Now Ye're Talking - to an Emergency Department Nurse

allandanyways

Thank you for answering my question in so much detail - from the patient's side, it looked as though the nurse was being threatened into prescribing, so I'm glad to hear that there are such strict regulations around that sort of thing.

Just coming back to your point about dedicated mental health emergency centres - I agree wholeheartedly. Can I be so bold as to ask a second question in relation to this?

I've been in hospital a few times with panic attacks where I genuinely thought I was having a heart attack/stroke/asthma attack. I've had varying levels of concern from nursing staff - from very sympathetic and kind to impatient and frustrated.

What is it like on your side when the patient is adamant there's something really seriously wrong with them and you know from their chart that they're actually fine? Is it hard to bite your tongue and refrain from telling them to just calm down? I'm just curious how you handle it personally, as I know when I'm in the middle of a full blown attack and convinced I'm dying, I just lose the plot completely and nothing the nurse says can tell me otherwise and it's only afterwards I think what a headwreck I must have been!:o

wonderfulname

Brilliant thread, thanks for doing this OP, it's very informative.

So I'm taking the time atm to rebuild a solid first aid kit and knowledge both for day to day and when I'm back outdoors come spring.

My question is what do you think is the most important thing for a person to know, be it recognising a stroke, treating a minor sprain or just eating and drinking right, and equally are there any mistakes people tend to make that just make your job harder when a patient gets to the ER?

kowloon

As serious as A&E is I'm sure you've seen some things that you can't help but laugh at. What's the funniest/dumbest thing you've seen?

DeltaWhite

I don't even have a question Just wanted to commend you for all your hard and selfless work that you do.

The Intensive Care nurse who looked after my Mam in her final days was honestly such a comfort to my family in those gut wrenching hours. Sometimes I wonder how she managed to sit there all day watching us in complete and utter despair. In my opinion it takes a special kind of person to be a nurse. I wish things were better in the health system, personally I think our Government are completely out of touch with reality when it comes to the current issues in hospitals. I hate to be negative, but I genuinely cant see anything changing.

Well done on all you have achieved and I wish you the very best in your career.

I'm an Emergency Dept nurse, AMA

Fluorescence wrote: »

Excellent thread so far! Thank you for all your hard work, nurses are some of the best people in the world

My question is if there was any one thing that made you want to become a nurse in the first place? An event, a person, a childhood dream? And, if you weren't to be a nurse, what other career could you see yourself doing?

Hi Fluorescence. Thank you, I agree, nurses are great!

I had a little cousin who was very sick and I think that is what first sparked my interest..... I also had a mother telling me not to go into nursing but I did as any teenager would do and went against what she told me to do :P I guess I always had an empathetic side to me and acted as a bit of a counselor in school so I'd say I would have went down a social work or counselling route if I didn't become a nurse. I would absolutely love to pack it in some days though and go work in a nightclub :cool:

TG1 wrote: »

I don't really have a question but wanted to chime in as someone who spent 24 hours in a&e recently with a fractured pelvis, the work a&e staff do is amazing, and the manner in which patients are dealt with in such a busy environment is phenominal. I was so well looked after by the nursing staff, both in a&e and later on the ward, they really made a horrible experience bearable! The experience has just put me in awe of the work you do and the positive attitude you maintain while doing it in incredibley stressful conditions, and I think this should be highlighted at every available opportunity!

Hi TG1, I am glad your experience was made that little bit better by the care you received! Always great to hear good stories

whiskeyman wrote: »

Firstly, thank you on doing what you do.
There's no way in hell I could do it, and I see it as a vocation, one that you need to be better praised and paid for!

With the Christmas season coming up, are you dreading the increase in already problematic incidences of alcohol abuse / violence to staff etc...?
As you're one of the many people on 'the front line' when it comes to our alcohol abuse problem, is it as bad as the media make it out / are you shocked by it yourself?

