What Have We Become

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#1696692 31-Dec-2016 05:54

I can understand some of the reasoning behind hospital staff not attending, such as ambulance staff being the ones properly trained to move injured people with the lowest possibility of causing further injury and/or complications. That said, I do find it a little disturbing that this person was on hospital grounds and no-one attended him. Even if it was just a registrar coming out to give him a once over to determining if it was actually an emergency or not. Certainly not a great look for a hospital to have a prone person in the carpark for a long period of time with a security guard having to redirect traffic. There's mention of it being a hot, sunny day but no mention of hospital staff attempting to provide shade or water - basic needs.

To take the thread on a slightly different tangent, based on the title, I think a lot of this is down to an increasing lack of empathy within society as people are becoming noticeably more and more focused on themselves. In other words narcissistic. There's a growing commentary on an apparent significant rise in societal narcissism. A couple of basic but informative articles on the subject can be found here and here.

frankv

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#1696696 31-Dec-2016 07:44

I work at PN hospital, so I can give a little more background.

Hospital policy is that hospital staff should only move patients around within the hospital building, on beds. There are H&S reasons for that. Staff don't have the equipment or training to deal with patients outside. The line is drawn at the door of the main hospital building; beyond that an ambulance is required. Afternoons are busy times for ED; they always have a waiting room full of patients at that time, and staff are all busy treating patients. The building where I work is perhaps 200m from the main building; if I have a heart attack at work, an ambulance will be used to transport me to ED. So the receptionist did the right thing in calling the ambulance.

I don't know why it took 55 minutes for the ambulance to arrive. Three calls were made for an ambulance; my understanding is that the receptionist called the ambulance twice. I believe there was some kind of misunderstanding about the first call. Perhaps it's relevant that the ambulances are not stationed at the hospital; they're a block or two away.

It appears that there were no drivers or ambulances available at the time.

St John Manawatu operations manager Steve Yanko said the ambulances were stretched at the time.

"There was a lot going on at the time. When there's other, life-threatening emergencies going on, people have to wait," Yanko said.

It was concerning that no-one raised the issue with St John, he said.

If you don't like this situation, you need to call your MP to increase the Health budget.

Pumpedd

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#1696724 31-Dec-2016 09:58

frankv:

I work at PN hospital, so I can give a little more background.

Hospital policy is that hospital staff should only move patients around within the hospital building, on beds. There are H&S reasons for that. Staff don't have the equipment or training to deal with patients outside. The line is drawn at the door of the main hospital building; beyond that an ambulance is required. Afternoons are busy times for ED; they always have a waiting room full of patients at that time, and staff are all busy treating patients. The building where I work is perhaps 200m from the main building; if I have a heart attack at work, an ambulance will be used to transport me to ED. So the receptionist did the right thing in calling the ambulance.

I don't know why it took 55 minutes for the ambulance to arrive. Three calls were made for an ambulance; my understanding is that the receptionist called the ambulance twice. I believe there was some kind of misunderstanding about the first call. Perhaps it's relevant that the ambulances are not stationed at the hospital; they're a block or two away.

It appears that there were no drivers or ambulances available at the time.

St John Manawatu operations manager Steve Yanko said the ambulances were stretched at the time.

"There was a lot going on at the time. When there's other, life-threatening emergencies going on, people have to wait," Yanko said.

It was concerning that no-one raised the issue with St John, he said.

If you don't like this situation, you need to call your MP to increase the Health budget.

I am sorry, but I am getting sick and tired of hospital staff hiding behind things like budgets and privacy rules...its pathetic. This is typical spin by non medical staff to say a lot was going on.

All that was needed was for someone medical(doc or nurse) to spend a few minutes to at least look at the person in distress outside to determine what was required (if anything). May well be the best solution was to call an ambulance, but based on what people are saying in this thread you would need 3 ambulances as it needs 5 people to lift a single patient.

Lets get real and get some common sense back in bureaucracy in this land of ours.

TheMantis

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#1696725 31-Dec-2016 10:00

frankv:

I work at PN hospital, so I can give a little more background.

Hospital policy is that hospital staff should only move patients around within the hospital building, on beds. There are H&S reasons for that. Staff don't have the equipment or training to deal with patients outside. The line is drawn at the door of the main hospital building; beyond that an ambulance is required. Afternoons are busy times for ED; they always have a waiting room full of patients at that time, and staff are all busy treating patients. The building where I work is perhaps 200m from the main building; if I have a heart attack at work, an ambulance will be used to transport me to ED. So the receptionist did the right thing in calling the ambulance.

