The waiting room of the emergency department was blocked, as always, with patients sitting for hours, tightly packaged in hard metal chairs. Only those with conditions so difficult needed immediate care – such as a heart attack – saw immediately.
A man had enough. He fell into the glass window in front of the receptionist before he took out. As he left, he attacked a nurse who took a smoking break. “Hard at work?” He called, as he fell.
No, the event was not real, but it was the art that looks like life in “The Pitt”, the Max series that will broadcast the season finale on Thursday. The show takes place in a fantastic emergency room of Pittsburgh Hospital. But the underlying theme – scary overcrowding – is universal in this country. And it’s not easy to fix.
“The EDS is Gridlocked and overwhelmed,” said the American emergency college in 2023, referring to emergency departments.
“The system is at the point of breaking,” said Dr. Benjamin S. Abella, President of the Department of Emergency Medicine at Mount Sinai’s Icahn School of Medicine in New York.
“Pitt” follows doctors, nurses, students, caretakers and staff with one hour for one day, as they deal with all medical issues, ranging from a drowning child helping her little sister come out of a swimming pool to a patient with a spider. There were heart attacks and strokes, overdoses, a patient with severe burns, an influence poisoned by heavy metals in a skin cream.
Because this is television, many of the thorny problems are resolved neatly in the 15 episodes of the show. A woman who seems to have left her elderly mother returns, apologizing for sleeping. The parents whose son died of an accidentally overdose of fentanyl come around to donate his organs. A pregnant teenager and her mother, unlike a medical abortion, come to a resolution following a doctor’s adviser.
But again and again, the image is a system that works beyond its ability. There is the blocked lounge and the “settlers” – patients parked in emergency rooms or corridors for days or more because there are no hospital beds. (The American College of Emergency Doctors calls on boarding a “national public health crisis”.)
There are long expectations for simple tests. There is the corridor drug – patients who see a doctor in the hallway, not in a private space, because there is no room else to put them.
And there is violence, verbal and physical, by patients with mental problems and those, such as the man who hit the nurse, who are just coming in.
“” The Pitt “shows the pressure of the system,” said Dr. Abella. “Throughout the country we see this day and day.”
But why can’t this problem be fixed?
Because there is no simple solution, said Dr. Ezekiel J. Emanuel, co-director of the Institute of Health Transformation at Perelman Medicine at the University of Pennsylvania. The problem said they are “multiple and there is no magic wand”.
Part of him is money.
Having patients with blockage in emergency rooms guarantees that no bed will be unused, reinforcing the revenue for hospitals.
Then there is the problem of discharging patients. The spaces are rare in nursing homes and rehabilitation centers, so that patients ready to leave the hospital often stick to a place to open elsewhere.
Schedules are another difficulty, said Dr. Jeremy S. Faust, who is watching the doctor at Brigham and the Women’s Hospital of Emergency Medicine. Many rehabilitation centers admit patients only during working hours, he said. If an ER patient is ready to be discharged in one over a weekend, this patient should wait.
In “The Pitt”, as in real life, patients often appear in emergency rooms with problems – such as a child with ear – that a private doctor should be able to handle. Why don’t they just go to their own doctor instead of waiting for hours to see them?
One reason, Dr. Emanuel said, is that “primary care goes to hell in a handbasket”.
In many cities finding a primary care doctor it is difficult. And even if you have one, making an appointment can take days or weeks.
Many do not want to wait.
“The modern mindset, for better or worse, is: If I can’t get it now, I’ll look for other solutions,” said Dr. Abella.
This often means the emergency room.
Even the building of larger emergencies did not help with overcrowding.
Dr. Faust said his hospital opened a new emergency room a few years ago with a large increase in the number of beds. A colleague, giving him a tour, proudly told him that there was so much space that there would probably be no more patients with a corridor.
“I looked at him and said,” Bwhahahahaha, “Dr. Faust said.” If you build it, they will come. “
He was right.
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