On our first episode of Season 3 of the Healthy Matters Podcast, we learn about the intense and unpredictable world of emergency medicine. More specifically, what it’s like for the team members who tirelessly navigate the chaos and life-saving moments of a major metropolitan safety net hospital – the busiest one between Chicago and the West Coast. I talked with Dr. Jon Cole, who began his life here when he was born at our hospital (a newborn intensive care graduate), and now spends quite a bit of time at HCMC as an emergency medicine physician and medical director of the Minnesota Poison Control System.
Dr. Cole describes HCMC’s emergency department – which is part of our comprehensive Level I Trauma services:
“It’s physically a really big place, taking up almost an entire city block, which as a medical student was really overwhelming. There are approximately 60 beds, and we care for more than 90,000 patients each year. In fact, we recently saw 287 patients in one day.”
As a Level I Trauma Center, HCMC has all the available resources to take care of any trauma patient who comes through our doors. HCMC is also a safety net hospital, taking care of anyone, regardless of their ability to pay. HCMC is truly a statewide resource, with two helipads and dozens of ambulances. People are literally coming to the hospital from all over the place.
“We take care of obviously a lot of the people who live in the neighborhood around us, which is true of any hospital. When we recruit prospective physicians, one of the amazing things we always get to talk about is we really have a tremendously diverse patient population that we’re honored to care for. We care for trauma patients who come to us from all corners of the state too, and sometimes even the Dakotas and Western Wisconsin as well. We really take care of everybody.”
What does a “typical” day look like in the emergency department? It’s anything but typical.
“Emergency medicine is the only specialty that’s defined by our patients,” said Dr. Cole. “We don’t hang a shingle and say, ‘we take care of hearts here.’ We hang a sign that says ‘emergency’ and the patients decide what the emergency is – and they come to us.”
As Dr. Cole explains the typical atypical day, we must explain the meaning of “triage” which means “sorting” in French. It’s the process of caregivers making sure that patients are receiving the best care for their condition as soon as possible. But this also means that if you’ve cut your hand and need a few stitches, you may have to wait until the patient arriving by ambulance with a heart attack through the back entrance is stabilized.
“When you come to the emergency department, you check in at the desk so we can get you in the electronic medical record. And then frequently the first person you talk to is one of the attending emergency physicians. There’s usually one doctor and two nurses working up front. And part of that is to begin the triage process. The downside, of course, means that some patients may have to wait for care – without understanding what is happening ‘behind the scenes’ in the emergency department.”
Since the pandemic, healthcare resources have been incredibly strained through every level of entry – and exit. Clinic appointments can be challenging to obtain, but emergency departments are always open – and unlike other areas in the hospital, they cannot say “stop – we’re full.” It’s a national phenomenon, and Dr. Cole experiences it firsthand:
“We are boarding patients in our emergency department much longer than we used to. This is one of the ways that we’ve had to adapt care and really change the fundamental way that we practice in our specialty, because there’s just not physical beds for them to go to upstairs, partly because the patients who are upstairs don’t have physical places to go back out into the community. It’s just backed up at every step of the healthcare system. Some people refer to emergency medicine as being the proverbial ‘canary in the coal mine’ because it’s such a dynamic environment. We always want to remain open, but it does get very stressful and stretches our resources sometimes.”
Minnesota is so fortunate to have compassionate, talented emergency professionals like Dr. Cole and his team always HERE to care for patients who are critically ill or injured. Hear incredible stories and insight from emergency medicine in our first episode of Season 3 of the Healthy Matters Podcast.