Surviving the ER

Wednesday, April 22, 2015
Being a caregiver in the ER is usually pretty awful. It feels like I’m always in the way. The hospital staff seem to either ignore me or the patient – they never acknowledge both of us at once. I have to walk the fine line between advocating for my loved one and making myself a nuisance. Sometimes it feels like the staff are providing care based on how they view me – I’ve had the best ER experience when I’ve been calm and professionally dressed.

Usually you don’t know ahead of time, but sometimes you know when a trip to the ER is more likely, like when a chronic condition is flaring up or when beginning a new treatment. It helps to be prepared.

I keep a bag packed with a few items that are handy for trips to the ER as well as weekends away. It’s got:
  • a clean t-shirt,
  • underwear,
  • a toothbrush and toothpaste,
  • a notebook and pen,
  • a book, and
  • granola bars and other snacks.
Some of our members have suggested bringing a sweater or blanket and something to do besides reading, like knitting.

Avoiding the wait
Some hospitals now post wait times on their website. You can also call ahead to see what local ER has the right specialist on hand. I’ve decided which hospital to go to based on doctor’s recommendations, friend’s suggestions, and even Yelp.

Hospitals work on shifts, so the staff tends to be coming on duty at 7 am. If there’s some flexibility in when you head to the ER, that’s the time to go.
Know which hospitals are covered

Do you know if you need to get authorization from your insurance to visit the ER? Do you know if all area hospitals are covered? Find out now. Don’t be afraid to ask about cost when treatment options are being explained, but don’t be surprised if they don’t know the details of your insurance.

Bring medication and supplements with you. This way you can make sure the doctor is getting the correct information about what medications your loved one is taking and you’ll have access to the medication. When in the ER, always check with the staff before taking medication, eating, or drinking.

My wife and I have a file on Google Drive with our medical histories, along with scanned copies of our power of attorney documents, living wills, and insurance cards. It’s important to have all of the doctors names and phone numbers – hospital staff usually won’t look this up for you. If you would rather have a paper copy, I’d suggest making a pocket in the back of your journal and keeping important papers there.
Hospital staff are people
I’m an expert in the conditions that affect the lives of my friends and family – I bet you are, too. Unfortunately, there are so many different conditions that it’s unlikely the ER staff will be familiar with what’s brought you to the ER. Their job is to stabilize patients and set them up with appropriate follow-up care. If a doctor doesn’t seem to know the details of a certain condition, it doesn’t mean they’re a bad doctor. Share what you know with them to make sure your loved one gets the best care.

Hospital staff often work long shifts and have huge workloads. You know what it’s like to be ‘on’ all the time – they’re likely to be just as exhausted, stressed out, and hungry as you are – give people the benefit of the doubt.

Everyone’s pain scale is different
As anyone who’s been to the ER before knows, some people are more vocal about their pain. If your loved one’s pain isn’t being taken seriously, try ditching the pain scale and putting things in perspective. Asking ‘does it hurt more than when you had a ruptured disk?’ can get a doctor to understand what a ‘7’ means.

Accept that you’re stuck
Going to the ER, the DMV, getting through airport security – it can feel like a Kafka novel. Don’t pretend that you’re getting out of there anytime soon. The faster you accept it, the better it is for everyone. People will ask the same questions 100 times. You’ll be moved back and forth between the same rooms in a building set up like a maze. As long as your loved one is getting the care they need, just go with the flow.

Ask what’s going on
Some medical professionals will patiently explain what they’re doing, why, and what’s going to happen next. Other’s dive right in. Don’t hesitate to ask what’s going on and what the options are. This is especially important with discharge instructions. Be your own advocate.

Before I got a smartphone, I would always have two or three library books and would bring all of them to the ER. Nowadays, I can download ebooks from the library on my phone and my iPad, so I have less to carry around. I also use Pocket to save articles on my phone to read later, so I have a virtual stack of newspapers to keep me busy if there’s a long wait. Nowadays, going to the ER is sort of like flying – a surprisingly good opportunity to get some work done. Just don’t forget your phone charger!

Some hospitals now have wifi. My cable company and wireless company both offer wifi hotspots for their customers. Check with your providers to see if they offer wifi hotspots and make sure to note your customer login information.

Find a quiet space
You don’t have to be by their side every moment. Patients like their privacy, too (okay, not allpatients, but some). Go for a walk or a cup of coffee. Every hospital has a chapel – it can be a wonderful spot to sit and find some balance. Check in with the staff to make sure your loved one won’t be transferred anywhere before you go.
External Resources

MJH Associates
American Journal of Managed Care
MD Magazine
Pharmacy Times
Physicians' Education Resource
Specialty Pharmacy Times
OncNurse Resources

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