In a letter to Biden: Doctors and nurses warn of a “breaking point” in hospital emergency rooms

a message To the Biden administration that was drafted jointly last week by 33 medical groups, including the American College of Emergency Physicians (ACEP) and the Emergency Nurses Association (ENA), paints a devastating picture of the ongoing crisis overtaking emergency departments across the country.

EMT Giselle Dorgalli, second from right, looks at a monitor while performing chest compressions on a patient who tested positive for coronavirus in the emergency room at Providence Holy Cross Medical Center in the Mission Hills Department of Los Angeles. [AP Photo/Jae C. Hong, File]

The letter was sent to President Joe Biden with copies to Secretary of Health and Human Services Xavier Becerra and Secretary Alejandro Mallorcas of the U.S. Department of Homeland Security.

The letter’s authors called for a summit of healthcare leaders to take urgent collective action to address the evolving crisis, as “emergency departments (EDs) have reached breaking point.”

There was not a single word from the Biden administration in response to the nine-page letter. In the aftermath of the midterm elections, the pursuit of the war in Ukraine and the pursuit of the interests of US imperialism remain at the fore in the White House. While all her attention is on foreign policy, all mitigation measures against the COVID pandemic have been lifted ahead of what is likely to be a devastating winter of disease and death.

After acknowledging the impact of the pandemic on residents and frontline healthcare workers, the message begins by saying: “Our nation’s safety net is on the verge of irreparable collapse; EDs clogged and burdened with patients waiting – waiting to be seen; waiting for admission to an inpatient bed in hospital; awaiting transfer to psychiatric, skilled nursing, or other specialized facilities; or simply waiting to return to a nursing home.This breaking point is completely beyond the control of emergency physicians, nurses, and other highly skilled emergency department personnel doing their best to keep Everyone is alive.”

As ACEP notes, the number of patients held in emergency departments awaiting care, also known as boarding, has reached crisis level. The letter emphasized that staffing levels are dangerously low and waiting times are worse now than at any other point in the pandemic. The Joint Committee defined boarding as “the practice of holding patients in an emergency department or other temporary location after an admission or transfer decision has been made.”

Current standards require boarding times to not exceed four hours, to avoid increased deaths and longer hospital stays. Violation of the “standard of care” is a particular problem for the poorest segments of the working class, especially those who lack health insurance or have difficulty accessing primary care practitioners.

ACEP wrote on its website, “Emergency care teams are stressed to their limits. Demand for emergency care and services shows no signs of slowing as we head straight toward this winter’s ‘triple threat’ of influenza, COVID-19 and pediatric respiratory illness. Like RSV filling emergency departments. The influx of patients is putting more pressure on the shoulders of emergency doctors who are doing their best to treat anyone who needs them.”

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