Emergency Department Boarding Stories

"In the emergency department we are used to dealing with issues in the setting of minutes and hours. Most will notice that us emergency folks will become uncomfortable when dealing with boarding patients for 12, 24 hours, much less days. This summer we experienced the odd circumstance of becoming the “home” for a 9-year-old boy after he was dropped off by police and DSS. This was actually his fourth presentation to an area emergency department since he was sent home from his most recent months-long group home stay. At each emergency visit his parents are very clear – they do not want him.

He needs a loving stable home, yet here he was in our adult emergency department, wearing mesh OR panties and cut off paper scrubs.

They want to give him up for permanent placement, they feel they cannot handle him, and that he is so disruptive to their family that they fear for the safety of their other young children. His parents flat out refused to get him. Usually they didn’t even answer the phone. They never visited him in the ED. DSS was involved but also refused to get him, stating there was no placement available.  He therefore lived with us in our community ED behavioral holding area for the entire summer. Our emergency department staff – doctors, nurses, techs, security guards – were all placed in this frustrating situation where we were told we had to parent this little boy with no end in sight. Our little friend had no normal attachment. He had no ability to control his anger when disappointed. 

The people who are supposed to be helping this little boy, child protective services, failed wholly and utterly, so we were left holding this child with nowhere to go.

He needs a loving stable home, yet here he was in our adult emergency department, wearing mesh OR panties and cut off paper scrubs. For months.  Every week or so I, as the medical director, and I’m sure also our social worker and nursing manager, was asked by some newcomer or someone who had been out on vacation for a week “Why aren’t you fixing this”  “Why is he still here?”  “This is Inhumane!” came the cries. Rightfully so. The people who are supposed to be helping this little boy, child protective services, failed wholly and utterly, so we were left holding this child with nowhere to go. Frankly, It was quite a frustrating and angering position for us to be in, as if we were being blamed for his continued presence."