The waiting room of the emergency department has been jammed, as is always, with patients sitting for hours, strictly packed on hard metal chairs. Only those with such terrible conditions that needed immediate care – like a heart attack – were immediately seen.
A man had had enough. Mars was on the glass window in front of the reception -edge before falling. As he left, he attacked a nurse making a steaming break. “At work?” He called, as he moved away.
No, the event was not real, but it was the art that resembled the life of “The Pitt”, the Max series that will broadcast its season finale Thursday. The show takes place in an emergency room of the imaginary hospital in Pittsburgh. But the theme below – frightening overcrowding – is universal in this country. And it’s not easy to solve.
“The and are blocked and overwhelmed,” said the American College of Emergency Medicine in 2023, referring to the emergency departments.
“The system is at the breaking point,” said dr. Benjamin S. Abella, president of the Emergency Medicine Department of the ICAHN SCHOOL OF MEDICINE OF MONTE SINAI in New York.
“The Pitt” follows the emergency room doctors, the nurses, the medical students, the janitors and the staff now for now for a single day while facing all types of medical problems, ranging from a child who is drowned helping her little sister to get out of a swimming pool with a patient with a spider in your ear. There were heart attacks and shots, overdose, a patient with serious burns, an influencer poisoned by heavy metals in a skin cream.
Since this is television, many of the thorny problems are solved very well in the 15 episodes of the show. A woman who seems to have abandoned her elderly mother returns, apologizing because she fell asleep. The parents whose son died of an accidental overdose of Fenetanil comes around donating his organs. A pregnant teenager and his mother, in contrast to a medical abortion, come to a resolution following a wise medical consultant.
But again and again, the image is of a system that works well beyond its ability. There is the jammy waiting room and the “pensioners” – patients parked in the emergency room or corridors for days or more because there are no hospital beds. (The American College of Emergency Physicians calls on board a “national crisis for public health”)
There are long expectations for simple tests. There is the medicine of the corridor: patients who see a doctor in the corridor, not in a private area, because there is nothing more to put them.
And there is violence, verbal and physical, by patients with mental and those, like the man who gave a hand to the nurse, who gets tired.
“” The Pitt “shows the coercion that the system is below,” said Dr. Abella. “Throughout the country we see this day after day.”
But why can’t this problem be solved?
Because there is no simple solution, said dr. Ezekiele J. Emanuel, co -director of the Health Transformation Institute at the Perelman School of Medicine of the University of Pennsylvania. The problem, he said it is “multiple and there is no magic wand”.
Part of it is money.
Having patients glued to the emergency room guarantees that no bed will not be used, strengthening revenues for hospitals.
So there is the problem of downloading patients. The spaces are scarce in the nursing homes and in the rehabilitation centers, so patients ready to leave the hospital are often blocked while waiting for a space to open elsewhere.
The times are another difficulty, said dr. Jeremy S. Faust, attending the doctor of the Department of Urgency Medicine of Brigham and Women’s Hospital. Many rehabilitation centers admit patients only during working hours, he said. If an ER patient is ready to be discharged during one during a weekend, that patient must wait.
In “The Pitt”, as in real life, patients often present themselves in the emergency room with problems – like a child with an ear sickness – that a private doctor should be able to manage. Why don’t they just go to their doctor instead of waiting hours to be seen?
One of the reasons, said dr. Emanuel is that “primary care are going to hell in a basket”.
In many cities finding a general practitioner is difficult. And even if you have one, get an appointment can take days or weeks.
Many don’t want to wait.
“Modern mentality, for better or for worse, is: if I can’t take it now, I will look for other solutions,” said Dr. Abella.
This often means the emergency room.
Even the construction of larger emergency work has not helped with overcrowding.
Dr. Faust said that his hospital opened a new emergency room a few years ago with a great increase in the number of beds. A colleague, giving him a tour, proudly told him that there was now so much space probably there would probably be no more patients with corridor.
“I looked at him and said:” Bwhahahaha, “said Dr. Faust.” If you build it, they will arrive. “
He was right.