The A&E crisis-it hasn't gone away...

# 91

Posted: 08/10/2006 21:56

A&E is an abused access point in the acute care system. How is its role and function defined?Who accepts clinical responsibility irrespective of appropriateness or need? Self and non-clinical referrals can, like GP referrals, be assessed with a triage protocol provided there are alternative 24/7 interventions or supports available.Otherwise fear of litigation or political/media hype will act as DETERRENTS. A whole system solution cannot be found solely in the hospital!

# 90

Posted: 05/10/2006 14:39

Mags, I agree totally with you. The Drunk & Drugged have no place in A & E Depts.
The sooner they are made take responsibility for their own actions the sooner the A & E\'s will work efficiently.

# 89

Posted: 01/06/2006 15:56

My finance recently had a work related accident and badly hurt his back. He was taken to St. James A&E at 4.30 and eventually seen at 10 that night. While we were waiting to be seen I could not believe that the Ambulance service was called out to bring in Drunks off the street and men who had been drinking and got involved in fights. They get "dumped" in A&E to annoy and abuse ordinary people. People waiting were frightened by some of these guys because often times they were abusive. If they are brought in Drunk they should be put in padded cells to sleep it off. I thought the staff at James' were wonderful and dont deserve that kind of nonsence. Isolate the drunks.

# 88

Posted: 19/04/2006 15:06

I went to the A&E in Cavan General, there were no bed from day to day and during the day we put into a room sitting all day by nite time u would be wreck tired and also there were people who nothing wrong with them and were asked to go home but refused and then they would asked for clothes or gowns which they provided and was thrown bak in their face. what a joke

# 87

Posted: 18/04/2006 09:42

So Mags, you want the slur taken off the act of getting twisted and the slur be put on psychaitric care?

This is precisely the backward atitude that the 'mental' institutions - as you so label them, have been fighting for years in this country and with one stroke you want to put that work back 50 or more years.
That is REgressive, not progressive.

Incidentally, those who are drugged / drunk ned to be triaged for pysical problems FIRST. You will not be able to provide psychiatirc assessment to someone who has died of an overdose or choked on their own vomit.

# 86

Posted: 15/04/2006 13:21

As a retired nurse I think that people are entitled to complain about dreadful service often offered in Casualty depts.
However staff need to be protected from violence and abuse. I firmly believe that drunken/drugged patients shoud be ambulanced directly to Psychiatriac units for assessment and totally isolated from general patient population. I think that that might give a clear message to drunks and drugged people that their behaviour is totally unacceptable.If going on the town with the intention of getting 'locked'or 'twisted' or whatever the current slang terms are, are going to end up in psychiatric care then they might be more careful of what they imbibe and who they indulge with.
Ending up in casualty might be a fun story to share with your friends, but ending up in a 'mental' institution might not seem so glamourous
Also fearful or agressive staff should be aware that violent behaviour is a two sided process.One feeds off the other.
Mags - (retired RGN of the dragon variety.There to treat not judge!)
We are in an extreme crisis.

# 85

Posted: 15/04/2006 06:21

it is interesting to see the emergency rooms at the Cavan hospital is now closed . perhaps instead of winging you should ask atishho bertie ahearn i have delibiratly mispelt his title what plans there are under the Ballyconnell agreement to use the new hospital in Enniskillen when it is built .As i have said before there are many hidden goverment agendas within the two health services and i should know living in north ireland
We need to get the polititions out of healthcare and the staff into the management of healthcare
We also need to look at the inovations i have entioned in another posting as only innovation will chang e the health service . Are theri any inovators posting on to this site . please understand that innovtion including air ambulances jumbulances and other inovative projects need to be utilised to prsent a patient focused service . indeed services can be privitiesed however they must be focused on non profit making organisations tht though they do except profit they do not pay outragouse fees to their management but plough any excess capital back into the hospital , nursing home the next year . unfortuanally until the posters take the inititive we are going to have more off the same .
So i challange you let us build a cross border health service second to none and embarres out politicos on both sides off the border .
IT CAN BE DONE IT SHOULD BE DONE LETS STOP WINGING AND START THE BALL ROLLING

# 84

Posted: 14/04/2006 12:15

I Fell down the stairs 4 weeks prior to be hospitalised with a small clot in the lung. Would this cause the clot

# 83

Posted: 04/04/2006 12:51

In my opinion it is preposterous of clooney to suggest that 91% of a&e admissions is the result of alcohol. Clooney, do you have any proof or evience to back this up at all?
Incidentally, I have never seen the VFI or indeed any publican force alcohol down anyone's throat.

