“23 year old male, hand injury”
Right, the time has come to get back to basics. This blog is aimed at anyone who isn’t in the know or is confused about what’s what when it comes to getting treated by the NHS. So, first things first.
Hospital: A hospital is a health care institution providing patient treatment by specialised staff and equipment.
Accident and Emergency: Accident and Emergency is a department within a hospital and is a facility specialising in acute care of patients who present without prior appointment, either by their own means or an ambulance. Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life threatening and require immediate attention. All A & E departments in the UK are financed and managed publicly by the NHS. As with most other NHS services, emergency care is provided to all, free at the point of need and regardless of an ability to pay.
Ambulance: An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury. The word is most commonly associated with road-going emergency ambulances which form part of an emergency medical service, administering emergency care to those with acute medical problems.
Triage: Triage is the process of determining the priority of patients’ treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning to separate, sift or select. In a hospital setting patients are divided into three main categories based loosely around the old wartime triage process:
- Those who are likely to live, regardless of what care they receive;
- Those who are likely to die, regardless of what care they receive;
- Those for whom immediate care might make a positive difference in outcome.
Ill people go to hospital. Really ill people go initially to accident and emergency. If they can’t get there due to their illness or injury they get an emergency ambulance. Once at hospital they are triaged. That triage will determine the speed of their treatment. Those rules apply to everyone.
So, we were called to a young guy with a hand injury. Not a bad hand injury but a painful one all the same. He had managed to close his finger in a door. It was swollen. It was bruised. He couldn’t fully bend it. He was in pain. He didn’t take any pain killers. He called 999 and asked for an EMERGENCY ambulance. This was deemed to be one of the acute medical problems that we are there for. He lived half a mile away from the hospital. His girlfriend was there. She had a driving licence. She owned a car. Her car was parked outside. His brother was there. He had a driving licence. He owned a car. His car was parked outside. His mum was there. She had a driving licence. She owned a car. Her car was parked outside. His dad was there. He had a driving licence. He owned a car. His car was parked outside. On the notice board in the kitchen was a business card for a local taxi service. They did not use it. 30 yards from the front door was bus stop. The bus which stops at said bus stop also stops outside the hospital. The patient had legs. They were not injured. He could have walked to the hospital. He chose not to.
After a brief assessment in the £750-a-call-emergency-ambulance we drove him the half a mile to hospital. His girlfriend and mum came with us. The brother and dad followed in the car and parked in the pay & display car park. We walked the patient into the accident and EMERGENCY department. We spoke to the triage nurse and gave her a detailed history of what happened, what we have found and how he has been with us. She then triaged him based on what we told her and what her cursory look at his finger told her.
- Those who are likely to live, regardless of what care they receive;
- Those who are likely to die, regardless of what care they receive;
- Those for whom immediate care might make a positive difference in outcome.
“Waiting room please”
The girlfriend with a driving license and car stepped forward.
“The waiting room? He’s in pain, you haven’t even treated him yet”
“He has a hurt finger. I have 46 patients in the department now, all of which are a higher priority. There is a baby in there who may die. There are 2 patients in there who also may die. There are 16 patients in here who NEED a bed and require treatment because they are THAT ill. There is 1 doctor on duty, 4 nurses and 2 health care assistants. There are no beds free at all. The fact you called an ambulance for a finger injury is a gross abuse of the NHS. The fact I am sending you all to the waiting room should tell you that his hurt finger never has and never will be an EMERGENCY, now go and wait for your name to be called like everyone else.”
With that, she walked off. I was in awe! She summed up in 30 seconds what I have wanted to say to every single patient who has called an ambulance for nothing and who has been sent to the waiting room.
Why do people think there are long waits in hospitals?
Erm...because there are people who could wait to see a GP who are sapping resources.
Why are people surprised they sometimes have to wait a long time for an ambulance?
Erm...because so many people are calling an ambulance for the most puerile of complaints.
Why are people surprised that they are send to the waiting room?
Erm...because they don’t need to be there.
Why do people seem to want to spend night after night sat in a hospital?
I have no answer to that. Maybe a hospital lover can enlighten me!
When I am ill I want nothing more than to lie in bed and feel sorry for myself. I will ONLY go to hospital if I absolutely have to. I would never called an ambulance unless it was a life or death emergency or if I was too injured to get myself into a taxi or a car. People seriously need to get a grip and stop expecting miracles from our free health care service. The NHS is being killed by its misuse. Accident and Emergency. THE CLUE IS IN THE NAME. Emergency Ambulance. THE CLUE IS IN THE NAME. When someone picks up a phone and dials 999 they are greeted with a question. ‘What’s your EMERGENCY?’. How anyone can hear themselves say ‘I need an ambulance because I have hurt my finger’ or ‘I have a headache’ or ‘I can’t sleep’ is beyond me! In London alone the call rate has doubled to around 1.7 million calls per year in less than 10 years. Of that, 1.2 million people get an ambulance. This jump is not down to an increase in population, nor is it down to a population that is more ill or more accident prone. It is because people are not using the services as they are intended to be used. They have become lazy and reliant on a free service and are abusing it.
Please please please people! Stop killing our NHS. Once it’s gone, it will not come back.