Abdus Salam Kha, MD FACP
The emergency department acts as the last refuge for all the patients all over the world. This gives it the unique position to see all ages and to deal with all acute illnesses. These illnesses, range from minor headache of insignificant variety to life-threatening cardiac arrhythmias.
People who serve those patients in the Emergency Department do the most difficult job. And that is not to deal with grave situations or difficult attendants, but having to differentiate between an insignificant issue and significant problems. So at times a potentially sick patient is sent home because they didn’t look sick or at other times someone gets admitted who otherwise should have been sent home. People working in the emergency department do their best to balance the risk of discharging patients, against the safety of keeping them in the hospital. We routinely monitor the failed discharges by noting how many come back to the hospital with same complaint after being discharged.
The general population should help the emergency doctors in creating those balances. The best step should be, to come to the emergency department with serious illnesses. The minor illnesses in patients increase the burden of emergency and cause the physicians/nurses to take decisions of being extra careful. This leads to extra work for the emergency staff which lead to some dissatisfaction among those patients who wanted a quick fix. They should understand that in the emergency department, staff is not trained for quick fix, but to play save and to save lives.
The second thing that Patients can do is to have trust in the system. The emergency care unlike routine care of patients is very complex and depends upon mutual interplay and good communication. Any concern should be brought to the attention of emergency physician in ways to come to a solution rather than escalate an already initiated problem. Similarly all doctors and nurses should value the input of the patients into their own decision making and also communicate to them if there are issues pertaining to the care of the patients.
Emergency care is the teamwork and the emergency staff should include the patient and attendance in that team to achieve maximum benefit and also good patient satisfaction. The patients feel the pressure to be discharged earlier and a solid decision be made quicker while it is not possible at times. A good communication and trust does lead to better outcome for all.
I hope that our emergency staff and the patients work together for the safety and the best outcome of our patients.