I don't know why it took 55 minutes for the ambulance to arrive. Three calls were made for an ambulance; my understanding is that the receptionist called the ambulance twice. I believe there was some kind of misunderstanding about the first call. Perhaps it's relevant that the ambulances are not stationed at the hospital; they're a block or two away.

It appears that there were no drivers or ambulances available at the time.

St John Manawatu operations manager Steve Yanko said the ambulances were stretched at the time.

"There was a lot going on at the time. When there's other, life-threatening emergencies going on, people have to wait," Yanko said.

It was concerning that no-one raised the issue with St John, he said.

If you don't like this situation, you need to call your MP to increase the Health budget.

Thanks for that info, really interesting. Ambulances ideally should be part of the DHB resources and funded as such (just like they used to be). Air ambulances should be the same.

Dratsab

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#1696737 31-Dec-2016 10:27

frankv: I work at PN hospital, so I can give a little more background.

Hospital policy is that hospital staff should only move patients around within the hospital building, on beds. There are H&S reasons for that. Staff don't have the equipment or training to deal with patients outside. The line is drawn at the door of the main hospital building; beyond that an ambulance is required. Afternoons are busy times for ED; they always have a waiting room full of patients at that time, and staff are all busy treating patients. The building where I work is perhaps 200m from the main building; if I have a heart attack at work, an ambulance will be used to transport me to ED. So the receptionist did the right thing in calling the ambulance.

I don't know why it took 55 minutes for the ambulance to arrive. Three calls were made for an ambulance; my understanding is that the receptionist called the ambulance twice. I believe there was some kind of misunderstanding about the first call. Perhaps it's relevant that the ambulances are not stationed at the hospital; they're a block or two away.

It appears that there were no drivers or ambulances available at the time.

St John Manawatu operations manager Steve Yanko said the ambulances were stretched at the time.

"There was a lot going on at the time. When there's other, life-threatening emergencies going on, people have to wait," Yanko said.

It was concerning that no-one raised the issue with St John, he said.

If you don't like this situation, you need to call your MP to increase the Health budget.

Thanks for the info Frank. On one hand it affirms what I've already said. On the other hand it shows that there are cracks in the system which can be exacerbated by an ongoing lack of decent funding for both hospitals and ambo services.

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#1696738 31-Dec-2016 10:30

The way i see it, policy exist in such organizations to protect staff from doing the wrong thing. In this case, a very tricky situation, the policy protects them into making an easy decision. The intention of the policy however is to improve quality of service to clients, in this case, patients already in the ED.

But policy is not the maximum standards, rather, usually, minimum standards. Anyone with a brain could go and assist the collapsed man. Even if there's no stretcher there are other forms of first aid that can be applied.

gzt

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#1696751 31-Dec-2016 11:46

Pumpedd: All that was needed was for someone medical(doc or nurse) to spend a few minutes to at least look at the person in distress outside to determine what was required (if anything).

That function was effectively performed by the ED reception (I'm assuming it was ED reception and not a non-medical main desk) and then by the ambulance call center.

I don't see anybody hiding behind anything.

If a nurse had been sent to perform an assessment would the outcome have been any different?

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Geektastic

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#1696758 31-Dec-2016 12:02

frankv:

I work at PN hospital, so I can give a little more background.

Hospital policy is that hospital staff should only move patients around within the hospital building, on beds. There are H&S reasons for that. Staff don't have the equipment or training to deal with patients outside. The line is drawn at the door of the main hospital building; beyond that an ambulance is required. Afternoons are busy times for ED; they always have a waiting room full of patients at that time, and staff are all busy treating patients. The building where I work is perhaps 200m from the main building; if I have a heart attack at work, an ambulance will be used to transport me to ED. So the receptionist did the right thing in calling the ambulance.

I don't know why it took 55 minutes for the ambulance to arrive. Three calls were made for an ambulance; my understanding is that the receptionist called the ambulance twice. I believe there was some kind of misunderstanding about the first call. Perhaps it's relevant that the ambulances are not stationed at the hospital; they're a block or two away.

It appears that there were no drivers or ambulances available at the time.

St John Manawatu operations manager Steve Yanko said the ambulances were stretched at the time.

"There was a lot going on at the time. When there's other, life-threatening emergencies going on, people have to wait," Yanko said.

It was concerning that no-one raised the issue with St John, he said.

If you don't like this situation, you need to call your MP to increase the Health budget.

Reminds me of a story ages ago in the UK when two policemen refused to jump into water to save a person in difficulty because it contravened some H&S rule or other...!

