So after just finishing a manic 3 week attachment at one of the busiest A&Es in London I thought I’d reflect on what I’ve learnt.
1. Always look before crossing the road
After seeing a number of patients hit by cars/lorries/buses/bikes I have realised the damage they can do and just how common incidents are. Obviously not all of them were avoidable but taking the time to look properly before crossing the road could save you a lot of trouble. If you are from the rest of Europe remember to look the other way (we drive on the other side!)
I spent all three weeks being obsessively extra careful when crossing the road, knowing that my consultant would really not appreciate me being the trauma patient!
2. The staff work incredibly hard
Contrary to the stories the press/politicians might have you believe the staff in A&E work very hard! They were literally running from patient to patient, with several patients on the go at once in order to deliver the best care possible. And often that didn’t stop them offering the patient a cup of tea! What a job!
3. It is not much like the TV show Casualty
No team rivalries and fights or no affairs in the store cupboard- the staff were too busy for that! Although some of the medicine in casualty is realistic (they have a show medical advisor), the biggest difference I found is that people do not wake up and recover straight away from CPR in real life.
4. A curtain separates life and death
This really blew my mind. One patient chatting to their family feeling better, behind a 3mm paper curtain next door a really sick patient about to die. The strangest part about this was going to meet non medic friends after my day on placement. With them all chatting about their challenges at work/lectures, I didn’t even know how to express the roller-coaster of physical, emotional and spiritual challenges I had experienced through things I had seen earlier in the day.
5. Lots of people who call an ambulance or come to A&E don’t need it
If you are unsure calling 111 is a good idea- they talk to you about the problem and then instruct you where to go for medical care (pharmacy, GP, A&E, 999).
6. Lots of people who call an ambulance or come to A&E really need it
It was surprising how unwell some patients were, especially some who had walked into the department feeling like something wasn’t right then suddenly taken a turn for the worst. If you think you need medical help go get it!
7. Knowing some basic CPR is really important
When someone has a heart attack their ‘down time’ is really important for their outcomes. Phoning help as soon as possible, and then keeping their heart pumping through CPR can make a real difference to their outcomes. Why not find a first aid course to learn? You could save someone’s life! Either way always remember to call help as soon as possible.
8. The police do a lot more than just arresting people
There was always some police officers in A&E making sure the person they bought in was okay, working with the family and ensuring the staff knew all the relevant information. After thinking that all police did was arrest people, I was surprised and pleased to see them caring for people and staying with them to make sure they were being cared for and hadn’t lost their belongings.
9. The staff put up with a lot of challenges
Drunk abusive patients, on their feet all day, gruelling shifts, few breaks, pressure to hurry up, managing really sick patients, patients tired of waiting… It’s emotionally and physically challenging.
10. A lot of confidence and knowledge is needed to work in A&E
I have the upmost respect for doctors working in A&E. They simultaneously deal with different patients with a range of problems stretching from all areas of medical, surgical, psychiatric and social care. At times patients can be very challenging and the number of patients waiting can be overwhelming. The staff work confidently work really hard as a team to ensure that the best care is delivered. It was a privilege to work with them for a few weeks!