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Seeking alternatives to the Emergency Department

By Emily Morris - 1 October 2014 2

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The Chief Minister was forced to apologise last week over an elderly man being left in his own urine in The Canberra Hospital as nurses were too busy to clean him up. During an ABC666 discussion on the matter, someone sensibly (I thought) questioned why this was a job for highly skilled nurse busy with more pressing matters.

I have three small children, one of whom is asthmatic, so through winter (in particular) we often have numerous trips to the Emergency Department (ED). Every time, I marvel at just how busy they are and at how stretched the nurses are. Our last visit was to patch up my middle daughter’s forehead after she had come a little too close to a door frame much too fast. We waited about 90 minutes to be taken through from the waiting room (I was pretty impressed by that, we have waited for 6 hours in the past). Before we went to Emergency we enquired as to whether it was something that could be handled at CALMS by a GP or nurse there. The answer was that if my daughter was aggravated and wouldn’t let anyone touch it (she’s 2 ½ – she was never willingly going to let anyone near it), she would need to be sedated so would require Emergency. We waited a further 90 minutes to be seen by a doctor once through to Paediatric Emergency, who then told us that she would need to be sedated in order to stitch the wound. The doctor then went off to find out about a bed in Resus. About an hour later he emerged to advise us that Resus would be a long wait – not in the foreseeable future, so the recommended treatment to stitch her head was revised to gluing. In hindsight we probably should have requested the original recommended treatment rather than plan B, but hindsight is never particularly useful at the time. After another hour of ‘in and out’ by the doctor (which I do understand, it was a busy night), the nurse prepared the gluing tray, wrapped my daughter in a sheet and glued the wound. It wasn’t a pleasant couple of minutes but was done and dusted and we were out of there. Ultimately my daughter would probably have a smaller and neater scar had she have been stitched, but given the outcome I can’t help but wonder why we held up an Emergency bed for 4 hours rather than have a GP check her at CALMS and a nurse glue her head there: faster and less traumatic for us and a better outcome for ED I would assume as we wouldn’t have been in there to take their time away from more pressing matters.

The ACT Department of Health recently urged Canberrans not to use the Emergency Department in cases where there wasn’t an emergency. With ED presentations increasing faster than population growth, it’s a real issue.

But, for me, as a mother there are often times between 11pm and 6am when I need a child checked – whether it be my asthmatic daughter having her chest checked over and prescribed steroids if needed or her Ventolin managed; or just having a doctor assure me she is OK and not in need of respiration; or a deep wound that needs stitching or gluing; or any other number of medical issues that need to see a doctor before morning but don’t necessarily need the Emergency Department. On the numerous occasions I have been waiting in the Emergency waiting room, I can’t help but wonder how many people could manage if seen by a GP (particularly when late at night or early hours of the morning).

I understand the recent introduction of the National Home Doctor Service may ease this concern but I can’t help but feel like a house call is a bit like putting a plaster cast on a scratch. I wonder if there is a reason one of the Medical Centres aren’t kept open 24 hours in alternating patterns. Surely the cost would be cheaper than paying a doctor for house calls…? The house calls could then simply be kept for those who are immobile or unable to leave home due to their illness.

Nine times out of ten, I call the Healthline prior to taking a trip to ED and most of the time I am referred to Emergency, particularly if out of doctor hours. What I often need is to see a GP. If there was an option available that allowed me to do that rather than head for ED, I’d most certainly take it, but I don’t necessarily need a home visit.

Would the availability of a GP have saved you a trip to ED in the past?

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2 Responses to
Seeking alternatives to the Emergency Department
miz 8:52 am 02 Oct 14

Also we have found the helpline to be next to useless – staff are abrupt, don’t listen and interrupt constantly, are only interested in working through a checklist, and ultimately tell you to see a doctor. A complete waste of time.

miz 8:48 am 02 Oct 14

The walk in centre’s remit is far too narrow. They constantly have to refer patients elsewhere because their limited brief prevents them from dealing with the matter at hand. Of the alternatives, CALMS (out of hours GP roster) is not an option for ‘working poor,’ i.e., those who don’t have a health care card but don’t have any money when they need treatment. It is inevitable that those people will seek treatment at the ED. It seems obvious to me that there is a surprising proportion of hidden ‘working poor’ in Canberra, given the high cost of rents etc.
I’d be very interested in the stats on how many and what kind of presentations are declined and referred on by the walk in centres.

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