Is anyone else being pressured to come in to stop breaches whilst they are
on-call? This is specifically because patients have waited about 3 hours to
see an A&E doctor and are likely to breach because of this wait to see a
clinician in A&E. I'm on-call for the next four days and know that the
on-site manager has been told to phone the A&E consultant if breaches due to
wait to see an A&E doctor are 'likely' to happen.
--> Told by whom?
Speaking as someone who comes in when on call, from home, to major trauma
calls and other CLINICALLY-relevant events on a frequent and regular basis,
I know what I would say to this at 3am...
- I would be as polite and as uncritical as I can of the "messenger".
- I would offer my full cooperation.
- I would ask him/her to set up a meeting to discuss the problem. I expect
that senior managers/physicians/surgeons and nurses, would all wish to be
included, as the solution will involve earlier discharges from THEIR wards.
Not sure whether he'll be able to sort a meeting out for 3am, but he has my
blessing and I WILL attend if they do.
- I will also ensure that, as for all other clinicians, those of us who
attend on site at 3 am (and it will be quite a number of them with me) have
the correct compensatory rest to follow.
- While he's organising this meeting, I will telephone the department and
check that no patients are being harmed by the delay. As the only benefit to
any of them from being moved at 3am would be a better actual bed to lie on,
I will make sure the relevant non-clinical on-call managers are alerted to
procure and transfer such equipment down to A&E for their use.
Or...
- I'll just tell him to go outside and cover the word "department" on the
A&E sign and put up a sheet with the word "ward" written on it - no more
breaching right there.
Or...
- I'll tell him to solve the problem like the rest of the world by massaging
figures or using statistics
Or...
- I'll tell him to call someone who cares...
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