Agreed

How come another Specialty can dictate what happens in the ED?

CQC then quotes it as though it is mandatory..... mind you in our report
they got the number of patients attending completely wrong. I think they
must have done a cut and paste with another department 67 miles away!

Ray

-----Original Message-----
From: Accident and Emergency Academic List

[mailto:[log in to unmask]] On Behalf Of Bethel, Jim
Sent: 01 July 2014 11:13
To: [log in to unmask]
Subject: Re: ACAD-AE-MED Digest - 26 Jun 2014 to 27 Jun 2014 (#2014-17)

came from the RCPCH - supported by the RCN Children and Young Adult Nursing
group - neither feasible/desirable/essential - in my humble opinion an ED
nurse with paed experience has as much place caring for sick kids as anyone
else

jim

________________________________________
From: Accident and Emergency Academic List [[log in to unmask]] on
behalf of ACAD-AE-MED automatic digest system [[log in to unmask]]
Sent: 28 June 2014 00:02
To: [log in to unmask]
Subject: ACAD-AE-MED Digest - 26 Jun 2014 to 27 Jun 2014 (#2014-17)

There are 4 messages totaling 638 lines in this issue.

Topics of the day:

  1. CQC (4)

----------------------------------------------------------------------

Date:    Fri, 27 Jun 2014 11:05:14 +0100
From:    Richard Bailey <[log in to unmask]>
Subject: Re: CQC

Probably none Ray - we have 1 children's trained nurse in total and have
failed to recruit more despite several attempts. We're hoping to establish a
children's assessment unit in ED when we redevelop the department in 2 years
time staffed by paediatric and ED nurses so that should go a long way to
resolving the issue. Not sure where the recommendation comes from

BW Bill

Sent from my iPhone

> On 26 Jun 2014, at 18:09, Ray McGlone <[log in to unmask]> wrote:
>
> We had a "Good" report from a recent CQC report but one point they
> stressed was the lack of a 24/7 paediatric nurse
>
> How many departments with no separate paediatric unit actually have 24/7
paediatric nurses? Most small to moderate sized general EM departments seem
to have difficulty retaining them as they get deskilled.
>
> Having worked nights recently in my own dept I didn't see many children at
0200 hrs.
>
> Does this standard come from the College or another body?
>
> Ray McGlone
> Lancaster

------------------------------

Date:    Fri, 27 Jun 2014 10:08:36 +0000
From:    "McCormick Simon Dr, Consultant, A&E"
<[log in to unmask]>
Subject: Re: CQC

We can't manage it, despite having nearly 18,000 under 18 a year.

Not many want to come and work in the ED, those that do tend to wear out
quite quickly (much more intense than on the ward) leave.

Few kids after midnight although the number of kids attending in the late
evening, early night continues to rise and is spilling over to after
midnight.

The bigger problem is the lack of medical expertise after midnight as many
of our MGs are locums with variable experience/expertise.  We've ended up
making in mandatory to discuss ANY child under 3 months old at any time in
the department with a consultant and when we are not in they must be
discussed with the paediatric MG on-call.  Just had too many errors made in
this group.

Simon


"Hospitals with overcrowded Emergency Departments are overcrowded hospitals
that have chosen to manifest the overcrowding in a single location"
Full Capacity protocol: an end to double standards in acute hospital care
provision Emerg Med J 2011;28:547-549

________________________________
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Ray McGlone
Sent: 26 June 2014 18:10
To: [log in to unmask]
Subject: CQC

We had a "Good" report from a recent CQC report but one point they stressed
was the lack of a 24/7 paediatric nurse

How many departments with no separate paediatric unit actually have 24/7
paediatric nurses? Most small to moderate sized general EM departments seem
to have difficulty retaining them as they get deskilled.

Having worked nights recently in my own dept I didn't see many children at
0200 hrs.

Does this standard come from the College or another body?

Ray McGlone
Lancaster

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------------------------------

Date:    Fri, 27 Jun 2014 13:14:02 +0100
From:    Adrian <[log in to unmask]>
Subject: Re: CQC

I think the recommendation is from the RCPH, not CEM

Sent from my iPad

> On 27 Jun 2014, at 11:05, Richard Bailey <[log in to unmask]> wrote:
>
> Probably none Ray - we have 1 children's trained nurse in total and
> have failed to recruit more despite several attempts. We're hoping to
> establish a children's assessment unit in ED when we redevelop the
> department in 2 years time staffed by paediatric and ED nurses so that
> should go a long way to resolving the issue. Not sure where the
> recommendation comes from
>
> BW Bill
>
> Sent from my iPhone
>
>> On 26 Jun 2014, at 18:09, Ray McGlone <[log in to unmask]> wrote:
>>
>> We had a "Good" report from a recent CQC report but one point they
>> stressed was the lack of a 24/7 paediatric nurse
>>
>> How many departments with no separate paediatric unit actually have 24/7
paediatric nurses? Most small to moderate sized general EM departments seem
to have difficulty retaining them as they get deskilled.
>>
>> Having worked nights recently in my own dept I didn't see many children
at 0200 hrs.
>>
>> Does this standard come from the College or another body?
>>
>> Ray McGlone
>> Lancaster

------------------------------

Date:    Fri, 27 Jun 2014 12:24:33 -0700
From:    Jel Coward <[log in to unmask]>
Subject: Re: CQC

I see many children in the practice every day I see many children in the
emerg dept most days I do not have a paediatric nurse.  I am not a
paediatrician.

The kids get great care from our greatly skilled, true generalist,
nurses.....be that for minor illness or full-on resusc.

The opposite of a generalist is a partialist.....who would want one of
those?  ;-)

....just sayin'  ;-)

jel



On 26 June 2014 10:09, Ray McGlone <[log in to unmask]> wrote:

> We had a "Good" report from a recent CQC report but one point they
> stressed was the lack of a 24/7 paediatric nurse
>
>
>
> How many departments with no separate paediatric unit actually have
> 24/7 paediatric nurses? Most small to moderate sized general EM
> departments seem to have difficulty retaining them as they get deskilled.
>
>
>
> Having worked nights recently in my own dept I didn't see many
> children at
> 0200 hrs.
>
>
>
> Does this standard come from the College or another body?
>
>
>
> Ray McGlone
>
> Lancaster
>



--
Jel Coward

Some Open-Source and Creative Commons interests.....
The CARE Course http://www.theCAREcourse.ca Wilderness Medicine Twitter
account <http://twitter.com/#%21/wemsiint>
WEMSI-International http://WEMSI-International.org OSCAR open-source EMR
http://OSCARcanada.org

------------------------------

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