What are some common emergency room/hospital mix-ups?
October 4, 2018 7:05 AM   Subscribe

I'm writing a scene for a fictional character in which he tries to meet his girlfriend (who was in a serious bike accident) at the emergency room, and I want to make things at the hospital and confusing and disorienting as possible for him. Sorry, I know this sounds sadistic! It's part of a larger motif. I have so, so much sympathy for anyone who has ever had to deal with a stressful situation like that. Anyone–especially doctors, nurses or paramedics–have insight into plausible mixups at emergency rooms or hospitals? What can go wrong for someone trying to visit a loved one in a serious accident?
posted by ennuisperminute to Grab Bag (37 answers total) 9 users marked this as a favorite
 


You can start by just having him get confused looking for the emergency room. I work in a very large hospital and our ER has moved several times over the years. I'm located off-campus and last year a coworker drove me to our ER and I honestly had no idea where our ER was located. It's scheduled to move again in a couple of years.
posted by bondcliff at 7:17 AM on October 4 [5 favorites]


Twice I've been in an Emergency Room at change of shift, and twice I was "lost" for 6 to 8 hours.
posted by Chitownfats at 7:17 AM on October 4


If it’s set in the present time you could just go with them complying with HIPAA and the front desk people not even telling the characater if his girlfriend is back there.
posted by Gev at 7:18 AM on October 4 [6 favorites]


Hospitals can be very difficult to navigate. My local one is a confusing maze with signposts for the public that end up pointing you to locked "Authorised Staff Only" doors or non-public service elevators.
posted by EndsOfInvention at 7:19 AM on October 4


I broke my right femur playing football. Around the same time, some guy about my age damaged his left leg in a motorcycle accident.

As my family arrived, they were sent to the other room. When I got admitted, the orderlies caused me serious pain by gently cradling my left leg and leaving my right one to flop around - they thought I was the other guy too.

Several hours later a nurse came in to check the bandages on my left leg, but there weren't any because he was in a different room.

I triple checked the surgeon knew which leg before I went under.
posted by Pogo_Fuzzybutt at 7:21 AM on October 4 [2 favorites]


I don't know if this is common, but I once took my mom to the ER because she had chest pain*. I dropped her off at the ER door and went to park the car. I came back from parking the car expecting to see my mom either in triage or in the little waiting room waiting to be called in. She was in neither, so I figured she had been taken in. So I went to the triage nurse and asked about my mom...by name, by general physical description, by symptoms...nothing but blank stares. They swore she hadn't been there. I asked if I could go into the ER rooms and look around for her. They said I could, I did. I didn't find her. I asked at the ER nursing desk (on the inside of the ER where the exam/treatment rooms are) and they said she wasn't there. They would have her name on the board and her name wasn't on the board.

I went back out to triage and kept asking again but they said they hadn't seen her. At this point I'm freaking out -- like she was in very bad shape. My mom who has had many health problems in her life had said she had never felt so sick. And now she was just missing. I was thinking, could she have collapsed between the door and the triage desk? I mean I walked right past there, but I was rushing to get in...could she have been lying on the ground and I ran right past her? So I go back outside...nothing...Could she have gotten confused and wandered off? I'm completely freaking out.

I go back in. As with many places with winter, the hospital has two sets of doors. An inner door and an outer door a couple of metres apart with the heat blasting between the doors to keep the cold from outside from getting in when people go in or out. So I'm going back in and as I'm passing someone comes out of a room that has a door between the two entry/exit doors, like this:


OUTSIDE
-----OUTER DOOR-----
O S |
P P |
E A /door to
N C / secret room
E |
-----INNER DOOR-----
INSIDE


So a nurse comes out of that secret door I've never noticed before and says "Are you [myname]?" and I say "Yes" and she says "Your mother is in here."

So apparently they have a super-extra-urgent triage/preliminary treatment room where they can do the initial blood work and an ECG right in the triage without even waiting for patient to go in and someone had spotted my mom coming in, obviously in terrible shape and pulled her in there to see her right away. But because they just do this as a super-urgent thing, there as no record of it because they're not wasting time doing data entry. And because the room is normally used for people brought in by ambulance, the regular triage nurse never even thought to suggest that she might be in there.

