Emergency Department Boarding Stories

"It is time to stop believing that One Flew Over the Cuckoo’s Nest is the only way for patients with psychological illness to be treated. It is time to stop thinking that state run institutions are the devil and capable only of hurting or poorly treating their patients. I work in a large urban busy emergency department. And it is not uncommon for those with severe developmental delay or severe psychological issues are housed in our emergency department for long periods of time. And I mean housed literally. These patients are clothed, bathed, fed, and given a private room and a place to sleep in the emergency department!

They are given a one to one sitter, psychiatric nurse, and security officer. They are not appropriate for a psychiatric admission to the hospital. They are not appropriate for medical admission to the hospital. And they cannot take care of themselves, making it inappropriate and unsafe, to discharge them to the street. And so they stay. Taking up increasingly rare resources and time. Because there is no other place for them to stay. But One Flew Over the Cuckoo’s Nest does not have to be the rule. We are fully capable of funding institutions that provide caring attention to those with severe mental illness and developmental delay.

Patients suffer bouncing between emergency departments psychiatric stabilization facilities and other facilities that do not have the ability to care for them long-term.

These individuals need a safe place to go. We can give this to them. But we lack the courage to chart this path, and so these patients suffer bouncing between emergency departments psychiatric stabilization facilities and other facilities that do not have the ability to care for them long-term. And they suffer. In the emergency department suffer as these patients take up valuable space and time when our waiting room numbers are frequently greater than the number of beds available in emergency department and almost half of our beds are taken by those waiting for admission to the hospital. Sometimes patients wait for over 24 hours in our emergency department to get admission to the hospital and this issue is often the worst for those with psychiatric illness. They often wait the longest. And they often suffer the most. These people are easy to overlook, but it is time that we as a modern society stop overlooking them and provide for them. It is time that we stop letting our fears of a bygone era govern our current decisions.

These people are easy to overlook, but it is time that we as a modern society stop overlooking them and provide for them.

We should stop allowing these people to suffer, because we are afraid of what used to be. It is time to look forward to what could be better care for these people as possible if only someone had the courage to say so, and open the doors to safe institutions once more for the most vulnerable of our society. We claim to care about the weak and the vulnerable and the marginalized. It’s time to put our money where your mouth's are, and actually mean the words that we say. Everyone knows that actions speak louder than words. It’s time to make that a reality. Until someone is brave enough, strong enough and courageous enough to speak out for these people, they will continue to crowd Our emergency departments spend days and precious resources that could be diverted to those with the need for acute medical stabilization and without permanent care they suffer. It’s time to care about their suffering."