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Making friends in the ER: an ode to the Montreal General

Barbara Moser

December, 2009

In some respects, it was a productive and relaxing day. I lost some weight, made three new friends, corrected 30 of my students’ poetry essays, read The Gazette cover to cover, and got editing help for articles in this issue.

I spent the day – the entire day – at the Montreal General Hospital emergency waiting room. Like many who waited with me, I had little choice but to appear at the ER at 9:30 am. We all had problems that could not wait or could not be tended to by our family doctors.

After being told, when I arrived, by the triage nurse that there was an eye clinic at the MGH that day and that I wouldn’t “have to wait long,” an ER doctor directed me, nine hours later, to take a taxi to the Royal Vic and to make it snappy because the eye clinic there was about to close. I raced over and was examined first by a resident and then by her teacher, a retinal specialist, to determine that my retina has not detached. I was treated exceptionally well by these doctors and am grateful for their care.

Back to the MGH at 9:30 am. There was a line up to register and see the triage nurse. Then we had to find a chair in the waiting room while watching a new smaller waiting room for H1N1 patients go up before our very eyes, complete with plate glass windows. If you had an ear problem, the three hours of drilling and banging certainly didn’t help.

At one point there were four stretchers in the waiting room and little room to walk around them! People were getting called in once or twice an hour, but these same people were coming back to the waiting room to wait for the next step in their diagnosis or treatment or for a test result.

To get to the café, the closest place for food and water, one had to go outside and through a set of doors. No one alone and in pain, and certainly those on stretchers, could manage it, so those of us who were able bodied, helped by going to buy these poor people bottled water. It can’t be healthy to go without food for an entire day!

Try not to go alone to the ER if you are in pain. You absolutely will need someone to tend to you while you wait… and wait …. and wait.

Arriving in an ambulance does not always ensure you will be seen right away. One of my new friends had been having a root canal earlier that morning. Suddenly she had a severe reaction to the codeine her dentist had given her. It seems he hadn’t read her allergy list. Probably because he didn’t want to take any chances, he sent her by ambulance to the hospital. But when she arrived, she was told her problem wasn’t serious and she had to wait with the rest of us.

My new friends, Norma and Jack, waited longer than I did. We kept each other company editing articles for The Senior Times, sharing chocolate bars Norma brought from her car and doing crossword puzzles. We got to know each other.

In nine hours you get to know someone.

Norma and I discovered we both love garage sales. Luckily we were well enough to carry on a conversation.

Masks are in the entrance for anyone who… well… I’m not sure whom they are for. One woman sat with a mask on all day even though she had no flu symptoms. Another guy coughed a few times into the air of the waiting room until I reported him to the guards who promptly brought him a mask.

One poor man lay on a stretcher in the middle of our small waiting room for hours. Finally he was called in. An hour later he came out, found a chair and started moaning. He pointed to his side. It was some kind of sciatica, which can be brutal. He cried and writhed till three of us walked up to the registration desks (there were no nurses around and when they rushed through and someone nailed them, they pulled away, one stating “I’m not here.”) In any case, after three or four of us complained about the inhumanity of his plight, a nurse approached the man and loudly asked him why he was breathing so heavily. He was obviously in panic from the pain. She finally found him a stretcher and one of us helped him walk into the newly built H1N1 waiting room, where he remained alone and in pain for quite some time. He was still there when I left for the RVH.

At 6 pm, Irwin showed up, and brought miracle upon miracle — fresh strawberries, apples, bananas, small juices, cheese and crackers. I began to serve all my friends and then lo and behold, I heard my name called. I was in shock.

Was I really the Barbara Moser whose name was being called?

Thank goodness Irwin was there to accompany me in the cab in the rain to the RVH a half hour later. I quickly said goodbye to my friends promising them each a free subscription to The Senior Times for their editing help.