* She spent 5 days in the hospital with probably a virus that affected her heart sac and now she is fine.

** I thought there used to be a way to do fixed width fonts.
posted by If only I had a penguin... at 7:31 AM on October 4 [5 favorites]


Building on the theme of hospitals being confusing, often I've been in a hospital that is partially under renovation, so there will be temporary signs printed on paper and taped up on walls showing where to go. Occaisionally I've even seen signs that are just arrows and the collor of paper they are printed on is supposed to be the destination. I've even had signs direct me (briefly) through plastic draped areas under renovation. Imagine someone re-orienting an arrow, or even a critical sign falling down and lost (or not lost; perhaps the story is as good knowing that there's an arrow on the ground and not knowing which way it *should* point) such that one's wandering through plastic draped renovation areas wondering if this is really right or not.
posted by nobeagle at 7:43 AM on October 4 [1 favorite]


Maybe not common per se, but every once in a while a surgeon amputates the wrong appendage. When my father in law was having his leg amputated in a VA hospital, he wrote on the correct leg "THIS ONE" and on the incorrect leg "NOT THIS ONE."

I used to tell that as a joke. Then last year my hip surgeon, in our last few minutes before they wheeled me into the OR, wrote his own signature on my correct hip.
posted by ImproviseOrDie at 7:53 AM on October 4 [2 favorites]


One time they kept insisting my foot wasn't broken when it clearly was. (I never saw a doctor; this was a PA). On my follow-up appointment with the orthopedic surgeon, he discovered that they'd been looking at an old X-ray of my other foot.
posted by The Underpants Monster at 7:57 AM on October 4 [2 favorites]


Sorry--I just reread your post and realized you're looking for ER-specific mixups. It's exceedingly common for people to be given the wrong medications or treatments of any kind--sometimes with life-threatening consequences. That's why there are so many checklists in place, and that's why every time a (conscious) patient interacts with any kind of provider, they're always asked their name and DOB. Many hospitals also use QR codes and barcode scanners to verify and match the patient with the correct procedure or medication.

When I was in the ER for suspected appendicitis years ago, an orderly came to get me for a scan. He didn't verify my name or DOB before trying to get me onto the gurney. He said "I'll be really careful with your hip because I know you're in pain." Alarm bells went off in my head. I said I was there for my appendix. He goes "Oh, are you 18?" Me: "Double that and add some." Him: "So you're not the cheerleader with the dislocated hip?"
posted by ImproviseOrDie at 7:57 AM on October 4 [6 favorites]


I got forgotten. I was sent to the emergency room because of sudden severe vision disturbances. They had a major road accident not long after I arrived with many super seriously injured people & needed the beds so I was sat in a chair in the emergency room, not the waiting room mind you but deep in the heart of the ER section. 8 hours later when things had quietened down at 2 am with my eyes getting so bad I could barely see across the room never the less find my way through the corridors to the nurses station, I was tired so laid down on the row of chairs to sleep & a nurse came out to tell me off as visitors weren't allowed to sleep there. I simply held out my arm with the patient band around my wrist to show I wasn't a visitor. I have never seen a bunch of nurses move so fast to find me a bed & what the hell happened to my charts. Luckily it wasn't a brain tumor, or any of the other things they suddenly decided to rule out at 2am in the morning.
posted by wwax at 8:00 AM on October 4 [2 favorites]




My husband was given scrubs to change into before he came into my room, then a nurse asked if he was ready to take me to the OR, assuming he worked there.
posted by yes I said yes I will Yes at 8:03 AM on October 4 [5 favorites]


If the girlfriend's name has a slightly-off-standard-spelling (Kayliegh, Maddison) or is pronounced slightly differently from it's spelled (Mueller-pronounced-Muller) or is just close to another name (as I've noted here before, people hear my daughter Rory's name as "Laurie" nearly 100 percent of the time upon first meeting), then it's easy for someone to screw it up and "lose" them.

