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Marilyn McCullum is an emergency nurse.

Alex Pretti’s death: Why politics belongs in emergency medicine

Marilyn McCullum, RN
Conditions
January 31, 2026

Emergency medicine trains clinicians to recognize patterns early, anticipate deterioration, and intervene before outcomes become irreversible. We pride ourselves on seeing what others miss. Yet we are repeatedly instructed, explicitly or implicitly, to ignore the largest pattern of all. Political decisions consistently and predictably shape who arrives in our emergency departments, how sick they are, and how unsafe the environment becomes for the people expected to care for them.

If political …

Read more…

Alex Pretti’s death: Why politics belongs in emergency medicine

Emergency department metrics vs. reality: Why the numbers lie

Marilyn McCullum, RN
Policy
January 27, 2026

The emergency department didn’t suddenly get worse.

The numbers did.

Every shift, emergency clinicians are measured by dashboards that insist on telling a familiar story: Door-to-provider times are too long, length of stay is unacceptable, left-without-being-seen rates are creeping up. The implication is clear. We’re slow. We’re inefficient. We’re failing.

But those numbers are no longer describing clinical performance. They’re describing system saturation.

Emergency departments today operate in conditions that were once considered temporary …

Read more…

Emergency department metrics vs. reality: Why the numbers lie

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