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How you can help ease late-night hell in A&E
LONG waiting times, abusive patients and staff stretched to breaking point – everyone has heard the horror stories about late-night A&E trips.
So I went and spent an evening observing staff and patients to see if things really are as bad as they say.
With capacity for 15 beds in the major injuries unit, about five in the resuscitation room and four in the examination room for minor injuries and illnesses, Southend A&E treats an average of 250 patients a day.
Staff are dedicated to meeting their four-hour waiting time target to treat patients, from their entry to A&E, while still providing the best care possible.
From arriving at 7pm to leaving at 1.30am, the flowof patients bucked the usual Friday night trend and steadily eased.
Ambulances were queued up outside A&E when I arrived, but the loading bay was completely empty when I left.
The hospital has come in for criticism in recent weeks over ambulances having to wait longer than 15 minutes to transfer a patient and leave. However, it is easy to see how this could happen.
With only a limited number of beds available, it is sometimes inevitable patients will have to wait to be seen.
Dr Caroline Howard, clinical lead for A&E, said: “We will always see the people in most need first. Sometimes patients cannot wait to be treated so others have to – it’s not first come, first served.”
One of the friendly faces that patients see in A&E is receptionist Kim Allain, who has been at the hospital for 18 years.
She’s the one in the firing line if patients are not happy with their wait, or the care they receive.
She said: “We have the public shouting at us and we do get a lot of abuse.
“We have to explain to patients that we are sorry they have not been seen yet, but I do not have anything to do with the nursing staff.
“Some people get frustrated and find it hard to understand that it is not when you come in, but the priority of their illness or injury.”
Abusive patients are sadly a reality for staff in A&E and Dr Howard uses a card system to deal with problem patients.
A yellow card indicates a patient is on a warning and, should they continue to be abusive, they get upgraded to red.
A red card means a patient is banned from Southend A&E should they not require urgent care, in which case staff are ethically bound to treat them.
Dr Howard said: “When I come in on a Monday morning after a weekend, there will almost always be a red card.
Unfortunately it is a lot more common now.”
The nerve centre of the A&E is undoubtedly the patient boards in both the minor and major injury units. These boards are constantly watched over by a camera, beaming pictures back to a control room.
In charge of the boards are nurses, logging each patient in and out, noting what tests they have had, when they next need checking, what medication they are on – the list goes on.
Bec Boyes is a senior sister and has been at Southend A&E for 14 years. She thinks the number of patients visiting A&E would reduce if theywere more aware of the alternatives.
She said: “We screen people when they come in and filter the people that could just be seen by an out-of-hours GP.
“People don’t know there is also a walk-in centre at St Luke’s Health Centre, in Pantile Avenue, which is open 8am to 8pm.”
Luckily, Kevin Thompson, 54, from Leigh, found A&E quiet when he came in with a wrist injury.
He said: “I was waiting for all the Friday night drinkers, but they’re not here. Other than a bit of a wait, the care has been very good.”
Crystal White, 21, from Southend, added: “I was resisting coming because I thought it would be rammed, but I didn’t have much choice. I’ve come a few times and never waited longer than an hour.”
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