Patients are sicker and stay longer. But for staff at Royal Melbourne Hospital, little moments of satisfaction punctuate the day.
Behind a nondescript door on the ground floor of the Royal Melbourne Hospital is a small warren of offices belonging to the bed management team.
No matter how dire things look in the morning, Strapps says they always find a way to balance the ledger. On the red days there are regular video meetings with senior staff to talk through how they can improve the patient blockages. Johnson says code blues – the highest-level medical emergencies – are now reasonably rare because the hospital has lowered the threshold for MET calls, meaning they are seeing people before they become so sick.
Before the pandemic, demand on the general medicine wards would usually ease over summer, to around 80 to 100 patients, and then rise over winter, to about 120 to 130 admissions. But in the last 12 to 18 months there has been no dip, and admissions are now hovering at around 120 to 140. Part of that increase in demand has come from COVID patients, but not all of it.
“But now we’ve got this central equipment library, there’s just this really great trust that you’re always going to have enough.” As a trauma centre, the intensive care unit often cares for patients who have been in car crashes and workplace accidents and men, in particular,These people often have significant multi-organ trauma, the most concerning of which, MacIsaac notes, are those with traumatic brain injuries. “They often, unfortunately, have a poor prognosis,” he says.
“I think it probably makes you inherently a little bit more cautious,” he says, when asked if what he sees at work changes the way he lives his own life. “You won’t find me on a motorcycle.”Dr Emma West plops down her bag in the office above the emergency department and takes a quick scan through the list of waiting patients.
The director of emergency medical training sometimes works as the ED’s triage doctor, along with triage nursing staff keeping an eye on incoming patients to ensure they are not losing people with time-critical conditions in the queue, such as those with severe infections that need antibiotics.“It’s a mad role,” she says. “You’re pulled in every direction at every moment … You might get three questions a minute and you’re having to process huge amounts of information all the time.
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