Wait times at emergency departments grow as hospital staffing shortages continue

DURHAM, N.C. (WTVD) -- When Kelley Ung brought her daughter into the emergency department, she knew there would be a wait but was stunned by just how long they were left without care.

"I wouldn't want anyone to go through what we went through ever because it was traumatic," she said.

Ung said back in July, her 22-year-old daughter started experiencing severe pain and bleeding after getting her tonsils removed.

"She would start doubling over in pain and just, I mean, it was excruciating," Ung remembered.

This all happened around 9:30 p.m., so the family's only option at the moment was Duke Regional Hospital.

Ung said she doesn't remember the waiting room being too full but still, the hours began to tick by.

"I was probably at the station probably every 10, 5-10 minutes. Just trying to get a feel as to how much longer," she said.

As the hours went by she recalled feeling helpless.

"It was gut-wrenching because I kind of felt like there's nothing you can do. Where do I turn now if I can't get what I need at my hospital?" she questioned. "I can't get what I need. What are my options? I have no options."

She said around 10 hours later, at 7 a.m., they finally saw a doctor.

I felt very just vulnerable to having my child and you know, have all this pain and I can't do anything about it. And here I am a nurse you know, and I just felt so like I was letting her down, you know?" Ung said. "So I was very overwhelmed. I was very frustrated."

'A struggle' for sufficient staffing

She's not the only one who has reported waiting extended hours for care.

One viewer told the ABC11 I-Team that they waited up to 16 hours. Another viewer said they had to wait seven hours and were never seen before they had to leave for work.

"Throughout the pandemic, it's been a little bit of a struggle, say the least, trying to staff all of our emergency departments across the state at optimal levels," said David McDonald, an emergency nurse in North Carolina and the president-elect of the North Carolina Emergency Nurse Association.

He said during the height of the pandemic, the large volumes of patients affected wait times, but now those delays are caused by staffing.

"We're having a harder time staffing emergency departments, harder time staffing inpatient beds, which is causing that backlog," he explained.

Triangle care wait times on the rise

The latest federal data from Medicare.gov reveals the average patient in North Carolina spends around 3.6 hours in an emergency department, this is about 18 minutes more than the latest reported national average.

The ABC11 I-Team found that both Duke Regional and University Hospital and UNC's Rex location reported wait times higher than the state average, based on the latest federal data. WakeMed's Cary location reported a slightly faster average wait time.

This is causing frustration for workers as well.

"It's frustrating for us being in the hospital environment because we want to get people in, and we want to be able, this is what we're doing. However, the patients that are presenting are sicker than they've ever been," said Meka Douthit EL, the president of the North Carolina Nursing Association.

The ABC11 I-Team asked the local hospital systems for their staff vacancy rates. Only WakeMed shared that data, saying that 20% of its emergency department positions are open, a rate higher than normal.

Duke declined to share statistics but said partially in a statement, "Our goal is to provide the best care for our patients, and we have dedicated systems in place to address wait times in our emergency departments. Staffing shortages are a reality throughout health care nationally and the effects have wide-ranging impacts. At Duke University Health System, we are welcoming and onboarding nurses and other skilled staff, and are a leader in these efforts."

Similarly, UNC admitted its hospitals are dealing with the nationwide shortage of nurses and other healthcare workers, a challenge that is elevated because of the expanding local population. A spokesperson for UNC Health said the average wait time at UNC Health Rex Hospital in Raleigh is usually 30 minutes.

McDonald said the staffing levels within the emergency departments aren't the only shortages that are affecting patients' wait times. If there are shortages in other departments or other in-patient units that affect how quickly patients can move out of the emergency room.

"That puts a significant burden on our staff because it's just, there's not a lot of output or throughput through the emergency department and we rely on patients being able to expeditiously move to their final levels of care to be able to bring in the next level," McDonald said.

He said that across the state, it is not uncommon for patients to wait two to three days for an in-patient bed.

An ongoing nursing shortage

Nationwide, the American Hospital Association reported staff turnover in some hospitals has increased from 18% to 30% because of COVID-19 pressures. The association also pointed to an analysis that found staff shortages have cost hospitals an additional $24 billion throughout the pandemic.

A 2021 labor market analysis by Mercer projected that by 2026, North Carolina will be short 59,000 lower-wage healthcare workers and 13,000 registered nurses.

To combat the rising wait times, McDonald said some departments are trying to start some processes earlier such as lab work and X-rays in the waiting room, so by the time patients get into a room a lot of the information is already collected.

However, in the long-run more is needed to address the ongoing nurse shortage.

McDonald said the North Carolina Emergency Nursing Association is working to add further protections to healthcare workers from workplace violence that has been increasing. Another big need is funding a sustainable pipeline for nurses. McDonald said this would be improved by better funding for nursing schools.

Patients need patience

But in the short-term, patience is needed.

"I think it's important for our patients to know that the nurses are doing everything that they can to take care of them, and so that it's important that patients have perspective and as much as possible they give the nurses, especially in emergency departments some grace," McDonald said.

Patients can also help by better evaluating their level of care and only choosing the emergency department if absolutely needed.

"Is there an urgent care (center) that they can go to? Is this something that they can call and get because some physicians are extending their times in the office, right? So if they can get a visit or a virtual visit or telephone call," Douthit EL said.

Patients can also check wait times at local hospitals ahead of time but need to keep in mind the severity of their injury will affect their place in line and these times can change quickly.