Emergency? Please take a seat

March 26, 2007 12:00 am
ER entrance ().
ER entrance ().

By Cornelia de Bruin

Triplicate staff writer

Stretched as thin as medical providers are in Del Norte County, Sutter Coast Hospital's emergency room wait time is about average.

"Our problems here are consistent with the rest of the country, but our length of stay is shorter," the facility's Clinical Supervisor/Emergency Services Beth Brown said. "Our wait times are within the national average, and we have had up to five to six hours."

But because many local residents use the hospital's ER facility for non-emergency care, patient loads can rise and waiting times lengthen.

Brown's staff saw 21,698 Emergency Room patients last year, admitting 230 of them to the hospital for further treatment.

During the past two weeks, 882 patients sought help from Sutter Coast's ER, a figure Brown said is consistent with her records that indicate 1,800 patients are treated there each month.

The hospital sees about 280 ambulances each month, she said. Mental health emergencies come to about 20-25 a month.

The patient load is linked closely to the Emergency Medical Treatment & Labor Act, which was passed by Congress in 1986 to ensure public access to emergency services regardless of ability to pay.

Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services. It mandates that hospitals provide examination or treatment of an emergency medical condition, regardless of a patient's ability to pay.

"We have to take everyone," hospital spokesman Grant Scholes said.

If a second orthopedic care physician were to move to Crescent City, Brown said, the emergency room "would feel a relief."

The facility' smaller size also can cause problems. There are 12 rooms in the ER section.

Brown gave the example of an already full emergency room that's suddenly deluged by the arrivals of four ambulances.

"We put patients on gurneys when we have to," Brown said. "Our left-without-being-seen rate of 5 percent is higher than the national average, but the people who use the ER as non-emergency care, they're the ones who walk off."

From the midst of what many would consider a chaotic work environment, the sparkle of high-class professional care shines through, hospital staff say. It is enhanced by the professional caliber of the ER staff, many of whom have a decade of experience backing them up.

"I have given this hospital 17 years of my life," she said. "We've never put people back in the waiting room."

Other employees range from 7-12 years in experience.

When people are waiting for emergency room care, Brown said her nurses periodically "scan the lobby" to make sure no one's condition has worsened to the point of needing immediate intervention.

Each month, Brown and one of her ER physicians reviews a case the staff has worked on in which a "question" has developed.

"It might have a good or a bad outcome," she said in describing the case.

That translates to recovery or a death.

"The physician will give a talk explaining where things went wrong, where we could have done better or what we did very well," Brown said.

Her staff fights a "huge perception" within the community, however.

"It's important to (the staff) that the community trust them, that they know we really care," she said.

Because of an emergency room's nature, not all comes up roses there. People die, or have life-changing experiences — those in which they are disabled from an accident, heart condition or stroke.

It's not a work environment that everyone could take to. Brown jokes that her staff kids about being "adrenaline junkies," but under the kidding is a deep pride that they can rise to the occasion and render competent care to their patients.

In her office is a white board that carries a quote from the German philosopher Johann Wolfgang von Goethe:

"Knowing is not enough, we must apply.

Willing is not enough, we must do."