Abuse of the system

Most hospitals have some kind of procedure in place where in the event an emergency occurs (i.e. someone stops breathing), a staff member will announce a code over the public announcement (PA) system, prompting a legion of doctors assigned on duty that particular day to go running towards the patient to resuscitate him/her. This procedure is used for a variety of purposes such as when there’s a fire or when a patient or visitor turns violent, or if someone brings in a weapon.

In the current hospital i am based at, i am appalled at how the system is used. The person announcing is unclear in her instructions (if you do not mention the location properly, how will the team know where they should run to?), and the system is used for paging doctors. What is the point of having pagers if you are just going to yell the doctors’ names for everyone to hear over the PA system? If the doctor did not respond to the first few flurry of pages, surely that means he/she is busy, and you demanding for him/her over the system will be as futile?

I think the last straw came for all of us when there was an emergency announcement right in our unit. We looked at each other horrified, and the consultant went to have a look. He ambled back a few minutes later, completely relaxed. We gave him quizzical looks.

“That was not an emergency. The nurse made that emergency call because the doctor she has been paging did not reply and she wanted an IV cannula inserted into the patient.”

Our jaws dropped. IV CANNULA?! Every nurse knows how to do that; in fact nurses are probably better than junior doctors at inserting cannulas. What the hell was wrong with this nurse? She made the whole team (which by the way includes doctors from the Intensive Care Unit and Emergency Department) sprint to the unit only to discover the defibrillator and all those fancy heart equipment they hauled along were redundant, and they only need a bloody cannula. Amazing, i tell ya.

Equally astounding was this nurse was not reprimanded nor re-briefed on the proper procedures and that what she did was a blatant misuse of the system. In fact the consultant dryly drolled that if a nurse ever asked us to insert a cannula, do it immediately to spare anyone else the misery.


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