Saturday night at the ER

Mac McPhail Contributing columnist

December 29, 2013

“We’re on lockdown.” When I heard the nurse say that I knew my long Saturday night at the ER had just gotten longer, but a lot more interesting.

Around 11:30 last Saturday night I arrived at the Emergency Room at Sampson Memorial Hospital to be with my uncle who had just been taken there by the rescue squad with severe stomach pains. I went back to one of the cubicles as the nurse was taking Uncle Clifford’s vital signs. Most of the curtain lined cubicles were already filled with patients. The hospital staff was scurrying from one cubicle to another treating each patient. To them, it probably was a typical Saturday night at the ER.

They wanted to do a CT scan on Uncle Clifford to determine what was causing the pain. So, for the next couple of hours I assisted in helping him drink about a quart of some cherry Koolaid looking solution that helps make the CT scan more effective. (Uncle Clifford said it sure didn’t taste like Koolaid. He had to drink it slow to keep from throwing it back up.) It was around 1:30 AM, and he had just about finished the solution. The nurse had told us that she would be back in a few minutes to take him up for the CT scan. Then things became interesting.

“We’ve got a couple of gunshot victims coming in,” I heard one of the nurses say. The already fast pace of the ER picked up considerably. A nurse apologized but said she was going to have to pull the curtain across the front of our cubicle. I could not see what was going on, but I could hear it, and it was interesting. (It was another of those times that I hated having some hearing loss.)

I could hear the ambulance pull up and I could hear them roll one of the victims into the ER and into a cubicle. The nurses and staff were rushing around getting what they needed to work in the patient. As they frantically worked on the patient, they used all that medical lingo, just like you hear on TV. I felt like I was in the middle of an old “ER” episode.

One of the nurses told the patient that the ER was now on lockdown and no one in the ER waiting room would be allowed to come to the back. She explained that they didn’t know who the shooter was, so they didn’t want him possibly coming back to where the victim was being treated. I thought it was a good idea since Uncle Clifford and I were only a couple of cubicles down from the victim.

A few minutes later, the rescue squad delivered the other shooting victim to the ER to be treated. While operating at an obviously fast pace, I noticed that everyone’s voices were calm and professional. Although Uncle Clifford was still hurting, we knew that he’d have to wait until they had handled the potential life or death situation. After about an hour, things started to calm down and he finally went to have the CT scan.

The CT scan showed that Uncle Clifford’s severe pain was from a hernia. The surgeon told us that he needed to go ahead and have surgery immediately in order to avoid possible further damage. The surgery team was called in and by 6:30 Sunday morning he was being readied for the operation. By 8 o’clock the surgery was over. It went well and he is on the road to recovery.

While that Saturday night at the ER was interesting, it was a long night. I had time to observe and think. (Because you sure couldn’t get much sleep in those chairs in the ER.) Looking around, I knew Uncle Clifford had health insurance. But I wondered how many of the other patients in the ER had insurance, and how much money, if any, the hospital would ever receive for their treatment. I also noticed how professional and friendly the medical staff were during the night. I remember Terri saying the same thing when her father was at Sampson Memorial during the past few months.

I think we’ve all come to realize that with the Affordable Healthcare Act, (Obamacare) that there are going to be winners and losers. (I know that we were told that we all would be winners. You were also told that everyone would be able to keep their health coverage.) One of the losers will probably be smaller hospitals. For example, under Obamacare, hospitals that re-admit “excessive” numbers of Medicare patients within 30 days of discharge confront significant penalties. The maximum penalty is 1 percent of a hospital’s Medicare reimbursement, increasing to 3 percent in 2015.

“That may not sound like a lot, but for hospitals already struggling financially — especially those serving the poor — losing 1-3 percent of their Medicare reimbursements could put them out of business,” Harvard Medical School professor Stephen Soumerai and University of Pennsylvania sociologist Ross Koppel wrote recently in The Wall Street Journal.

We often take it for granted, but it’s good to have a hospital locally. And we have a good one. With the stagnant economy and the constant changes in medical care, it’s a tough time for smaller hospitals. Just this past September, Vidant Health announced that they were closing Pungo Hospital in Belhaven. I’m glad Sampson Memorial Hospital is still in business. Otherwise, I probably wouldn’t have had such an interesting Saturday night.