Suggestions for changing the emergency room procedures at the MGH in case anyone’s listening:

If there is no specialty clinic or if it’s moved, why not inform people when they arrive so that they can move themselves to another hospital where there is such a clinic?

Why can’t people not in life-threatening situations or in pain get a number like they do in a bakery or at the SAAQ? Then they could go home or sit in a cafe and come back at a certain hour. Of course they never know because of the number of ambulances that come in, but with more than 20 people waiting more than nine hours, surely, they have some idea. They seem to thrive on giving out as little information as possible. Whom does this benefit?

Could they at least put a vending machine with water and sandwiches in this waiting room or have someone selling drinks and snacks from a cart like they do on the train? If patients are alone on stretchers for hours in the waiting room, a nurse’s aide should come every so often to check on them and get them water if they need it or help them to the bathroom.

The waiting room is just too small. There are not enough seats for everyone. So expand the waiting room and put in more chairs. Why can’t we afford a few of those recliners? If you have H1N1 symptoms, go to a special clinic set up to diagnose and treat you, not to a hospital emergency room! Please! The triage nurse should be sending these people back to these clinics unless they are having serious respiratory problems. If they are, a 12-hour wait could kill them!

And yes, we already know we shouldn’t go near an ER unless absolutely necessary, but couldn’t the triage nurse let us know if it is absolutely necessary?

Postscript: Norma and John waited until 1am to be seen — another six hours after I left.

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At December 30, 2009 at 12:50 AM , Anonymous oceanica said...

Ms. Moser,

I read with interest your comments about your recent wait at the MGH... as I have also been a patient there on several occasions, I would like to reply. First of, you mentioned that you were there for an eye problem but then you said you spent your time correcting papers - seems a bit odd that someone with very urgent eye problems would be reading. You also mentioned that the waiting room is too small but you wanted a vending machine there in order to get food - what do you want, more space for patients or a vending machine? The walls do not stretch. Of course, you said you were there at 9:30 am and I happen to know that the hospitality cart passes through the waiting room in the morning to allow patients and family members to purchase food. I'm sure you must have noticed it. Regarding the construction of the isolation room for respiratory symptoms... how would it look if there were no place for these patients? The line up at triage is unavoidable because of the international nursing shortage. The nurses there are doing their level best to ensure that everyone is seen in a timely manner, however, it is their job to prioritize on medical severity. So, perhaps you will have to wait - it is the nature of the beast. For the inconvenience of having to walk around outside to get to the coffee shop - well, there was a time that you could pass through the psychiatric emergency section via the hallway, however, this is no longer an option (to my knowledge) because it disturbs the pyschiatric patients and there is an increased security presence in order to protect the staff. You mentioned that no one passes to check on the patients in the waiting room, however, madame I have found this not to be true. In my experience, the patient attendants were constantly passing taking stretcher patients to and from tests and were always available to assist patients whenever necessary. I realize sometimes patients have to wait a few minutes because the staff is busy with someone else but I have yet to see someone left to their own devices due to staff neglect. Your idea about giving out numbers is ludicrous at best... there is a place that gives out numbers to patients - it is Clinique Medical de l'Ouest on the corner of Verdun Avenue and 2ieme avenue. If the emergency department started giving out numbers, they would have to be able to predict the future which as of yet, I don't think they can do. There is no way to know how long it will be and I think you already know that. You are aware, madame that the MGH is a level one trauma centre, no? That means that major traumas like the shooting at Dawson are brought there for treatment and obviously, those patients are seen first. So, madame, my advice to you is that before you start complaining and criticizing those individuals who are giving their best, you spend a few hours in their place. I have watched these hard-working, dedicated, compassionate souls work in the most trying of circumstances, severely short-staffed and caring for the sick, wounded and dying of our city and I tip my hat to them. The are the modern-day superheros who very rarely are thanked for the outstanding job they do. If anyone deserves a pat of the back and a hearty thank-you, it's the staff of emergency. Perhaps you should think about that.


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