By Hemesh Patel
Daily Bruin Staff
For the past decade, emergency departments around the country,
including UCLA, have been experiencing overcrowding and financial
problems.
In response to this problem, the state assembly is holding a
hearing Feb. 15 regarding the issue of overcrowding in
California’s ERs.
“Its been feeling like a crisis for the last few
years,” said Kelly Hubbell, nurse educator for UCLA’s
emergency department.
A number of ERs around the country have had to shut down in
response to financial difficulties.
According to the California Medical Association, by the end of
2000, 355 of the state’s 568 acute care hospitals still had
emergency rooms ““ and 285 of these lost money.
“Funding is so poor ““ its not what it should
be,” said Dr. Marshall Morgan, chief of emergency medicine.
“The emergency departments that are open are seeing patients
that are sicker.”
Los Angeles County emergency services lost $94.9 million between
1998 and 1999, according to CMA.
Because emergency departments across the nation are closing
down, those that are open have become more and more crowded over
the past 10 years. As a result, ER physicians must give priority to
patients who are more seriously hurt, leaving those who are less
injured to wait.
“Patients have to wait sometimes for hours and they get
stressed,” Morgan said.
About 100 to 120 patients come in for treatment at UCLA’s
ER each day, he said.
But despite problems, officials at the hospital said patient
care is not being sacrificed.
“The quality of patient care is extremely high and the
satisfaction levels are high despite all the stresses thanks to
dedicated nurses, physicians and staff,” said Dr. Gerald
Levey, dean of the School of Medicine.
Some hospitals may only have two doctors at one time to handle
the number of patients that come in each day. UCLA’s ER has a
total of seven or eight doctors tending to patients at once.
“Because we are a teaching hospital we have two attending
doctors, three residents and two internal physicians at any given
time of the day,” Marshall said.
He said these numbers vary depending on how busy the ER is and a
greater number of doctors doesn’t make up for the space
shortage.
“When its really, really busy and an average person comes
in with a sprained ankle, we’re just not able to do
much,” Morgan said. “The staff is occasionally
stretched pretty thin when it gets busy ““ the doctors in the
ER can’t take care of all the patients that come
in.”
Physicians and nurses also said equipment, all of which is up to
date, is being overworked.
“The situation now is that we are well equipped but its
the large number of people that appear, whose illnesses demands
these resources,” said Dr. Steven Rottman, professor of
emergency medicine and public health. “There are periods when
resources get stretched.”
While other departments in the hospital can turn away patients
if they are too crowded, the emergency department must accept
anyone who walks into the door.
“The kind of medicine we practice dictates us to take care
of everyone at any time of the day,” Rottman said. “The
ER is a fixed facility and is designed to accommodate only so many
patients.”
Because UCLA is a level one trauma center, it takes the most
difficult cases and a large number of very sick patients, in
addition to the less sick who come to get treated.
According to physicians, the basic principle is to take care of
those who are more unstable sooner and serious medical trauma is
prioritized.
With a nursing shortage affecting the nation, a limited number
of nurses must care for all of the patients that come in.
“Are they feeling overworked? Of course they are feeling
overworked,” Hubbell said.
With a need for more nurses, hospital beds and better funding, a
clear solution for this problem may take a while.
“We’re sort of in this position for a number of
years, unless we get an acute outbreak of wellness,” Rottman
said.