I am a poor American, I eek out an existence so far below the poverty level as to not appear in any counted demographic. I am one of those who have up looking for work in their chosen career path because they saw their wages drop. I did outsource contracting gigs where the take home worked out to about $20 an hour including travel time. That didn’t include gasoline and travel expenses especially during the summer. I am lucky because I live in the bluest purple state in the union modeled after the Federal Government with more active voter participation via the ballot process. My state legislature setup it’s own exchange and handles those without insurance or a means to pay for it.
I have seen and experienced things in the Dignity Health run Mercy San Juan Medical center that only happen because of the economic status of the majority of their patients. I have seen a lack of compassion, understanding and above all a desire to overcome all of the obstacles necessary to provide care. We need to accept that people who are physically sick enough to seek out treatment via the nightmare that the ER need to be treated with kid gloves.
Mental health is as important to physical health as any other part of the treatment. Patients may be in pain, they may be afraid and they are most assuredly put off by the entire process. The notable presence of security officers adds to the tension and fuels the escalation of moderately tense situations. Parents concerned about their kids or anyone who is concerned about someone will get upset if things are not explained properly or they feel like they are being ignored.
When a mother raises her voice asking why they are doing something, the proper response is to allay her fears and explain the protocols they are using. This is the most important part of their job because they are the only ones who can do it, the patient and their family need to feel like the hospital ER staff are their advocates. That the hospital ER staff listens to and addresses their needs and concerns.
My first ER visit, I arrived just before 10am and I raised my voice 8 hours later demanding a supervisor. I didn’t use foul, abusive or threatening language or tones. I used “Daddy’s” voice to ask for a supervisor. The security guard quickly moved in to a combative position, leaning towards me telling me I need to lower my voice or he was taking me outside. He missed the part where I explained in the time I had been sitting here, the inflammation and swelling had climbed up my calves to my thighs and they were really warm. The pain had exceeded a ten on a scale of one to ten. I was hungry. I was thirsty. I was feeling faint. I had already almost passed out when they drew blood.
He threatened to roll me outside of the ER, from a place with security cameras to a place without them. I had almost passed out, I felt on the verge of doing it again. I shut up and told him he had no permission to touch me or the chair. He walked away and I asked about the supervisor and he told me I couldn’t talk to one. When I challenged his authority to make this decision, he said he had such authority. So I got up and hobbled through the pain to the intake workers and asked them for one. I just looked at the security guard and smiled.
When the supervisor came, I explained how long I had been there without food and water. She admitted to knowing I had been sitting in the uncomfortable chair for that long. The obvious circulation issues. I asked her what the difference between being in a bed on the floor or sitting in a chair in the ER was? While we were talking, the security guard had called a couple friends and he was trash talking. She offered me a sandwich, pain medicine and fruit juice as she walked away.
After eating, I asked the security guard for his name. He gleefully wrote it in a visitor badge and handed it to me saying something about nothing happening or nothing I could do. I just smiled that shit eating grin only a nerd who knows they have the thirteen highest trump cards. Somehow, after they fitted me with an IV, they gave me opium via the IV and I misplaced the deuce of spades. No matter, when you step that far off the job description, you are going to get shit for it. I have a 20 year IT career and I understand security and the rules guards are expected to follow.
I explained everything to my nurse and she explained everything to her supervisor. The supervisor talked to me then called the ER director and the security director and the security guard contract administrator. See, I explained my credentials and I also explained that while my voice may have been emotional my tone was not hostile or threatening. I just wanted my needs to be met and magically not long after my talk to the supervisor, I was taken to a room.
The next time I went was a super bowl Sunday and I still waited three hours but they admitted me as I had been released the day before. My next visit was a pain visit, I was there because I had never had pain this bad before in all my life. They asked to remove the bandages and explained if they did, I would need something for pain. They promised they would give me something. An hour and fourth-five minutes later, I used my daddy voice to ask about the pain and once again a uniformed guard dressed in paramilitary tactical pants begins telling me he will escort me from the property. It’s only a matter of time before they admit me. I am in unbearable pain, in the verge of tears.
The staff tried to explain it away because of the mentally ill, the drug addicts and the homeless they get. Poor people are less likely to object to being told to go elsewhere. The mentally ill, drug addicts and homeless are more likely to escalate when presented with the threatening security guard and being told to go elsewhere. In almost all of these cases, empathy in the form of expressed sympathy should rule the attitudes of the workers. Instead of telling me that waiting an hour and forty-five minutes was nothing, he could of thought about how it felt to have the bandages ripped off and suffer that pain for that length of time. Admit they neglected my needs, that their standard of care in that regard was substandard and below the levels they stride to provide.
This is a symptom of a problem we have in this country where we ask police and security to mediate everything and they are least trained to do so. It is why it so often ends in violence because of the lack of training and the lack of repercussions resulting from abuse. If we instead had social workers, the reliance on criminal courts, and jails to house drug addicts, mentally ill and other homeless would decrease. Utah did this, building housing for the homeless in Utah because providing housing and social workers was significantly cheaper then building prisons and providing guards.
Meanwhile, I blew another semester by failing a 9 unit class. Three trips to the ER and three weeks in total in the hospital in a semester make it difficult to pass. But I am healthier today then I was when all this began. Thanks Covered California.q