. They spent a LOT of time waiting for each other to move out of the way so that they could pass, or so they could see their patient. It was the most inefficient health care setting I have ever seen, and my entire career has been in healthcare. Out of hundreds of healthcare environments that I have professionally worked in and managed, I have never seen an environment where staff spend a significant amount of time waiting for space to move in.
“The back hallway” and all of the beds in all of the hallways are horrible ways to treat patients.
Overnight is ridiculous. There is NO chance for sleep or rest. More importantly, it looks as if you have been doing this for years and that it is now the way it is. Is this true? You have normalized inhumane treatment of patients?
I totally understand that it is difficult to treat patients who cannot pay, or who use the ED for primary care, but how did you get here?
Compromising Patient Rights
If people are in the hallway, there is no privacy. HIPAA be gone! But that’s not the worst of it, no darkness to close your eyes in and constant noise. Rest and sleep be gone! No place for family to sit with or tend to sick family members. Family be gone! There is no place for the doctor to complete a conversation, much less a consultation with anyone. Privacy be gone!
What are you charging for those beds? Whatever it is, it is too much!
Look, I graduated from USF from the College of Public Health. I spent much time with my Professor who was a board member. My memory says that my college and my hospital are thought leaders who use their incredible influence to help the world. In the 1990s I was involved in AIDs research and there were good things being done.
Thought leaders don’t allow the current social constructs to dictate care.
It seems as if that influence is gone. My thinking is that you have lost your space in conversations about health care in America. My Hospital should be in the conversation, for example: about how legislators are now practicing medicine and telling doctors how to treat patients.
Universal Health Care should be a top conversation for all of the hospitals who do indigent care and spend time and effort taking care of people with no or limited money.
Why don’t you have a seat at the policy table? Why have you decided to be passive?
If you are going to do indigent care, you cannot use that as an excuse to treat people inhumanely. It doesn’t mean that having hundreds of patients lying in beds in hallways is okay.
Staff Time and Efficiency
The last point (and then I give it a rest). Professionally, this is the most inefficient use of staff and facilities that I have ever seen. Staff need to move freely to get to patients and to patient beds. I see your staff spending a lot of time waiting… They work desperately to keep track of their work tools and end up carrying a ton of tools around with them. I once had a problem in my clinic with admissions taking 4 hours to complete, we ended up completing a study about where the breakdown was, that study (no blame, lots of gain) reduced admit time to an hour and a half.
P.S. Do you all know anyone who does diagnostics?