Hi whiskeyman, I think the stories in the media are pretty accurate but what I find is more of an issue are the people who we see again and again and again with drink problems no matter what time of year it is. It is sad in one way but completely frustrating in another. I also think people have the wrong idea when it comes to people getting a trolley just because they are drunk.... don't get me wrong, I would rather that trolley going to someone elderly or sicker but what people don't realise is that person who is drunk may be so comatosed that they need assistance with breathing not to mention intravenous fluids to maintain their blood pressure which tends to be low along with a whole other host of things. People don't realise that someone may be drunk but they may also be seriously ill.... until the drink wears off and then they get up and leave

Eugene Norman wrote: »

Who is ultimately responsible for patients on trolleys? Is it funding or mismanagement and if the latter is it hospital level mismanagement or a higher regional level, or the health executive or the minister.

Hi Eugene Norman, My honest answer as stupid as I may sound is I really don't know. I feel like it is a higher up issue. I honestly feel like hospital management do try their best. I feel like the closure of some departments has left horrific strain on others. The lack of staff and beds meaning that patients need to wait longer in the department is a huge issue but from what I can see hospitals are trying to fix this with little support so I guess it does lie in the hands of the department of health but that would be my own opinion.

myshirt

I have two questions:

1. A lot of the newer nurses are better trained, better educated, and better motivated. How do senior nurses in the department reconcile in their conscience what they/your union done to student and young nurses in favour of the retention of benefits for the older members of the union? Particularly at a time of need for new thinking, and for an errosion of youth unemployment.

Are your pensions and benefits way too high? Will nurses voluntarily concede on these and allow the money to be spent on younger nurses?

2. Is it fair to say that a lot of bullying goes on in the profession? How do you cope with this in the face of pressures on the service? Do you take your work home with you?

I'm an Emergency Dept nurse, AMA

irishgeo wrote: »

What you like to see change in A and E depts to makes things easier/better for nurses and everyone else?

Hi irishgeo, What I would love to see is a system more like the UK. Take a northern Ireland hospital I have been to for example. They have a system where you go into triage and there is a doctor there who does a quick assessment, orders what needs to be ordered, does bloods, refers patients on where they need to be referred to. This does happen in some hospitals here but I think this should be a nationwide initiative. I think it would speed everything up for patients, nurses and the doctors. They also have GPs within emergency departments in the UK who can see a patient and quickly send them on their way if they do not need further investigations or admission. To me these are small, easy initiatives that yes would cost money at the start but I think it would save massive amounts in the long run.

allandanyways wrote: »

Thank you for answering my question in so much detail - from the patient's side, it looked as though the nurse was being threatened into prescribing, so I'm glad to hear that there are such strict regulations around that sort of thing.

Just coming back to your point about dedicated mental health emergency centres - I agree wholeheartedly. Can I be so bold as to ask a second question in relation to this?

I've been in hospital a few times with panic attacks where I genuinely thought I was having a heart attack/stroke/asthma attack. I've had varying levels of concern from nursing staff - from very sympathetic and kind to impatient and frustrated.

What is it like on your side when the patient is adamant there's something really seriously wrong with them and you know from their chart that they're actually fine? Is it hard to bite your tongue and refrain from telling them to just calm down? I'm just curious how you handle it personally, as I know when I'm in the middle of a full blown attack and convinced I'm dying, I just lose the plot completely and nothing the nurse says can tell me otherwise and it's only afterwards I think what a headwreck I must have been!:o

Hi again allandanyways, I won't lie, it can be incredibly frustrating when dealing with someone who is panicking but I can't actually imagine how frustrating it must be to have someone telling you you are ok when you feel like you are dying! I am quite stern and I find this usually works. In my experience I think if you tell someone in a nice but firm way that they need to calm down and most importantly explain why they feel like they do then they usually can calm down. I think it is so important to tell someone that the reason their lips are numb and their hands are locked is because they are breathing too quickly and that once they concentrate on their breathing that this will begin to ease. One thing I try and do is I try to distract someone, for example I ask them to name 5 things beginning with a certain letter around them.... almost like i spy :P Distraction methods are a great way for people to end a panic attack! And also always remember if you are having a panic attack and are able to say the words I can't breath then you can and are breathing and try to distract yourself

wonderfulname wrote: »

Brilliant thread, thanks for doing this OP, it's very informative.