And even for people with names that are impossible to misspell, a small input error (typing "Simth" instead of "Smith") can lose a person for virtually any amount of time you need them to be lost, because people never think "Let me look for all the possible typos of that...".
posted by Etrigan at 8:04 AM on October 4 [1 favorite]


Another thing, in my local ER for some reasons I can never get a cell signal. So once when I was in for chest pains (turned out to be nothing), I couldn't manage to contact my wife and son (who were camping in Maine) until I was able to use an in-house phone.

Plus you could just have him deal with uncaring, unhelpful people.
posted by bondcliff at 8:08 AM on October 4 [2 favorites]


The day I broke my arm falling on ice, I was one patient too many at our local emerg. However, our hospital has an overflow emergency department, so I got sent there. The overflow emergency department was just like the regular department - a waiting area, and a treatment and diagnostic area visible but barricaded off from the waiting area.

I was the only patient in the overflow emerg. I sat in this silent, empty waiting area, looking into a silent and empty, staff-less overflow area that had most of the lights off. After about an hour and a half a hospital employee arrived and escorted me into a corridor that had no lights on and told me to wait in an examination room. And there I paced for another forty-five minutes in what looked like a closed part of the hospital. It had become evening. It was very quiet and when I looked out of the room there were only a few faint lights on at distant nursing stations.

I was not forgotten. I was only low priority since I had taken a painkiller/anti-inflammatory before I went to the hospital, and there happened to be a blizzard going on so they were on reduced staff and weather implicated emergency increase in emerg patients. When they were finished dealing with the people who triaged more urgent I got x-rayed and splinted and sent home, for the swelling to reduce so they could put a cast on two days later. But it sure looked and felt like I had been forgotten or mislaid and if they had not assured me that I was not going to be forgotten, I might have thought I had been.


I have frequently seen the staff come out and call for a patient in the waiting area during busy times, only to get no response because the patient had given up and gone home. I have also seen people waiting in Emerg leave temporarily either to walk all the way across the parking lot to have a cigarette off the property, or to go to the fast break to get a coffee. Savvy patients inform security that they are doing these things. Not so experienced patients do not.

If you do get through triage and then disappear on them they won't know whether you have gone to look for a bathroom, gone home - the wait in the cubicle could be three hours too and if the daycare is going to call emergency intake to collect your kids at six-fifteen you may decide that your broken arm can wait until the morning - gone for a cigarette or gone for coffee. Cubicles and nursing stations are often laid out in repeat patterns, so it is not impossible for a patient to go find a bathroom, come back and go into the third cubicle to the right of the computer at the nursing station, but not realise that they picked the wrong one of three nursing stations, until the patient who was actually assigned that cubicle is brought back from diagnostic imaging and they are told they are in the wrong cubicle.

There is one special class of missing patient - the disoriented patient. When a patient goes missing and they think it is unintentional and the patient is lost and needs to be found that is announced over the intercom as a Code Yellow.

Shell games can occur.

There are times when they insist that ambulatory patients use a wheelchair. Usually this is obvious, as when someone is dizzy and stumbling. but there are times when a patient you would not expect is told that they are not allowed to walk and must be wheeled around by their family member or by staff. This could result in recognition issues for the family members.

Regarding wait times at Emerg. Waiting in Emerg is not a bad thing. Trust me, I know. You know what's worse? When they take you first. You never ever want to be the patient that jumps the queue. "Come right on in. We'll register you later..."
posted by Jane the Brown at 8:20 AM on October 4 [5 favorites]


I got forgotten.

My sister was too, when she was giving birth to a premie which ultimately lead to serious birth defects.
posted by The_Vegetables at 8:30 AM on October 4 [1 favorite]


Have every registered professional ask the same questions over and over. This is a common occurrence and it's surreal, especially when you're under duress.
posted by Dressed to Kill at 8:45 AM on October 4 [5 favorites]


The 1971 film The Hospital gives a host of examples, many originating in the ER. Although almost 50 years old, the film is sadly not out of date in the slightest.
posted by ubiquity at 8:53 AM on October 4 [1 favorite]


The ER in my city treats pretty much everyone in portable beds lined up in the hallway. There's no privacy and you're there for hours, so you see a lot of unpleasant things and everyone else sees and hears all about your problems, sometimes commenting on them.
posted by metasarah at 9:00 AM on October 4


Oh, this is like my zone.

