Wednesday, 28 July 2010

Crummy Handovers

I started my elective on Monday morning, and so far it has been fantastic! I've spent the last 2 days with a lovely critical care paramedic and a paramedic who've gone above and beyond to make me feel welcome and to teach me stuff.

We haven't been that busy, but we have had some interesting jobs that I'm sure I'll mention in the future. However the most important thing that I've learnt so far is about a good handover.

A good handover seems to be a mysterious thing for ambulance crews. This isn't their fault.

Over the past few days I've witnessed many incidents of nurses and doctors not really listening or not allowing paramedics to handover properly.

A prime example of this was yesterday. We brought in a lady with a serious neurological condition. We did this because we witnessed her change conciousness levels, black out and switch between aggressive and just simply away with the faeries. To put it into context one minute she'd be thrashing around, shouting abuse and trying to get out of the ambulance, the next she'd be slumped and not even flinch while having a wide bore cannula shoved in her arm.

Turns out she'd self discharged against medical advice the day before. She'd also been aggressive towards the hospital staff. As you can imagine they weren't happy bunnies. In fact, the hospital staff were so rude while handing over that the patient tried to get up and leave. Great. Making her more aggressive. They then kept interrupting while not listening. The handover could have been 30 seconds long and if they'd have listened they'd have understood that we'd seen some worrying clinical signs. Annoyingly it took us about 4 minutes to get someone to listen to these clinical signs because they were too busy interrupting and basically saying that they didn't want the patient because the patient had been trouble before.

So next time you're in a&e listening to a handover, do just that. Listen. You might learn something new about the patient even if you've known them before.

Once you've listened and got the full story, then start asking questions or making comments. If you do so before you just look stupid and grumpy.

Lily xXx

No comments: