Hundreds of unfilled residency spots in emergency medicine are telling us that critical care is in trouble
If you are lucky, you quickly check in with a triage nurse who takes your vitals and registers your complaint—before sending you back to the lobby. Hours pass and it’s likely you still have not been treated. You are surrounded by other sick people, some with contagious diseases. As the clock ticks, many people leave, taking a risk to manage their illness on their own.
By now, thanks to COVID, many people are aware of the challenges of working in an emergency department. But many of these problems existed before the pandemic, and it looks like things are getting worse.
But lately, my love has dampened. In some parts of the U.S., particularly in rural areas and states without Medicaid expansion to cover uninsured people, my colleagues have to send some out after their emergency visits without viable options for follow-up. This affects their health outcomes. The uncertainty of having to think on our feet that initially fueled our adrenaline has morphed into an uncertainty of staffing and resources that now fuels our anxieties.
A fully functioning emergency department requires more than just doctors. Hospitals have to reinvest profits and devote a critical part of their budget to hire more nurses and ancillary staff. We need nurse to patient ratios that promote quality care rather than the bare minimums we often have. They have to make emergency care better paying and safer for nurses, otherwise they leave, and then doctors cannot do our jobs as effectively.
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