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Are we getting ready for flu season?

By 23 January 2013 4

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The Impacted Nurse has tweeted us (and Jeremy Lasek showing a keen understanding of who runs this town) with his concerns for the upcoming flu season and the impacts it has on the emergency department.

I have been working as a nurse in the emergency department for many years now. During the winter season, we see a large increase in demand for hospital in-patient services from our community.

Typically, this quickly overloads our hospital bed capacity. With the hospital full, patients presenting to the emergency department (ED) that require admission have no-where to be sent, and must remain in the ED until a bed becomes available.

This inability to access in-patient beds is known as access block. It leads to a situation known as emergency department overcrowding.

With no-where to place these admitted patients, and a vital need to keep treating new arrivals, inevitably patients are moved into our corridors and other non-clinical areas.

There are now many studies that show these patients, and indeed all patients cared for within this overcrowded environment, are at a significantly increased risk of morbidity and mortality (that is, an increased risk of poorer health outcomes or even death).

An overcrowded, high-stressed emergency department needing to care for its usual workload and the additional workload of patients waiting to access the hospital, quickly becomes demoralised, exhausted and at increased risk of medical errors & accidents.

He offers some suggestions (an end to quarantining the overflow to the emergency department) but also asks that our health leaders start planning for the entirely predictable inflow.

Here’s hoping.

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4 Responses to Are we getting ready for flu season?
#1
Madam Cholet12:55 pm, 23 Jan 13

Interestingly, he or she doesn’t make any comments on unnecessary presentations at ED, although i understand that they are talking about those that need to be admitted. Still, might have been worthwhile reminding people that ED is not a GP clinic.

I’m 40 years old and have spent 3 hours in ED (in one session), in my entire life. I have a four year old son who when he is sick, I take to the doctors, if necessary. I only went to emergency on the advice of a numbskull doctor who thought she had far more cred with the hospital than she actually did. It was pretty much a waste of my time.

Perhaps I have so far been in rude health, but I’m constantly surprised by the numbered people I meet who run their kids down there for the slightest sniffle. I have never had the flu jab, and have had flu twice in my entire life…maybe three if last years bout was in fact flu. And you know what, I stayed at home and looked after my flu-ridden son for a week. I think that most people who are in good health needn’t present to ED, but make a docs appointment.

#2
FioBla2:31 pm, 23 Jan 13

Madam Cholet said :

Interestingly, he or she doesn’t make any comments on unnecessary presentations at ED, although i understand that they are talking about those that need to be admitted. Still, might have been worthwhile reminding people that ED is not a GP clinic.

It’s easy to think that those are problems, but it’s possible he doesn’t feel that way:

https://twitter.com/impactednurse/status/251496376658194432

When I say “easy”, one of the things I mean, is that it’s an uncontroversial position to take. While if I (or most people) see a pregnant woman smoking, I would walk past, and not ask them to stop. We don’t go up to heavy smokers or the incredibly overweight to tell them they will become a burden on a shared health care system. We don’t tsk tsk if an elderly person/their family doesn’t have an advanced directive in place apart from “we want everything done”. And God forbid we actually legislate human behaviour—that would be really unpopular.

On the other hand, wagging a finger at those who need not be in ED i.e. “these people are taking advantage of a free handout”, is, as usual, a much easier idea to propagate.

#3
sepi5:10 pm, 23 Jan 13

He’s talking about vast numbers of people who do need to be admitted. People who turn up with minor things are just an annoyance really, they are not the major issue here.

The big issue is that emergency cannot cope with all the people who actually should be seen by them.

#4
ATypicalUsername3:42 am, 24 Jan 13

I agree with Madam Cholet.
And as for FioBla, It may be an easy fight, but most people aren’t bold enough to stand up and comment on situations where one should and taking a stand against something is better than just throwing in the towel and letting anyone with a cold thrust their hands into medicare and the health system at large’s pocket.

on that note, however;
Why is it that we live in a society where a pregnant woman, smoking and drinking heavily, is treated equally, whereas anyone who dares say “Sorry, not that it’s my business but that sort of behaviour can lead to massive complications for your child that could cause problems for their entire lives, or even kill them” is treated with disdain.
Why are we so afraid of offending that we must pull every metaphorical punch, where we dare not say anything that could possibly be taken “The wrong way” even when the comment is designed to be taken that way?
Where is the line there? If you see somebody attempting to walk into traffic, would you dare to pull them back, or would you stay where you are, for fear of offending somebody who thinks you should “mind your own business”?
Sorry for going so far off topic, but Fiobla’s comment got me all riled up.
I’m not one for taking the easy fights, if I see a chain smoker out the front of a primary school, I’m not going to hesitate to tell him he’s setting a bad example.

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