Suggestions for people visiting ERs in the coming weeks... A thread.

Firstly ask yourself if this is something that really needs an ER visit. If you have access to other care, maybe this isn't the time to go to the ER for a UTI.

2/If you think you have COVID & aret very sick or high risk, don't come "just to get a test". Waiting rooms are full & you could literally kill someone by breathing on them. If you're short of breath, have bad chest pain, or confusion, come. But if you can, stay home & save lives

3/If you think you need specialty care pick your ER wisely. If you had surgery at hospital X & come to hosp Y, we can't transfer you b/c NO ONE has beds. If possible go where your specialist is. If you come to my small ER w/ a heart attack, I can't transfer you to a cardiologist.

4/Expect a wait. Expect not to see your family. Bring everything you may need w/ you (including a cell charger). Expect to sit in the ER & maybe not go up to a room on the floor. For days. Or possibly to be sent to a tent or field hospital in a stadium. It's not going to be nice.

5/Be nice to the nurses. These amazing professionals have the highest exposure & literally are risking their & their families' lives to help *you*. Show them the goddamn respect they deserve & if they get upset, are exhausted, or brusk, the correct response is THANK YOU.

6/If you or your fam get COVID19, talk early about what level of care you want. Grandpa is 98, has diabetes, kidney failure, & told you he doesn't want heroics: RESPECT HIS WISHES. Even if you aren't high risk before you go tell the fam what you want if you get really sick.

7/Be realistic & remember you probably won't get the level of care we expect in the US. It won't be fast & we probably can't transfer you for the lifesaving care we usually can: no one is accepting transfers. You get care, which may be limited, available at the hospital you go to

8/Realize none of us want this. We want to provide the best care possible to every patient, but the resources just aren't there. This is what we chose when we decided that we couldn't skip one Thanksgiving. And it's only going to get worse if we decide that for Christmas.
/fin

9/Just realized I should have added a 9th comment. The above is almost all about adults. Hospitals are accepting kids in transfer b/c they have beds on peds wards. Some are converting peds to adult wards temporarily or taking young adults too. But peds is not nearly as impacted.