Melissa Tyler

March 25, 2013

In order to find out more about the trending factors of healthcare, I interviewed my brother, Stephen J. Tyler. He is an RN (Registered Nurse) at the Community Hospital of San Bernardino in California. I asked him what variety of patients he most commonly came across in his department of emergency healthcare. To give an overview of the area of San Bernardino, in 1993, it was placed second in the nation for the most poverty-stricken city, just behind Detroit. The results are as follows:

Trend #1 – A Patient Who Has Been Shot or Stabbed:

Also in 1993, along with being placed second for poverty, San Bernardino was placed ninth for its city’s murder rates. This being said, Stephen concludes that the most common patient he sees in the ER is one who has been shot or stabbed. In order to treat these patients, they “throw in the biggest IV [they] have” on the person. They give the patient normal saline (water, salt, and sugar) and blood. The blood is given because the wound is causing the patient to lose large amounts of blood and volume, so without it, the organs would shut down. If the patient has been shot in lung, they insert a chest tube which drains the blood, liquid, or air from the lungs. Mr. Tyler told me the odds of the hospital’s patients still alive while leaving the hospital (to go to a larger hospital like Arrowhead or Loma Linda) are probably 9 out of 10.

Trend #2 – Patients Who Have Abused Drugs:

 These types of patients come into the ER feeling like they are having a heart attack or anxiety attack, but it is usually because they did meth or some other drug, and are coming off of it. San Bernardino’s poverty makes for an easy assumption that it would be one of the best environments for drug abuse. In which case, a lot of the patients have come in from having smoked marijuana they got off the streets, laced with other drugs without the person knowing.  Stephen imagines that probably 70% of the people in the ER are abusing some type of drug. Since drugs are the problem in the first place, they treat them by giving them nothing more than Tylenol or Motrin to calm them down. Sometimes they are given Adavan if it is really bad. They then keep a close eye on them and help them to sleep.

Trend #3 - Snowboard Accidents:

The location of this hospital is at the bottom of the mountain where Big Bear is located and more recently, it has been winter season. This makes it likely that many people would come in from an accident they had on the slopes. Usually, their shoulder, or some other body part, is popped out of the socket. The hospital treats them by putting an IV in them, getting them on a monitor, sedating them, and then popping the arm back in place. Once the arm is back in place, the pain goes away. It is still sore, but the pressure is gone. This happens more with teenagers and adults.

Trend #4 Behavior Health a.k.a. Patients with Mental Disorders:

Those with mental disorders are less likely to have jobs, and without jobs they are more likely to live in a poorer area. The mental disorders my brother most often sees in the ER are schizophrenia and bipolar disorder. These people have come to the hospital because they want to kill themselves or have caused self-harm. The hospital tests the patient’s blood to make sure they have not overdosed, and test this through their levels of salicylate, acetaminophen, etc. Afterwards, the patient then speaks to a BHS (Behavior Health Service) and they take it from there.

 Trend #5 Patients Who Are Homeless:

The amount of homeless persons in San Bernardino is large because the amount of poverty and amount of insurance holders. These types of people typically come to the hospital because they do not have a place to stay, and most often come in drunk. They pretend that they physically cannot do anything (like walk) and exaggerate the slur of their words so that they have to be let in. In some cases, they are picked up by police officers or even a family member and brought to the hospital. Other times, they just want somewhere to sleep. The hospital watches them all night until they know the patient is able to walk and then they can leave. And even sometimes prostitutes call the ambulance faking that something has happened just to get a ride across town. They ride all the way to the hospital, but then sign that they did not want to go and are then allowed to leave.

Dulany, Josh. "InlandPolitics.com." The Sun: San Bernardino among Most Poverty-stricken in Nation. 16 Oct. 2011. Web. 25 Mar. 2013.

Jet. “Findarticles.com.” FBI report lists cities with highest murder rates in 1993. 19 Dec. 1994. Web. 25 Mar. 2013.