Tuesday, 1 March 2011


Quick question for you, once you've read this article.

Which one really needs redesigning?

The A&E departments, or the behaviour of those who attend them?


Deborah said...

Agree - those attending need to get their act together. It's not acceptable to kick someone's teeth in because you can't find your way to A& E

Anonymous said...

But which is cheaper and more likely to work?

Eileen said...

In South Africa I have seen A&Es with separate areas divided by a barred partition with locked doors. You only get through to the treatment area if you have been triaged and the attendant posse doesn't get there. I know they had/have some different issues but sometimes they seem not so different from parts of the UK on certain nights of the week. If people can't behave in a civilised way they deserve to be treated as barbarians.

However - as long as Premier league footballers can behave as 3 have done over this weeked (who takes a gun of any sort into work and claims they didn't know it was loaded; self-defence - against what; and I'm in a paddy so I'll damage someone else's property) and there is no proper form of disapproval expressed by the authorities) how can you expect some Joe Publics to understand it's not acceptable behaviour and needs punishment not imitation?

Eileen said...

Forgot to mention - in our local A&E here in northern Italy, there is an enormous sign: patients get a label according to need. Red: immediately life threatening, straight in; Orange: serious, possibly life threatening if not dealt with; Green: needs dealing with now in the emergency setting but not life threatenting and White: you have no business here in the EMERGENCY department, this is a reason to consult your GP or go to a pharmacy for advice!

I should maybe mention that the Italian visitors (as opposed to the locals who are of a rather more Teutonic background and therefore more stoical) flock to the A&E because they fell over skiing and have a minor scrape or a small bruise which obviously needs an X-ray, plastercast or - even more likely - antibiotics so it doesn't get infected!

wv - frati - see it knew it was an Italian comment!

Oneunder said...

Give all staff tazers and all patients go to a locked cage.

Theresa Jones said...

Both. I gave up ER nursing due to the violence and abuse. I now work in surgeries, boring, but safer. I think that the admin and society as a whole needs to crack down on unacceptable behaviour. Either that or have bad patients escorted out, put in cuffs, or arrested for lewd behaviour, until they can be trusted or treated safely. A patient's bad behaviour also needs to be charted and attached to their record and should follow them, not to mention be sent to the authorites. Great post.

InsomniacMedic said...

Deborah - agree with you wholeheartedly.
Anon - It costs nothing to know how to behave and keep your actions in check!
Eileen - The point about the footballers is a really good one. When the people who are supposedly role models in society clearly don't know how to behave, who do we look to next?
OU - It's a good thing I know who you are...

Theresa - I'm sorry to hear that you left the front line, but can totally understand. I agree that there should be zero tolerance, and whilst it's always mentioned, often it's not carried out... thanks for commenting!

TOTWTYTR said...

What needs redesigning is the brains of the administrators and politicians that think that redesigning the A&E departments will fix the problem.

The problem is not the design of the facility, but the lack of consequence for people who assault the staff.

Assign a few cops to the A&E department, arrest the criminals, prosecute them. That will do more to solve the problem than anything else.

Alas, I don't expect that will happen.