A trip to a hospital emergency room is no one's idea of a swell time. But more than 130 million times a year, people in the U.S end up there—often with non-life-threatening problems that can mean hours of waiting for treatment. As a volunteer EMT, I can see the frustration, confusion, and fear on patients' faces. As the parent of a chronically ill child, I've felt it first-hand myself.
So how can you minimize your misery time and maximize your quality of care?
"The most important thing you can do is preempt going to the emergency room in the first place if your problem isn't truly urgent," said Dr. Young-Jin Sue, MD, an attending ER physician at Children's Hospital at Montefiore Medical Center in the Bronx, NY.
Her tip: Establish a relationship with a primary care provider whom you can call for advice and who may be able to make space in his schedule that day to see you. There are also about 10,000 urgent care facilities in the U.S. that care for just the kind of problems that can leave you languishing in the ER (think possible broken ankle, finger meets bagel knife—here's more on how to tell what's a good fit for urgent care vs the ER). So get the name of a good one near you and keep it in mind.
If you do end up in the ER for something less than life threatening, here's the skinny from ER insiders on what can make your visit faster, safer and easier—and what won't.
1. Don't believe that an ambulance arrival will get you treated more quickly.
My ambulance will get you into the hospital pretty fast. But just because I take you in the back it doesn't mean you'll stay there. You'll see a triage nurse, who will rate the urgency of your problem from 1 (get a doctor now!) to 5 (may I introduce you to this lovely plastic waiting room chair?). (Looking for more insider health tips? Get your FREE trial of Prevention today!)
2. Have your doctor call ahead.
If your physician believes you need urgent attention, he can pave the way for your arrival.
"We actually have a "pre-expect" form we fill out about a patient and his condition when a doctor calls. It's not unusual for us to then 'up triage' the patient and get him to see someone sooner," Sue said.
3. Don't lie!
Fib about seeing blood in your vomit and you may get into an exam room faster. The bad news? Your "symptom" may send ER staff barking up the wrong tree. "Even if you dial back what you said, we may have to pursue your exaggerated complaint to cover ourselves," said Dr. Leana Wen, author of “When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests.” That could mean more tests and more of everyone's time wasted—including yours.
4. Bring your paperwork (and more).
Recent test results and a list of doctors, medical conditions, allergies and current medications (or the drugs themselves) are real time savers. And regardless of the season, take a sweater or a light blanket with you. ERs can be ice-box-chilly—a plus for always-scrambling staff but often brutal for sick and long-sitting patients. Most importantly—bring another person who can ask questions, take notes, and advocate on your behalf.
5. Keep your story short and sweet, but complete.
"Eighty percent of diagnoses can be made based on what patients tell us," Wen said. So, if possible, think up a concise script of what your problem is and include other relevant factors.
"If you just say you have a headache, we might assume anything," Wen said. Much better: I have history of migraines, this is the worst one ever, and I've had it for three days."
6. Squeak but don't scream.
Chewing out ER staff generally won't get you anywhere—other than on their bad side. Come expecting to wait. That said, don't fade into the woodwork, either.
"It is possible in a very busy ER to be forgotten," Sue said.
If no one has popped in to your exam room for ages, touch base with the charge nurse or hit the call button and politely tell him so. If time in the waiting room has become intolerable, talk to the triage nurse. Especially if you're feeling worse.
"It can be as simple as telling her your fever seems higher or your pain is more intense. Triage understands people's conditions change and may very well raise your priority," Sue said.
7. Enlist an ally.
If you're feeling lost in the shuffle and aren't getting anywhere with the triage or charge nurse, ask to see the social worker on duty.
"Just about very ER has one," said Jacqueline O'Doherty, owner of Healthcare Connect, LLC, a patient advocacy practice in Califon, NJ. "Social workers may not be able to get you treated sooner. But they are generally very nice, can calm everyone down and help ease communication between you and the ER staff."
8. Go to the right place.
Do a little homework now, especially if you have kids or any preexisting conditions. Some hospital ERs are better prepared than others to treat certain conditions, like strokes, burns, and mental health issues. Some also have designated pediatric ERs—where you'll find specialists who treat children and a more family-friendly vibe all together. If you hail an ambulance, you can request a specific hospital if it's within their driving radius. If you travel by car, you'll know where to head.
9. Question just about everything.
If you're told you need a test or procedure, ask what it's for and what your other treatment options might be.
"Don't assume that there's only one right way," O'Doherty said.
For example, your assigned physician might order a cardiac catheterization for your chest pains. But someone else might opt to treat the problem with medication.
"As a patient, you have the right to know your treatment options and that you have the right to choose," she said.
10. Track names, track times.
As soon as they slap on that ID bracelet, request the name of your charge nurse, your assigned doctor, and that shift's attending physician. These are the people to ask for and who are responsible for you. If they're drawing blood or doing any tests, ask how long it will take for results.
"If they say an hour, don't assume they'll be right on those results," O'Doherty said. "Keep track and if that hour passes, it's perfectly appropriate to give them a reminder."
11. Don't depend too much on technology.
There are all kinds of phone apps and zip drives where you can store your medical info. Sounds great in theory. But…
"We don't have time to start figuring out if and how we can use it," Wen said.
A simple printout is still your best bet—or a good back up. Apps that tell you how long the wait will be at various ERs should also be taken with a grain of salt. The very nature of emergency care is that everything can change in a blink. General wait times also don't reflect the most basic issue of all: how sick you are. Because that's, ultimately, what determines how fast you'll get in.