So I'm taking the time atm to rebuild a solid first aid kit and knowledge both for day to day and when I'm back outdoors come spring.

My question is what do you think is the most important thing for a person to know, be it recognising a stroke, treating a minor sprain or just eating and drinking right, and equally are there any mistakes people tend to make that just make your job harder when a patient gets to the ER?

I am going to do a separate post for this actually wonderfulname, It deserves a long reply

DeltaWhite wrote: »

I don't even have a question Just wanted to commend you for all your hard and selfless work that you do.

The Intensive Care nurse who looked after my Mam in her final days was honestly such a comfort to my family in those gut wrenching hours. Sometimes I wonder how she managed to sit there all day watching us in complete and utter despair. In my opinion it takes a special kind of person to be a nurse. I wish things were better in the health system, personally I think our Government are completely out of touch with reality when it comes to the current issues in hospitals. I hate to be negative, but I genuinely cant see anything changing.

Well done on all you have achieved and I wish you the very best in your career.

Hi DeltaWhite, I am sorry to hear about your mam It is so difficult to see a family or a friend fall apart and it is so difficult to try and remain professional and not cry your eyes out with them especially if you have built a bond with the patient or their family or in a sudden death situation. I recently stood with a family in a room with their mam while she took her last few breaths, It was very difficult to remain professional and not cry with them and I also found it difficult to know how to say their mam had died even after all these years. You know that they are the words they will remember anytime they think of that moment. I do think it is made so much easier when you know that you really have done everything you possibly can to make that patient comfortable though.

I sadly agree with nothing changing anytime soon as difficult as that is to even think about especially as every department in the country seems to be close to breaking point at the minute.

Thank you for your kind words x

kowloon wrote: »

As serious as A&E is I'm sure you've seen some things that you can't help but laugh at. What's the funniest/dumbest thing you've seen?

Hi kowloon, There are days and nights where we end up falling around laughing at the silliest of things that people end up doing. One funny story that I was told and we have had many laughs at since was someone who turned up to a department on Valentines night with a Rose in his Penis.... he thought it was a romantic gesture until he realised there were little thorns left on the stem.... Do not try at home folks...

beertons

Can I just say, I think you do a great job.

Now, when were you in Coppers last?

GLaDOS

What sort of shifts do you usually work? What's the longest Shift you've ever done?

mirrorwall14

Just want to say thanks. I've been to A&E twice in recent years with bad asthma attacks and you guys are fantastic

Yintang

I agree wholeheartedly with the other posters with regard to the trojan work nurses do - how you manage to do such much under such constraints is beyond me. Thank you all for everything you do for us!

Two questions - is the hand hygiene of doctors improving? I had heard the spread of the likes of MRSA etc was largely due to doctors either not observing correct hand washing techniques, or things like their ties being a source of germ transmission. Do you ever have to pull up your doctor colleagues on this, and how do they react?? Or are hygiene practises across the board just very under-par?

Secondly, do you sometimes find it hard to switch off and leave the more disturbing incidents behind you after a shift?

Thanks again for taking the time on this thread, really interesting insights!

I'm an Emergency Dept nurse, AMA

wonderfulname wrote: »

Brilliant thread, thanks for doing this OP, it's very informative.

So I'm taking the time atm to rebuild a solid first aid kit and knowledge both for day to day and when I'm back outdoors come spring.

My question is what do you think is the most important thing for a person to know, be it recognising a stroke, treating a minor sprain or just eating and drinking right, and equally are there any mistakes people tend to make that just make your job harder when a patient gets to the ER?

