Red Alert.

The hospital has just declared a red alert….

This is one of their escalation states whereby they are basically saying their departments and wards (usually A&E) are becoming unsafe. They make a declaration that has two key effects. Firstly, we the ambulance service are advised to re-direct our patients to other hospitals unless their problem is immediately life threatening. Secondly, certain members of staff in the hospital, the bedsite managers for example can start shifting beds around with that bit more authorize weight behind them. It’s hard for a ward manager to defy the will of the mighty bedsite at the best of times. Its harder still when the hospital escalates.

A little while ago I was standing in A&E with my patient who had chest pain. This virtually guarantees a bed your patient a bed. If there is a bed available that is. I was standing in a cue of six ambulance crews. Lets put that into perspective. Its a night shift. Ipswich has three night crews. Felixstowe has one. Saxmundham has one. Stowemarket has one. Sudbury is pulling up outside. Thats all the cover from Sudbury all the way up to Beccles… gone. There are three fast response cars sitting on patients screaming for backup. There is no backup, and there isn’t going to be any unless the hospital can make some room. There are simply more people coming in through the front door than there are leaving through the back. We are anticipating a two hour delay before we can even off load our patient ont to a hospital bed. That means that the patient will have been in the hospital for two hours before they are even seen by a nurse let alone a doctor. Bad eh?

We are all nervously looking at each other. One big car crash now and thats it all over. We’ll have nothing to send from Suffolk. There is a policeman here too. He is saying that they currently have one car currently covering all of Ipswich. Another is stuck babysitting a drunk in the cells, and then theres this one stuck at A&E. So lets assume it’s not a big car crash that comes in but maybe a stabbing instead. That would be police and ambulance wiped out and unable to respond.

One of my favourite questions to ask the general public is ‘How many ambulances do you think cover the town at any one time?’ Their answers vary widely but I’ll tell you this…  Not one of them is even remotely close. The lowest figure I had been given was twelve. Twelve!! My god we’d be laughing! The true figure is much different. We have six ambulances during the day. Three at night. We have begged and pleaded for more but the answer is always the same. No money in the pot. This is so frustrating. The population of our town is increasing all the time. We even have a university now. Yet in the five years I have been here I have seen no increase in the number of resources we have. I have seen many new managers though. When I started here we had two covering the whole of East Suffolk. Now we have five in Ipswich alone. Its madness.

Let me tell you how effective our manager was tonight. Control rang him up to say that crews were spending a long time in A&E and that nothing seemed to be moving. Could he please investigate? So manager screams round there in his brand new state of the art fast response car. He quickly establishes that the hospital has run out of beds. He approaches the A&E coordinator. He is told that there is no beds, we are doing the best we can. He then approaches the bedsite manager. He is told there is no beds, we are doing the best we can. Manager rings our control up and says that there are no beds and that we are all doing the best we can. Manager stands around with his hands in his pockets. Manager suddenly becomes aware of a crew that have been standing in one place in the corridor for nearly two hours. He walks over and offers the hospital’s tea facilities. Crew smiles and says thank you. Manager smiles and reports to control. He says he has secured refreshments for the crews. Manager leaves and returns to base. Crews continue to wait in A&E for beds to become available, drinking tea they have already been offered by nursing staff.

Now how pointless is that? That manager gets paid a hell of a lot to basically go around stating the obvious.

I think I’ll go have a cup of tea.

M:-)