Patients Overcrowding in ER? Lets hangout in Hallways!! few are in cafeteria-

(Image from dailylife .com)

I came across this article while surfing which made me read it again carefully. The health blog in the wall street journal describes a novel way of managing Emergency overcrowding

Here’s one way to ease overcrowding in the emergency room: Move patients to the hallway.

Some hospitals are giving it a try, putting patients in hallways when they’re ready to be admitted, the Associated Press reports

The bizarre ideas germinating in managerial cubicles would put Dilbert’s Pointy headed Boss in throes of delight. The practice was justified by

Peter Viccellio, clinical director of the emergency department at Stony Brook University Medical Center in Stony Brook, N.Y., was involved with a study that found that the practice didn’t do any harm. And before the hospital went this route, on busy days “things would grind to a halt and people would wait to be seen,” he told the AP. Worse, infectious patients would wait in the ER hallways for isolation rooms to open up elsewhere.

I wonder if the said observations were deduced from the hopelessness of the situation. The statement which struck me the most came from one of the proponents of the idea

Nurses, meanwhile, tend not to like the practice. But Carolyn Santora, who heads patient safety efforts at Stony Brook, told the AP that’s fine with her. “I want them to hate it,” she said. “I want them to do everything to expedite flow to get the patient out of the hallway.”

This attitude is typical of the adversarial roles the clinicians (including doctors, nurses, paramedics,cleaners etc as a team) have to face as a team from the managers and the public in general as ‘the problem‘. It is like shooting the messenger-

The reason the nurses are uncomfortable is because they know how dangerous the practice is; they know the enormous stupidity of the move and because they care about the patients despite perceptions otherwise.

Just give them time to accept and acclimatize to the new rules and they will no longer be so uncomfortable!! After all they are powerless and the strings are in someone else’s hands.

The rules and circumstances are so different in India but the end result is all the same. I used to send people with minor lacerations for tea just to have space to deal with the real sick.

Photocredit: taken out of context here.