Hospital delays and the effects they have on EMS systems are a hot topic right now and while not new, COVID has certainly drawn more attention to it. Most discussions surround the damage extended hospital delays cause to available resources in the system, response time delays and the ability for ambulance services to meet their response time compliance requirements. My focus in this column, however, is to reflect on the negative effects this has had on our crew members holding up the walls of hospitals.
As a leader, I am constantly concerned how our employees are treated by hospital staff while they wait – at times, up to several hours – for a bed for their patient. In speaking with staff, it is sad to report that the burden of hospital delays goes much further than the actual wait itself. The responsibility of reassuring the patient that the hospital is working on getting them a proper bed or room is solely on our crews. When patients become upset and anxious that is has been much longer than reasonably expected, our crews are left to explain away the delay and keep the patient happy. As one can imagine, any frustration a patient has with a delay in receiving in-hospital care, or discomfort they have from extended time on a gurney is taken out on our crews. The patient, rightfully so, does not understand that we are not the cause of the delay, although recent news reporting has gone a little way to explain the issues and pressures crews and their patients face together.
Unfortunately, many providers report that hospital staff complain to our crews about them being in the way and taking up their workspace. Crews are forced to stand for hours on end, while there are no chairs available for them, and no place to grab a quick bite to eat or to complete their patient care reports. Our crews tell me they are made to feel uncomfortable as if they are a burden to the hospital. At the recent California Emergency Management Committee APOT hearing, labor colleagues also gave evidence that they had experienced this across the state.
As if working through COVID hasn’t been difficult enough for our workforce, they have spent hours standing in hospitals due to the lack of properly managed ambulance patient offload times. The net effect resulted in missing meal breaks and rest periods as patient care is delivered. While it was and is the right thing to do, the absence of hospitals staff and their own ability to control the flow through their facility is causing our own response system to falter – if we are delayed on the wall, we cannot get to the next patient, and there is always a next patient!
With the increase in burnout from so much time at the hospital, and the resultant and constant delay in getting off shift, crew members are calling in sick more often just to get a break. Our workforce is tired of being utilized for prolonged in-hospital care, which not only is a unsafe practice putting them at risk, as well as the patient, but it is preventing them from being able to provide the pre-hospital care they want to provide on the street.
What is both the takeaway and lesson to learn? In our fight to address the burden of hospital delays, we must keep the strain it places on our employees as one of our top concerns. While COVID may now be declining, hospital bed delays (for this is the most appropriate description of wall time) remain and we must look after our people, so our people can care for their patients.
Learn more about hospital bed delays
- On-demand webinar: Ambulances held hostage. Wolfberg and Wirth answer your questions, including, “When can we leave?”
- Can the hospital make you stay? Addressing the hospital’s legal responsibility to patients
- Should we stay or should we go? The factors EMS should consider when deciding whether to remain with hospital patients
- EMS strategies for reducing ambulance offload times. Remedies to hospital bed delays
- EMS Burnout Repair Kit. Reigniting your EMS passion
