BIRMINGHAM, AL – Just when things in the emergency room (ER) couldn’t get any worse with influenza A in full swing, all 435 beds at Birmingham Medical Center filled, and the hospital on both med-surg and ICU diversion, ER resident physician Travis Peters has just been sent to the penalty box to serve a 5-minute major for boarding.
“There was no way for me to avoid the inevitable, ref!” Peters barked while skating to the sin bin. “Bullsh*t! There’s no where for the patients to go! They’re admitted but there’s no beds available. This call is bullsh*t, total bullsh*t!”
For those who don’t follow the National Hockey League (NHL) or the ER board, boarding refers to the practice of holding admitted patients in the ER until a hospital bed opens up. Boarded patients may sit in chairs or lie on gurneys for hours or even days, sacrificing both comfort and privacy. Because boarding can have a negative effect on patient safety and patient satisfaction, it often leads to both a major penalty and a game misconduct.
No ER patients have reported any injuries resulting from Peters’ actions, which is why he has not been ejected. However, he does have to serve the 5-minute major, which leaves his ER colleagues shorthanded.
“Man, we were already shorthanded and had a terrible CEDOCS score before the boarding call, we’re in deep trouble,” said ER attending Miriam Williams. “Sure we can ice the patients but we might need to call a timeout and catch our breaths before starting on the penalty kill.”
The good news for the ER team is just 40 seconds into the major penalty, a waiting room patient got flagged for unsportsmanlike conduct: he demanded Dilaudid. This will negate the advantage as the patient will likely sign out AMA (against medical advice).