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whitewriterNight one
So I got sent to ED short stay unit (ED SSU) last night.
ED in Australia is the American equivalent of the E.R. Our stands for Emergency department (and in Britain it would be called A&E or accident and emergency) . The target in Australia for the E.D. is to maintain a turnaround time of 4 hours per person.
That means from the time you are seen in triage, and categorised into category 1-5 (1 being holy shit your in trouble need to be seen immediately) to 5: which is the same as why are you here buddy you really should just make an appointment with your GP, oh wait, you didn't foresee that you would run out of your prescription medication on Christmas day and your GP is closed? type of presentation.
Regardless of why your there (category 1-5) the overall goal is to have you sorted within 4 hours. If you need to be admitted, and on the ward : then you should be on that ward.
Some pt have ongoing needs that, whilst are essential, are clogging up a bed. For example: chest pain awaiting repeat troponins. Troponins are markers present in a blood test if you've had a death of cardiac muscle (typically seen in a heart attack or infarct of the heart- myocardial infarction or MI) the thing with a troponin is that the baseline is typically low (like less than 30) but it only rises after 4 hours post-- and in the absence of an abnormal ECG saying SOMETHING IS CLEARLY WRONG HERE then troponin is another way to tell if something is slowly brewing, or that the ECG changes are just super subtle.
That clogs up an ED bed for 4-6 hours, for someone who could just have muscular pain who needs say, a heat pack/deep heat/go see a physio v. someone who actually needs to go to the cath lab and get admitted to cardiology.
Hence they invented ED short stay. A ward where people go to wait. I wondered if that was just covering the problem (that ED should be better staffed or expanded or have better processes backing up the system to make it run faster) but from talking to their in charge overnight; she thought it was a really good solution. It takes people who do need to be there, but is just waiting for things out of the busy chaos that is ED. Settles them in a place where they can be monitored or treated for a little longer. It allows the hospital to ensure they stay within their 4 hour target (as they are no longer in ED, and are admitted to the ward, even if its just for an extra 2-3 or maybe 8 hours.
Gives the teams a little more time to see someone waiting for a consult (because, remember, they have to see all their current patients too, and attend their own booked appointments in their rooms, and not to mention, perform surgery or whatever other tasks they have going on that day).
It's much like ED as the pts don't get full care. No one will really wash them or do pressure area care, or provide more than observations, cardiac monitoring if required, medications as needed, a note, and basic food if they're allowed to eat.
One of the nurses looked at me a little wistfully whilst she said "wow. you get to provide full patient care down there[in icu]" and I thought, yeah. That is something that makes the job feel satisfying.
Usually we shake in our boots when we're being sent. But I rather liked short stay and would gladly be sent there again.
So I got sent to ED short stay unit (ED SSU) last night.
ED in Australia is the American equivalent of the E.R. Our stands for Emergency department (and in Britain it would be called A&E or accident and emergency) . The target in Australia for the E.D. is to maintain a turnaround time of 4 hours per person.
That means from the time you are seen in triage, and categorised into category 1-5 (1 being holy shit your in trouble need to be seen immediately) to 5: which is the same as why are you here buddy you really should just make an appointment with your GP, oh wait, you didn't foresee that you would run out of your prescription medication on Christmas day and your GP is closed? type of presentation.
Regardless of why your there (category 1-5) the overall goal is to have you sorted within 4 hours. If you need to be admitted, and on the ward : then you should be on that ward.
Some pt have ongoing needs that, whilst are essential, are clogging up a bed. For example: chest pain awaiting repeat troponins. Troponins are markers present in a blood test if you've had a death of cardiac muscle (typically seen in a heart attack or infarct of the heart- myocardial infarction or MI) the thing with a troponin is that the baseline is typically low (like less than 30) but it only rises after 4 hours post-- and in the absence of an abnormal ECG saying SOMETHING IS CLEARLY WRONG HERE then troponin is another way to tell if something is slowly brewing, or that the ECG changes are just super subtle.
That clogs up an ED bed for 4-6 hours, for someone who could just have muscular pain who needs say, a heat pack/deep heat/go see a physio v. someone who actually needs to go to the cath lab and get admitted to cardiology.
Hence they invented ED short stay. A ward where people go to wait. I wondered if that was just covering the problem (that ED should be better staffed or expanded or have better processes backing up the system to make it run faster) but from talking to their in charge overnight; she thought it was a really good solution. It takes people who do need to be there, but is just waiting for things out of the busy chaos that is ED. Settles them in a place where they can be monitored or treated for a little longer. It allows the hospital to ensure they stay within their 4 hour target (as they are no longer in ED, and are admitted to the ward, even if its just for an extra 2-3 or maybe 8 hours.
Gives the teams a little more time to see someone waiting for a consult (because, remember, they have to see all their current patients too, and attend their own booked appointments in their rooms, and not to mention, perform surgery or whatever other tasks they have going on that day).
It's much like ED as the pts don't get full care. No one will really wash them or do pressure area care, or provide more than observations, cardiac monitoring if required, medications as needed, a note, and basic food if they're allowed to eat.
One of the nurses looked at me a little wistfully whilst she said "wow. you get to provide full patient care down there[in icu]" and I thought, yeah. That is something that makes the job feel satisfying.
Usually we shake in our boots when we're being sent. But I rather liked short stay and would gladly be sent there again.