I think this is a great question wonderfulname.

So as far as a stoke is concerned... FAST.
Face-look for a droop on one side, get someone to smile and show you their teeth to make this more obvious
Arms-this could be someone not able to hold onto a cup or dropping something, get them to hold out both arms, palms facing upwards, close their eyes and hold them there for 10 seconds, if one drifts or drops this is a major sign of a stroke.
Speech-A persons speech may be slurred or they may be unable to find the words they are looking for or have confused speech patterns this is a sign.
Time-Call an ambulance or get the patient to an emergency department as soon as possible.
It is really important to note the time of onset as treatment such as a clot busting treatment should be administered within 4 hours of onset.
There are two types of stroke, a bleed and basically a blockage. If its a blockage a clot busting drug may improve this but it needs to be within those 4 hours.
There are also other signs of a stoke such as sudden onset of vomiting, dizzyness and headache.

Heart attack symptoms include jaw pain, arm pain, back pain, shortness of breath, discomfort in chest. If someone shows symptoms of a heart attack you can offer them 300mg aspirin to chew (disprin is a good one for the first aid kit) as long as they have no previous history of9 a bleed in their bowel or stomach or blood disorders. And obviously call an ambulance.

If someone is bleeding apply pressure.... I often see people bleeding even after a IV cannula is removed from their hand or arm and they hold their arm out with blood dripping everywhere... pressure and bandage.

Some simple mistakes people make are things like when a tooth is knocked out and they don't bring it in to hospital with them.... if it is a clean knock out with root still attached the tooth can be put back into the gum and saved but put it in a glass of milk until you get to hospital. Another mistake is when people chop off the tip of a finger or get part of their ear bitten off... do not put it straight onto ice as this will kill it. Put it into a bag of water and put the water onto ice and bring it into the emergency department.

Eye injuries are something people do not look after at all. Wash it out and keep washing it out for at least 10-15 minutes.

Burns.... when anyone burns their hand or finger they tend to just run it under the tap for a minute (myself included) Keep the burned area under a tap for at least 10 minutes. A cement burn continues to burn inner layers of the skin. A cement burn could need up to an hour under cold water to prevent further burning.

Electric shocks are a weird one. Someone should always have their pulse checked after an electric shock as it may be enough to cause a cardiac arrhythmia. Electric shocks can also cause internal burns so if it is a significant shock a person should always get checked out to be on the safe side.

Seizures. Wait for a seizure to pass. Do NOT put anything in a persons mouth including fingers. Place something under the persons head and make the area safe around the patient. After a seizure a person may become aggressive or may be confused, just try to keep them safe.

If someone collapses, call for help. Check if they are breathing for up to 10 seconds. Start chest compressions, 30 compressions then 2 breaths if willing to give mouth to mouth. I would advise EVERYONE to do a basic life support class.... you never know when it could be needed. Bystander CPR gives someone a real fighting chance.

I'm an Emergency Dept nurse, AMA

myshirt wrote: »

I have two questions:

1. A lot of the newer nurses are better trained, better educated, and better motivated. How do senior nurses in the department reconcile in their conscience what they/your union done to student and young nurses in favour of the retention of benefits for the older members of the union? Particularly at a time of need for new thinking, and for an errosion of youth unemployment.

Are your pensions and benefits way too high? Will nurses voluntarily concede on these and allow the money to be spent on younger nurses?

2. Is it fair to say that a lot of bullying goes on in the profession? How do you cope with this in the face of pressures on the service? Do you take your work home with you?

