Emergencies readdressed

The Emergency Department at Enloe Medical Center has long needed some additional elbow room. It sees 50,000 patients a year—an average of 137 a day—in a space that’s morphed over time as demand has multiplied.

Curtains, not walls, separate beds. Quarters can be cramped. And certain fundamental tests, such as X-rays and CT scans, require patients to take gurney rides to other wards.

All of that is set to change Monday (Aug. 25). Upon final regulatory approval, which was pending at CN&R press time, Enloe will open a bigger, better ER and usher in an advanced era of emergency medicine in Chico.

“This is very significant for us,” said Stacy Vincent, nurse manager of the Emergency Department. “Since the Emergency Department started in 1981, we’ve definitely outgrown our precious space, and we’re definitely looking forward to this expansion so we can care for patients in our community in a beautiful, large, comfortable setting.”

That setting encompasses 18,000 square feet, which is 8,000 square feet larger than the existing Emergency Department and more than double the size of the hospital’s first ER. Upgrades include a two-bay trauma room with an overhead digital X-ray machine; five resuscitation suites; 25 private patient rooms; two behavioral health rooms; decontamination shower room; negative-airflow isolation rooms; a dedicated X-ray machine and 128-slice CT scanner.

The facility will grow even larger next summer after the second phase of the expansion transforms the existing Emergency Department and other hospital space to accommodate 13 more rooms. When complete, the complex will comprise nearly 25,000 square feet.

Dr. Michael Fraters is especially excited. As a boy, he often came to Enloe with his father, Dr. Terrence Fraters, who helped launch emergency medicine in Chico as well as design the hospital’s inaugural ER. Mike Fraters is now a physician there.

The present iteration differs from the original, evolving to handle growth spurts. Currently, he explained, “the charge nurses really have to act like air-traffic controllers, trying to keep beds open for sick patients who may come in at any time.

“It’s always been a real challenge, juggling all these different patients and where they can go in the department, but with the new department being more uniform [in design], I think that will be less of an issue. The new department is really going to open things up.”

The new ER’s entrance is a déjà vu of sorts. During construction, Enloe had to close the doors on Fifth Avenue and reroute emergency patients to another entry point. The new building fronts Fifth Avenue with a covered entry dedicated to car and foot traffic, separate from the approach for ambulances.

Upon entering the lobby, patients and whoever accompanies them will meet immediately with a health care professional. This marks a major change: In the current ER, a patient-access representative makes the first greeting, but now someone with medical training—such as a medic—will assess the situation.

In addition, department personnel will be able to start visits, where appropriate, and even perform tests such as blood draws or X-rays before the patient sees the doctor.

“It’s really going to improve the flow for the staff to take care of the patients,” said Connie Rowe, Enloe’s vice president of nursing.

Rather than get treated in a confined space encircled by a curtain, each patient will be in a private room, where family members can stay with them. The five resuscitation suites are large enough to accommodate nine medical professionals and the pieces of equipment needed to revive a comatose person. The trauma room is roughly twice the size of a standard operating room and can handle two critical patients at once—neither of whom needs to leave in order for doctors to get X-rays, thanks to the overhead-mounted scanner.

You may be wondering: “When should I go to the ER?” Certain maladies cry out for immediate attention, but the waiting room fills up with emergencies and nonemergencies alike.

“We can see anything from a hangnail to a cardiac arrest,” Fraters said. “The ER in some ways has become less of a place for emergencies and more of a place for, ‘I need this done in a hurry and I want it taken care of,’ regardless if it’s life-threatening or not.”

The shortage of primary-care physicians contributes to the ER burden. Chico and surrounding communities do have urgent care centers that offer same-day care; consider calling or visiting a clinic when the need isn’t dire.

However, Vincent added, “anytime anyone feels like they need immediate attention, and their primary-care doctor isn’t available or a prompt-care-type clinic isn’t open, we want them to come to the Emergency Department and be evaluated.”

Enloe will not—and cannot, by law—turn anyone away from the ER.

“Chico’s getting bigger and bigger,” Fraters said, “and we’re seeing more volume from a lot of the outlying areas. I think we still do a pretty good job … but with the new department, it’s only going to be more efficient, and I think it’ll be really good. This has been a long time coming.”