As a Nurse Expert Consultant and RN with over 22 years of experience in the area of emergency medicine, I’m accustomed to questions about ED (emergency department) wait times. When you’re sick or injured, any wait seems too long, of course, but many things factor into the time it takes for an ED patient to be seen and treated.
In 2014, the Centers for Disease Control and Prevention reported average emergency department wait times (about 30 minutes) and treatment times (about 90 minutes), adding up to roughly two hours in the ED. Patients with immediate, emergent and urgent needs are seen sooner (and treated longer) than urgent, semi-urgent or non-urgent patients. But did you know that wait times may also be affected by the weather and season?
Working as an RN in the emergency department had its share of challenges on a daily basis, but come winter, it is a whole new ball game. In the winter, the patient population explodes, but the number of beds in the ED and the hospital remain the same. With this increase in patient load also comes an increase in patient acuity (higher level of care), placing an immense deal of stress on the facility.
When winter weather arrives, patients with respiratory issues, such as COPD (Chronic Obstructive Pulmonary Disease) and asthma, have greater difficulty and can frequently end up in the emergency department. During the pre-winter months of October and November, influenza and RSV (Respiratory Syncytial Virus) patients fill the ED and hospital beds; so right off the bat the hospital is in a difficult position.
Not only is this a challenging time for the nurses, but also for the patients. In many instances, the patients that need to be admitted to the hospital will remain in the ED for over 24 hours. This leads to limited space for the influx of ambulances and “walking wounded” that continue arriving at a steady pace and need to be cared for immediately.
In the winter months, it’s not unusual for patients in the ED to be placed on stretchers, in wheelchairs, and in desk chairs in every hallway available and even surrounding the nurses’ station. Granted, this is not the best placement when a patient is sick or injured, but during a busy time it might be the only option available.
Frustration on the part of the patient and their family members is completely understandable. It is also a highly stressful time for the nurse as she/he is trying to care for a large patient population with varying levels of acuity, from the least serious to life-threatening.
Being educated on what to expect when entering the ED during these times can save the patient and their family members undue stress. Understanding that the ED is not a first-come, first-served area of treatment can better explain why a person coming in after another may be taken to the treatment area sooner. Life and limb-threatening cases will always be a priority.
Any RN who has worked the ED knows the biggest concern is to provide safe care for patients as effectively and efficiently as possible. Providing the best care, no matter the situation, is always the goal — while also trying to keep the flow of the ED moving during a tremendously challenging time.