Batman

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#1696767 31-Dec-2016 12:42

I wouldn't jump into a tsunami to save anyone for example

gzt

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#1696789 31-Dec-2016 13:28

Geektastic:
Reminds me of a story ages ago in the UK when two policemen refused to jump into water to save a person in difficulty because it contravened some H&S rule or other...!

Yeah I just googled to find that one you spoke of. That's far from what actually happened, but I completely agree if you are talking about that.

There was a chance the person could have been revived and an attempt should have been made.

I see there was an inquest into the death of the person, but the output from that is unclear to me.

frankv

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#1696917 31-Dec-2016 21:16

TheMantis:

Ambulances ideally should be part of the DHB resources and funded as such (just like they used to be). Air ambulances should be the same.

Ambulances, and air transport between hospitals *is* funded by DHBs. I don't know to what extent helicopter rescue services are.

frankv

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#1696927 31-Dec-2016 21:51

joker97: The way i see it, policy exist in such organizations to protect staff from doing the wrong thing. In this case, a very tricky situation, the policy protects them into making an easy decision. The intention of the policy however is to improve quality of service to clients, in this case, patients already in the ED.

But policy is not the maximum standards, rather, usually, minimum standards. Anyone with a brain could go and assist the collapsed man. Even if there's no stretcher there are other forms of first aid that can be applied.

The policy is not only to improve quality of service to patients already in the ED. It is also to protect the person collapsed in the carpark from being moved/treated inappropriately by unqualified staff... not all nurses nor doctors are trained in emergency medicine, and certainly are not paramedics. It's also to protect the staff from harming themselves (e.g. lifting someone wrongly and causing themselves back damage).

But mostly it's about making the best use of scarce resources... an ED doctor is most efficiently used in an ED environment, with appropriate support. A paramedic is best used to handle people outside the hospital. Unfortunately, there's not enough money (and never will be) to always have an ambulance or two to spare in case something happens.

I do agree that policy is a "one size fits all" that is designed for people to follow without thought. The difficulty is that you need to be *sure* you're right any time you go outside policy, because if anything goes wrong, *you* are the one that's liable. And nowhere is that conservatism stronger than in medicine and hospitals.

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#1696932 31-Dec-2016 22:02

frankv:

joker97: The way i see it, policy exist in such organizations to protect staff from doing the wrong thing. In this case, a very tricky situation, the policy protects them into making an easy decision. The intention of the policy however is to improve quality of service to clients, in this case, patients already in the ED.

But policy is not the maximum standards, rather, usually, minimum standards. Anyone with a brain could go and assist the collapsed man. Even if there's no stretcher there are other forms of first aid that can be applied.

The policy is not only to improve quality of service to patients already in the ED. It is also to protect the person collapsed in the carpark from being moved/treated inappropriately by unqualified staff... not all nurses nor doctors are trained in emergency medicine, and certainly are not paramedics. It's also to protect the staff from harming themselves (e.g. lifting someone wrongly and causing themselves back damage).

But mostly it's about making the best use of scarce resources... an ED doctor is most efficiently used in an ED environment, with appropriate support. A paramedic is best used to handle people outside the hospital. Unfortunately, there's not enough money (and never will be) to always have an ambulance or two to spare in case something happens.

I do agree that policy is a "one size fits all" that is designed for people to follow without thought. The difficulty is that you need to be *sure* you're right any time you go outside policy, because if anything goes wrong, *you* are the one that's liable. And nowhere is that conservatism stronger than in medicine and hospitals.

Put it this way. If the collapsed person were: Prime Minister, Queen, Dan Carter, Receptionist's mother ... you think they'd stick to the policy?

MadEngineer

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#1696958 31-Dec-2016 23:34

I think you'd need a bloody big nurse to lift up dan carter

Isn't every school goer in nz taught not to move people so ruling out anyone but someone with a stretcher? Joe Public wouldn't know how to load someone onto a stretcher anyway, unless they had the privilege that some kids had of CD training.

You're not on Atlantis anymore, Duncan Idaho.

Batman

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#1696998 1-Jan-2017 07:16

MadEngineer: I think you'd need a bloody big nurse to lift up dan carter

Isn't every school goer in nz taught not to move people so ruling out anyone but someone with a stretcher? Joe Public wouldn't know how to load someone onto a stretcher anyway, unless they had the privilege that some kids had of CD training.

Maybe so. But I'd like to see a vote of who thinks they'd stick to the policy of 100% ignoring the person and waiting for the ambulance.

Didn't want to do this but replace the man collapsed with a pretty lady. Still think they'd stick to the policy? [I smell a prank - I mean social experiment to follow ...]

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