Name mispelling or DOB can make someone pretty impossible to find if the ID is lost (especially if it's a common last name (doe ) and then instead of say John they put jay, everyone will say nooope!

Two people with similar names getting confused for eachother.

Multiple people from the same scene going to different hospitals in critical condition the stress of trying to navigate two ERs at once

Allergic reaction to common treatment...

Language barriers if applicable / communication difficulties for patient (head injury, broken jaw, sedation)

It's harder for non legal significant other to get info if they can get it all

Just other stuff going on which makes doctors distracted on getting back

Losing items (like not having shoes in winter)

Not knowing phone numbers after cell phone breaks to contact

OK thats what I can tgink of off the top of my head.
posted by AlexiaSky at 9:25 AM on October 4 [2 favorites]


Oh, forgetting your wallet in a panic and having to pay for parking.
posted by AlexiaSky at 9:51 AM on October 4


After a car accident a friend's boyfriend had to follow the ambulance to the hospital, then fill out a million intake forms (while not knowing how badly injured his partner was). The staff member who was facilitating the forms was fascinated by the boyfriend's tattoos and started asking a million questions about where to get similar tattoos done. Finally the guy was like "can we quit talking about tattoos and speed up this process!?"
posted by pseudostrabismus at 10:05 AM on October 4 [1 favorite]


Another thing, in my local ER for some reasons I can never get a cell signal.

I think this is actually normal for ERs. That could be an additional source of frustration for your character.

The "wrong patient" thing seems pretty common. When my son was born, the hospital staff tried to hand him off to my roommate instead of me. They said his name, which is how we knew they were giving her my baby.

My brother was given the wrong chemo at a major research hospital for a week in the 80s. I would hope they've got procedures in place to prevent that now, but I wouldn't depend on it. (I was going to say I wouldn't bet my life on it, but I basically do.)

Also, when I've had elderly relatives hospitalized in the past few years, I've found it absolutely shocking how willing the hospitals have been to just let somebody make medical decisions with absolutely zero legal authority - this happened in two different hospitals.
posted by FencingGal at 10:44 AM on October 4 [2 favorites]


The last time I was in the ER, three things struck me:

-Everyone kept asking me if my dad was my husband. When new people walked in the room, I would start with “THIS IS MY DAD” to forestall it. (Misunderstanding the relationship between patient and visitor happened a lot in our family. It was sometimes funny, but it usually sucked.)
-I had never understood vomiting from pain before, but SO MUCH. I was lucky to always have a receptacle, but there were times when it was a close call. Your character getting puked on is extremely likely.
-After a scan of some kind, an orderly left me in the hallway in my bed for another orderly to come pick up. It was extremely strange to be trying not to puke, in my pajamas, laying in bed, in a hallway where people were walking around. I imagine that could be a bit odd for a person walking around as well.
posted by a fiendish thingy at 10:46 AM on October 4 [2 favorites]


Oh, and I've had a bunch of pregnancy tests done without my knowledge, even after telling staff that I had a complete hysterectomy/oopharectomy years ago. Being told, "Your pregnancy test was negative, by the way," is always a hoot and a half.
posted by The Underpants Monster at 10:50 AM on October 4 [4 favorites]


Last year I vaporized my collarbone in a surfing accident. I had to take an ambulance ride to the local trauma center for a a CT scan of my brain because I had also hit my head and rubbed off a brunch of skin off my forehead and temple.

But because there are no mirrors in the ocean, I actually didn't know I had hit my head that hard (by the grinding in my shoulder, I definitely knew my clavicle was toast, lol). So I actually walked out of the water, rinsed off, took my wetsuit off (I literally don't know how I did this, even besides the pain I couldn't move my arm), put most of my clothes on (I couldn't my bad arm through the t-shirt hole), put my surfboard away, all before going to a harbor services dude to ask them to call the lifeguards and get me an ambulance.

