Emergency Rooms have a really bad rap.  Drab, barren of any comfy furniture whatsoever, filled with sick people and, worst of all, usually painted an awful green color.  How fitting.  So when I hit the ER this past week for some stitches to the chin, I wasn’t exactly expecting to have a great time – but just how bad a time, even I would never have guessed.  And interestingly, it had nothing to do with the people – the admin people, nurses and doctor were all more than amiable – but more with the seeming total disregard for basic tenets of design that had gone into the place.  Here, in chronological order, are the design problems I encountered over the course of the evening:

7:35pm

I enter through the front of the hospital from the regular parking lot.  No need for real ER parking, since I’m not about to keel over.  Unfortunately, this means I have to “sign in”.  A quick gesture to my chin grants me automatic access, and I’m off into the bowels of the hospital.

7:37pm

I finally find the ER, which is so unremarkable that I almost miss it.  No sign in desk here, just a huge security desk that is so high I can’t tell if someone’s behind it.  Reminds me of a kids play fort.  Overall, it does nothing to make me feel safe, since I wonder what the security is meant to protect me against.

7:38pm

After looking around the micro waiting room, I eventually notice an unmarked door …and a table with sign in sheets sitting outside.  Printed on a pink 11″x7″ is something to the effect of “Fill out one of these sheets with your medical emergency information, and the triage nurse will get to you soon.”  No mention of how soon this will be, how the nurse knows you’re even there (the sign in sheets are out of view of the triage room), or what to do if you’re bleeding profusely and in need of immediate help (I suppose screaming might help).

I fill out the sheet, use the word “gash” to give my description a visceral, important feel, and drop it into the sign in drop box.

7:50pm

The nurse comes out, picks up the sign in sheets, flips through them, and calls my name.  I don’t know if he calls me first because my sheet was first, or because the other ER patients didn’t use cool words like “gash”. Who cares, I’m in.

8:00pm

Done with triage, where I explained how I injured my chin (surf accident), I head over to Registration.  This takes about 10 minutes, during which time I realize I don’t have my medical insurance card.  I have the info in an email, but the woman behind the desk doesn’t seem interested.  I know I’m not the only one who forgot his card, so it’s surprising that this is a problem.

8:10pm

The waiting begins.  I’m sitting on a chair from the 60s (which is weird, because the hospital was built in 2002), that almost cuts me when I happen to run my hand down its leg and catch a finger on a nail.  Good thing I’m getting a tetanus shot.

8:45pm

Name hasn’t been called yet. Have been watching Lethal Weapon 4 on the TV across the room – for the first time ever in an ER (at least in my experience), the TV is A. not on CNN and B. not on mute.  I thought I wouldn’t like this, but I enjoy Mel Gibson and find that everyone in the room gets into the harrowing action sequences.

9:00pm

Yay! My name is called and I get moved to my own room (after scarfing down a sandwich my friend brought me…thanks Etan!).  The room, as with most ER rooms, is a bland beige color, and replete with hospital bed, doctor’s stool, sink, cabinets, and those weird trolley things with the wires sticking out of them.  I play with the wires and check my Oxygen stats as I wait for something to happen.

9:15pm

No men’s magazines.  Only Health, Martha Stewart Living, and some other female cover.  I’m not saying the hospital is sexist, but…

9:35pm

Someone arrives to clean my wound (”irrigate” is the term they used, which I find vaguely discomforting and agricultural), and asks me how I hurt myself (again). They leave me holding gauze on my chin – I get my friend, who I snuck into the room with me, to root through the cabinets for tape so I can free up my hand.  Amongst all the leads, bedpans, and gauze we find some.  Awesome.

I trade my t-shirt for a gown (at the behest of the nurse), only to take it off when I feel an overwhelming sense ofutter humiliation overcoming me within seconds of putting it on.  I do notice the first positive design feature of the evening: a foot pedal faucet (presumably to keep hands free and clean).  Not bad.

9:50pm

The doctor came around 9:50 and asked me what I did (yet again).  She’s nice, and surfs too, so we get along.  Says she’ll be back soon to stitch me up.

10:15pm

Doctor stitches me up.  Takes all of 5 minutes.  The lidocaine pin pricks only hurt a little, but the most disconcerting thing of all is the huge suture sheet she uses to cover everything except my wound.  Good thing I’m not claustrophobic – couldn’t they at least make it transparent?

11:10pm

I just sat around for almost an hour waiting for…”discharge” papers.  No word from anyone, even when I try to stare down the nurses walking down the hall.  Like great bartenders, they have this uncanny way of avoiding your gaze. Weird.

11:15pm

I flag down a male nurse, who gets my papers ready in just under 30 seconds (what did they do over the last hour, anyway?!).  I walk past Registration (they tell me I’m good to go), and I’m scott free.

***

So overall, a pretty standard ER experience.  Which is to say, absolutely unacceptable!  Here are some major design flaw themes of the evening:

1. No feedback. It’s almost as if the hospital does its very best to totally keep everyone in the dark.  The waiting room experience is interminable, punctuated only by repeated visits to the Registration area to ask for information and look baleful.  The wait in the ER/treatment room feels like solitary confinement, and is absolutely devoid of stimulus.  From a safety perspective, I would keep people busy with at least a TV so they don’t rummage through every drawer, open ever cupboard, and twiddle every knob on the machinery (just like I did).

How about putting in a TV screen that shows your name and approximate wait time left? Even the DMV does something like this, and I can guarantee that a little information will go a long way toward keeping people calm.

2. Repetition. I get it, it makes sense for the various medical staff to ask what happened to you so they can weed out the crazies/head trauma patients who can’t keep their story straight.  But honestly, this only ended up annoying me, and I considered lying just to have some fun.  If someone is obviously coherent, write down the story in the records, and get everyone who sees them read it.

3. Waiting. I know, I know, hospitals are busy places.  And real medical emergencies take precedence over minor scrapes like mine.  But really, is it necessary to keep someone in the ER for 4 hours when only 10 minutes are actually relevant?  I’m sure there’s some scheme with the insurance companies where time in the ER = money charged, but this is ridiculous.  Waiting only stresses patients out (because we all think our emergency is the most important), so making sure we get in and out quickly should be priority #1.  Some hospitals try to trick you by getting you into a treatment room in record time, only to leave you languishing on your own and without TV. My recommendation? K.I.S.S. (Keep It Short, Stupid).

Do you have an ER horror story like this one (or worse)?  Share away!