Emergency Department Boarding Stories

"This event occurred in a 25 bed ED. Every one of those beds was occupied by wither a patient awaiting admission or awaiting transfer to a higher level of care. Each nurse was managing five or six patients (the typical ratio is 4:1). There were numerous patients in the waiting room. A woman came into triage with the complaint of headache and blurry vision. She had delivered a baby four days prior. Her systolic (upper number) blood pressure readings were over 200.  The clinical picture was that of post-partum pre-eclampsia, a true medical emergency, and one that placed her at high risk, even likelihood, of sustaining seizures.

There were no rooms, beds or nurses to care of this woman. She was frightened and in pain.

There were no rooms, beds or nurses to care of this woman. She was frightened and in pain. Shortly after the triage nurse did her initial assessment, I called her name in the lobby to do an initial exam, but she did not respond, and someone said they thought she had left.  I called her on her cell phone, expressed my concern for her, and convinced her to return to the ED, assuring her I would figure out how to care for her.  She received her treatment in a chair, in the hallway. The nurses were so overwhelmed I had to initially administer her medications myself. After several doses of intravenous medications, we did get her blood pressure down and her headache and blurry vision started to abate.  We finally found an extra stretcher for her, and she spent the night in the hall.