Just Another Day in the Desert

Just another day here in the beautiful desert southwest. Flowers blooming, grasshoppers swarming, and temperature rising. Here I sit at my desk in the emergency room, having just admitted our first patient of the morning, and awaiting the usual Monday morning rush. Mondays at the E/R can either start out slow and pick up by late morning, or start out busy, and slow down some by mid morning. It just depends on how many of our illustrious citizens decided to wait until the weekend was over to seek the medical attention they needed days or even weeks ago. They usually wait until a relatively minor situation blossoms into a major illness before seeking attention, or trying to get in to see their primary care physician. Then there are those who think they have a need to come to the emergency room, when in fact all they have is something minor that can be treated at one of the local urgent care centers or their primary care physician.

It seems like as our population ages, and more and more older Americans move to rural areas like Pahrump, that we get a little more worried about our health and forget that many of our symptoms can be cleared up rather easily and with over the counter medications. We clog our emergency rooms with unnecessary so-called emergencies, making it harder for those who really do have an emergency situation to be seen promptly and receive the quality of care they need. In Nevada, and I presume in many states around the country, we as a hospital emergency room cannot turn anyone seeking medical attention away. They have to at least be seen by a Triage Nurse and evaluated to determine if in fact they are in need of emergency medical treatment. Even so, there are many who still insist on being seen by a doctor, and sit some times for hours waiting to be seen by a physician rather than go to an urgent care center, clinic or their own doctor.

Being a small town hospital, we have a limited number of beds, emergency treatment rooms, and staff. This puts some of our growing number of citizens at risk, especially with all the non emergency patients we see on a daily basis. For a long time, Pahrump was considered a retirement community of people who had worked at the Nevada Test Site, mining companies, and other such businesses in the area. Over the past several years Pahrump has grown to a population of over 37,000, and many of them younger people who have been forced to relocate here due to higher housing and utility costs in places like Las Vegas and southern California. As a result the population is shifting here, but we still have a substantial older population. To make matters worse, we have physicians in this town who do not support the hospital due to their own business agendas, and also never seem to have enough time to see their patients when needed.

As a result we see many of their patients in the emergency room even when it's not a true emergency situation, just because they cannot get into to see their doctors when they aren't feeling well. This is only one reason why we are often times busier than we should be, the other reason is that even if a patient has no insurance we cannot turn them away. As a result, even those seeking attention for non emergent situations, or with such problems as abscessed teeth and other type conditions are seen here. There are doctors and dentists in town that we treat uninsured people, but they have to come up with at least some money at the time of service. Why not go to your local emergency room knowing that they cannot turn you away, and that they will try to collect from the county for your services rendered?

The hospital has been opened for nearly two years now, and we are experiencing growing pains. We also are experiencing problems in keeping enough staff on board to handle the work load now, but we are always looking to hire more qualified individuals as well as bringing more specialists on board to handle our more involved cases. We do have two surgeons, an OB-GYN on staff, but are sorely in need of a cardiologist, gastroenterologist, and orthopaedic surgeon. Management is actively recruiting for these types of physicians as well as good RNs to support those physicians as well as those already in place. It has been a tough road to hoe, but we are all hopeful that everything will be where it should be by no later than the end of the year.

So far it has been a fairly quiet Monday morning, but I am sure we will be busy before long. For now I will drink my coffee, and try to wake up some more, as I don't do mornings real well, and wait for the onslaught. LOL