ER experience for teen in pain - is this typical?

I'm sorry, this sounds like a bad experience for your poor son. I also have Kaiser and we go to the ER at Oakland. It is more staffed, and seems to better handle the larger volume of patients. So that's lesson #1 for you. Lesson #2 is feel free to offer pain relief at home ASAP for any situation where your child is in pain if you feel it's warranted. There is a LOT more hesitancy around pain medication in hospitals in the past 10 years regardless of patient age, in my experience. I believe this is due to misuse of pain relief meds (although obviously there's not a black market for advil, yet!). I can't say if it's common to get codeine in this situation (having not been in this exact situation) but I would be surprised if it were presented as a choice. Lesson #3 is something I struggle with myself, but it's essentially to be a LOUD voice in this situation and assume you have to advocate for everything (start shouting for pain relief the second you were checked in, for example). Again, none of this is your fault (or even Kaiser's, we weren't there), but lessons I would take away for next time.

I agree 100% with Anonymous - we've had to go to the ER several times in the past 2 years and Oakland is by far the most efficient local Kaiser. 

Also agree about the pain med hesitancy and being a squeaky wheel - like anything else with Kaiser you need to be your own best advocate, even in the ER. 

All that said, I'm sorry it happened to your son, and hope he's healing well. If it's any consolation, we self-pay way more than double your costs for a family of four.  Since you are paying so much take full advantage of all the programs and services they have to offer, some of which (like health education) have been great.

I had to take my dad to the ER at Summit two weeks ago. There was a woman in the waiting room holding her arm and just rocking and sobbing in pain. As far as I could tell, they wouldn't give her anything until she had gone through triage and was in an actual ER bed. I felt for her - she seemed so miserable. My dad was experiencing pain in his lower leg caused by an enormous hematoma, and they didn't give him any pain meds until he was officially set up in an ER bed. So no, unfortunately I don't think your experience was unique to Kaiser.

I am so sorry you went through this (it’s always hard seeing our kids in any discomfort) and that you are second guessing your decisions / actions. I am sure that you did amazingly and your son is lucky to have you advocating for him and proactively considering his needs
 

I would be surprised, in any situation, if they would offer codeine first. I imagine typical protocol would be to try to get it assessed first (so that you can more effectively pinpoint the location and type of discomfort) and then offer treatment. I would also assume they’d start with mild pain relief and then escalate if needed. That said, you know your son and his pain tolerance best so could probably advocate for medication sooner and at higher dose / treatment if you felt it was warranted. 

My 6yo daughter broke her arm this summer and we went to the Oakland Kaiser ER. Her arm bone was visibly broken and there was a small wound where the bone had pushed through the skin in the fall. We saw the triage person almost immediately and he offered her a sling and said that he would try to make sure she got seen as soon as possible. We waited in the waiting room for about 20 minutes, after which I asked the triage person if they could give her anything for pain, even over the counter stuff. He said they can't, it has to be prescribed by a doctor. He did manage to get us into a room about 15 minutes after that though (so waiting outside for 45 minutes) while my daughter was hugging her arm and going in and out of crying inconsolably with moments of gritting her teeth and just getting through it. Once we got into a room, it was at least another half hour before she was offered Tylenol, so overall, from the fall to pain medication, my daughter had to wait about 2 hours. Once she was seen by a doctor though, they offered her morphine, but as the Tylenol seemed to take the worst of the pain away, we rejected it. Over the time we were there, we asked for pain medication to be given several times before it was, and kept getting the same answer about a doctor having to see the patient first, which was really excruciating for us. My daughter ended up needing to go under general anesthetic for wound cleaning later though so I guess they also just don't know what the next steps are going to be, so are hesitant to give anything without a consultation with the doctor. I'm still not sure how I feel about the whole thing, but overall, I'm grateful for the care she got, and she healed really well. If something like this happens again, I might just give my kid some Tylenol en route to the hospital and let the doctors know what we administered.  I'm sorry you had to go through this with your son and I hope he's healing well, and that you're recovering from this traumatic situation as well. 

Sounds about right. I have only been to an ER once in my life and after that I told my family that if anything happens to me I would prefer to just die at home rather than going to one ever again. Not being facetious here. I have been to an urgent care twice in my life many years apart and both times the experience was fine. ER: NO WAY am I going there if I break a bone no matter how bad the pain is.

Unfortunaly having experienced multiple broken arms, we have loved UCSF children's hospital in Oakland. A pediatric ER is amazing and has everything kid-sized, and the doctors and nurses there have been great, even when they are super busy. It's one of the reasons why we wouldn't want to leave the Bay Area. We also always called an ambulance for (clearly) broken bones since the EMTs can properly wrap the injured limb before jostling it around in transport, and it gets you past the waiting room. 

In my experience, no ER will offer pain medications to a patient before they have been assessed. They need to make sure as in your case if the patient has any internal issues before so they need to be examined. As for security most ERs are crazy with Security these days. But the best place to take an injured minor is Children’s Hospital Oakland. I assume Kaiser will cover the ER anywhere but not certain 

My experience going to the ER with a child and even just myself at Alta Bates has been very good. I left Kaiser a long time ago because of the things you described—needing to advocate for myself constantly. However, my mother in law often goes to Kaiser’s ER in Oakland and says she has a fine experience so maybe it was just Richmond. 

I would say this is typical, actually, and not a Kaiser-specific thing. A few years ago, my then 12 year old was bit in the face by a dog in another state. So definitely not Kaiser, and it was a trauma hospital that we went to. It was pretty awful, some puncture wounds plus a 3 inch gash from the corner of his mouth that went all the way through. His face was gaping open, he was screaming in pain. It took over an hour and a lot of pestering by us before a very annoyed nurse told us they don't usually do this, but offered him Tylenol. He didn't get anything stronger until after his emergency surgery a few hours later. And no, I wasn't going to stop by the medicine cabinet at home before rushing my child to the hospital. It's horrible they don't offer pain relief right away for these cases, but it sounds like standard procedure, unfortunately.

So sorry about this experience! But I would echo what everyone says--we have had two good experiences with our kiddo at the Kaiser ER in Oakland. The waiting room was calm, the wait was not long, and everyone seems to be organized and know what's going on. It's also inside, no tents. It's funny because I otherwise hate going to Kaiser in Oakland as opposed to Berkeley or Pinole, but I think their ER is the best. Actually way better than experiences I've had with non-Kaiser ERs in the past. 

I just want to explain a bit why they don't give any medication in to the ER (or any other medical setting) before evaluating the patient: We need to make sure the medication is appropriate for the patient, they are not allergic to it and it does not adversely affect them in their current condition (because if we don't, you *will* sue us). And we can only do that after assessing the patient. In addition we need to document any medication or treatments they are given in their file, so if we haven't started a file, there is nowhere we can put that information. And we don't want someone to overdose on any medication because they got some before paperwork was started and then another dose because the treating MD didn't know they had already got some.

ERs often have long wait times and they are triaging the people in the most danger before the people in the most discomfort. So I don't know if there's an ER that is super comfortable right now. Kaiser seems to have weird waiting room security rules - I wasn't allowed to have my partner with me when I had to go to the ER there recently - which I do not believe is the norm in the Bay. But overall I don't think Kaiser is worse than other ERs. 

Having said that, you can legally go to whatever is the closest ER even if you have Kaiser (check out the EMTALA law). Recently I had an injury during a strike at Kaiser so went to a Sutter facility. I was treated and charged the same co-pay I would have been charged at Kaiser. I then scheduled my follow up back at KP.

Sorry you had a bad experience.