Frequently when the term “emergency” is used, it is usually connected to a visit to the hospital. In the event of an earthquake, terrorist attack, or pandemic one can expect the hospitals to be taxed greater than 600% of what they are equipped to handle. Ironically, any time you have a situation in which there are more patients than a hospital is equipped to handle, you’re faced with a sub-crisis within your crisis. Today I wanted to give you some real numbers and some real facets to consider with regard to a hospital’s ability to respond in a disaster.
If you’ve never heard of the practice of “just in time delivery and inventory systems, that you may want to check out this report generated by the American Trucking Association which carefully outlined the impact that just the right disaster would have on our nation as a whole as a result of how narrowly grocery stores, pharmacies, nursing care centers, and yes, hospitals stock their necessary supplies. Instead of stocking up, they keep their financials as liquid as possible by taking advantage of the luxury of overnight delivery and a smooth transportation system. It’s almost magical to think that we can actually see something that we want on the other side of the country and have it in our hot little hands the very next day. But, as they warn in fairy tales, magic always comes with a price. And when it comes to hospitals, that price may be much more than you bargained for.
First of all, let’s remember that Hurricane Katrina wreaked all kinds of havoc, but it certainly wasn’t the worst we could have seen. There were many more “close calls” in which vulnerable infrastructure was spared. And yet even though it wasn’t the “worst possible scenario”, within a matter of 30 minutes into the aftermath, the hospital waiting rooms that were at maximum capacity! Keep in mind that’s in light of the fact that traveling to a hospital wasn’t exactly easy after Katrina had her say. Worse, many persons attempted to come to the hospital for no other purpose than having some semblance of shelter and to be “near” medical care “just in case”. As a result there were many bodies taking up space that could have otherwise been used for the seriously ill or injured.
Let’s also not forget the fact that Mother Nature has signed no treaty of respite for hospitals, water systems, electric grids, etc. Hospitals are buildings that can be thrashed around just as easily as some homes in an earthquake. They are also run by real people, not eternally alive vampires. As such, a disaster that hits a community can just as easily hit a hospital and all the people working therein.
This leads me to a present crisis that we’re experiencing in the U.S.—a shortage of hospital staffing. Doctors are retiring early in lieu of taking on the gargantuan expense of malpractice insurances. Not enough doctors are coming into the workforce to replace them (medical schools are at maximum capacity) , and nurses “calling off” regularly result in leaving hospitals all over the U.S. regularly understaffed. And let’s not forget the human component. Doctors and nurses have family and friends too that they will be concerned about and want to take care of in emergency events. Let’s not forget the ancillary staff members who make sure that the messes get cleaned up, food gets prepared and delivered as needed, and mechanical functions of equipment are maintained. Oh, yeah, and they aren’t super heroes that can repel the effects of a pandemic or the wrath of Mother Nature either. So that vulnerability presents a shortage of staff scenario as well. (see for more info here.)
Consider also that nearly every hospital in the U.S. is already taxed to their near maximum capacity with emergency room intake as well as hospital beds—this is without a Pearl Harbor scenario or a San Francisco fire, or a Hurricane Katrina scenario being thrown into the mix. This is in PEACEFUL TIMES.
Without even getting into the “just in time” inventory and other procedures that are observed in order to keep the payables as low as possible each day, even in a BEST CASE scenario, you’ve got TWO HOURS at the MOST before a hospital has exhausted all of their supplies necessary for emergency room and inpatient needs. And yes, at the first hint that such a scenario is even possible, hospital staff will be forced to make judgment calls on who has the most pressing need for care, not who got there first.
In fact, the report created by the American Trucking Association actually says that 2 hours is generous. It states unequivocally that hospitals and pharmacies would be “IMMEDIATELY jeopardized” in the face of a serious crisis. In fact, to be blunt, Al Cook, former president of the Materials Management Association and current member of the Medical Materials Coordinating Group, which is advising the U.S. Department of Health and Human Resources on emergency preparedness says that NO HOSPITAL in the U.S. has sufficient supplies on hand to support a large scale medical emergency.
There are also volatile shelf-life issues to consider on many of the supplies used by hospitals. For example, cancer patients use radiopharmaceutical supplies for their treatments and diagnostic services. These items only have a shelf-life of a few hours.
Then there’s that nasty little speed bump so many are dealing with nowadays—prescription drug shortages. If you haven’t heard yet, there are many prescription drugs right now that are categorized as a “scarcity status.” (By last count the number was up to 238 different life-saving drugs were on that list ) Again, remember, this is PEACE time, folks. These aren’t obscure drugs in many of the cases, these are drugs which people need to stay reasonably functional. While I won’t go into all of the back story on WHY this is the case, the bottom line is, there are a lot of people who have been suitably panicked over the past 4 months wondering if they will be able to survive if there was anything else to occur that would disrupt this vulnerable system.
Paramedics are also reporting having to work with less supplies in their vehicles as a result of these shortages AND as a result of fiscal shortfalls. Boy, if that doesn’t hit you square between the eyes to be told that there isn’t any morphine available for the severe auto accident victim who’s back has been broken until he gets to the hospital. (You can check here to see if any of your prescription drugs are on the shortage list.)
Unfortunately, as ironic and unsettling as it may be to hear this, there are many hospitals that are failing their initial assessments of emergency readiness as a result of a lack of training, practicing proper protocol and patient prioritization. This is the same reason that so many people died in the Twin Towers on 9/11. There were safety protocols in place for their situation, nearly exact as a matter of fact due to a bombing attempt a few years earlier, but as a result of a lack of training, information dissemination, and continuity of training and practice, in the heat of the moment far too many missed grabbing a hold of their lifelines and perished. Will the hospital you go to be capable of handling a true emergency?
Last but not least, even if your hospital is superbly capable of handling a crisis, the people who are fleeing to the hospital are NOT. I’d be just as concerned exposing myself to the desperate, morally bankrupt individuals amidst a disaster as I would insufficient medical care. I don’t really need to paint the picture do I? Suffice it to say pharmacies aren’t the only sources for drug addicts to rob and desperate people tend to have the loudest voices and the shortest tempers when accompanying someone they desperately love and are worried about.
So in the event of an emergency, should you try to go to a hospital? Well, my suggestion would be to think long and hard about what you’ll do under those kinds of circumstances. As I write this I can think of a lot of things that people go to the hospitals for that I know I could learn to better handle myself. Uncomplicated childbirth, setting simple broken bones, treating cuts, wounds, bronchial infections, minor burns, etc. are all scenarios that most go to the hospital for, but which could be handled properly at home with the right tools and training. Regardless of what your answer is, at least now you have more to consider in making that decision. As for me, I intend to do my best to avoid making matters worse by exposing myself and those around me to any more chaos than is absolutely necessary--looking at these odds doesn't exactly scream "safe and secure" in my mind.