A Behind-the-Scenes Look at ER Wait Times

Making the decision to head to the emergency room is stressful on its own. But getting there only to discover you have to wait for care can push stress levels to new heights. Even more infuriating is watching someone come in after you and get taken immediately in for treatment.

It leaves you wondering what the devil is going on. Isn’t the emergency room the one place where no one should ever have to wait?

The answer to that question is both yes and no.

Despite appearances, the process for determining who gets in to see an ER provider and when, is guided by a very detailed set of protocols (aka procedures) that are followed for every patient, no matter how they arrive at the ER.

For every patient, the first step in the process is meeting with a triage nurse who conducts an interview to determine why they’re there, gathers important medical history and medication information, takes their temperature, and checks their heart and blood pressure.

That information is used to assess the patient’s condition and essentially rank the seriousness of the condition against other individuals in the ER. Suspected strokes go to the head of the line while twisted ankles—no matter how painful—may have to wait.

It’s important to note that while patients may not being doing anything while they wait to be seen, the ER team is actually doing a lot behind the scenes to advance the care that will be provided. For example, if the intake nurse or provider determines that blood work, an EKG, or x-rays would be beneficial, the ER team will get the ball rolling and make sure the provider has the results and information in hand with sufficient time to interpret them before you’re even brought to the back. While it takes time to get, this information helps in the making of clinical decisions and developing the safest and most optimal plan for care. All the coordination and interpretation happens out of sight of waiting patients, but is critical to ensuring your issue is addressed as promptly and efficiently as possible when you are seen by a provider.

While all this is happening, there’s a good chance other patients may come in—some through the lobby, some via ambulance, some even from other areas of the hospital. Like every other patient, they’ll be assessed for care. In some cases, they’ll ‘jump the line,’ while in others—including those that arrive by ambulance—will find themselves waiting for care behind more urgent cases.

Because the needs of critical care patients are always the top priority, other patients may experience additional—but necessary—wait time even once they are brought into the ER. Very often, critically ill patients require more attention, resources, and even multiple providers or nurses to see them through whatever crisis they’re experiencing. Once the crisis has passed, the ER can shift their attention to other patients and provide them with the same level of care, concern and compassion.

As frustrating as waiting can be, especially when you or a loved one is suffering or in pain, it’s important to remember that there’s a reason emergency care isn’t first come, first serve. ER providers and staff always prioritize the needs of the sickest and most vulnerable. In fact, it’s a line you never really want to have reason to jump.

Olivia Marko, BSN, RN, CEN, is a ED Clinical Coordinator at SVHC and the Project Leader of Goodwill Ambassadors, a program that aims to educate and empower patients and improve their ER experience.