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Flashes and Floaters, oh my


March 5, 2013

When getting up from my chair yesterday, I saw a  lighting like crescent shaped streak in the periphery of my right eye.  “Hmm, that’s weird” I thought.  I quickly dismissed it because it was  instantaneous and painless and I could see fine.  Well, it kept up all day long.  Then later in the afternoon, after putting make up on under bright lights, I had a big black worm like floater.  It looked like soot from a candle.  I have had that off and on ever since, along with just rare “lightening like” flashes.  I had an important meeting last night, but before I went, I called my primary care doc.  She responded quickly and recommended that I get my eye examined sooner rather than later.  It was probably dumb, but I went to my meeting about healthcare first, and then to the Eastern Maine Medical Center ER.  I know, my eye should have been my primary concern…we only get two of them.

At approximately 9pm, my husband Mike  went with me to the EMMC ER.  This is may alma mater.  I worked as a triage nurse in this very same ER in the 90s.  It has changed a whole lot since then…and not at all in good ways.

The first thing I had to do was go through a TSA like screening.  “Walk through here, put your purse here, remove pocket contents, walk through the scanner, come over here and get your purse, etc etc.  They did not frisk me however.  The Bangor TSA did frisk me from head to toe last week.  I think it’s time for some profiling.  An old lady like me is 99.99% unlikely to be a threat to anyone.

Next I went to the registration desk.  I stood there for a few minutes while 2 young women had their backs to me about 6 feet away.  They chatted and obviously did not know I was there, so I moved the chair in front of me and made a noise.  No response.  Then just as I quietly said “excuse me”, the security guard came over to alert them to the fact that I was standing there waiting. They finally turned to look at me. I had begun to sit down at one widow, but was quickly told to “come over to this chair”. There was no Please and no Thank You.   I followed my direct order.   The young woman who registered me might as well have been a robot.  She never said “hello”,  and NOT once did she make eye contact.  She was cold and lacked empathy as she mechanically ‘registered’ me.  Her “triage” question was “What’s going on tonight”.  She got the job done, but I could have done just as well at a kiosk with no human  being part of it, similar to printing out a boarding pass at the airport computers.   I was instructed to “sit over there” and wait and the triage nurse will come get you.  There were not many people in the waiting room and I figured (wrongly) that it wouldn’t be long.  The triage nurses are behind closed doors with glass and blinds blocking their view of the waiting room.  A young woman and her mate (husband, boyfriend or partner) sat about 15 feet from me. She was trying to lie on her side in an upright chair.  She was crying and so was her mate.  She was clutching her abdomen and obviously in agony.  My observation was that nobody paid attention, nobody cared, and nobody monitored what was going on in that waiting room.  I was appalled.

When Mike noticed  the sign that said the wait time was  2 to 3 hours to be put in a room, I made a quick decision.  I guess if they put that sign up, we “patients” should be patient and willing to just accept that.  Even if we are in agony, and crying in pain, like that poor young woman I described earlier,  we are expected to wait.  NO, that is not acceptable.  I made a phone call to the competitor, St Joseph Hospital, and I was told that the wait would not be that long.  I told the triage nurse and the cold distant registrar that I would be heading across town  to the competitor.  The nurse looked a tiny bit surprised, but said “oh, ok, that’s fine”.  It seemed that this was not the first time this had happened…and I would guess it happens a lot of the time. As a nurse, I feel guilty that I did not offer to give that poor suffering young woman a ride over to St Joseph Hospital with us.  As a patient, I had absolutely no regrets that we left.   As both, I am very sad that by my observations, the EMMC ER has not improved in customer service and efficiency of care.

St Joseph Hospital reception was a complete turn around from EMMC.  I was warmly greeted, with eye contact and a smile. The triage nurse took me back to the triage room immediately after I took my coat off.  She was about my age and I knew her name, although we had never met.  We connected immediately.  I chatted her up while she efficiently triaged me.  We continued our conversation behind a closed door in the ER exam area.  She is a long time ER nurse and knows so much.  I waited over an hour in that room after she left.  She walked by and asked if anyone had been in to see me.  I said ‘not a soul”.  It was only about 5 minutes later that a Nurse Practitioner came by to examine my weird eye.  He was kind, thorough and efficient.  Aside from a boring hour in the exam room, my visit to St Joes was excellent.

Today I will see an ophthalmologist.  I hope my retina is intact and where it belongs and I have a good feeling that it is.  My ailment is not life threatening at all, and  I do realize that.  But, I fear that even if it had been, my greeting at the EMMC ER would not have been much different, unless I arrived in a speeding ambulance with lights flashing and a warning to the triage nurse. (Update: my eye is fine..no detached retina.)

When I worked at the triage desk at EMMC, my desk faced the entrance door, and the waiting room.  There was no barrier.  The registrars sat perpendicular to my desk and they also faced the door and waiting room.  We all watched what was happening there, even while we registered and triaged other patients.  Once a patient had been signed in, we were responsible for observing them and caring for them while they waited.  It seems now that nobody is watching or caring about the patients who are waiting in the waiting room.  Improving privacy for patients and safety for patients and staff has to somehow still allow for observation and care of patients who are waiting for emergency care.  Sometimes those patients need attention because their triage status can change.

If I had the opportunity, I would go to EMMC, sit down with their ER leadership and tell them exactly how I felt about my visit last night.  Maybe I will send a letter and offer to do just that.  If my brief encounter is any indication, my alma mater has not improved over the years, it has gotten worse. I am sad to be saying that.  I know some great nurses who work there, and I suspect that these things I have mentioned are systems problems…like work overload, understaffed, clogging up of the flow because no in patient  beds are available, no beds are available because there is no staff to accept them  and poor coordination of care.  As in most cases, it is a mess that needs to be fixed from the top down.   My letter will go out to the EMMC Chief Nursing Officer tomorrow……



  1. March 11th, 2013 at 10:21 | #1

    Good luck with reaching out to EMMC ER supervisory staff. If somehow, despite your charm and the strength of your position, you do not get a persuasive vow to do better, I hope you will proceed to EMMC administrative offices. If they aren’t concerned about ER ambience and patient comfort, the higher-ups might be concerned about liability if someone dies in their ER prior to triage — as has happened in at least one NYC ER recently.

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