Whatcom Health: 10 things to know about the 'ER'

FOR THE BELLINGHAM HERALDMay 5, 2014 

14 Health ER

Nurses Carol Shore, left, and Tanja Reiss, talk in the ER at St. Joseph hospital,Tuesday, Jan 14, 2014.

PHILIP A. DWYER — THE BELLINGHAM HERALD Buy Photo

According to the federal Centers for Disease Control and Prevention, each year about one in five Americans visit an emergency department.

In Bellingham, St. Joseph hospital's emergency department handles about 55,000 visits in a year's time, with some some patients visiting more than once.

It should come as no shock that the emergency rooms depicted in television and movies don't often reflect real life. For a dose of reality, Leah Gehri, director of critical care and emergency services at PeaceHealth St. Joseph Medical Center, offers 10 insights that might surprise you about Bellingham's emergency room.

1. It's no longer officially called an ER. For more than 20 years it has been referred to as an ED, short for "emergency department."

"When emergency rooms first started, they were really just a room," Gehri says. "Now, our ED has 33 rooms."

2. There is a pattern of busiest times, but it isn't Friday nights.

"You can almost guarantee that Sundays, Mondays, and the day after any holiday will be busy," Gehri says.

In general, Gehri says, if you can go very early or very late, you're likely to find the waiting room less crowded. If you need to be seen but it's not life-threatening, consider toughing it out at home until a slower time. You can either feel miserable in the waiting room, or miserable at home.

3. Patients are seen by order of severity, and many of the most seriously ill people do not arrive by ambulance.

"We know it's extremely frustrating to be legitimately very sick, with something non-life-threatening but still serious enough to bring you to the ER, and see people go ahead of you, or to wait a long time," Gehri says. "But it can't be first come, first served."

4. If it's a true emergency, call 911 and arrive by ambulance. Paramedics are extremely good at evaluating patients, and can start treatment before you arrive. They can also alert the ED to be ready for you.

Time is critical when treating a heart attack or stroke, so let the paramedics help you sooner rather than later.

5. The most important document to bring with you to the ED is not your insurance card but a list of the current medications you're taking and the proper doses - including over-the-counter vitamins and supplements.

"Then we can know exactly what we're dealing with," Gehri says.

She suggests that people always carry such a list in their purse or wallet.

6. Thanks to a federal law, the Emergency Medical Treatment and Active Labor Act, every patient who comes to an ED is entitled to a medical screening exam.

"We will always see and treat anybody who shows up at the ER regardless of their ability to pay," Gehri says.

PeaceHealth has programs to help bridge financial gaps for people who don't have insurance or who are under-insured.

7. A quiet ED is not necessarily a slow ED. While it might look quiet, you can't always tell what's going on behind a closed door or curtain.

When the waiting room looks low-key, it may be because every medical person is busy in a room with a patient.

8. Gehri staffs the ED based on historical trends, so numbers flex up and down for predicted volumes.

"We start out with a smaller crew in the morning and steadily add staff every two hours or so throughout the day," she says.

St. Joseph's ED can have up to 20 people at a time working in various capacities, including physicians, nurses and lab technicians.

9. St. Joseph's ED averages about 155 patients a day, from folks with life-threatening issues to those who can't be seen by their primary doctor at the time (think a super-fussy toddler at 3 a.m. with a double ear infection).

"If places aren't open, you've got to come in," Gehri says.

The percentage of people who come through who are sick enough to require hospital admission is about 22 percent, about 34 patients a day.

10. The entire ED staff knows to never say never.

"You learn very quickly that you don't ever think that you've seen it all," Gehri says. "The minute you think you have, something's going to come in that will completely shock you.

"The only thing that's predictable is that you're going to have an unpredictable day."

Stacee Sledge is a freelance writer in Bellingham.

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