"If the department by some chance happens to be empty, the poor patient
STILL has to be seen by a triage nurse before they get to see the doctor!
Why?)"
Well they don't. In Lancaster our A&E cards get printed out near the main
nurse station where the doctors also are based. If the doctors are "free"
when it's quiet they can see them straight away. They put their computer
code in the Triage box on the card to satisfy the collection of statistics.
I agree Triage shouldn't slow down the throughput of patients if it happens
to be quiet.
Ray McGlone
Lancaster A&E
----- Original Message -----
From: "Rowley Cottingham" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, March 23, 2002 6:13 AM
Subject: Re: Initial medical assessment
> I do think that we are, as so beautifully described, arranging deckchairs
on the Titanic. The triage
> process itself is an admission that we have too few doctors/ENPs to see
patients at the rate they
> turn up - under normal circumstances. It relies on the sporadic nature of
attendance to allow the
> doctor to catch up; three people come in within 10 minutes and each takes
20 minutes to be seen.
> This works fine if nobody then comes in for an hour. (It has now taken on
a bizarre life of its own. If
> the department by some chance happens to be empty, the poor patient STILL
has to be seen by a
> triage nurse before they get to see the doctor! Why?)
>
> I digress. It all goes wrong if the level of attendance overwhelms this
substitution of time for staff.
> Patient numbers slowly accumulate in the waiting room until such time as
the inflow abates;
> normally between 23:00 and 02:00, depending on the type of department.
There is then a large
> cohort of increasingly angry and usually sobering, usually young people
who then cause problems.
>
> Now we are planning to use another doctor to see the patient before the
nurse before the doctor.
> And that saves time, huh? Come on guys, the King's new clothes are not
purple. There has been a
> moratorium on SHO numbers since 1998. Staff grade posts are now being
filled by people waiting for
> their SpR number, few people want Trust grade posts and every department I
know needs more
> medical staff - full stop.
>
> It is so important that we do not allow ourselves to be diverted from the
real issues by this sort of
> rhapsodising.
>
> Best wishes,
>
>
> Rowley Cottingham
>
> [log in to unmask]
> http://www.emergencyunit.com
>
|