This is specifically about the ER care from 4am-6:30am on week days. I had a kidney stone passing through me, and the pain was so bad, my partner insisted I go in. The receptionist was wonderful, and she could see I was in pain. She made sure I got in immediately. It was all downhill from there.
The nurse was counting down the hours until her shift was done (out loud). Before the doctor would consider any kind of pain meds, I had to get a urine sample down at the other end of the hall. When I got back, the doc gave me an interim lecture about opioids, which I take for chronic conditions, but they clearly weren't working. After the lecture, we waited for lab results. It took a long time because the lab tech dropped my urine sample. Before I could get a cat scan, I had to have another urine sample. I was in so much pain, and was not allowed water (in case of surgery), but the nurse sent me trundling down the hall again. The urine sample was to test for a pregnancy that would have been a miracle for several reasons, but the test must be done (silly policy needs to stop).
After that, they whisked me down a cold corridor (no blanket for you) for a cat scan. I was lucky to ask for a basin as soon as we got to the room, because I threw up twice upon arrival. The techs were kind, and they gave me a blanket before sending me back for treatment.
The doctor saw a stone was lodged in my ureter (and there was a spot on my pancreas I need to get checked out), but still refused me any painkillers, which I didn't ask for but assumed he would probably offer. Ultimately, the puking, hydration iv, and anti-inflammatory injection helped. But I can't imagine the poor soul who gets sent home with some liver-destroying Tylenol as backup for when the stone actually passes. I have meds, but the policy is horrific for those with a "small" 3.5mm stone waiting to pass.
My doctor clearly has't had a kidney stone, as he thought that was going to be easy. Anyway, I heard my nurse say she was leaving in 9 minutes as I left the ER for the last visit I will ever make there. Emergency Care is not the time or place for a lecture. I have doctors who define my treatment plans. I was lucky to get some relief, but others may not. If you have severe pain, this ER may not be a good choice for you.