Hi myshirt. I agree that newer nurses are coming in with a better academic background and the newest knowledge and skills but they get trained on the wards by the senior nurses. Yes their motivation may be better but no-one can deny that we need the experience of the senior nurses to help teach the newer nurses that come along. No nurse gets to sit back now and not keep up to date with courses or new knowledge and skills. It is a requirement for us to keep our portfolios up to date and these portfolios can be spot checked at any time. I think the very high majority of senior nurses deserve their pensions and benefits. Pensions because they have paid into them for starters. Benefits wise why shouldn't senior nurses with a wealth of experience and service get particular benefits. As far as I am concerned the government should not be cutting new nurses wages. The health service should concentrate on the retention of experienced staff as well as the employment of newly graduated nurses. Would you feel happier on a ward with 3 newly qualified nurses running it or 3 senior nurses? I know which I would choose.

Nursing is a predominately female career, girls in my opinion can be quite bitchy and cliquey but this is the same as any career. People do get bullied but I don't think it happens any more in nursing than it does anywhere else.

Yes I take my work home with me. It is difficult not to especially when working in an emergency department. I am quite happy and jolly in work and quite cranky at home a lot. This is something I need to learn to deal better with. Ill get there some day.

beertons wrote: »

Can I just say, I think you do a great job.

Now, when were you in Coppers last?

Hahaha Beertons. I haven't been in Coppers in years. Last time I went there i was grabbed and not even on the boob or bum so I vowed to avoid it ever since.... it's working so far!!

ScienceNerd wrote: »

What sort of shifts do you usually work? What's the longest Shift you've ever done?

Hi ScienceNerd. Nurses usually work 3 to 4 13 hour days (12 not including breaks) per week and a week of night duty every 4 to 5 weeks. This week of nights is either done all in a row or 4 nights one week and 3 the next.

mirrorwall14 wrote: »

Just want to say thanks. I've been to A&E twice in recent years with bad asthma attacks and you guys are fantastic

Hi mirrorwall14, Thank you Asthma is a tricky and scary one to get into the emergency department. I hope it is well under control in this changeable weather

Yintang wrote: »

I agree wholeheartedly with the other posters with regard to the trojan work nurses do - how you manage to do such much under such constraints is beyond me. Thank you all for everything you do for us!

Two questions - is the hand hygiene of doctors improving? I had heard the spread of the likes of MRSA etc was largely due to doctors either not observing correct hand washing techniques, or things like their ties being a source of germ transmission. Do you ever have to pull up your doctor colleagues on this, and how do they react?? Or are hygiene practises across the board just very under-par?

Secondly, do you sometimes find it hard to switch off and leave the more disturbing incidents behind you after a shift?

Thanks again for taking the time on this thread, really interesting insights!

Hi Yintang. I think, or at least I hope, hand hygiene is improving across the board. I don't think it is fair to solely blame the doctors however they used to be pretty poor at it. As far as I can see everyone in my department is very good at it. I have never had to pull anyone up on it and have never been pulled up on it myself but I think it is much better nation wide.... although I do put this down to all the information put out during outbreaks of the winter vomiting bug. Health promotion works when it works

Yes I defiantly find it very hard to switch off a lot. If I see something traumatic it may take me days to get over it. There are still days where I will think back to a disturbing incident and still feel shook from it. Ill be fine in work as you have to act professional but I come home and am a thundering cow. I have a few friends in different areas of nursing who I get to talk to and it's great but unless friends or family are in the same field they will never understand as much as they try to. The way I try to see it though is that I have gained invaluable experience from these events and if I can teach someone what to do in the same situation or know what to do next time then that has to be a good thing

Does Pharmacy have any involvement in your ED department?

devnull

I'm an Emergency Dept nurse, AMA wrote: »

Hi irishgeo, What I would love to see is a system more like the UK. Take a northern Ireland hospital I have been to for example. They have a system where you go into triage and there is a doctor there who does a quick assessment, orders what needs to be ordered, does bloods, refers patients on where they need to be referred to.

This does happen in some hospitals here but I think this should be a nationwide initiative. I think it would speed everything up for patients, nurses and the doctors. They also have GPs within emergency departments in the UK who can see a patient and quickly send them on their way if they do not need further investigations or admission. To me these are small, easy initiatives that yes would cost money at the start but I think it would save massive amounts in the long run.

A quick question on that.

I've been in an A&E and it's pretty obvious I need blood tests or xrays etc the moment I arrive. However I have to wait 10 hours to be seen by a doctor, who then sees me for about 30 seconds and sends me for a blood test or an xray that I then have to wait hours for results for.

In the UK some nurses and Nurse Practitioners will order these tests straight from triage so when you see the doctor they already have the results rather than having all of this wasted time, that is what should be done here, it makes the system far more efficient.

When I was in Manchester a few years ago, I went from Triage to x-ray to doctor to leaving in about 90 minutes, despite the fact that there was 15 people ahead of me, since triage sent me for an x-ray. more or less straight away.

Also there are a number of arrogant doctors in the profession who have no people skills whilst others are really great with people, how do you find it coping with the wide range of personalities you have to work with? Generally nurses come across as more kind-hearted and has there ever been an occasion where you felt a doctor wasn't sensitive?

allandanyways

Your answers are so insightful, considerate and really show how much you love helping people - you've definitely found your calling and I hope you enjoy your career and continue to help people as much as you have already!

I'm an Emergency Dept nurse, AMA

Deleted User wrote: »

Does Pharmacy have any involvement in your ED department?

Hi The_Dazzler. Yes pharmacy have a huge involvement in any department in a hospital. They supply all the drugs we use. Keep us stocked with what we need and ensure that patients are receiving their correct meds and dosages.

devnull wrote: »

A quick question on that.

I've been in an A&E and it's pretty obvious I need blood tests or xrays etc the moment I arrive. However I have to wait 10 hours to be seen by a doctor, who then sees me for about 30 seconds and sends me for a blood test or an xray that I then have to wait hours for results for.

In the UK some nurses and Nurse Practitioners will order these tests straight from triage so when you see the doctor they already have the results rather than having all of this wasted time, that is what should be done here, it makes the system far more efficient.

When I was in Manchester a few years ago, I went from Triage to x-ray to doctor to leaving in about 90 minutes, despite the fact that there was 15 people ahead of me, since triage sent me for an x-ray. more or less straight away.

Also there are a number of arrogant doctors in the profession who have no people skills whilst others are really great with people, how do you find it coping with the wide range of personalities you have to work with? Generally nurses come across as more kind-hearted and has there ever been an occasion where you felt a doctor wasn't sensitive?

Hi Devnull. To be honest with you, our department does bloods and gets doctors to order an x-ray before they are seen by a doctor but sometimes this cannot happen due to the pressure the nurses may already be under that day or night. They may be already looking after 12 patients in an area you can't see.
I do agree with you though, if this could be done all the time and if nurses could order x-rays this would save valuable time. When I do a patients bloods because they think there is an infection somewhere, at least I can say to them your bloods are clear but it is up to you if you want to wait 6 more hours to be seen.

In an emergency department you come across so many doctors from all different teams. Many are nice because they want to keep us on side for when they want us to do bloods etc for their patient. Like any job though there are some absolute pricks walking around the place. The stratagy I use these days is I call them out on it by saying something like 'we all work as a team here, there is no need to be so rude' and I generally find this works. Many of these people appear as if they have spent their lives being spoiled and I honestly think they do not know when they are out of order. There are of course nurses who still walk around as if they own the place.... You just try to let them at it and ignore but I have always been a bit of a sensitive soul and I sometimes find it hard to ignore things.

allandanyways wrote: »

Your answers are so insightful, considerate and really show how much you love helping people - you've definitely found your calling and I hope you enjoy your career and continue to help people as much as you have already!

Thank you allandanyways. Best of luck with everything and remember distraction.