So, when I got to the hospital, I was a mid 30's white dude with half his face rubbed off, but on paper I was a surfer with head trauma who took an ambo ride way up to UCLA/Reagan. People kept coming into my room, looking at me, checking my chart, leaving, coming back, and then finally would say something like "man, usually surfers bring the whole ocean with them!!!!". Because most of the time, injured surfers are in wetsuits and are very wet and sandy. And here I was in shorts and a t-shirt and sandals.
posted by sideshow at 10:51 AM on October 4 [2 favorites]


If you want to start before he makes it into the emergency room, where I live there are three large hospitals within walking distance, so he could be at the wrong hospital.
posted by the agents of KAOS at 1:17 PM on October 4


A rather batty friend of mine was once in the hospital for a wrist injury (she was into parkour at the time) She got sent to a different floor to get an xray, but accidentally got off the elevator on the wrong floor. After wandering around a bit, she realized her mistake went back to the elevators to get to the right floor. Weirdly, the buttons by the elevator didn't work, so she went to the nurses station to ask how to get an elevator. The nurses were all "don't you worry about that, what room are you in?" Turns out the floor she was on was a psych ward, and the elevator could only be used by the staff. It took her a long time to convince the nurses that she wasn't one of their patients! Luckily she did have the form saying that she was supposed to be getting an xray, so they begrudgingly let her go.
posted by 5_13_23_42_69_666 at 2:05 PM on October 4 [3 favorites]


Just last week my husband was in the ER for chest pains after an abnormal EKG (he's okay!) and the intake nurse looked at his file and asked him if he had been born a man; apparently his file said he had been pregnant (he was and he hasn't). The funny thing was that she wasn't able to delete it from his record and to exit the screen had to enter "does not have a uterus" in one of the fields.

The doctor later explained that it was probably the patient ID# - that one of the numbers had gotten flipped or something.
posted by Pax at 2:23 PM on October 4


My husband for years went to a teaching hospital for all his care (they had the best transplant unit in town); I spend maybe 2-3 nights a year there with him. Besides all the students, it was the ER that cops brought anyone injured in custody, or anyone unidentified or without visible means of payment. Even in the wee hours it was crowded, loud, and chaotic. Some surreal moments I can recall:

On multiple occasions, doctors arguing with us about where husband's transplanted kidney was installed. For reasons, his kidney was installed on his left, while it is more standard to install on the right. Even showing the scars from the transplant did not convince some of them.

While dozing on an IV for about 6 hours with an unknown infection, he was awakened and asked about his advance directive every 30 minutes or so. It was in his paperwork but it must have been the lesson of the day for the students. A great way to cheer up the patient - while we're waiting for lab results, what should we do if you stop breathing? Husband's favourite answer to this one was "beat on my chest and scream "don't die!!!""

Contrary to all expectations about HIPPAA, privacy, and security, in 18 years of this I was never asked for ID and rarely even for a name. I just said "I'm his wife" and never was challenged. They never even pretended to enforce visiting hours either.

Cops brought in a man that was shouting and trying to twist out of their grip despite being handcuffed. He realised he was in a hospital and started demanding the immortality drugs. Moment was beautifully defused by a staff member who explained he had to fill out these forms to get the immortality drugs, and the guy calmed down and cooperated, though what I could hear of his answers was pretty surreal.

Student doctor came in our curtained alcove and asked if he could practice doing an intake interview; Husband as usual said sure because it's less boring than staring at the ceiling. It took more than 90 minutes, partially because the guy got a nearly 30 year history of kidney failure and transplant aftercare, wrote down everything word for word, and Husband was in for the MRSA infection in his lung and had to stop to breathe for a while very few words.

Husband had scarring on his arms from an allergic reaction to an IV drug long ago, so the veins there were pretty inaccessible. Also when he got feverish his veins shut down in all his limbs. On various occasions they inserted IVs in his neck at the collarbone, back of the shoulder, top of the foot, inner thigh.

