Emergency Department Boarding Stories

"We are a 70-bed tertiary emergency department as part of a health system and we continually have holding of ten to 30 patients in our emergency department for seven to 72 hours. This holding may be a result due to volume, a lack of movement upstairs on the inpatient floors (having ‘clean’ beds available so the nurse doesn’t get another patient), holding ‘dead beds’ for theoretical post-operative patients and trauma victims, nursing ratios of how many patients an inpatient nurse can see.

Boarding admitted patients in the hallways is a national issue.

I’ve seen elderly patients that cannot fend for themselves in the hallway under cared for and dwindling for hours. I’ve seen pediatric psychiatric patients held with no free bed to transfer to for two to three days. I’ve see adult psychiatric patients locked away on a constant observation order in a 4x6’ room for 48-80 hours with only the freedom to walk to the bathroom and back (no sunlight, no exercise). Boarding admitted patients in the hallways is a national issue. Hospitals don’t seem to care about this issue either. They are driven by the finances and don’t take further measures to fix the issue. Meanwhile the emergency department is she scapegoat for hospitals and society.

It is a burden on the patients, but it is one of the preeminent issues driving physician apathy and burnout.

Whether it is due to hospitals being overcrowded, hospital administration trying to make more money on giving beds to heart/lung/liver/kidney transplants and open heart surgeries rather than giving the emergent admitted patients an open bed, or even hospitals selectively closing down wings for staffing measures and red tape financial bureaucracy. This is the predominant issue affecting patient care on those that come in emergently to be treated in our health systems. It is a burden on the patients, but it is one of the preeminent issues driving physician apathy and burnout."