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Who is clinically liable for patients attending at 0200 hr when you have one nurse in charge... and a porter? If it's you then you need to put it in writing to the Chief Executive that it is unsafe. Ray McGlone Lancaster A&E ----- Original Message ----- From: <[log in to unmask]> To: <[log in to unmask]> Sent: Saturday, March 09, 2002 6:23 PM Subject: Re: trolley waits > With respect to public consultation, we have tried to put the problem of our > MIU in a small hospital 18 miles from the base DGH to the local health forum. > > > The Problem: > MIU staffed by a solo NP after 5pm. > Medical admissions to wards without lab back-up and no anaesthesia on site. > > Monthly problems with airway failure on the wards and MIU. > Because of medical admissions, Ambulances delivering medically sick patients > to the MIU with slow medical back-up from the wards. > Several Coroners reports about the lack of back up in MIU and a CHI report saying > it is unsafe plus several reports to the Governance Commitee re risks from yours > truly. > > Result: Under no circumstances will the MIU be closed at night and we wont pay > more. > > Added problem: having trouble retaining NP's who feel unsupported and underprotected > at night and now a shortage of applicants! And who can blame them? > > It seems no one can shroud wave as well as local politicians! > > Andy Volans > > The government could improve every level of hospital medicine, not by > >> increasing > >> NHS funding, but by increasing the level of funding for Rest Homes, Nursing > > >> Homes, Home Help etc, but I guess it's just not as sexy. > > > >In reference to this and the Maryland experiment mentioned, does anyone know > > >what the votes in Oregon were when they tried similar medical spending > >referenda? > > > >My impression is that as the public demands a more direct voice on how > >government acts (heath spending, MMR vaccination etc), then there will be a > > >learning curve for the public. > > > >They will initially make a lot of stereotypical 'mistakes' such putting more > > >money into A&E and less into care homes, or offering triple vaccines instead > > >of MMR. It will take them a while to realise these choices don't work, if > > >they learn this at all. It will also be a learning curve to realise that > >the 'safety harness' of paternalism has been removed, and that if they > >choose to increase mortality rates with their choices, no-one will > >physically stop them. > > > >The public is perhaps a bit like the Opposition in Parliament. They can say > > >what feels good because they don't have to suffer the consequences of > >actually doing the things they are saying. > > > >Do people think: > >(1) that the public should be able to decided on such issues? > >(2) that things will initially get worse or better, when the public have a > > >greater say? > >(3) that the public will develop better risk/causality assessment skills if > > >they are actually making the decisions? > > > > > > > >Robbie Coull > > > >email: [log in to unmask] website: http://www.coull.net > > > >==^======================================================================== = > > >ATTENTION GPs, NHS TRUSTS and LOCUM DOCTORS > >visit http://www.locum123.com the online locum messaging service by doctors > > >for doctors and send or receive requests for locum cover by SMS and email > >==^======================================================================== = > > > > > > > >