The conversation I expect to have in a couple of weeks with our genuinely Very Sweet Nurse Practitioner:
VSNP: I'm so sorry that you had to go to the ER. That's too bad. I hope the wait wasn't too long.
VSNP, I need to tell you this, because I need you to understand --
It's not about the wait. That's to be expected. It's about FEAR. I feel confident that most of your patients' parents who have taken their children to the ER at this hospital would echo my sentiments--taking our kids to this ER scares us to bits. If we judged this hospital by its ER, we would not come here.
Here is my experience: I drove into the parking garage here at 2:00 in the afternoon. I sprinted to the elevator with LW in my arms, but you know what the elevator situation is like ... when I got here, to the clinic, they said it was about 2:15. They called back and spoke to your nurses. They did not tell me to go to the ER, they said to wait. I waited. At 2:30, you and a nurse came out and said so sorry, but I didn't make it in time, so I needed to go to the ER.
In the ER, a couple of nurses came to our little room to access LW's port. They asked what size needle to use. Whaaaattt? This is not information given to parents. I held LW down while they put a needle in her port. They couldn't get a blood return. They removed the needle. They changed gloves, changed equipment. I held LW down again, her crying. They put another needle in. Still no blood return. There is a big bubble in the line, which, thankfully, they notice, so they decide not to push the saline. They remove the needle. My daughter is, understandably, more than a little upset. Finally, a third nurse comes in, an expert from the TPN department. She puts the third needle in through LW's skin into the port, as I hold her down, my heart crying as I whisper, "I'm sorry, I'm sorry" into her ear as she screams.
Instant blood return. I ask if it's slow. The TPN nurse wrinkles her forehead. "No, not at all." She looks at the ER nurses. They begin telling her that they think there was still contrast in LW's line from the day before. She asks why they think that. She looks dubious. She asks why I didn't just go through the clinic. I tell her that you said we were too late by 15 minutes. She shakes her head. She knows what the ER is like.
LW is hooked up to IV, her blood taken for testing, her standard Xray done. I take her to the bathoom a couple of times and it is filthy. I am afraid for her feet or more importantly, her IV line, to touch the floor. We are in the ER for 7 hours. The bathroom never gets cleaner.
At some point in the middle, the "doctor," (my guess is an intern) comes to give us the news that her counts are good enough for us to go home but um, erm, they screwed up and gave her the 8 hour antibiotic rather than the 24 hour antibiotic, and no, we can't go home and come back, and no, we aren't going to be admitted to a hospital room, but instead, we need to stay there til the 8 hour antibiotic runs its course, which will be around 1 am, then we'll get the 24 hour antibiotic, and when that's done, probably about 2 am, then we can drive home! Whoopie!
And it is at this point that I am thinking ... because we got to the desk at 2:15, rather than 2:00, we will be here until 2 in the morning.
And I am further thinking ... I think I would feel safer being treated by the doctors at (the local hospital for indigents).
We got lucky, if that's what you want to call it, because the ER actually called the doctors who do hematology/oncology and told them of their nefarious plan and the hem/onc doctors, God love 'em, said, No, just go ahead and give her to 24 hour antibiotic now.
(They've been pumping her full of chemicals for 6 months that could fell a cow, what's a bit of extra antibiotic?)
And that is why, VSNP, that is why you saw me look quite upset when you said that we were too late for triage, and had to go to ER. It wasn't because I was worried about the wait and being bored. Bored? Ha! It was because I was worried about the level of excitement I would be under, a fear that, once again, proved to be true.
15 minutes. Well ...
NO CUPCAKES FOR YOU!!!