Along with IV issues, it could be really hard to get a blood sample. One time when three different nurses had given up, they all agreed to 'call Angela'. I got the impression that calling her was a last report but wasn't sure if ti was because it was admitting defeat, or because she was very busy and had an actual job to do. Angela filled several gloves with hot water from the tap and tucked them around his arm to warm him up while she scrubbed and set up her stuff. She pulled his arm off the bed to hang down and then sat on the floor to reach it. It worked, but only after she smacked his wrist with a warm glove-balloon for a few minutes, while chanting "Jesus give me blood" under her breath.

I still vividly remember the sounds: jesus-give-me-blood WHACK jesus-give-me-blood WHACK
posted by buildmyworld at 2:59 PM on October 4 [18 favorites]


I had a heart attack. (Blocked artery... I am much better, now, thanks.) I went to the hospital and they did an angioplasty and inserted a stent. In the middle of the operation, I was lying on the operating table, fully conscious, with the wires and tubes and electrodes all stuck in me when lightning struck the hospital and knocked the electricity out. The backup generator came on immediately, but the resolution on the monitor did not come back on clearly enough to continue the operation. The doctor found the monitor in the next operating room was working properly. With all the tubes and wires and electrodes all stuck in me, I had to crab crawl onto a gurney so they could wheel me into the next operating room, and then crab crawl onto the operating table there. Could your protagonist experience a mixup when the internet-connected technology of the hospital fails, and no one is around to fix it?

Also, one other time when I was in the hospital, the orderly was wheeling me around in a wheelchair. He got so busy flirting with the nurses, that he got off the elevator on the wrong floor.
posted by Multicellular Exothermic at 3:10 PM on October 4 [2 favorites]


Speaking of power outages - this was in the regular hospital, not the ER, but on the last day of my most recent hospital stay, the hospital lost main power because one squirrel chewed through one wire.
posted by The Underpants Monster at 4:00 PM on October 4


I'm frequently accused of not being me, and of not having the medical conditions I have. Medication mix-ups are common, especially when you're someone who takes a lot of medications. Every time I go into the hospital for anything, I take my box of meds with me, along with a detailed list of what I take, how much of it I take, why I'm taking it, and who prescribed it. (I gave up about 4 hospitalizations ago on people being able to do accurate data entry allowing them to provide me with correct medications.)

Memory issues can cause all kinds of hilarity to ensue. I'm sure you know by now that every time a medical person walks into the room, they want to know your age and DOB. When I had conversion disorder giving me all the symptoms of having had a major stroke, I couldn't tell anybody my name or DOB. At all. I still get aphasia from time to time when I'm overly tired or stressed out.
posted by The Almighty Mommy Goddess at 8:27 PM on October 4 [2 favorites]


Trying to figure out who can help you with something in the ED can be very confusing, because there are all sorts of people who don't actually work in the ED but are there to do consults, admit patients to the hospital, perform studies, transport patients back and forth, change settings on ventilators for specific patients, etc.. But they're not ED staff and not supposed to be involved in the care of patients other than the ones they've been specifically called to see, because it throws off the care that those patients are getting from their designated team.

I always felt bad for patients in the ED when I was working as the admitting doctor for my inpatient service, because given the crush of admissions I would be down there all night. People would see me adjusting IVs, writing orders, and explaining things to the person next to them and ask me to do something or who their nurse was (care plan related--I'm always happy to get a blanket or whatever) and I would have to say "I'm sorry, I'm not actually working down here, I'm just taking care of this patient" and as they gazed on the desk space that I had been intermittently occupying for the last six hours I could always tell that they didn't really believe me.
posted by The Elusive Architeuthis at 9:25 PM on October 4


Most imaging - X-ray, ct scan, ultrasound - takes place out of the room and the person is wheeled out on the stretcher. So when a visitor is let back and told their loved one is in room 26, but they get there and the stretcher and patient are gone it can be frightening.
posted by pintapicasso at 9:25 AM on October 5


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