See and treat can help immensely in minors; however, the gain is almost
entirely from one simple change; empowering the assessment nurse to
treat there and then and discharge or simply to turn the patient away
untreated (i.e. the self-help stream). That is not a trivial change to
implement and essentially needs an ENP. The only thing required after
that is a defined escalation policy and escalation levels. However,
several of us are uneasy about the change in the case mix, experience
and training of SHOs which nobody seems to have thought about.
R
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of
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Sent: 23 November 2002 18:12
To: [log in to unmask]
Subject: Re: See and Treat
I attended the Leeds "See and Treat" bunfest.
The co-ordinator or whatever she was patronised us to hell and beyond. I
have experience of her style from her former life in A&E! The general
feel from the clinicians on the floor was that with adequate staff
levels, exercises such as see and treat would not be required. The
demand to do this as well as take on ECL,Streaming, Education, Audit and
see patients and manage a department is excessive. The presentations I
saw were for the use of ENP's managing the minor stream with a nominated
middle or senior clinician, and another for a dedicated minor side. We
had a dedicated minor side in Sheffield at the Hallamshire and Hull for
years but still would get overloaded when the numbers rose. I have three
MIU's run by ENP's who also get overloaded. We have never Triaged in
Scarborough because we have never had enough staff. Now they tell us
Triage is passee! I never thought of it as I have seen it performed, as
anything other than a crowd management tool. I am trying to install
"Empowered Triage" which is realy low level ENP function on protocol.
The only real way to cope with the patient numbers is to have Expensive
Trained clinicians, ENP or Medical of sufficient numbers and seniority
so that we can assess and treat. Where is the miracle cure in that? APV
>Colleagues
>I see from the attendees list that there was a large turn out for
yesterday's study day in Manchester on the above topic. Unfortunately I
couldn't attend. Through the list I would like to canvas people's
opinions. Without wishing to offend some of the quasi acaedemics who
seem to flourish on this list I will keep my own council but I would
value other comments.
>
>Danny McGeehan
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