Regarding Sutter’s conversion to a Critical Access Hospital (CAH), this would leave the community woefully in need of “real” Emergency Services. In a CAH emergency ward, there need only be a nurse “on-site” to perform intake; this nurse may then summon other professional staff who are “on-call,” but unfortunately this does not have to include a physician! Rather, after waiting for this person to be summoned to the hospital you might find that he or she is simply another nurse, and then after diagnosis you might still be shipped or flown out to a treatment center outside the county. This is the level of care one expects from an aid station, not from a hospital emergency department.

The CAH puts specialized nurses into the same category as doctors when describing minimum staff requirements. The following is taken from the Rural Assistance Center's Web site (www.raconline.org) frequently asked questions about CAHs: “The staff … could be a doctor of medicine or osteopathy, a physician assistant, a nurse practitioner, or a clinical nurse specialist, with training or experience in emergency care. In certain very limited circumstances, the coverage could be provided temporarily by a registered nurse.”

Furthermore, you will not know until you arrive at the hospital if there is a doctor in attendance or not: “a CAH, that does not have a physician on site 24 hours per day, seven days per week, [must] provide a notice to all patients upon admission.”

Nowhere in the CAH definition is it ever guaranteed that a physician will be “on-call” at all times and able to come to the hospital if needed: “CAHs are required to provide oversight by a physician, but the oversight provisions are very liberal. This can be especially useful in communities that have had difficulty recruiting physicians.”

This illusion of an Emergency Ward is worse than no emergency ward at all. The waiting time for treatment allowed by these standards is scandalous. It would be better to give training and funding to ambulance staff so they can perform triage themselves and get injured parties to an appropriate place of treatment.

For more information visit www.raconline.org/info_guides/hospitals/cah.php.

 

Janis Paris and Paul Frindt live in Spring Valley.

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