Overloaded at the ER

Times Staff Writer

Visits TO an emergency room are confusing and nerve-racking events that one emergency room doctor describes as “usually the worst day of a person’s life.”

That makes for a poor setting for good communication. In a study published last week in the Annals of Emergency Medicine, researchers found that 78% of patients do not fully understand the care and discharge instructions they receive in the ER. Moreover, most people are unaware they don’t understand what the doctor has said. One woman interviewed by the researchers immediately after her discharge could not name her condition (pelvic inflammatory disease) and misunderstood most of the instructions for home and follow-up care.

The problem, says principle investigator Kirsten Engel, of Northwestern University, is that doctors often deliver loads of complex information in a short amount of time. Patients are emotional and distracted, failing to listen carefully.


Engel says patients should take notes while in the ER, ask about anything they don’t understand, have a friend or relative present to help absorb information and read discharge instructions carefully. “Make sure you are an aggressive consumer of your health care,” she says. “You know you best. Ask questions. Challenge things that don’t make sense to you.”