Some (but by no means all) paediatricians feel that all children should be
seen by a childrens specialist. A few years ago this led to an insistence
that all children attending a local A+E were seen by a paediatrician.
Apparently this lasted less than 2 days as numerically A+E departments see
more children than paediatricians - they simply could not cope. I am fairly
sure that most GP's see more children than A+E departments as well!
It would seem that your nurse has come through an RSCN course emphasising
the special needs of children perhaps a little too much.
Simon Carley
SpR in Emergency Medicine
knackered after 1st A+E shift in a very long time
Hope Hospital
Salford
England
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-----Original Message-----
From: Jel Coward <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 04 January 1999 20:14
Subject: A+E, Paeds, Primary Care, Four Weddings and a Funeral
>Hi all
>
>I would like to kick something about if I may.
>
>This refers to the UK
>
>There is a situation in a hospital A+E where there is a primary care
>service based out of the same location. Many of the paediatric
>attenders in the A+E department have primary care type problems. The
>primary care service are happy that the paediatric nurse (RSCN), who
>does the triage, refer patients directly to them rather than to the paed
>SHOs. The GPs then either advise or treat or can speak to the
>paediatric registrar to discuss or admit the patient.
>
>This system seems eminently sensible to me and is an example of the team
>work that so often seems to be missing these days.
>
>There is now a move for this practice to cease - this comes not from the
>primary care docs or the original nurse that set up the paediatric part
>of the A+E but from a new nurse who is one of the new breed of nurses
>that have not been through the generic nurse training but have
>specialised from early on.
>
>I find this all a bit odd. It is my impression that the general feeling
>these days is that much of what comes into A+E is most appropriately,
>effectivly and efficiently dealt with by a primary care physician. To
>me this stands to reason with primary care type problems - a GP deals
>with these things far more often than a paed SHO (who may be just our of
>pre-registration house jobs).
>
>I am tempted to beleive that the nurse that wants to stop referring to
>the primary care docs knows little of the majority of medicine that
>occurs in the community - but I am resisting this temptation until I
>know more.
>
>I would be interested in views from the list - and also to hear of
>anyone with experience of triaging patients to on-site primary care docs
>or other primary care facility. Does it work? Is it safe? Is everyone
>happy?
>
>If anyone can save me the leg work of hunting out any references in this
>area then I would be very grateful.
>
>TIA
>
>Cheers all :)
>--
>Dr Jel Coward
>
>'There's no such thing as bad weather - just bad clothing"
> Anon Norwegian
>
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