Is It an Emergency? Inside Midland Memorial's ER with Dana Taylor

When should you go to the emergency room, and when is something else the better call? The director of Midland Memorial's ER walks through it, including the part everyone finds most frustrating.

When the ER Is the Right Call, and When It Isn't

Stephen Bowerman put the everyday version of the question to Dana Taylor: you are not bleeding, but you do need to be seen. What are the options?

Urgent care, she said, is often the better fit. Her examples were the ordinary ones: the flu, an earache, a toothache. Things that genuinely need attention but are not emergencies, and that do not need the machinery of a hospital emergency department behind them.

Primary care is a different thing again, and the conversation kept returning to it. As Bowerman put it, primary care is a relationship: regular wellness checks with somebody who knows your biology, your blood pressure and your labs, and can track them over time.

Not Every ER Is the Same ER

This was the most practical thing in the episode, and it is not widely understood. Bowerman described calling around after hearing that a specialist would not respond, and finding out the patient was at a freestanding ER rather than at the hospital.

“Those guys don't have specialists on call. Our guys don't respond to any of the freestanding or any of the urgent cares. So if you have that kind of a condition, you can't go somewhere else and get the same level of care if you need that level. You're only going to get that at the hospital.”

The signage looks similar from the road. The capability behind it is not.

Why Someone Who Arrived After You Gets Seen First

Taylor named this directly as the part of her department people misread most.

“Triage is definitely one of the most misunderstood aspects of an emergency department. At its core, the nurses that are in the front that are triaging, they're assessing everyone that walks in the door.” Dana Taylor, director of the emergency department

A team at the front assesses every arrival and sorts by who needs to be seen now, who needs to be seen quickly, and who can safely wait. A sore throat waits. That is the system working rather than failing, even though it rarely feels that way from a lobby chair.

Twenty Years of SANE Nursing

Taylor is a sexual assault nurse examiner herself, and the program she described has been running at Midland Memorial for more than two decades. Six SANE nurses practice there now, covering the surrounding region as well as Midland.

“A lot of times people shy away from that. I have a lot of people that say, I could never do what you do. But somebody needs to do it. Somebody needs to be a voice for the victims of sexual assault.” Dana Taylor

What the Front Desk Absorbs

The most personal stretch of the conversation was about what her staff take on. Taylor connected it to how fast the city has grown and to a general rise in anger, and she was blunt about where that lands.

“No nurse ever wants to go to work to get a pot of coffee poured on them, and nor do they deserve that. They're there to help you through your worst time, or your best time.” Dana Taylor

She noted the same team that handles the worst night of someone's life also delivers babies in the department, and that the switch between those two things is not easy. Coming to work wondering whether someone will be violent toward you, she said, makes people ask whether this is simply what the job is now.

What She Would Ask of You

Asked for the one thing she wanted listeners to take away, her answer was not clinical.

“Just be kind, and know that they are there to take care of you for anything that you need. You might come in for a sore throat today, but you will also be here for your chest pain, or your emergency, your car accident. They prepare for that and they're there for that every day.” Dana Taylor

Thank a nurse, she added, and bring a little extra patience, kindness and grace.