Mmmm, that's true - my brother is a paramedic in Brissie and I routinely listen to him gripe about some of the stuff he gets called to - like man-flu.:
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Mmmm, that's true - my brother is a paramedic in Brissie and I routinely listen to him gripe about some of the stuff he gets called to - like man-flu.:
The department i worked for had pamphlets and videos explaining just that in every different language avaliable to everyone and put in letterboxes of the intake area:
sent via my vortex manipulator
There are times when the patients are seen by the nurse practitioner instead of the doctor. They are limited by a scope of practice so things may be taken ahead of more unwell patients because they do not fit within that scope. For example, I do not see abdo pain because it is a time consuming assessment. But if you come in pregnant with PV bleeding / fractures / lacerations / abscesses / tonsilitis / eye foreign bodies / post tonsillectomy bleeds blah blah blah then you may see me instead of a doctor. But not if you are having a heart attack / headache / back pain etc etc
Or people may be there to see a specialty team - referred by another hospital or their local doctor.
Or they may be needing a specialised area because they are sicker, but the less sick patients are being churned through because they are in a different location / area of the department manned by different staff. Just the waiting room is the same.
Triage is identifying the things most likely to kill you / cause you permanent physical damage. A cut arm got seen ahead of a chest pain on Monday because the cut was bleeding to death with an arterial bleed. Normally the chest pain (of a classic cardiac sounding nature) trumps most things. But if 5 chest pains turn up, triage has to try to identify which one is most likely to need medical care first. They may all get a Cat 2 but there are limited resources to give. Who gets them first??
Most of the time we would love you to write a complaint about the extensive waiting times. We hate not being able to provide appropriate and expedient care for patients. We also hate being yelled at, threatened and abused for the waiting times which are mostly beyond our ability to change. We want you to express your displeasure to the hospital administration because they just tell us to get on with it and improve our practices :rolleyes: Sometimes it is poor practice. Sometimes it is just trying to keep people alive when you do not have enough rooms / beds / staff to do your job properly.
Astrid - PM me if you want to discuss something specifically. I can give you a more direct answer.
ETA: And fake fainting / calling an ambulance does not get you seen quicker. But it may prevent someone you love from getting the treatment they need, when they need it.
I have been to 4 different ED's in the last few years - Royal Children's (baby with suspected UTI, toddler with chest infection/suspected asthma), Williamstown (clumsy DP fell off bike and cut eye open and wouldn't stop bleeding), Royal Melbourne (clumsy DP brought roller door down on own head and wouldn't stop bleeding) and St Vincents (by ambulance when I was knocked off my bike by car door) and we were seen very quickly all times. I couldn't fault the order or the waiting time and I think each time we were assessed appropriately. I did see/hear people who were in there for reasons that could have waited until the next day but they were still waiting when we left - so maybe they did wait until the next day....
Both my very early Premmies have ongoing respiratory issues, they are usually in some level of respiratory distress and as soon as I mention they are ex 28 and 25 weekers we are taken pretty much straight away, I have never waited more than 10 minutes.
I took my DD2 (35 weeker) in with extremely high temps, in pain and very lethargic and we waited nearly 2 hours, turned out she had swine flu and was very sick.
So even though DD2 looked sicker than DD3 and DS4 she waited longer because resp distress can potentially be more serious.
I have been given evils by other parents because we have gone in so quickly and it may not look obvious what was wrong.
I've just gone to the ED here twice in the past week. The first time I went in, we were put in waiting and they triaged 2 other patients before us. The ED waiting room here has a different triage and section for children and adults, so 2 other children came in one with a broken foot and one with a sore arm who was jumping off the seats. They both went in before Matilda and we didn't mind too much except Matilda was vomitting and had diarrhoea in the waiting room and I was covered in vomit and poo and people were all around us... after 90 minutes we got in and were admitted pretty quickly and on the ward soon thereafter.
The second time we presented, while they were doing her obs in the waiting room, the nurse grabbed her and put her in a wheelchair and raced her off to resus. The team knew we were coming becuase I had phoned the ward ahead and the paediatrician warned ED that we were on our way in. When we arrived, she wasn't in a good way at all and I think we waited 1 minute? by the time we arrived at resus the paediatrician was waiting for us with 3 nurses.
We had to go to adult resus because the children's was taken... but it was amazing, without the quick thinking on the paediatrician's behalf on the phone things wouldn't have gone so well for us.
We are home now... thankfully
DD1 was recently in the eye and ear with metal in her cornea, waiting room wasn't busy so wait wasn't long, a week later after an op to clean the rust out of it, we were back in eye and ear emergency with pain, it was flat out, she was triaged cat 1 which surprised me as there were many in pain, but after reading what Michelle wrote I'm guessing it was because they suspected either an infection or remnants of the metal and there was concern about permanent damage. I felt bad that we got seen so quickly, but very thankful!
I've taken Will to the GP afterhours clinic and he's given me a letter to give to admissions, I've been taken in very quickly (eg hadn't even settled down in the waiting room!) and other times for the same thing I've waited 4 hours. When I splashed hot oil in my eye I went to a private hospital ER and was home after being flushed out for 45 mins by a (very very hot) nurse who's also a firey (yum) cause I knew it'd be a low priority.
knowing the area you live and having been in the CFA, I think I know who you're talking about! And yes... he was hotter than anything else on the fire ground. Made it very hard to concentrate when he attended a course I was also on.:
Tairae- thats a good start.
ED here saved my hubbys life when he had mengitis. We had seen drs every day for a week and alll said he was fine, the day before the dr put him in outpatient iv and just gave him some meds. The morning he couldnt get off the floor, we got an ambulance(not like our 1s just a van to get you to hospital) and the ED shunted him round departments and eventually he got lucky and came acroos a dr who knew what was wrong- the point being- they keep on trying and that saved his life.
Here, they see some pretty bad stuff that could be prevented too. awsome job folks