Waiting to be seen at an emergency department is monotonous, no matter the location, circumstance or mode of arrival. Any one of us with any experience sitting in a crowded waiting room as a patient, parent or loved one, will know that it’s boring. In days gone by, the stack of well-thumbed magazines quickly lost its allure and nowadays, mobile devices either run out of battery or we run out of interest in continuous scrolling. So how do we fill the time? People watching.
We begin to look around. Observe the order of play as nurses or doctors call out for the next patients in line. Gaze over at the door to check out newcomers and their injuries or ailments. Glance around amongst others seated and standing. Listen absentmindedly to interesting conversations. Hone in intently to the fascinating details we overhear from others.
Imagine the intrigue that non-medical people must feel when they find themselves in similar situations? It’s all new – like having a front row seat in a fly-on-the-wall documentary.
When we consider the popularity of reality shows, in particular the medical and emergency services-based favorites, it’s mind-blowing just how many hours of footage viewers enthusiastically devour. Many aspects may seem tedious or repetitive to us, but every second counts for millions of others, when they thrive on the “behind the scenes” nature of our roles.
So, what is the impact of the “hurry up and wait” style of working that so many of us are now forced to adopt into everyday routines? It puts us on display and under heavy scrutiny for extremely long periods of time.
No matter what we call our “wait time,” “wall time” or “ramping,” it is a growing burden. Parking stretchers in hospital corridors and remaining with them for hours on end is tiresome. Something none of us trained for. Now that it’s happening more and more often, even those medics who initially enjoyed the chance to take a break begin to dread the prospect.
There’s a routine that we adopt over the years, where it’s all go as soon as we arrive on scene. Treatment, interventions, rapport and reassurance usually do the trick and most patients become comfortable, both physically and emotionally, by the time we arrive at a hospital. Then we hand over care and move on. But now that we’re destined to remain together, in close proximity, for unlimited periods of time, balancing out the humor and chit-chat is vital.
If there’s only so much we can talk about for a whole day or night with our own nearest and dearest, maintaining this with strangers indefinitely is bound to prove challenging. So, what can we do to purposefully build and maintain a healthy and professional balance between highly observant or expectant patients and our boredom?
1. Avoid center stage
It’s easy to fall into a habit of satisfying curiosity by answering questions about prehospital care, and it’s just as easy to chat with colleagues and forget our patient. No matter the circumstance, every patient waiting with us in an inner sanctum corridor full of medics will overhear every word. Some of us love the attention, some detest it, but either way, the spotlight is on us and what we put on display. If it’s dark humor, stories of other patients or personal ramblings, we risk causing shock, horror, insult and of course, complaint. Imagining our family members in the patient’s shoes provides instant insight into how we may be perceived after several hours of listening.
2. Manage the scene just like any other
Conditions may be cramped in either designated or makeshift spaces, but while a patient is in our care, we still have responsibility for managing that scene.
If family members or friends are with the patient, are they appropriate company and would they be better suited to waiting elsewhere?
Is the patient at risk of pressure sores or increased pain due to their position and is there anything we can do to avoid this?
Are we concerned about their condition and need to speak up on their behalf?
Advocating for patients remains front and center of our care, no matter where the scene of the call happens to end up. Their safety and our professionalism remains paramount.
3. Form habits to maintain the right mindset
Creating new ways of working when based in hospital waiting areas can save our own sanity and help to maintain the professionalism that patients hope to see in every one of us. Using the time to brush up on service guidelines and protocols, work through continued professional development, practice drug dilutions and dosages with colleagues or similar activities is manageable and has multiple benefits.
Learning can be done during wait time rather than on days off; skills and knowledge are sharpened; less mindless chatter happens; patients, employers and hospital staff consistently see professionalism on display; continuing education hours are racked up with ease and there is less pressure to provide constant conversation over the entire waiting period.
4. Set expectations and stay in the zone
Setting patients up for what’s in store can help to soften any blow that extreme delays may cause. Letting them know what’s likely to happen next will help to put their minds at rest, as well as give ourselves a little structure and predictability through an unpredictable wait time.
Use timers on monitoring equipment or devices to keep on top of regular vitals and let the patient know how often this will happen.
Explain that they can snooze in the meantime, otherwise they may not realize that this is an option.
Tell them that advanced bathroom warnings are important due to the steps involved in managing this safely.
If we can find ways to maintain some semblance of routine and order for our patients, they can feel safer and will likely require less constant reassurance from us while we wait.
5. Keep it real
It may be less than ideal, and it’s probably a far cry from the emergency lifestyle some of us thought we were signing up for, but for any medic working in a system that currently experiences long waiting periods, some level of acceptance before transport even begins may make all the difference.
Encourage patients to pack a book to read; a portable craft project, like knitting; or a device to watch, headphones to listen with and a charger for extra battery life. Having patients and family members prepared in advance for the reality of what’s in store will not only ensure that they have something other than the crew to keep their minds occupied, it will increase their understanding, sense of control and appreciation of the informed care that we are providing.
Waiting in line is no longer limited to walk-ins at any emergency department. Queues of ambulances outside and stretchers inside are now a long-term issue. No matter how much we love or loathe the situation, there is no obvious immediate solution, therefore it’s up to prehospital care providers to do what we do best and improvise, for our own peace of mind, sense of professionalism and positive lasting impression amongst the general public.
If that means advocating for change and becoming involved in policy review, harness every bit of enthusiasm and run with it right now. The real-world insight that experienced medics can bring is inspiring. But for frontline providers currently entrenched in the daily grind of lights and sirens calls resulting in hurry up and wait situations, forming new habits can help.
Making corridor care more manageable, predictable and controlled may be key in providing positive experiences for patients as well as some sense of satisfaction for ourselves, in this stressful new aspect of the prehospital role.
Read next: 4 things to explain to patients to increase their comfort and compliance
