The couple's Newburyport house was packed and a flight booked for Aug. She accepted and underwent a routine physical for new employees. In June 2006, Novartis, the giant pharmaceutical company, offered her a job heading global recruiting. Manley was supposed to be enjoying Basel, Switzerland, not staring at the worn, gray linoleum floor in the emergency room. "You see someone right away but then you wait and wait." She felt the nurses and surgeons provided very good care, but the delays were stressful, she would say later. General spend an average of about eight hours in the ER before getting a hospital bed, but some, like Manley, wait far longer. General allowed a reporter and photographer access to the hospital's triage operations, an attempt to shed light on one of the vexing problems of US healthcare - why so many patients are trapped in the emergency room for hours, so close to a hospital bed, yet unable to get one - and how the hospital, with some success, is tackling the problem. All day, the triage nurses shouldered dilemmas with no easy answers.įor several days, Mass. General patients, surgeons wanting patients transferred from other hospitals, and physicians pushing for beds for family members. The nurses' phones and pagers buzzed with requests - internists seeking space for longtime Mass. The few open beds were off-limits because they were in specialized units, or because patients in those rooms were contagious or especially susceptible to infection. The hospital's medical and surgical floors were at 96 percent capacity. While Manley and 21 other emergency room patients waited for beds, a team of triage nurses pored over computer screens and reports that offered a worrisome picture.
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General about how to distribute one of the most valuable resources in medicine: hospital beds. What Manley couldn't see from her gurney was the sometimes wrenching behind-the-scenes decision-making that occurs at Mass. Though a physician had decided to admit her for treatment, there were more patients than available beds. So far, she'd spent 12 1/2 hours in the emergency room, with no idea when she would get a room upstairs - an uncomfortable limbo faced by ER patients in hospitals across the country. Then, at 1 a.m., a nurse had led her into one of the ER's 49 bays, where Manley changed into a johnnie and at last received morphine and nausea medicine. The previous night, she had spent 2 1/2 pain-filled hours in the waiting room, throwing up into a plastic supermarket bag. It was 11 on an August morning, and she was back where her battle against cancer had begun a year earlier. Lisa Manley shifted uncomfortably on her narrow gurney in Bay 28 of the Massachusetts General Hospital emergency room, watching nurses and doctors rush past the open curtain of her cramped cubicle.
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