JiscMail Logo
Email discussion lists for the UK Education and Research communities

Help for ACAD-AE-MED Archives


ACAD-AE-MED Archives

ACAD-AE-MED Archives


ACAD-AE-MED@JISCMAIL.AC.UK


View:

Message:

[

First

|

Previous

|

Next

|

Last

]

By Topic:

[

First

|

Previous

|

Next

|

Last

]

By Author:

[

First

|

Previous

|

Next

|

Last

]

Font:

Proportional Font

LISTSERV Archives

LISTSERV Archives

ACAD-AE-MED Home

ACAD-AE-MED Home

ACAD-AE-MED  August 2006

ACAD-AE-MED August 2006

Options

Subscribe or Unsubscribe

Subscribe or Unsubscribe

Log In

Log In

Get Password

Get Password

Subject:

What we need are roadies.

From:

Rowley Cottingham <[log in to unmask]>

Reply-To:

Accident and Emergency Academic List <[log in to unmask]>

Date:

Mon, 14 Aug 2006 22:20:00 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (124 lines)

It wasn't really picked as a throwaway line, but I take the point that 
burst speed is not sustainable. Certainly in optimum conditions it is 
easily possible, but I concede that a couple of mysterious indigestions, 
a suicidal and a collapse ?cause can bog me down.

I am most emphatically NOT trying to spark a doctors v nurses row - I 
want to move us on from an anachronistic attitude and approach which is 
irrelevant today.

The point I am making is that we seem to collectively have a complete 
group of staff missing. They are the people to do the unglamorous jobs. 
A department needs someone going round restocking, cleaning and tidying. 
We need someone to ensure that patients are called in and sat or laid 
down as appropriate to be examined. Gofers. Roadies. Once upon a time 
nurses did it, but as their numbers decreased and their skills, 
education and training increased (pace Robin, of course empowering 
nurses and improving their education has been beneficial) they have 
neither had the resources nor inclination to do these so-called menial 
tasks. We desperately need someone between the cleaners and the nurses.

> *From:* Paul Bailey <[log in to unmask]>
> *To:* [log in to unmask]
> *Date:* Tue, 15 Aug 2006 01:16:24 +0800
> 
> 20 patients per hour is an easy throw away line that is not likely to 
> ever
> be tested.  The simple truth is that if one bottleneck in the system 
> is
> removed - eg the unlikely event that a doctor is able to see 20 
> patients per
> hour - other bottlenecks will be revealed eg access to radiology, 
> ability of
> clerical staff to generate paperwork etc.
> 
> Whilst it may be possible to physically see 20 patients per hour, I 
> question
> whether:
> * this is possible for anything but the most 'minor' complaints 
> (should they
> be in an ED in the first place?)
> * this is possible to do across a whole shift - eg 180 patients in a 
> shift!
> * it is possible to practice high quality medicine in this manner - eg
> documentation, vigilance for low frequency / high morbidity conditions
> 
> The US system is probably the best system to use for reference.  They 
> are
> set up so that the high cost individual (the doctor) has unimpeded 
> access to
> patients.  In this system, the usual across all shifts patient 
> activity is
> around 3.5 pph.
> 
> PB
> 
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Dunn Matthew Dr. 
> (RJC) A &
> E - SwarkHosp-TR
> Sent: Monday, 14 August 2006 5:26 PM
> To: [log in to unmask]
> Subject: Re: 20 patients an hour, easily[Scanned]
> 
> Don't know about Dr Cottingham, but the rate is achievable. I do from 
> time
> to time go at that rate or higher myself, although in a relatively 
> small
> department it is unusual to have 20 patient present at a time. It 
> does rely
> on having the patients present in the cubicles when you arrive; 
> already on a
> trolley if they are slow at getting on a trolley and with the 
> appropriate
> body part exposed. The way to combine it with teaching is to go in 
> with the
> F2, see the patient and tell them what to write while they write up 
> the
> notes. Or alternatively swap roles. The two doctor idea was one I came
> across as an experiment in Stoke while I was a registrar- either Tony
> Redmond's or Mark Prescott's idea, I think. I was initially sceptical 
> about
> efficiency but in fact the talking/ examining and writing take about 
> the
> same length of time. What struck me was that whether I was in with a 
> doctor
> of the same, higher or lower grade and whether I was the examining or
> writing doctor it worked as a learning experience. 
> Outside Emergency Medicine, things have changed but when I worked in 
> General
> Practice (in the days when no evidence of being adequately qualified 
> to do
> so as a locum was needed) it was not uncommon to have 3 minute 
> appointments.
> 
> > "I could easily see 20 patients 
> > an hour and teach an F2 in minors in such a system."
> > 
> > 
> > I challenge Dr Cottingham to do this.
> > 
> 
> 
> Matt Dunn
> Warwick
> 
> 
> This email has been scanned for viruses by NAI AVD, however we are 
> unable to
> accept responsibility for any damage caused by the contents.
> The opinions expressed in this email represent the views of the 
> sender, not
> South Warwickshire General Hospitals NHS Trust unless explicity 
> stated.
> If you have received this email in error please notify the sender.
> The information contained in this email may be subject to public 
> disclosure
> under the NHS Code of Openness or the Freedom of Information Act 2000.
> Unless the information is legally exempt from disclosure, the
> confidentiality of this e-mail and your reply cannot be guaranteed.
> 


/Rowley./

Top of Message | Previous Page | Permalink

JiscMail Tools


RSS Feeds and Sharing


Advanced Options


Archives

March 2019
April 2018
January 2018
November 2017
May 2017
March 2017
November 2016
February 2016
January 2016
December 2015
August 2015
June 2015
May 2015
April 2015
March 2015
February 2015
January 2015
December 2014
October 2014
September 2014
July 2014
June 2014
May 2014
April 2014
February 2014
December 2013
November 2013
October 2013
September 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
May 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
November 2005
October 2005
September 2005
August 2005
July 2005
June 2005
May 2005
April 2005
March 2005
February 2005
January 2005
December 2004
November 2004
October 2004
September 2004
August 2004
June 2004
May 2004
April 2004
March 2004
February 2004
January 2004
December 2003
November 2003
October 2003
September 2003
August 2003
July 2003
June 2003
May 2003
April 2003
March 2003
February 2003
January 2003
December 2002
November 2002
October 2002
September 2002
August 2002
July 2002
June 2002
May 2002
April 2002
March 2002
February 2002
January 2002
December 2001
November 2001
October 2001
September 2001
August 2001
July 2001
June 2001
May 2001
April 2001
March 2001
February 2001
January 2001
December 2000
November 2000
October 2000
September 2000
August 2000
July 2000
June 2000
May 2000
April 2000
March 2000
February 2000
January 2000
December 1999
November 1999
October 1999
September 1999
August 1999
July 1999
June 1999
May 1999
April 1999
March 1999
February 1999
January 1999
December 1998
November 1998
October 1998
September 1998


JiscMail is a Jisc service.

View our service policies at https://www.jiscmail.ac.uk/policyandsecurity/ and Jisc's privacy policy at https://www.jisc.ac.uk/website/privacy-notice

Secured by F-Secure Anti-Virus CataList Email List Search Powered by the LISTSERV Email List Manager