# 82

Posted: 31/03/2006 21:28

91% of all a/e admissions are created by abuse of alcohol, while the vinters assocation have an annual advertiseing budget of over €3million. it is not right that the assocation who profit from all abuse of alcohol should pay a levy to the H.S.E. its only about time that they takr responsibility for there members actions

why arnt the vinters assocation

# 81

Posted: 19/03/2006 23:42

I AM TIRED OF LISTENING ABOUT THE IRISH HEALTH CARE SERVICES IT STARTED IN THE MID EIGHTIES WHEN CHARLE HAUGHEY STARTED HIS CUT BACKS WE HAD TO ALL TIGHTEN OUR BELTS AND THE CONSULTANTS STARTED A FEE PER ITEM SYSTEN IN ADDITION TO THEIR NEW CONTRACTS THE OLD PEOPLE OF THIS COUNTRY DID NOT EARN A FEE PER ITEM THEY WORKED THEIR GUTS OUT TO MAKE THIS COUNTRY WHAT IT IS TO DAY AND MADE GREAT SACRIFICES FOR US ALL AND IT IS A DISCRACE THAT THEY ARE TREATED WITH SUCH INDIGNITY BY THE POWERS THAT BE DOCTORS NEED TO EXAMINE THEIR CONCIENCE THAT IF SOME OF THEM HAVE ONE THERE ARE SOME EXCELLENT DOCTORS BUT THEY ALL DONT EXCELL TO THE LEVEL THAT THEY SHOULD AS WE ALL KNOW TO WELL WHILE WE HAVE MARY HARNEY BUILDING NEW PRIVATE HOSPITALS ON PUBLIC PROPERTY AND WARDS CLOSED IN PUBLIC HOSPITALS NOW WHERE IS THE LOGIC IN THAT

# 80

Posted: 26/01/2006 19:24

this day 4Weeks ago ,I had a Seizure .Rushed in to S.C.H.at 1am.Sean and Eddie were the Ambulance Men on Duty.Bless Them.!I Then had a 2nd one in Aand E.I had no Warnings, Was not aware of the Swift treatment that saved myLife until I Found myself on ward 7 Two days Later.I Was Taken to St VincentsHospital x 2 for Mri and Ct Scan. Tg,All Proved Negative .I was then put on IV Antibiotics and anti Virals for 7 days.
I Was in a Public Ward .Bewildered at what happened .and still am !
I Could not thank all the Staff enough for their Respect Their Efficiency at all Times .Catering, Cleaning ,nurses .Adm. Doctors.
I am So indebted to them for saving my life.
Their was one shower for 35patients one bath.
I Will not rest until this Wonderful Hospital is Given Proper Facilites.
The Conditions the Staff try and Carry out their Duties has to be seen to be Believed .
Dick Roche is our Minister .and I will be contacting Him When i Regain my strength.
The night Staff never stopped .
I Am So Grateful to you all.
GEMMA.

# 79

Posted: 19/11/2005 05:18

Look for innovative ways off providing all types of care Accident and emergency care does notneed to be provided in an accident and emergency unit of a hospital look at putting accident and emergency rooms into health centres with the appropiate jumbulances and medical staff to allow the less serious patients to be treated in priamery care . Finally in responce to one poster force the government to have a review of public administration and get rid off all the self interest groups and put in quality manageemnt with patient particapation groups . Also look at cross boarder excess capacity and bring your sick across the border to local units there it is planned by myself and others to entroduce this idea to your health minister shortly . P.S a jumbulance is a large ambulance which can be used as a mobile enmergency unit or an intensive care unit or indeed any major service provider including a mobile operating thetre
there is one way to sort out the drunks and druggies and that is to have a secure treatment room/s with the relevent security either off accident and emergency or on site with proper security .

# 78

Posted: 11/11/2005 20:30

Yes,Mary but let anybody try running a postal business from Spain selling prescription or other drugs at half the Irish price to Irish customers,and the customs authorities(at Fianna Fail,s behest)would close them down overnight.
One law for the vested interests-another law for the ordinary citizens.!
www.soldiersofdestiny.org
So much for the Common Market.! May as well scrap it .Only the farmers profit from the whole rip off.!

# 77

Posted: 11/11/2005 08:37

Hola John, and believe me you are so much better off.
My Spanish colleague here was perscribed a particular medication - which cost €70 per month for a 3 months (€210 in total) course.
She phoned her Mum, in Spain, faxed the percription to their local chemist and her Mum picked it up that afternoon and posted it over. She had it two days later.
(By the way, your postal service seems excellent too!).

# 76

Posted: 10/11/2005 22:48

Paddy, The publicans would want to be trained as well. Many a publican has been severly assaulted over anger and fights as well. Everyone blames them and yet they also think that they can defend themselves no problem. But with more and more people drinking at home before they come out at all how is a publican expected to get it right all the time. If publicans had black belts or something people might be more afraid to start fights thereby easing the pressure of A&E.

