Thursday, November 17, 2005

All walks of life from behind a pane of plastic

Sitting behind the triage nurse gives a really colourful insight to the people that present to the emergency department. Many of which of course aren't really emergencies per se. You'll be surprised (or maybe not) that so many people go to the emergency department for no better reason than to take their blood pressure or to ask for some prescriptions for the gastric problems. Or come after the emergency period has ended - an example would be presenting to the ED 10 hours after the initial anaphylactic event.

Many a times I wondered if emergency departments have degenerated into a 24-hour GP clinic with some expertise in trauma and some Holter monitors. Staffing problems of course makes it difficult for everyone to be seen as promptly as what everyone expects - within minutes of being triage and registration. After one hour, two hours, 4 hours - people start getting restless and feel that they are being ignored. The fact is all beds are full and yes, there are more critical patients. People deal with this in all kinds of ways -- some sit quietly, looking at the door occasionally hoping that the big mechanical sliding glass door opens and someone behind it calls their name. Others make noise, lots of it.

I remember last night (or was it the night before?) that someone asked me if I was a GP. Now I'm not complaining here, really, but this same person is also waiting to be triaged by the psych nurse (and I suspect it was her who was complaining of an evil spirit in the toilet to the clerk, but don't quote me on that).

It's a small place really, the emergency department, but my, the people you see there...


Michael said...

It's easy to be jaded in the ED but I highly recommend that you get out of triage and start seeing some patients on the floor.

Yes, people come with bizarre and minor problems and many may be triage category 4s and 5s. However, once you actually see them, a surprising number of people you will discover actually have problems that could not have been easily treated in a General Practice setting. The experience of those EDs with an attached GP practice is that it does not actually reduce the workload in the ED.

Anyway, best of luck in your training!

I'm a GP registrar working as a RMO2 in the Sydney Children's Hospital Randwick at present.

Best regards.

Guohao said...

Yeah I'll hopefully be getting to see some patients on the floor once my data collection is completed - otherwise I'll have to continue waiting at the triage for ambulances to arrive :(

I agree with you in the sense that an emergency department is more than just a GP practice. Still, some things are better sorted out in a GP setting since there's less time pressure.

Thanks for reading and your wishes! Good luck with your training as well :)