Critique On Code Black Documentary By Ryan McGarry

Ryan McGarry wrote and directed Code Black: A Look into America’s Busiest ER in 2014. Ryan McGarry describes, This documentary by Ryan McGarry, a physician and filmmaker who shot "Code Black" while he was a resident at LA County General, tells us of another definition. It was created to describe the condition of the emergency room's waiting area in terms of color-coding. Code Black means things are as bad as they can get. It means the "system" that is the county hospital is overwhelmed, as a body is overwhelmed during a heart attack, and may in fact be on the edge of death. The take away was these physicians came from different backgrounds that were touch by life changing experiences, in which made the choose to be a physician to help others. These physicians are junior and senior but they all recall when they were seeing the emergency room for the first time and how chaotic it seemed. This emergency room from a seniors view was calm and collective and reviewing other physicians and questioning what the physician was doing, while providing the change in the right path to save the patient. In other instances there was a nurse explaining to the physician how his decision to override the situation was consequential to other patients and the hospital, because pulling the patient in the hall way and treating them was not in regulations. The Overall point is these physicians had to utilize their education, and residency history to pave the way and break the ice at a Los Angles Hospital working with real patients; learning that not all patients will live but the physician has to move past life and death situations because it is part of their daily life. Being a physician you want everyone to live and care for everyone in the same fairness, but injuries of the body or disease of the body can consume the patient.

This Los Angles Hospital took any patient that was rejected from other hospital and all that are passing through. The controversy was between staff, funding, and new regulations peering in on the physicians that moved from an outdated hospital to a new facility that is up-to-date in code and regulations. The physicians were having issues because of the transition, but have realized the hospitals will be in constant change because of technology; it is the physicians that are not learning or being taught about the changes of technology. However if the technology fails the physicians will be better prepared to still assess the patient and take action and never forget what they learned from the Los Angles Hospital and The “C-booth known as the critical booth.

Objective

Code Black: A Look into Americas Busiest ER, describes the Amidst real life-and-death situations, McGarry follows a dedicated team of charismatic, young doctors-in-training as they wrestle openly with both their ideals and with the realities of saving lives in a complex and overburdened system. Their training ground and source of inspiration is "C-Booth," Los Angeles County Hospital's legendary trauma bay, the birthplace of Emergency Medicine, where "more people have died and more people have been saved than in any other square footage in the United States." Code Black offers a tense, doctor's-eye view, right into the heart of the healthcare debate - bringing us face to face with America's only 24/7 safety net. (

Watching the documentary Code Black by Ryan McGarry, the take way from this true event was that it doesn’t matter the age of the physicians or when they started; they started all in the same place and had to evolve their skills. As health care technology advances the healthcare physicians and nurses are behind the power curve of technology, but work with what they do have. Mindy has found herself in the emergency room on many occasions and had to wait over an hour each time and another four to five hours in the back before seeing a physician. Mindy was active duty in the military and had military health insurance and now she is out of the military she has Blue Cross Blue Shield, there is not a difference in the wait times nor the treatment measure. The Hospitals in Oklahoma do not deal with volume due to the subsidiary clinics and outpatient clinics to cut down on the wait time, however in Delaware that is a different story, as a veteran the closest veteran hospital with specialists is Wilmington. Even though there is outpatient clinic the doctors there are required to inform the patients, if it is an emergency see the Emergency room or the patients other provider. In The movie there was a shift in primary care from the physician’s office to the emergency department, because this is a learning experience hospital for new physicians and senior physicians that are running the scenes in the background. Nurses and other staff member of the administration will take the Subjective Objective Assessment Plan (SOAP) notes and transcribe them paper work from the nurse into billing and coding to either get medications or to request a preapproval for surgery. The paper work was new to the physicians because of the new regulations and guidelines being in place from moving to a new facility that was being regulated. The old facility was not and did not have the same guidelines or restrictions. Mark Olsen describes ‘Code Black’ in his article, “The film has extremely graphic footage, grisly even just in glimpses, which gives a sense of the chaos under which these doctors function even in the best of circumstances. The film's title refers to the emergency room being at or past capacity, and the shifts in intensity and volume of patients can be punishing”. Accuracy of Information Healthcare is not shortchanging itself, but is lacking the resources to purchase the new technology to keep up. One way to prevent failure is the healthcare organization contracting with leasing or buying the technology that is being used in the hospital. Contractors are over charging the hospitals and the hospitals have to find other means to charge the patient and community to support these technologies. In the video Code black, The issues of funding was address about the hospital receiving new technology to help care for the patients in a timely matter but it still did not decrease the patient volume or the seriousness of the injuries.

The problem became more about how many beds and the number of staff on hand by the hospital director. The hospital director shut down two other sections in the hospital to staff the emergency room during the code black week. Response Mindy does agree with the brotherhood and the setting of the documentary, because it is close to being a military style communication the physician listens other follow and no questioning the senior. Unfortunately time has changed since this move was published, it does not show what dilemmas are in the current emergency room today. Many Healthcare providers and administrative staff inform the patient of what is going on and what will happen along with informing the patient of the paperwork the nurse brings to the patient. The system has become more proficient with the Center for Medicine and Medicaid Services (CMS) providing training, quarterly policies Billing and coding, and statistics.

Conclusion

The author does allow outsiders to see a day’s work inside the emergency room and what is going on behind the scenes to ensure the emergency room is continuously running smoothly. Also the author is explaining that physicians make critical decision every second that it is important for the physician to get rest in order to make ample decisions daily.

Schwarts, N. (2018). Medical Decision Making Capacity in the Emergency Department, describes the capacity determination is a complex process, but can be simplified if we think of it in discrete steps: eliciting a clear explanation from the patient of their understanding of their condition as well as their goals, working with both patient and family to clarify these when they are obscure, recognizing situation likely to be problematic, and knowing when to call for help.

In the movie Code Black, a patient is looking at losing their leg due to “not taking medication” but this issue is not the healthcare organization nor the patient fault, it is the pharmacies and their suppliers costs. As an administrator informing the physician or the patient of non-name brand medication can help reduce the cost. The Affordable Care Act is now in affect and is changing healthcare, as administrator and physicians we must continue to learn and empower each other in making ethical decisions daily whether it is working in teams or along. We must learn how to problem solve and innovate at the same time.

Code Black: Look into America’s Busiest Emergency Room, shows the challenges of practicing medicine then and now and focuses on the balance. Mindy recommends this documentary because of the quick decisions that are being made in life and death situations in the emergency are also being made outside of the emergency room. Everyone that is included in the support of the emergency room always face challenges but balance is the key.