A night at Hutt Hospital ED

Hutt News health reporter Blake Crayton-Brown spent four hours in the Hutt Hospital emergency department one recent Friday night. He found himself surrounded by beeping machinery, blue scrubs and controlled chaos. We’ve had patients come in who just neede

It came as no surprise Friday night was a busy one for doctors and nurses at Hutt Hospital’s emergency department.

Decked out in scrubs and sensible shoes, they went about their business at a clipping pace, moving from a patient in one room to one in another, to one in the corridor before moving one and switching another. It was akin to a hospital-themed game of Jenga.

And at no point between 7pm and 11pm did the waiting room appear to empty out, with patients filling up most rooms in the department and beds lining parts of the corridors for most of my stay.

But there was always plenty of room to move – at least it looked that way with doctors able to stride past the patients in the hallways without disturbing them.

It was an evening where I was told more about procedures than prognoses.

I was surprised to learn that those arriving by ambulance were not guaranteed to be seen by ED doctors any faster than those who walked in. All patients who presented, however they arrived, went through the same triage process.

They were assigned a number between one and five measuring their acuity – effectively how bad their symptoms were.

Patients with an acuity number of one were in the worst shape, and would be seen almost immediately because their condition was life-threatening.

It could take some hours to see patients with an acuity rating of five, though.

For those in-between, a number of factors would affect how quickly they were seen by nurses and doctors.

How quickly patients could be admitted to specialist hospital wards, the severity of other patients’ conditions and the time of day a person presented would all contribute to how long a patient would wait.

One of the biggest challenges faced by the emergency department nurses was managing patient expectations, the charge nurse said.

‘‘Sometimes it’s difficult to get people to understand that they may have a health crisis but that some other person’s crisis is worse.

‘‘You may think we are queue jumping you but we are putting people where they need to be.’’

She said nurses tried to explain how the triage system worked to patients, but it could be difficult.

‘‘To them in that moment, The workload faced by Hutt Hospital’s emergency department can be heavy.

One of the Government’s key health targets is that emergency departments admit, discharge or transfer 95 per cent of people who come for help within six hours of their walking in the door.

For the period covered by the last set of available statistics, October-December last year, Hutt Hospital’s ED hit 90 per cent.

While they did much better on other key health targets, the ED result was 19th out of nation’s 20 DHBs. they are the one with an emergency.’’

To the untrained eye, there’s a lot of variety to be seen during a shift. During my four hours I witnessed men and women of all ages come through the door, some under their own steam, others in wheelchairs or on stretchers.

Some had felt chest pains, others had symptoms consistent with having had a stroke. A few were there after attempts at self-harm. To those initiated in emergency medicine, though, it’s like Groundhog Day.

To them, there’s nothing new about a patient presenting with cellulitis, or chest pain, or having an asthma attack. It’s the relative calmness with which I saw the doctors and nurses going about their jobs that was perhaps the most surprising.

I was warned to expect that things could get a bit grisly. I lucked out, I suppose, in not seeing things I would later want to unsee.

Unlike what you might witness at Wellington Hospital’s emergency department, few patients turning up to the Hutt Hospital emergency department do so after alcohol-fuelled misadventure.

Richard Makower, head of the hospital’s emergency department, attributes the difference to the lack of watering holes in the Hutt Valley.

With the many dozens of bars along Courtenay Place come the alcohol- related injuries. With the few bars along Jackson St or in Upper Hutt come fewer boozesoaked patients presenting.

What does prove to be a constant issue though, Makower said, was people turning up to hospital when they could have gone to a GP.

‘‘We’ve had patients come in who just needed a BandAid,’’ Makower said.

‘‘Part of the reason people come here is the public health campaigns that have been run.’’

There could also be issues when patients with acute medical concerns delayed going to the emergency department or downplayed their symptoms.

Makower’s advice to those looking to avoid needing to go to the emergency department was simple:

‘‘It’s about using responsibility – sensible drinking, no drugs and not smoking.’’