Emergency departments in hospitals

are not fun places to be. 

I had a number of trips to the emergency departments of both the major hospitals on this side of the city with the Senior Cat. On one occasion that also involved the ambulance we were in going at terrifying speeds down the wrong side of the road in peak hour traffic. Yes, it really was an emergency. The Senior Cat was seen almost immediately and whisked away from me for a look at his skull. (He had fallen backwards and had a 4cm crack in it.)

On that occasion, as on several others, I was there as the family member of someone who needed help. It gave me time to observe and I did because, on other occasions, I have been called in to help. On occasions it has been my job to "interpret" or, as I prefer to put it, "provide communication assistance".  I do this not for people who speak a second language (although some of them do know one) but for people who have difficulty speaking or may not be able to speak at all. It is my job to make sure they understand what the medical staff are asking and that the medical staff understand their responses. Communication in those circumstances is never fast. I have become adept at finding out what works best for the patient before the staff try again to communicate. I have become adept at rewording questions so the patient can understand and perhaps just answer "yes" or "no". No, I am not taking over. That is not my job. It is my job to make sure the medical staff can do their job. And yes, it is a responsibility - one I would rather not take on at any time.

I think all that makes me far more aware of what actually goes on in emergency departments. I have seen the staff coping with angry, abusive drunks, suicidal mental health patients, frightened and demanding relatives, all too quiet patients and much more. I have seen them when there is no room to move safely between patients, when someone collapses on the floor and much more. That they seem to cope with all this never ceases to amaze me.

But the staff in such places need support. In this state they are all too often not getting it when they could be getting it. There have been changes to the way we handle issues in society which makes their job that much harder.  When I was a mere kitten drug overdoses were rare. Yes, there were drugs around but they were not the problem they are now. Emergency departments were not seeing them every day as they are now. Alcohol was much less freely available and the emergency departments did not see as many cases of abusive public drunkenness. They were there of course but they were not as obvious. Mental health issues were handled in other settings and someone who presented to an emergency department threatening suicide or showing self-harm would have been removed almost immediately to a different location within the hospital. Now all these things get dealt with along with cardiac arrest, strokes, trauma and more. The work of an emergency department has expanded.

What has not expanded, or not expanded sufficiently, is the capacity to cope with all this. The role of a doctor in emergency is an almost impossible one. They are expected to be - but cannot be - experts in everything. They often need to make rapid decisions. They need to make them knowing that this might not be the best thing for the patient but that it is the best they can do. It is an impossible situation.

So, the head of the emergency department at one major hospital has just resigned. She has given them six weeks notice. She has given the powers-that-be who deal with the financial side, who decide on the levels of staffing and equipment and much more, a blasting. It is not a rushed decision on her part. She has been there for the better part of a decade. She has seen all the politics and the politically correct nonsense that has made her role more and more difficult. It has simply become too much. We have lost a damn good, caring doctor. We will lose more too.

Of course I will go in if I am ever asked. I will do it because of the patient. I will also do it because they are doing an impossible job without the help they should be getting.

But - to the government who got in on making an issue out of "ramping" and has since done nothing about it making the problem even worse, I have no time for your criticism of those who work there.