Secret Doctor: Temporary wards are closed on Friday evenings - only to miraculously reopen over the weekend

"Diplomacy is not always attainable. Consultants, just like children, sometimes succumb to emotional outbursts"

Pic: iStock

During the weary hours of my night shifts, a peculiar phenomenon known as the 4am slump takes hold.

Fatigue stealthily creeps up on you, as if your body’s internal clock grows fed up and implores you to rest. It’s a relentless battle against drowsiness, all the while praying that no major emergency disrupts the delicate balance of your workload.

As the night draws to a close, a bustling exodus ensues. Those concluding their nocturnal duties slip into their cozy jackets and begin their sluggish march towards the exit doors. Some opt to stroll home, while others await rides or embark on their drives. Public transportation serves for a select few.

An eager lineup of vehicles eagerly anticipates the departure of night shift workers, vying for coveted parking spaces. I know individuals who arrive hours in advance, hunkering down in their cars to secure a spot, a testament to the scarcity of staff parking facilities. I witness weary eyes meticulously applying makeup, utilising car mirrors to rectify any imperfections, while others eagerly indulge in overnight oats, their energy fix for the morning ahead.

Monday morning, the inception of a brand new week. We stride through the hospital doors, steeling ourselves for the challenges that lie ahead. In hospitals across the country, including our own, a ritual known as the “redistribution meeting” takes place each morning. This gathering brings together senior doctors, both consultants and registrars, to discuss all the medical patients who have been admitted. 

The primary objective is to identify the most suitable speciality team for each patient, striving for efficiency by preventing multiple teams from evaluating and offering their opinions on a single case. In the past, a more archaic model of care prevailed, where the on-call consultant would bear the responsibility of overseeing and managing all patients admitted within a 24-hour period.

This model inevitably resulted in an overwhelming workload, with a team of three doctors being responsible for an exorbitant number of patients, upwards of 30/40 individuals.

The redistribution meeting, however, is not without its fair share of consternation. Some teams find themselves disheartened by the workload or complexity of cases assigned to them for continued care.

Diplomacy becomes essential but not always attainable. Consultants, like children, sometimes succumb to emotional outbursts, witnessed in the form of metaphorical toys being flung out of prams. Whining, sighing, grumbling, and occasional cursing fill the air. As hospitals nationwide groan under the weight of escalating demands and limited resources, so too do the individuals working within their walls.

Following this meeting, various teams embark on the task of compiling their updated lists of inpatients, combining those who were already under their care with the newly admitted patients.

With their lists in hand, the teams make their way towards the bustling emergency department, a place where patients often find themselves housed despite their age, severity of illness, or any other mitigating factors. It is not the fault of the emergency department, as they tirelessly care for both the admitted patients and those who arrive seeking urgent medical attention.

However, the ED lacks the necessary resources to shoulder this burden, yet its dedicated staff work tirelessly to provide the best care possible. It functions currently as the pressure point for hospitals across the country, that precarious balancing act between life and death where the weight of responsibility hangs heavy in the air.

Apologies have become an all too familiar part of every interaction with newly admitted patients over the past few years. Walking through the emergency department, one notices chairs with perspex dividers, a recent addition during the height of the pandemic to ensure protection. These dividers now serve as makeshift partitions for patients. If you are too unwell to sit, you are offered a less-than-ideal resting place on a hard trolley — sometimes in a designated bed space, sometimes in a corridor.

Yet, by accepting these conditions, we condone them. Such circumstances are in no way acceptable. We apologize because we refuse to accept this as the standard of care.

Temporary wards are closed on Friday evenings only to miraculously reopen over the weekend, attempting to present an improved picture on paper regarding patients on trolleys.

Outpatient rooms have been hastily converted into makeshift trolley bays, their layouts entirely unsuitable for caring for the sick. I am aware that when politicians visit these bustling departments, trolleys are swiftly wheeled away to hidden areas, masking the underlying issues. These fleeting remedies offer nothing more than superficial solutions, devoid of any substantial change.

We stand in solidarity with our patients, acknowledging that all of these measures fall far short of the mark. They are symptomatic of the problems that plague the healthcare system in which we work, where hospitals have become the focal point for resources within the broader community. This, in turn, creates challenges in managing the workflow and results in delays in delivering services in a timely manner.