PH Hospital Rants #1: Why We Hate Non-emergency Cases in the ER

Disclaimer: The thoughts and opinions introduced in this post are based from the author’s viewpoints. It does not entirely reflect the whole health care system in the Philippines. You free to believe and search for the truth for yourselves.

(Mahirap naman talaga intindihin kung ano ang mundong ginagalawan ng mga taong nagtatrabaho sa hospital. Kadalasan sa point of view ng pasyente or bantay ng pasyente nakikita ng mga nangyayari na one sided. Maraming bullshit na makukuha sa mga telenovela sa mga scenes sa ospital, sa sobrang dami ng bloopers nakakatakot na isipin kung ano ba talaga pumapasok sa mga ulo ng mga taong walang alam sa pagtatrabaho sa mga ganitong lugar.)

It’s past midnight and things started to calm down after the recent wave of patients a few hours back. Motor vehicular accidents and multiple people involved will never spell chill in the ER. Whether you’re a nurse, resident doctor, or just a clerk on duty, all will come down to a consensus that the only consolation you will ever had from a toxic shift is not having an OPD case enter the ER. By OPD case, we mean an Out-Patient-Department case.

The first person the patient encounters in the ER is the Triage personnel. These staff are trained to categorize emergency and non-emergency cases. An experienced staff could easily stratify your risk level based on the history, sign and symptoms you manifestation upfront. It’s a no brainer to understand that when you are bleeding to death, got burned, or progressively loosing consciousness after a fall, the triage would classify your case as an emergency.

However, for the layman that came into the ER past midnight with a complaint of shoulder pain for 2 weeks, I don’t think that person knows where to direct himself for proper care. Seriously? If you’re discomfort is something that could be waited out for a few more hours when the OPD clinics are open, it’s not that serious enough to merit an ER visit unless specifically told by your attending physician otherwise.

(Imagine mo nalang na natutulog kana ng mahimbing at napukaw ka ng tawag mula sa katrabaho mo dahil nagtatanong kung pano e troubleshoot yung printer sa office para sa importanteng presentation bukas. Yung solusyon lang naman is restart or readjust yung ink cartridge. Ano konek? Yan yung feeling pag na abala ka ng pasyenteng may maliit na problema sa ER na pwede naman ma asikaso sa OPD.)

It’s not that we hate you for going into the ER with a minor discomfort. It’s just that we hate you for going into the ER during hours when we expect only emergency cases. There’s an OPD clinic during business hours for that. But no worries, OPD cases do end up being emergency cases occasionally but most can be treated without bothering the ER personnel at night. There are three things that grinds an ER staff’s gears when we get a non emergency case past 5-6PM and before 7:30 AM.

1. Attitude

We can forgive people who came into the ER with a complaint they have been enduring for a long time until it gets worse but never an attitude that the ER is a first come first serve basis. If you have to bitch about how much you are in pain for a small wound that only requires a few stitches, we hate you. There are other patients in the ER that are doing worse than you and they require more attention than your Urinary Tract Infection.

In the ER, the most stable patient gets to be the least priority. So if your case isn’t life or death, you’re in luck that you have to wait long before getting noticed by the resident. You’re in worst shape if you get top priority and do we really want that happening?

(Hindi first come first serve yung ER. Namimili ng priority case yung triage at sorry nalang kung hindi ka immediate priority kung maraming pasyente. Maging happy kanalang na hindi ka priority dahil nasa bingit ng kamatayan yung may premium treatment.)

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2. The reason you came to the ER isn’t that big of a deal.

If it can wait in the morning, then forget about coming to the ER. If the discomfort has been bothering you for weeks, why come into the ER and treat your condition like it was an immediate concern when you yourself have neglected it? Seriously, I just couldn’t find it in my heart to understand people that endure their discomforts and coming into the ER at the most inconvenient times.

(Katangahan nalang talaga ang dahilan kung bakit pinahihintay pang lumala yung problema tapos pupunta sa ospital at mag expect ng madalian na solusyon. Pag months na yung sakit mo, wag mag expect na magic yung pag punta mo sa ospital.)

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3. You Don’t Recall A lot of Details about Your Problem.

A headache or abdominal pain can have several causes and each disease behaves differently from the other. Telling us what you thought caused the problem, when it started, how long it started, what makes it worse and better, and etc helps us narrow down what the cause or treatment appropriate for the situation. Patients too irritable to share these critical info just delays the treatment that could provide alleviation.

(Pag alert ka sa pag bigay ng detalye tungkol sa sakit mo, mas mabilis kang hindi na aabalahin ng nag iinterview sayo. Need nila yung impormasyon para maka refer sa iba ng kaso mo or malaman paano ka papagalingin. Pag pinapatagal mo pa yung interview dahil may trust issues ka or di mo trip yung nag iinterview sayo, preho lang naman kayo magkakaproblema.)

We get that you are in pain but honestly, we can’t do much if your attitude just wards us off. We can’t help someone who refuses to cooperate.

Non-emergency cases are best handled on an OPD basis. We would immediately hate you if your reason for coming into the ER late at night with a minor complaint was to avoid the daytime crowd. For your convenience of not getting a consulting during business hours, you compromise care for those people that deserve it more. At the very least, it’s fine if you go to the ER while behaving like 2 and 3, that could be excused. We can accommodate.