I ended up in the ER on Labor Day. I fell in my house, slamming my right elbow down on the hardwood floor. Hard.
I knew right away from the level of pain in my arm that I had done something that went beyond a simple bruise. And I did what any woman would do: I got dressed, brushed my teeth and brushed my hair (with my left arm, of course). Then I woke up one son with instructions to wake up his older brother. I needed someone to drive me to the ER.
I was cradling my arm while trying to think what in the world I needed to do to get out to the car — pain and trauma affect the brain in ways that we just don’t understand. It would have been nice, in retrospect, to have my sons care for me after I injured myself. Note to self: teach sons simple first aid and basic care of a person who has been injured. Okay, back to my story.
I began to feel something sticky, and when I pulled my left hand away from cradling my elbow I saw blood. Not gushing, but enough to know that I had cut my elbow. I grabbed a kitchen towel and applied pressure (again, why were none of my sons grabbing the first aid kit and applying a sterile gauze pad to my cut???).
Finally in the car, my son drove me the 30 minutes to the closest emergency room while I moaned. I have a high pain threshold normally, and deal with daily, constant pain from Chronic Lyme disease, but this was different.
We arrived at the ER and saw only one other individual waiting. I was encouraged. Looks can be deceiving. It took a few minutes before the receptionist even took my information — insurance card being paramount, of course. Then it took at least 15-20 minutes before I was triaged.
When I was brought in for triage, after a quick glance at my elbow, and the nurse determined that it was an abrasion. I told them my pain level, and I was taken to a room. Well, an abrasion is no big deal, right? And pain is subjective.
A med tech came in first, bringing in a sling (of all things), and the “stuff” necessary to clean up my abrasion. Finally, he dove in to the task at hand. It hurt like hell. I mean, it HURT. Then he commented that there was definitely a deep cut and that he needed to thoroughly clean it out (he mentioned seeing something in the cut). Yeah, I knew that since abrasions don’t bleed like my wound had bled. I also knew that something else was going on because of the level and type of pain.
Next came the x-ray. Was I dizzy? Yes. I got a ride. X-ray hurt like crazy, turning, laying my arm out, turning hand this way and that. Done. I was wheeled back to my room.
After quite a bit of time, a doctor came in and announced that nothing was broken. I was relieved because my son at home needed to get to work in a few hours, and I knew a break would mean a longer time in the ER. Seriously, that was how I was thinking most of the time I was in the ER. I need to get out of here so my son can get to work.
The doctor discussed how many stitches it would take. Two to three was the determination — it wasn’t a large cut. But he did say it was quite deep. He pulled, prodded, and examined that wound, then injected numbing drugs. The pain relief was fast and welcome. He mumbled that he was going to check the x-ray one more time to make sure nothing was broken.
Some time went by and suddenly my ER room came to life. Doctor #1 came in and said that I was going to get IV antibiotics because of the location of the cut. Okay, no biggie.
Then Doctor #2 came in. Orthopedic specialist. He told me that because of the depth and location of the laceration on my elbow, I might need surgery to flush the joint with antibiotics. Alternatively, he could inject the joint with saline and watch for fluid escape through the laceration. After scaring the crap out of me, he determined that none of that was necessary and that I would be sent home with instructions to watch for signs of joint infection. Okay, that sounded like a great plan (I guess).
Doctor #1 came back in and announced that I had a bone chip. Yeah, I knew something was wrong with that elbow besides an “abrasion.” At this point, I just wanted out of there. I was exhausted, my son was exhausted, my other son needed to get to work, and we all wanted me gone.
It was amazing how quickly the ER staff jumped to it when it was discovered that my injury was more than an abrasion and bruised elbow. Duh. Why in the world would I go to the ER for a scraped, bruised elbow? Have ER staff members become so jaded that they fail to take patients seriously?
And then over the last week I have wondered if my gender affected the level of seriousness assigned to my case. Was I just a silly woman looking for attention in the ER because I didn’t have anything better to do? Do 21st century medical professionals even think that way anymore? Sure they do. Just read the headlines.
Psychology has so infiltrated the medical profession that doctors, nurses and med techs do not really listen to patients. They “evaluate” patients. They judge patients. They determine what patients need.
If someone had asked me what I thought, I would have explained that the type and degree of pain indicated some kind of fracture, chip or break. I would have explained that the way the wound bled indicated that it was cut, not scraped.
No one asked me. They asked me what my pain was from 1 to 10. Good grief, how ridiculous is that? I have given birth to 5 our of 6 babies with no pain medication. I know pain. I can handle pain. Pain evaluation is subjective, and there is no way that the ER staff can even come close to understanding a traumatic injury the way they handle patients.
They have a system. They guard against pain medication seekers. They guard against lawsuits. They guard against…who knows what. But they fail to provide effective care when they don’t listen to patients.
Back to the appearance of a slow morning: the ER was actually packed. Each nurse was responsible for 6 patients while I was in there. My injury was triaged as a scrape. That is the flaw in the system.
When the doctors realized that I had a deep laceration near my elbow joint, and that I had chipped my elbow, they immediately sprang into CYA mode. It had been nearly 1.5 hours since I cut my elbow before it was cleaned out. I knew immediately that is what they were doing. Care was not the issue. It was lawsuit potential.
And do you know that they released me without discussing how to care for my arm with a bone chip in the elbow? No instructions other than one doctor mentioning that I should immobilize my arm and telling me about a great software that utilizes voice for computer work (since I was not supposed to use my arm until it healed — no mention of how long).
I got two calls from the ER in the past week. Both were to determine whether anyone had told me that I had a bone chip. Apparently they were concerned that I had been released without this diagnosis. What a mess that ER was on Labor Day. I completely understand how busy they were. There were a lot of people who were ill, mostly. I didn’t see many other injuries. Lots of sick people.
But I was a perfect example of how ER staff can completely miss something potentially serious. If the cut in my elbow had gone any deeper and penetrated into the joint, I would have been at risk for serious infection. I would have needed surgery. They almost missed that completely. And missing the bone chip, in my opinion, was outrageous.
I have serious concerns about how this hospital’s ER is run and the quality of care they provide. This is not the first time I have dealt with issues there (long story, but one of my sons had a very serious laceration in his foot and I had to keep reminding the staff that they wanted him to have a tetanus booster before he was discharged — they kept pushing him out the door without it).
Female hysteria is not a new subject. The fact that it still influences medical care in the 21st century is outrageous. Did the ER staff think I was just there for attention? They had to initially.
I challenge all people to evaluate their responses to the pain of others over the next few weeks. How do you evaluate the level of suffering in others? What is your triage system like? Just something to think about.