IvyTheTerrible

Do you have colleagues that don't pull their weight?
Have you ever had to report a colleague for not doing their job properly?
Why do you think absentee levels are high among nurses in Irish hospitals?

killswitx

why i was charged 75euros for 4 days(=300e)? in the hospital on emergency when i was not there those days anyway (because i have left the hospital after waiting 3 days, and i have signed that i have refused treatment)

Dubl07

Does it bother you that some of us can access better urgent care by paying for it? The last time I was seriously unwell I paid a private hospital's ED rather than contend with the local teaching hospital. I felt it was money well spent, even though it seriously affected my spending for a couple of months. The previous south Dublin public hospital I attended has great nurses and doctors but it's an abject pigsty on a busy night with inadequate facilities especially when V&D are put into the mix. I now try and keep some funds aside to pay for private care. I begrudge having to do so but it might be the difference between walking out or being carried.

Toto Wolfcastle

I'm an Emergency Dept nurse, AMA wrote: »

I'd love to know what his ideas are :P I think it would do no harm for there to be a team looking at what works elsewhere in the world and trying to introduce those initiatives here. It has been done in Scotland and massive advances in patient care have been made there, I cannot understand why that cannot be done here too.

I don't have the letter to hand, but one thing that stood out that he'd like to bring into Ireland (that is used in other countries) is 'see and treat'. A doctor is there just to see minor issues straight from triage so that they can be moved on and out and don't end up sitting there for hours. So I suppose it's a good thing that he's looking to things that work in other countries. Hopefully things like that will be introduced and it may help to make your job easier.

bleary

Do you think the quality of doctors in the country has suffered with the emigration of newly qualified doctors .
Is there an issue with a lack of assessment of doctors in the country before taking up contracts , I have seen a number of cases with doctors lacking basic skills being reported weeks into their contracts by their colleagues.

What do you think about introduction of theatre assistants and other new grades to take up some nursing duties . It seems like a sensible approach to me especially when we just can't recruit nurses, I have never met a nurse who wants to spend their time in theatre but the inmo opposes it

are nurses still limited in what they can do in comparison to their practice in the uk. This was the case 40 years ago and still is I think, taking bloods etc

FGR

Hi there!

Just a question from outside of the box. How do you feel about the HSE using the A&E as a place of safety for children taken into care outside of social services working hours? I know gardaí aren't happy with that arrangement as neither them nor ye have the facilities to ensure safety - especially if the juvenile is of special needs or of an angry disposition.

PS I think they also know you guys are already up to your necks in work as it is :pac:

Slutmonkey57b

With the decision by the HSE to effectively close many Dublin a&e departments in favour of the big ones Vincent's, Blanch, etc, this has led to a situation where effectively there is one a&e for the whole of South Dublin, Wicklow, Wexford; all of whose population now has to funnel into the country's busiest a&e, with 4 triage bays, and an a&e ward full of pensioners with chronic conditions or fall injuries who could (and should) have facilities better suited for their long term needs elsewhere, meaning there are no beds in either a&e or inpatient wards for "unpredictable" cases that a&e are there to treat.

In retrospect, would you characterise this decision as stupid, moronically stupid, or farcically stupid?

Why not turn loughlinstown into a specialist hospital for the elderly, given that it's already equipped?

miamee

Do you ever do practice runs in the hospital or in your specific department for major incidents? Like say, for example, something like happened in Paris happened here or a large car pile up or train crash or something with large numbers of patients all needing treatment at the same time - would the hospital and staff be ready to deal with that type of thing?

It sounds like a very satisfying but difficult job, I don't think I could do it but I have great admiration for those of you who do!

faceman

Hello friendly neighbourhood Emergencey Dept Nurse! I respectably say, I don't envy your job, I'm terrified of hospitals. The smells, the systems, the sense of unknown when you're there. I can never wait to leave when visiting someone. To work there everyday, does that ever desensitise your humanity? Not to inquiries but to the plight of patients and their families? Asked with respect of course.

