What would you do today to relieve pressure on A&E? An acute care nurse's view

In the January 2015 edition of our newsletter for healthcare professionals, we asked subscribers the following question: What would you do today to relieve pressure on A&E? Here's one response from an acute care nurse.

I am an acute care nurse. I work in A&E I work mornings 7.30am-3.30pm, afternoons 1.30pm-9.30pm at night and I work night shifts 9.15pm-7.30am. There is hardly a time that I am not flat out busy. Sometimes ! don't get a break. Sometimes I manage 10 minutes to quickly drink some tea and throw down a sandwich then I need to go and relieve a colleague to do the same.

There are three sections to A&E; minors, majors and resus. I work all three areas in one shift pattern and I can't say that any are less busy than the other.

Minors can be a little more predictable at times, when the weather gets bad, because people fall and break limbs, cut themselves, etc. Majors is slightly more acute and we can predict times of day when it gets 'overload busy' but resus - well that's unpredictable and always busy.

What would I say is our biggest problem? The general public's attitude to their emergency service! I am not joking when I say that people book in for period pain, constipation, paper cuts and nosebleeds all the time! People come in drunk and abusive and swearing all the time.

However my real issue is relatives of patients shouting the odds as if they are determined to get a better service for their relative. They can be downright rude, aggressive, disruptive and demanding. I have a small amount of time when a patient comes in to hospital to work out what's wrong. I start to deal with that by taking blood and getting that off to the lab, give some medication like paracetamol if they have a temp, get them warm if they are hypothermic, and change a patient into a gown. Often I then start to look after an incontinent patient's situation aswell. It's not an easy job, there is a lot of responsibility and it's long hours.

So when I say that I am shocked by the way the media, with no knowledge of the stresses of this extreme side to medical care, berate the services, fuelling the attitudes of the public I really mean it. Nurses constantly hear how we provide a less than satisfactory service. We apparently don't care, get paid enough and fail in our duties a lot of the time. It's frankly disheartening. I had to go through over three years at university to do this job. Not just a Mickey Mouse course - a really hard one - whilst still doing placements and getting very little financial support. I didn't just do all that to be constantly criticised and treated so shockingly. I did it to make a difference in a crazy world. So that I could make people feel better and see some people through some really tough times. I really mean this when I say I don't know how long I can keep doing such a poorly paid job with such abuse and lack of respect.

Karen Shakespeare-Blair

Read more responses here and here.