Emergency Department Boarding Stories

"I work in several Emergency Departments, and the overcrowding and boarding issue is relevant at every single one of them. The way in which we deal with it differs amongst ED's; however no one place has figured out the solution. 

One particular ED is worse than the others in which in the last six months, we have had three people die in our waiting room. One of which was a 32 year old female. We are grossly understaffed and thus have an Emergency Department that has 36 rooms; however we are frequently only able to use 12 - 14 rooms. In addition, the hospital has approximately 100+ rooms on the inpatient side, but are frequently limited to 1/3 of those.

Our daily volume is routinely in the high 90's to 100's and unlike other entities, an Emergency Department can never close. People continue to come. The inpatient beds are filled, sick patients in the ED are admitted but never leave and thus the overcrowding and boarding problem.

In the last six months, we have had three people die in our waiting room.

Seeing as we have no other bed availability in the ED we are routinely asked to begin treating people in the waiting room where there are no monitors, people are frequently misplaced, and critical conditions are unmet. We frequently have elderly patients who present for chest pain or have unstable vital signs and given our circumstances are placed in wheel chairs where they just sit and wait until another room opens. We frequently encounter patients with excruciatingly painful kidney stones who we can't offer pain medication to because there is no one to watch them . Per hospital policy these people need to be continually monitored.

We have the ability and capacity to treat these people and provide them relief, however given the massive staff shortages and government and administrative red tape they have to just sit in anguish. This brings me to the young woman who recently died. She presented to the ED for a cough and not feeling well. Arbitrary orders were placed on the patient and a hodge podge of physicians and APP's saw the patient intermittently, but no one was able to readily take full responsibility for the patient. Because she was young and currently had normal vital signs, she was forced to sit in the waiting room. She sat for nearly 12 hours before she was again seen by a physician. She had complained on multiple occasions that her throat hurt and that she was having trouble breathing, but because she didn't "look labored" registration and other personnel in the waiting room thought she was faking it.

I have begun doing house calls in my neighborhood as well as Zoom calls with family to keep them out of the ED's because they are so dangerous.

The physician finally was able to see her in a side waiting room, he stepped out of the room for several minutes and on return she was face down and blue. They immediately began trying to resuscitate her, brought her back to our trauma bay in which they were unable to intubate her and then performed an emergent cricothyrotomy on her. She had anoxic brain injury and died.

While this sounds like a random occurrence, I am frequently asked to come to the waiting rooms to help carry people out of their cars or off the floor because they have passed out or gone into cardiac arrest in the waiting rooms on multiple occasions.

I have since reached out to nearly all my close friends and family and have begged them under no circumstances to go to the ED without reaching out to me first. I have begun doing house calls in my neighborhood as well as Zoom calls with family to keep them out of the ED's because they are so dangerous. In fact, I've gone as far as begun sending people home from the ED whom I would normally admit because the hospitals have become that dangerous. It's safer for many of these people to be discharged home and taken care of by family than run the risk of the multitude of mistakes that are taking place in the hospitals because there is no staff."