What are we getting so wrong? Our treatment of non emergent care. Our attitudes towards the "not sick" that ask for our care. Emergency staff (paramedics, firefighters, ER nurses, doctors, and supprt staff) divide patients into two categories: sick and not sick. "Sick" patients are dying. Right then. In front of our eyes, with unstable vital signs and failing organs and copious bodily fluids and an unholy bluish white tinge to their skin. They need everyone's immediate undivided attention and action to hold back death long enough to (hopefully) fix what's wrong.
"Not sick" patients can be SICK, vomiting on your shoes or feverish or sore. But they're not dying right there in front of you, this minute, today. So we say "not sick."
I have no issues with these categories. They help us emergency workers focus in situations where seconds count. They help us triage multiple patients into those who can wait, and those who cannot. We have an understanding that if patients are able to SAY they cannot wait, they can. It's the quiet ones who are circling death. The bleeders, the strokes, the septic, the burns, the silent babies, the traumas.
What I have an issue with is paramedics, firefighters, nurses, and doctors who treat the not sick with impatience. For certain, we all sign up for "sick." We want to secure airways, reverse overdoses, bust clots, breathe for drowning lungs and stop hemorrhage. We live for it. The trauma bay is our favourite place on earth. The problem is, the not sick need us, too.
Who needs us?
Those with mental illness. Depressed, suicidal, anxious, bipolar, schizophrenic, young, old, or in between. On their meds, off their meds, having a bad day or unable to access help any other way: these people need us.
The elderly. Those with increased incidence of falls. Constipated, unable to sleep, confused, weak, unable to pee, or just lonely. These people need us.
People with diverticulitis.
Folks with UTIs.
Young men or women who can't breathe and are crawling out of their skin with anxiety.
Patients who need transferring between facilities.
Those who are otherwise healthy with abdominal pain.
Individuals with the flu. Not just the run of the mill aches/pains/fever/malaise, but those who cannot manage at home, can't keep anything down, or are not getting better.
Those who are dehydrated.
Vomiting and diarrhea.
Bug bites, rashes, tooth infections, trench foot in the homeless, ulcers in diabetics, fungal infections and abscesses.
This list ain't sexy. It doesn't involve the trauma bay, airway intervention, bronchodilators, or the cath lab. Here, we don't defeat death. Here, we meet people. We care. We comfort and reassure, catch folks who fall through the cracks, and prevent some from ever needing the trauma bay in the future. I'm angered by impatience towards these patients. I'm frustrated by the attitude that Emerg is just for the "sick." It's not. It's for everyone. We cannot turn people away when they ask for help and we definitely cannot continue to convey that we are too good, too hard, too busy and important for the "not sick." Can we improve their situation? Their health? Their day? Can we educate to prevent ill health or future unnecessary visits? Can we advocate? Smile? Reassure? Always.
Do your job. Sick or not sick, no more excuses and no more impatience. The end.