What to expect in the emergency department

Walking into an Emergency Department (ED) can be overwhelming. Whether you're seeking care for yourself or supporting a loved one, the urgency, unfamiliar environment and uncertainty can heighten anxiety. Understanding what happens in the ED, why certain processes take time and how to navigate your visit can make the experience smoother and less stressful.

Many patients arrive expecting immediate attention, only to find themselves waiting, sometimes for hours. This gap between expectation and reality can lead to a sense of being overlooked. However, behind the scenes, our clinical teams are working diligently to prioritize care based on medical urgency, not arrival time. 

The workflow in an Emergency Department 

1. Arrival: Upon arrival, you'll check in with a registrar at the front desk.

2. Triage: A nurse will conduct a brief medical history and exam in a private triage bay to assess the severity of your condition. If no treatment room is available, you may return to the waiting area. Not all emergencies are equally urgent, and demand often exceeds available space.

3. Evaluation: The first available provider, whether a physician, resident, or advanced practice provider (APP), will examine you and may order tests such as blood work, imaging, or an EKG. During busy times, they may use Provider in Triage (PIT) process to begin testing before a treatment room opens – more on this below.

4. Registration: A registrar will confirm your insurance and contact details and request your signature on a consent form for treatment and billing.

5. Treatment: Once test results are available, your care team will explain the findings and diagnosis. Additional tests may be needed depending on your condition and the presence of other critical patients.

6. Discharge or Hospitalization: After treatment, you’ll either be discharged with instructions or admitted for further care. Staff will guide you through the next steps and answer any questions.

What is the PIT process during evaluation?

You might not head straight to a room, but that doesn’t mean your care is on hold. The Provider in Triage (PIT) process is designed to get you evaluated and on the path to treatment as quickly as possible, even if a room isn’t immediately available.

Here’s how it works: After check-in, you’ll wait in a designated triage area until a nurse calls you back for a full assessment (vitals, symptoms and an acuity check to determine how urgently you need care). If a room is available or your condition is critical, you’ll be taken back right away. If not, you’ll return to the waiting area, but you won’t be waiting without your care in mind. A physician or APP will bring you to a separate private triage area to obtain your history and perform an exam to initiate testing. 

From there, you might move to a “results pending” area, whether that’s a room or a chair. Either way, your care continues. Tests are reviewed, and if further treatment or a room is needed, you’ll be brought back promptly. It’s key to note that even if you’re not in a room yet, you’re still being actively prioritized for care.

Common misconceptions and realities

It’s natural to feel confused or frustrated during an ED visit, especially when things seem slow. Here are a few common misconceptions we often hear:

• “I’ve been waiting longer than others.”
  Our triage process prioritizes care based on medical urgency, not arrival time.
• “No one is checking on me.”
  Staff may be reviewing your results or coordinating care. Feel free to respectfully ask the nurse or tech at the front desk for updates.
• “Why can’t I get immediate results?”
  Lab and imaging tests take time to process and interpret. Accuracy is essential.
• “Why am I being asked the same questions?”
  Repetition ensures we gather complete and accurate information to guide your care safely.
• “How long will I be here?”
  Every case is different. Some tests take hours, and you may need to see a specialist. If you're unsure about next steps, please ask the nurse or tech at the front desk.

Tips for a better experience

While you can’t control everything during an ED visit, these simple steps can help:

• Bring a list of your current medications and be prepared to share a summary of your medical history. This helps us make informed decisions quickly.
• Stay calm and patient. Our team is working hard to help you, often under intense pressure.
• Ask questions respectfully. Write down answers or designate one family member to communicate with staff.
• Limit the number of visitors. A single point of contact helps streamline communication and reduce crowding.

How staff are working to help you

Emergency departments are staffed by dedicated professionals — nurses, physicians, technicians and support staff — who work together to deliver timely, compassionate care. We’re constantly striving to improve communication and reduce waiting times, and your understanding plays a vital role in that effort.

Where should I go for care?

Not every medical concern requires a trip to the ED. Here’s a quick guide:

• Primary Care Provider: For non-life-threatening issues, start here. Your provider knows your history and can guide you on the best options.
• Urgent Care: Ideal for minor illnesses or injuries outside of your regular physician’s office hours.
• Emergency Department: Reserved for severe symptoms or life-threatening conditions. Our goal is to quickly diagnose, treat and stabilize your condition.
• For life-threatening emergencies, always call 9-1-1.

For more information on what type of care is recommended for specific health issues, visit When to Get Care in Person vs. Virtual.

The ED is a critical part of our healthcare system, designed to handle urgent and complex medical needs. By knowing what to expect, you can reduce stress, improve your experience and support the professionals working to care for you.

See Dr. Van Rees discuss more at his interview on the Muskegon Channel. 

Find a Primary Care Provider, Urgent Care, or Emergency Care near you.