All ERs I work at are completely swamped with inpatient ER holds. The massive surge in COVID admits has completely logjammed the system.
Yesterday the shop I was at has capacity for 50 ER patients by being extremely creative(tents, hallways etc). There were at least 40 inpatient holds in the ER all day. By the time I left there were 46 inpatient holds.
The patients we admit have nowhere to go. The hospital is completely full. This with sending patients home that we wouldn't normally send home.
So basically we are running all of our ER volume through a handful of beds. Wait times are extremely long. Patients normally wait an hour at most on a busy day. Now patients are waiting at least 3 hours to be seen.
ER length of stays have ballooned as CT, lab, phlebotomy and nursing staff is completely overwhelmed.
The ICU has no room. So critically ill patients remain in the ER as holds for hours. This sucks up ER nursing resources as many of these patients require 1:1 nursing care. These nurses aren't used to caring for ICU patients for an entire 12 hour shift, so quality suffers. ER docs are also not trained to manage critical patients for prolonged times. Not good.
Unfortunately we've reached the point where people are going to start dying from delays in care and decreased quality of care. This applies to COVID and non COVID patients. The system is just completely overwhelmed. We're doing everything we can, but there's only so much we can do.
I'm not offering a policy solution or attempting to express political tribalism. Just giving my first hand perspective to something that is hidden from the view of the general public.