My other question is this. I've never worked in healthcare or the public service so perhaps this question is naive. Every time I hear of the health system running out of funds or needing more funds, it always troubles me. Do you feel resources are used in an efficient manner? If not, how much of that is the problem of the government or senior civil servants, or lack of flexibility in relation to work changes and improvements on the parts of unions? Do you think unions take into account patient needs when fighting for medical staff's employment conditions?

Final questions. Do you watch hospital dramas on TV? 

Galwayguy35

In recent years have you seen an increase in men choosing nursing as a career?

Ursus Horribilis

Do you think there should be more options for people who need to see a doctor out of hours? Should there be better availability of minor injury clinics with long opening hours around the country to ease pressure on A&E?

Neverforgotten

Are a&e nurses trained in how to handle situations like mental health crisis? I have been handled differently by staff and wonder is there any training provided.

Also, I wouldn't be here if it wasn't for the a&e staff and paramedics so am really grateful for your job and I don't envy it at all.

I'm an Emergency Dept nurse, AMA

Hi all, sorry about the delay in answering today, I had a bit of an unexpected busy day but I'm back to it now

IvyTheTerrible wrote: »

Do you have colleagues that don't pull their weight?
Have you ever had to report a colleague for not doing their job properly?
Why do you think absentee levels are high among nurses in Irish hospitals?

Hi IvyTheTerrible, I guess no matter where you work in nursing there are always one or two that don't pull their weight but I have to say I am so lucky in the department I am in. It is so busy that everyone pitches in and works as a great team.
The odd time you do pick on things that aren't maybe done as they should be and sometimes this does need to be highlighted to someone further up the chain, however, I am someone that would rather discuss it with the person first and ask why something was done differently or wrong and try and sort it there and then if possible.
I personally think its funny that sick leave isn't a lot higher when you consider what germs/illnesses we are exposed to! To be honest, sickness policies are so strict in most places now that people are nearly afraid to go off sick and really do take off when they really can't come into work. From my experience, most of the nurses I have worked with in recent years still come into work even when sick themselves.... Not a good thing at all but with staff shortages all across the board sometimes you feel like you have no choice!

killswitx wrote: »

why i was charged 75euros for 4 days(=300e)? in the hospital on emergency when i was not there those days anyway (because i have left the hospital after waiting 3 days, and i have signed that i have refused treatment)

Hi killswitx. I think this is an issue that should be brought up with that hospital directly to be honest as I really cannot answer it for you.

Dubl07 wrote: »

Does it bother you that some of us can access better urgent care by paying for it? The last time I was seriously unwell I paid a private hospital's ED rather than contend with the local teaching hospital. I felt it was money well spent, even though it seriously affected my spending for a couple of months. The previous south Dublin public hospital I attended has great nurses and doctors but it's an abject pigsty on a busy night with inadequate facilities especially when V&D are put into the mix. I now try and keep some funds aside to pay for private care. I begrudge having to do so but it might be the difference between walking out or being carried.

Hi Dubl07, Yes I think it is irritating that this is the case but I can honestly say if anyone needs urgent care then they will still always be looked after in any public hospital. Plus from having experience in both the public and private hospitals I know that I would choose a public over a private hospital any day as in my opinion (and I stress it is my opinion) I believe the care is better. Yes if you pay you can go have a CT/MRI or whatever on the same day but as far as I am concerned if you urgently need a CT or whatever other tests they will be done in a public hospital as quick.
I do think that busy emergency departments do put people off though.... I can fully understand that and really don't blame someone for attending a private emergency department for that reason alone.

Toto Wolfcastle wrote: »

I don't have the letter to hand, but one thing that stood out that he'd like to bring into Ireland (that is used in other countries) is 'see and treat'. A doctor is there just to see minor issues straight from triage so that they can be moved on and out and don't end up sitting there for hours. So I suppose it's a good thing that he's looking to things that work in other countries. Hopefully things like that will be introduced and it may help to make your job easier.

Hi again Toto Wolfcastle. If something like that was brought in I think it would be great. Someone asked me in an earlier question what I would change about EDs and that was basically my answer!