What Happens When You Walk Into Our Emergency Room at 2am

If this may be life-threatening, call 911 rather than reading this. Paramedics begin treatment on the way and can tell us you are coming.

Nobody explains this, and it is the thing people are most anxious about. Not the medicine — the procedure. Whether you will be turned away, what the paperwork is, whether you have to explain yourself to a stranger before anyone looks at you, how long any of it takes.

So here is the shape of it, from the door.

1. You walk in

There is nothing to book and nothing to check first. Both of our emergency rooms are open every hour of every day, walk-in, with no appointment and no referral. The doors work at 2am the same way they work at 2pm.

You do not need to have decided whether your problem is serious enough. That question is ours.

2. You are assessed on arrival

The first person you deal with takes your vital signs, asks what has brought you in, and asks about your history and your medications. This is triage, and its job is to establish how quickly you need to be seen — not to decide whether you deserve to be.

Say the worst thing first. People tend to be polite and lead with context: sorry to bother you, it has been a strange week, it is probably nothing. If the actual answer is chest pain, say chest pain in the first sentence. It changes what happens in the next thirty seconds.

3. Registration happens alongside, not before

This is the part most often described wrongly, including on hospital websites, so here is the accurate version.

Care and paperwork are not a queue. Registration details and, for self-paying patients, a cash-pay form are often completed while you are waiting to be seen rather than as a gate in front of it. You are not required to finish registration before you can be brought in, and if you are in no condition to fill anything in, that is not a problem to be solved before someone looks at you.

What we will not tell you is that you are “treated first and billed later”, because that describes an order of events that is not how a real department runs. The true and more useful version: ability to pay is not a barrier to assessment and access to care in our emergency rooms, and by law.

4. You are seen, and the order is not arrival order

A physician assesses you. Depending on what is going on, that may begin with an ECG, with blood work, with imaging, or with a conversation and an examination.

Somebody who arrived after you may go back before you, and if that happens it is the system working rather than failing. Emergency departments order patients by how sick they are, not by when they arrived. It is worth knowing in advance because it feels personal at the time, and it is not.

A long wait usually means you are not the sickest person in the building, which is good news about you.

5. Tests happen here

Both emergency rooms have CT, X-ray and a full laboratory in the building, staffed around the clock. That is the practical difference between an answer tonight and an answer later in the week.

Ultrasound is the exception — it is called in from an outside mobile service, often during the visit if it is ordered early enough, and otherwise scheduled for the next day.

Results take as long as they take, and the honest thing to say is that the wait for a result is usually the longest part of a visit. Blood work in particular has a floor set by the chemistry rather than by anybody’s effort.

6. A decision

One of three things:

You go home, with an explanation, written instructions, and a clear sense of what to watch for and what should bring you back.

You are observed here. Our emergency rooms can hold and monitor a patient for up to 24 hours where watching is the right call rather than admitting.

You are transferred. Our emergency rooms are freestanding — emergency departments without an inpatient hospital attached. If you need to be admitted, or need hospital-level inpatient care, we stabilise you here and arrange the transfer. That is the design rather than a limitation: there is no inpatient census competing for the team’s attention, and everyone in the building is an emergency patient.

Before you leave, ask these

Five questions worth asking while somebody clinical is still in the room. Most people think of them in the car.

1. What do you think this is, and what have you ruled out?
2. What should bring me back?
3. What should I expect over the next two days?
4. Who do I follow up with, and when?
5. What can I not do — driving, work, lifting?

Questions people actually ask

Will I be turned away if I cannot pay today? No. Ability to pay is not a barrier to assessment and access to care in our emergency rooms, and by law.

Do I need an appointment or a referral? Neither, ever. Walk in.

Can I come in at 3am for something that started this afternoon? Yes. Nobody will ask why you did not come sooner.

What if it turns out to be nothing? Then it was checked, which was the point. Being assessed and sent home reassured is a good outcome, not a wasted trip.

Should I bring anything? An ID, your insurance card if you have one, and a list of your medications — that last one is the most useful thing you can arrive with.

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Both of our emergency rooms are open 24 hours a day, every day of the year — walk in, no appointment and no referral, with CT, X-ray and a full laboratory in the building. Find your nearest emergency room →

Related reading: which door do you need · how triage works, and why the person after you went first