Sunday, 13 April 2008

When hell hit the department.....devil style!!

Well, things did not seem to to get better, the night staff looked exhaused when i came on duty and you can tell from those looks - oh i really want to be convince yourself its not that bad and then become quite optimistic with regards to the situation....really how atrocious could it get...?

We had a GP in today who refused to see anything remotely emergency related with regards to minor injuries and would only see medical problems...which leaves oneself wondering the point behind this? The department is slowly sinking deeper and deeper under the sea of patients which seems to keep multiplying every 5-10 minutes, everytime you look out theres been an exponential growth, the sea of patients seems to be evolving and suddenly I feel a very diminutive part of the 'ED ocean'.

I felt like the vampire queen today rushing here there and everywhere, 'stealing' blood from individuals, never truly managing to get a grasp on anything or anyone, as you do. Supposadly stable patients placed in the observation wards prove not to be so stable in the morning after all. An elderly patient who presented to the department yesterday, late afternoon with falls/collapse, shoulder pain and acute confusion seems not to be so well after noting melina after her motions. This made me feel a little uneasy as the the patient was in my care yesterday and i did flag up with the doctor my concerns with regards to this patient and passed on my views on how i felt, in an attempt to be the patient's advocate as she was acutely confused. It left me wondering should i have really stuck to my point, listened to my sick sense and intuition and pushed my point further, in attempt to really ensure the patient recieved the timely pertinent care and treatment she deserved. It was noted the patient was left without review during the 'night rush hour' which to be fair is the way of emergency care, at times, but the patient was obliterated and left in the 'land of limbo', as they do, people view them as clinically stable. Although problem being, the patient was not stable and had a CRP of 165 and urea 9.2, tachycardiac, with a MEWS score of 5 and ended up in resus for a full new assessment, this left a certain stroke of unease about how i could or what i should have accomplished for the patient yesterday, I feel as if i am partially responsible for this individuals deterioration in health.

By 12.00pm there were patients all over-some deteriorating sat on chairs causing the panic station to flash at full speed,but there were no trolleys for them! ambos could not off load their patients and resus was full on within trauma's and the critically ill. Everyone looks very confuzzled - not knowing where to start, which way to go but the question still lies, where were the SHA today or last night for that matter....?

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