From my friend, the emergency room charge nurse: “Epiphany”
Went to work the other day, found my assignment was in the treatment rooms, walked in and found I had five admitted patients: two fractured hips, a stabilized DKA (diabetic), and a couple of FTCs/FTTs2. All but one were over 80 and more or less unable to walk.
Then I had an epiphany: Acme Regional Health Centre doesn’t actually provide emergency services in the space they call the Emergency Department. What we provide is Outpatient Day Surgery, Home Care Evaluation and Ongoing Treatment, a medical/surgical ward, ICU/CCU services, Pre-op Clinic, Fracture Clinic, Ambulatory Care, Office space for Consultants, Psychiatric counselling and Inpatient Services, and a very special place for GPs (and Telehealth Ontario and nursing homes3) to dump patients.
2Failure to Cope/Failure to Thrive: a sort of catchall diagnosis, describing frail elderly patients, who can’t go home, usually because they (or their caregivers) have become physically or mentally incapable.
3One of my most petest of pet peeves are nursing homes who call EMS for their obviously failing patients despite utterly clear, written advance directives that state “No Patient Transfer to Hospital. Comfort measures only to be provided at nursing home.” And lo! They come anyway.
Yes, blame the physicians who seem unable to meet and treat patients in their offices.