I hope everyone knows me well enough that I don't make jibes -
especially at friends and colleagues. Jonathan is right; it looked very
exciting back in 1996 or so when Nigel Brayley (another v. good egg)
started trying to understand how to dissect the variable workloads
involved in managing emergencies. There were some fascinating blind
alleys. Consider - a young man turns up with a temperature, a productive
cough and creps at the right base. Seen by a Consultant, he is likely to
be given a scrip for an Amoxicillin (60p) and sent away. Very few
juniors would not do a CXR and bloods, taking 2.5 hours and £100 before
coming to the same conclusion and sending him away on co-Amoxiclav (£6).
It was fiendishly difficult to equate the workload when it was so
operator dependent. Nigel eventually hit on investigations as a
discriminator, hence the current list. Independently I came up with a
very quick and dirty three point scale; no nurse needed, one nurse, more
than one nurse. It is surprisingly useful.
/Rowley./
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