# 75

Posted: 10/11/2005 20:34

Where I live, in Gran Canaria (Spain )you can get pretty much any medicine/drug in your local chemist without the demand to produce a prescription.The unhealthy " vested interest" relationship between doctors and pharmacists(to their mutual benefit) does not exist in spain.Most medicines are up to 50% cheaper here.I am far away from rip off Ireland and its lousy health service and overpriced medicaments.Gracious a Dios.!

# 74

Posted: 10/11/2005 13:41

2000 nurses assulted last year and news to da y that a nurse was seriously assaulted last night in dublin,
training in assault prevention such as "anger in the workplace" and "care and responsibility" should be made manadtory, this may not cure the problem but research has shown that it reduces the number of assaults by teaching staff how to deal with violence and to breakaway safely, without injuring themselves or the client/patient.Research has shown that over a 12 mounth period, if all staff were skilled in the management and contol of violent and aggressive patients the number of incidents fell dramatically. The H.S.E. have a duty according health and safety to either eliminate the threat of violence which is seen as a hazard or train staff to deasl with it.

# 73

Posted: 08/11/2005 16:47

I would love a book voucher for Christmas (Waterstones please!).
If I'm out and have my car, i REFUSE A DRINK, If one is pured for me, I put it to my lips, put it down and leave it there. If asked why I'm not drinking my whiskey, I smile and say thank you but I'm driving - drinks innumerable cups of tea when it it;'s served, to make up for any slight I may have caused.

# 72

Posted: 25/10/2005 22:45

Why doesn't A&E kick up more about this alcohol crisis? How do they just leave this problem go on and on? With all their health talk they've done nothing decent at all about this alcohol crisis. I think they just want more money all the time and that is why they keep shouting.

# 71

Posted: 21/10/2005 14:29

I wouldn't call this action as being that of a nanny state! I would say it is a responsible state. Alcohol reaches its peak at Christmas so this is a great area to start with. If you want your bottle of malt then why not go out and buy it yourself.
Surely a voucher for clothes, jewellry, shoes, books or furniture would be equally delightful. None of these items would be dangerous (unless the piece of furniture fell on your toes!) and would remove the temptation of drinking to excess in family homes for some people. Remember you do not know what people are involved and you do not know what way they will distribute the drink you gave as a present. People at home have a habit of pouring glasses of whiskey for visitors with no measurement! You could end up with four drops in your glass. These visitors then go off and drive home afterwards! This is highly dangerous.
People need to be advised in this area for Christmas and I believe that it would be a huge improvement in the right direction. People may not be aware that these type of presents can produce bad results.

# 70

Posted: 21/10/2005 10:29

18:54, it sounds like you have prsonal experience fo this as chld, but belive me, out name as the drunken Paddies, around the world has long since gone.

What we need is to grow up in our attitude to alcohol - it is there to be enjoyed in moderation. Like, ay sunshine - if you overdo it you will suffer damage.
But do you really think we will be helped to grow up s a nation by someone attempting to ban exhanging giflts of alcoholic drinks at Christmas.
That is the nanny-state gone mad.

# 69

Posted: 20/10/2005 18:54

Anon 15:11
Firstly we are not Europeans in the sense of being French, German ect. We are Irish and we have some name around the world when it comes to alcohol! The Drunken Paddies! If we then are so different from these people then we need to find a system that first of all pulls us back into control. That's our first step. These Europeans do not seem to have reached that level so none of them can give us advice.
Your 21 year old bottle of malt may have got into the right hands in your case but how many times will that same vintage bottle get into the wrong hands.
Alcohol is as dangerous as holding a gun. It is absolutely vital that it is respected in this context.
We have too many families ruined from alcohol. This was my experience when I was young. I recall many a drunken night, fights and tears that sent me to bed sobbing my heart out. I remember as plain as pie having such a lack of food and clothing and how the house always felt so cold.
Alcohol is a hidden area for many women as well. These are known as the silent drinkers. Alcohol in our country is taken far too lightly and yet it has created some extraordinary problems (far exceeding any cigarette) and nothing properly being done about it.
And yet A&E is constantly having this same problem all the time.

# 68

Posted: 20/10/2005 15:11

13.19, you say that at the moment you are building up an addiction particularly with alcohol by allowing it to come into the home so easily??

Yet, Europe would contradict this completely. In mainland Euriope th where ther eis far less of a problem with alcohol, iut is always introduced in the home among the familt. They do not a have the same pub culture as us.

S ooo - now you want to legislate as to what people can give each pother as a Christmas present?
This is ludicrous as well as impossible.
I for one got a lovely bottle of 21 year old malt last Christmas. A luxury I WOULD NEVER INDULGE MYSELF WITH and my family and I enjoyed it from time to time over the following Spring.

