Real nursing experiences of A&E

[Triona]

Hi,

Can anyone tell me there experiences of working in A & E in the U.K?

Has anyone good suggestions of hospitals they have worked in?

What tends to be the nurse patient ratio?

Lastly, did you go straight into A&E once you qualified?

Any help would be appreciated.

Thanks

[Silverdragon102, BSN]

Moved to the Nursing in the U.K forum

[Rocknurse, MSN, APRN, NP]

Well it's been a really long time since I worked in an A&E so I'm sure everything has changed. I worked at the Royal Free Hospital in Hampstead, London about 100 years ago. I loved it. We had a majors and a minors side, and I worked majors and the resuscitation room. I can't remember how many patients I had. There was a separate pediatric unit so I never had to look after kids which is something I liked about it. I'm sure everything is twice as hectic as it was then.

[skylark, BSN, RN]

Are you comparing this to ER nursing in the US?

There is a similar thread already running, which compares them, but to give a short answer, UK nurses have a lot more varied role.

We do the triage process exactly the same and draw the labs, we also do EKGs where needed and order xrays.

The main differences are that wound care is a nurse domain in the UK, and doctors just don't get involved in it.

So you will be suturing, dressing wounds and applying plaster casts.

You also do a lot more 'hands on' nursing, including diaper changing, washing and feeding patients that need assistance, and ambulating them.

These tasks form the baseline of assessments, so they are not routinely delegated.

You cannot tell someone else to bathe them and then claim to have assessed pressure areas!

The other main difference is the time factor. All patients need to be out of the A&E in four hours.

That puts a lot of pressure on you, all the way through their journey.

Triage, vitals, labs and EKG have to be done in the first 15 minutes.

All investigations must be completed and reported on by two hours.

Decision to admit or discharge by three hours, and then gone by four.

Generally nurses work at least a year on the floor before joining the ER, although I have known exceptions when they were students doing their final placement in the ER and then just sort of stayed!

Ratio is about the same, usually 4-5 patients at a time.

[GrumpyRN, NP]

Yep, what skylark said.

I worked in a unit that did not do labs and EKG's unless they were clinically indicated or it was going to change management. Also we did not see GP problems. This enabled us to meet the 4 hour target 98% of the time.

Another difference - although this may just be us - is doctors are not allowed to scream and shout at nurses (some still do it but were taken aside and told to stop) and there was not really a divide between staff, very much a team effort.

[skylark, BSN, RN]

Yep, what skylark said.

I worked in a unit that did not do labs and EKG's unless they were clinically indicated or it was going to change management. Also we did not see GP problems. This enabled us to meet the 4 hour target 98% of the time.

Another difference - although this may just be us - is doctors are not allowed to scream and shout at nurses (some still do it but were taken aside and told to stop) and there was not really a divide between staff, very much a team effort.

I'd forgotten about the teamwork side of things.

Yes doctors and nurses work alongside each other as a team.

There is no hierarchy except the Consultants (Attending in the US), and its common for the team to socialize together as well.

Mealbreaks are taken together including docs, nurses, techs and housekeeping, and its just a far more pleasant vibe than many American hospitals.