Last May I interview at the local Emergency Department (ED) with a Senior Sister (charge nurse) and the manger for my now current job. She asked about quality measures we follow in the US. I recited the ones burned into my brain, blood cultures first followed by antibiotics within 4 hours of a pneumonia diagnosis. The catheter-associated urinary tract infection (CAUTI) bundles to decrease UTIs with Foley use. And a big one for the ED is having appropriate documentation and orders for patients in restraints. Both interviewers gasped “OH NO! We do not use restraints!” And “please tell us you will NOT put anyone in restraints.” During my previous shift I had put a combative child into four point restraints. It broke my heart and this was a welcomed concept. But then I wondered. How DO you manage combative patients in the ED? And more questions arose…
The things I learned as a bystander about healthcare since our arrival is that are two emergency numbers you can use. The first, 999, is equivalent to 911. Then there is newer non-emergent number 111. We used it during our isolation period when Gary had cellulitis. You dial 111 if you need help but it is not an emergency. Or if you are unsure if it warrants an ED visit. You might have a medical provider come assess you and then an ambulance might or might not transport you to the ED.
As in the case with our elderly neighbor, he got evaluated by a solo paramedic and then an ambulance was called to transport him. All ambulances have lifts, so there is no strain on the back. And this crew was all female which brought a smile to my face.
Questions…..
So fellow healthcare workers in the USA what burning questions do you have for me about the healthcare system and how things are done here?
I am taking note of them and hope to answer them via the blog as I document my journey as a nurse in England.
pre assessment vehicle
The questions I have come up with for now are
How do you get by not using restraints in the ED? Especially with a patient effected by drugs or alcohol?
Can you send away a patient to follow up with their general practitioners if it is a minor complaint without full ED provider evaluation? Like after getting triaged?
Do you have less tests or more test done since it is a national health care system?
Do you practice to protect your license less here and hence less unnecessary testing?
Will I get more quality time with patients?