Working in A&E What was your story?
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Working in A&E What was your story?
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I am commissioned to write a book 'Law in Emergency Care' . Having researched extensively I am sure that Doc2doc members have something to say about their experiences in A&E, or indeed preho
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Forums » Open clinical » General clinical » Working in A&E What was your story?
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Working in A&E What was your story?
posted at 23/1/2012 2:59 PM GMT
on bmj.com
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Posts: 382
First: 15/7/2011 Last: 19/5/2012 |
I am commissioned to write a book 'Law in Emergency Care'. Having researched extensively I am sure that Doc2doc members have something to say about their experiences in A&E, or indeed prehospital care. There are so many issues to discuss I thought I would throw up a few ideas and see how people react, you can answer any or none or just tell us your experience? 1. Did the four hour target hinder you in any way? 2. Did any specific Legal problems arise in y)ur experience (anonymity assured)? 3. What was your senior cover like? Easily available? Supportive? 4. How was your relationship with Nurses? Were they helpful? 5. Did you have an adequate Induction programme? 6. How did you cope with the sheer volume of patients? 7. Patients requiring help can be any sex, age and background. Where you able to get enough background information to assist making your diagnosis? 8. Did you feel competent to deal with most of the patients presenting with their problems 9. Did you require assistance to develop skills in Radiology interpretation? 10.What were your greatest frustrations whilst working in A&E? 11.How many years ago did you complete your A&E rotation? 12. Did you have patients who re-presented having seen a different Doctors days previously? 13 What about language barriers? as people travel around or families living in the country may have youngsters who speak perfect English but elderly grandmothers etc have no English speaking ability at all (I speak from Experience). Any other anecdotes or experiences that were stressful, amusing etc etc, None of the above will be printed it is just to help me add to the picture I have growing in my mind that might have an influence on legal issues arising. Thanks. |
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Re: Working in A&E What was your story?
posted at 24/1/2012 12:18 PM GMT
on bmj.com
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Posts: 8
First: 3/2/2010 Last: 16/5/2012 |
A suggestion from a Dutch GP for an extra theme: how do you cope with language-barriers? It is a big problem in communication for us if patients don't speak Dutch/German/English but only Arabic/Marroccan/Turkish/Polish/etc... |
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Re: Working in A&E What was your story?
posted at 24/1/2012 1:52 PM GMT
on bmj.com
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*Moderator*
Posts: 630
First: 7/4/2011 Last: 18/5/2012 |
It's not medical, but what about the design of A&E? Does this have any effect on how patients act and doctors peform?: http://doc2doc.bmj.com/forums/off-duty_news-media_redesign-ae-prevent-aggression-violence-towards-staff |
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Re: Working in A&E What was your story?
posted at 24/1/2012 7:49 PM GMT
on bmj.com
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Posts: 288
First: 13/4/2010 Last: 18/5/2012 |
As part of my GP training I did 12 months in A&E. After qualifying as a GP I did another 6 months as I wanted to work in remote communities and look after a community hospital A&E as part of that work (both of which I now do). A general comment is that too many doctors in A&E were inexperienced. Fortunately there were more experienced doctors on hand to advise/help. However, my GP training was invaluable and, in many respects, put me way ahead of my career A&E colleagues, even those at Registrar/SR level. This was because my approach was much more conservative (e.g. avoiduing antibitoics for sore ears, etc.). I had a much more general view of things, a much higher tolerance of uncertainty, a much higher threshold for requesting tests, investigations, second opinions, etc. Now given I haven't been in secondary care A&E for about 17 years my answwers to your questions are not up to date but here goes anyway: 1. I always ignored targets as I felt confident enough to justify I was dealing with people in order of need not waiting time (i.e. good triage). 2. no legal problems (except for patients occasionally!) 3. senior colleagues approachable, easily available and always helpful, kind and understanding of my limitations 4. nursing colleagues - nothing but praise - like having an extra pair of eyes, ears and hands. 5. yes, good induction. 6. volume of work - I worked in one of the busiest A&E departments in the UK with over 120,000 cases a year. It was insanely busy but I coped by taking my time, not getting worked up by the waiting time, being careful and methodical and knowing my limitations. Patients forgive long waits if they feel they have a thorough job done when they do see the doctor. The other thing that helped me cope was an absolute zero tolerance approach to hostility and aggression towards me or any member of staff and I was quite happy to stand up to people myself. 7. Yes 8. Yes 9. Yes 10. Biggest frustration - finding clean greens that actually fitted and paon in the butt journalists (who got told bluntly by me where to go) 11. As before, 17 years ago. 12. Yes - sometimes appropriate, sometimes not - just like GP land 13. Trust me as someone who was born and bred in Scotland - thee are parts of Scotland where I struggle to understand what is being said! In one A&E department I worked in we had a superb folder (I think originally from the International Red Cross) which contained sheets of common medical questions and answers in English and translated opposite into about 20 different languages. Invaluable sometimes. Anecdotes a plenty but that's for another time and space... |
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Re: Working in A&E What was your story?
posted at 8/5/2012 9:10 PM BST
on bmj.com
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Posts: 551
First: 27/3/2012 Last: 20/5/2012 |
I feel proud to get an opportunity to interact with a prominent personality like Mr. Kirked! I would try to answer the relevant queries in my own way, & request Mr. Kirked to kindly accept any errors if found. 1) The A&E is inherently architectured in a pattern that we forget the 'time' dimension for a while! So four hour target appear to be smaller & would not hinder in anyway. 2) A&E is always associated with many legal problems & this is its differentiating feature, where we can have experience related to medicolegal aspects. 3) Generally the seniors are always prepared to guide & support. 4) Here, the role of the experienced nursing staff is practically very important. 5) Many a times we have an adequate & satisfactory induction programs. 6) It is this place, where your skills are fully judged to cope with whatever the number of patients might be. 7) It is an essential part of our clinical examination, without which we cannot approach a find conclusion. 8) I did not experience any major difficulties,especially when our seniors were always there for our help. 9) To interpret a radiograph is purely a job of the clinician who has examined the patient & there is little importance to the opinion of a radiologist in general. 10) We are always appreciated if successful, but the real frustating time is when despite our adequate attempts we could not survive a life & thence become victims for criticism. 11) I have completed my A&E compulsory rotation twenty four years back! & now I am 47 years old. 12) Yes, it used to occur routinely. 13) The barrier concerning language is encountered very often, but can be solved easily if the patient is accompanying a competent interpreter, or when the patient is alone, we have to interpret according to our expertise to recognize gestures & facial reading or the body language of the patient, a job very difficult & akin to what the pediatricians routinely face. |
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