# 67

Posted: 20/10/2005 13:19

What I would aim for is the respect of the product. Cigarettes and alcohol have no respect at the moment. It should be the public house only where it was first day that should only be allowed to sell these products.
At the moment you are building up an addiction particularly with alcohol by allowing it to come into the home so easily. Another area that should be cut out is that people should not give alcohol as presents for people for Christmas. I have known some people who have ended up with 20 bottles of whiskey and this is absolute craziness! It would be far better to give people vouchers for food and clothes rather than alcohol. All games and card-games in pubs ect. should never include alcohol as their prizes. This is a huge area that could immediately be stopped or transformed. I am very conscious of this and I never give alcohol as a present.

# 66

Posted: 20/10/2005 10:22

23:35 - do you really think a chronic smoker or alcoholic would only stick to one drink or smoke at a time if this was introduced.
You are forgetting one supremely important factor.
You are not addicted to paracetamaol (or aspirins or whatever tablets you bought) nor is the poor unfortunate suicide.
Wheras the alcoholic and chronic smokr is addicted.

# 65

Posted: 19/10/2005 23:35

Chuckles I agree with you to a point that people could go off to the next shop and buy another packet of tablets. But I believe it is effective in that it sends a better message that this product is dangerous and I would prefer if you only had a certain amount.
It is the first time in my life that I have seen a product curtailed in this way and I was highly impressed. It certainly did make me aware that these tablets could be used for detrimental purposes. While you cannot fix the problem entirely, creating an awareness in this way certainly worked for me. I was quite taken aback by it and yet I understood. I was still able to use the product but somehow I gained a new respect for it.
I believe that this is the way to go to prevent the abuse of certain products.

# 64

Posted: 19/10/2005 16:10

Shops will only sell you one packet of paracetemol at a time, I only found that out one day I was in my local supermarket. I innocently picked up two packs as I normally keep one in my handbag (for work/out etc) and normally have a packet at home too. I was only allowed buy one as I might go home and commit suicide. But that's only so effective as I could have walked into the next shop and bought another packet if I really wanted it. I think the same applies to drink and cigarettes - people will go to any length to get them if they're addicted. You only have to look outside any work place on a cold wet windy day and look at all the smokers huddling around just to get their fix.

# 63

Posted: 19/10/2005 15:40

Anon 12:34
In the shops in my local area I cannot go up to the counter anymore and purchase two packets of tablet like hedex or paraceutemal. Their new rule is that they can only sell you one packet at a time. It is only in with a few weeks.

# 62

Posted: 19/10/2005 12:34

No, Anon, everythig is not grand and there is plenty ofneed to complain about the A&E crises.

What do you mean about shops selling only one packet of tablets?

# 61

Posted: 18/10/2005 17:48

Anon 14:29
What you are saying so is that everything is grand and that we will just carry on as normal? Oh, right, that's a fine world we are living in isn't it! Sure maybe there's no need to moan about the A&E crisis after all. Everything is under control!
How come they have decided in the shops to sell you only one packet of tablets I wonder?

# 60

Posted: 18/10/2005 14:29

Nonsense anon, if some one is addicted to any product, even an illegal one the will go out of their way to buy it, risking prosecution, even ill health and death. If that were not the case we wouldn't have any heroin addicts.

# 59

Posted: 18/10/2005 14:07

Cigarettes are sold not only in shops but supermarkets, off-licences and pubs. There is also a black market, airports and abroad. Alcohol is the same. This to me is everywhere! Why isn't there just one particular outlet selling these products. People would have to go out of their way then to buy these thereby reducing the abuse and subsequently resulting in fewer having to use A&E.

# 58

Posted: 18/10/2005 10:55

No - you can get tobacco in shops, not every where you go.
You can get alcohol in supermarkts,pubs and off licesnes, not every where you go.

# 57

Posted: 18/10/2005 02:19

Well, both products as John says should start with being sold in special outlets only. This will make it a lot harder for young people to access them.
Sure you can get both these products everywhere you go at the moment! No wonder A&E has a problem! I'm personally amazed that A&E hasn't suggested this already.
Surely if this was to happen we would all be living in a better reality. Simple really!

# 56

Posted: 17/10/2005 17:13

aND HOW EXACTLY DO you propose to get rid oof either in the face of what we call reality?

# 55

Posted: 17/10/2005 15:58

Alcohol is a lot worse! Get rid of this and all your trolly crisis would be sorted out on the spot! Trouble is you may not have any jobs left either!

# 54

Posted: 17/10/2005 11:08

What sort of special outlets do you propose John.

# 53

Posted: 14/10/2005 20:54

Smoking is a terrible addiction.It would be a start if cigarettes were only availible through special outlets.It should be made difficult for existing addicts to get them, and doubly difficult for young people to access them.

# 52

Posted: 14/10/2005 14:07

Anon 8:39
Well, it is nice to hear that these two hospitals made an effort. I know that there is still a danger for these people in those conditions but the very fact that they have tried to accomodate the smoker is great. At least there is compassion being shown which says everything.