BY MICHAEL BRESLIN
The number of physical assaults on staff in the Accident & Emergency Department at the Erne Hospital for last month was double that for the previous 11 months and, already halfway through January, the end-of-year figure has already been matched.
The Western Health and Social services Trust has adopted a 'No tolerance' policy towards assaults, either physical or verbal on its staff in hospital or a health care centre. It means any person misbehaving will be either refused admission or asked to leave and, if they refuse to do so, the Police will be called and legal action considered.
Over the last year, there were 16 reported instances of A & E staff being verbally abused and three incidents were staff were physically assaulted. Two of these physical assaults took place in December and, there were two more reported for the period 1st January-14th January this year, together with one instance of verbal abuse.
For Dr Ariel Stewart, one of three consultants in emergency medicine based in the £868,000 refurbished A & E Department at the Erne, distractions like these whilst they are trying to deal with patients who are in greater need are something they could do without.
She works from 9am-5pm, Monday to Friday and is on call every third week. She told the 'Herald' that the volume of callers to the Department during the Christmas period of patients injured as a result of alcohol shot up by between 20-30 per day compared to previous weeks. And, she added that, with the 24/7 licensing laws, the Trauma Team could be asked to treat people turning up in that condition in early morning. Assaults, both physical and verbal, occurred on those occasions like these.
"It is noticeable too all the time at week-ends', Dr Stewart explained. "Yes, I have been verbally abused myself, by the patients or those with them. Very often they don't understand we're trying to help them. They want the treatment and they want everything done quickly.
"The way I deal with verbal abuse is not to react to it directly because it makes people worse when they're not in a sober state. Fortunately, I get less of it in the sense that it happens most of the time overnight. Most of it then is verbal abuse, but you have physical violence which did occur over the Christmas period".
"The security staff do try to help as far as possible, but it's not always easy for them. They get the hangers-on outside and they do do a good job, they talk to them in the waiting-room and try to get them settled. It is important to know you have somebody like that at night time to call on".
Ironically, a well-disposed hanger-on can fulfil a vital role in briefing the Trauma Team on how their friend came to sustain an injury, if their friend is unable to speak themselves.
"If somebody comes in on their own", Dr Stewart explained, " we would always contact their relatives to make sure we have full details of their medical history. It could be, for instance, to see if they have a history of epilepsy or diabetes, although, sometimes, we can find that from the patient's medical records.
"But, we will always try to treat the person, and we always assume, where someone with alcohol on them is concerned, that alcohol isn't the main cause of their difficulty till we can prove that everything else has been cleared. That's where the person accompanying the patient can help us for it is always important to know, to get someone who has seen what has happened and can give us some information".
Dr Stewart took up her post as consultant in emergency medicine in the A & E Department at the Erne hospital in February, 2007. Prior to that, she has worked in various hospitals across the North. She places the department at the Erne on a par with the best she has worked in.
"One of the rooms in the main area is dedicated to children and young people as is one of the resuscitation areas. That's important because you need specific equipment for children and young people.
She shares the workload at consultant level with her colleagues, Dr Sam McBride and Dr Mutta who is a locum but who is expected to be permanently appointed shortly, and with Mr Moti Rahman who is an associate specialist in surgery and covers three sessions in the A & E Department.
All are part of the Trauma Team ('we are a very good team') which embraces nursing, administrative, security, cleaning and paramedic staffs.
Although the day staff clock off at 5pm, if an RTA occurs at 4.30 or 4.45 they will stay on to help the night staff: "You do need hands on for the first half an hour to an hour at least, then you can hang back but, in the initial stages, you need plenty of help.
Compared to hospitals in the UK where she worked in her earlier years, the Erne does not have a lot of patients presenting with drug overdoses.
"That's a good thing of course", she said. "Obviously, drugs are in the community in certain parts of Northern Ireland, but I haven't seen a lot of patients coming through here as a direct result of drug overdosing.
"We are aware that people who are brought in will say their drink has been spiked so, again, it's important that if they do come in that their friends tell us what's happened so we can treat them specifically."
