Not long ago I returned to the place where the saying, "They were all over me like bees to honey," no doubt was coined.
The chosen "bee" was David Dyer, a registered nurse who is unit facilitator at the McDowell ER. I found out he got into the field because of a curiosity of his own - a curiosity born out of tragedy.
"When I was a student at Eastern Kentucky (University), my best friend, Amy, was killed in a car wreck," said Dyer. "At the time I had a job in the pharmacy at (the University of Kentucky) and that was one of the occupations I was looking at, but the accident suddenly directed me toward nursing.
"Something about the accident really got to me, beyond the fact that I lost such a great friend. I had this curiosity about the accident. I needed to find out what was done and what could have been done for Amy. It wasn't that I didn't trust the people that tried to save her. It was more about finding out what they do."
Career began in 1992
Dyer started finding out first-hand in 1992, the year he received a nursing degree from EKU and began his career as an RN. Before coming to McDowell, the Hopkinsville native worked in the emergency room and cardiac care unit at the UK Hospital in Lexington; the ambulance transport program, where nurses ride along with patients with serious conditions, at Central Baptist Hospital in Lexington; and a statewide organ transplant program.
At the Danville hospital, Dyer works with ER unit director Linda Lalor in managing every aspect of the unit, from staff scheduling to patient admission and discharge. The goal of all the managing, he said, is to "get the patient in and out of the ER as fast as possible after providing the best emergency care and treatment as possible."
There is evidence Dyer, Lalor and the other ER personnel are accomplishing their goal.
"The national average for emergency room waiting time - the time that starts when the patient enters the ER and ends when the procedure he or she needs is completed - is four hours," he said. "The waiting time average at our ER is two hours."
Each year, he said, McDowell's 13-bay ER and its staff, which ranges from four to five nurses during the morning hours to six to seven during the "peak" 11 a.m.-11 p.m. period, sees about 28,000 patients. They range from children suffering earaches to people with critical injuries received in a traffic accident. And it's the first job of the ER staff and doctors to assess each patient and prioritize them.
"If someone is here for a simple earache or sore throat and other people come in at the same time with chest pains, a possible aneurysm or injuries from accident, the earache and sore throat have to go to the back of the line," Dyer said.
"The people with less serious complaints will be seen, but if they are, in a sense, competing with patients with more serious conditions, they may have to wait a while but not forever.
"We have received complaints from time to time from patients or family members over having to wait a couple of hours to be seen, but our job in the ER is to take care of the sickest people first, period."
A "method to the madness"
When the ER is particularly congested and the staff busy, Dyer acknowledged that the scene "can look very chaotic," but said there is a "method to the madness" as the staff is following an orderly triage plan that begins with assessment, goes through treatment and then ends with discharge from the ER or admission to the hospital.
"Flu season is particularly busy, and the ER can be full with all the flu patients plus people with a wide variety of serious to not-so-serious conditions," he said, adding that the ER's bed capacity can be expanded from 13 to 19 at busy times. "But as crazy as it may seem to an outsider looking in, with nurses, other staff and doctors seeming to be flying around, yelling at each other, there is the process and it is being followed.