Many Improvements Planned At Casualty Department

Press, Volume CI, Issue 29829, 23 May 1962, Page 18

Many Improvements Planned At Casualty Department

One of the busiest places in Christchurch on Saturday afternoons, especially in the football season, is the casualty department of the Christchurch Hospital. Last Saturday, the director of outpatient services to the North Canterbury Hospital Board (Dr. W. I. Paterson) showed a reporter of "The Press” round the department and outlined the board’s plans for much improved facilities there.

The plans for the department include the taking over of the old pharpiacy and the complete redesigning of the total area to provide a new double-berth ambulance bay and an eight-bed resuscitation ward, as well as a modern emergency operating theatre and separate cubicles for patients to sit in during treatment.

The resuscitation ward was needed badly, explained Dr. Paterson, because at present a patient who was so badly injured as to make moving hazardous had to be left in an open bed in the department or, at best, taken the short distance to the theatre recovery ward. A proper ward with the facilities necessary for dealing with such patients was essential. The new ambulance bay, to be let into the department on the opposite side from the existing bay, was another necessity, as under present conditions there were sometimes six ambulances crowded into the small yard by the orderlies’ office awaiting their turn for the bay. The old bay would be removed although, in emergency, patients could still be brought into the department by the ramp beside the orderlies’ room. Cubicles were highly desirable because, although injuries to parts of the body which it would be an embarrassment to treat in public could be attended behind a screen or in one of the smaller rooms, it was not, in general, psychologically good for patients to “sit looking at each other” while they were being treated. Improved equipment in the minor operating theatre in the department was another essential. Dr. Paterson described the existing equipment as “a museum piece.” “In sum, present arrangements leave much room for improvement,” said Dr. Paterson. “I marvel continually at what a good job the staff manage to do under zuch difficult conditions.

“In anticipation of fairly early action on a complete rebuilding of the department, the board has not felt justified for some years now in doing much in the way of improvements on any lesser scale. Action on the rebuilding is awaiting authorisation by the Health Department.” Last Saturday afternoon was not an exceptionally busy one. Even so, 47 patients were treated between 2 p.m. and 7 p.m. On some Saturday afternoons, the number may rise to twice the figure. A constant refrain among the nursing staff in talking to the reporter was. “You should have been here a fortnight ago, when we had patients lying all over the place.” On that day, in spite of several relief nurses being brought in from the wards, all the afternoon staff had worked through until 11 p.m. Although football, especially Rugby, accounts for the largest part of the extra work on Saturday afternoons in the department, there are other contributing factors. Children seem to get into more trouble when they are off school, and there are other sports that provide their quota of casualties, hockey and horse-riding being the most noticeable. Then there is the 6.15 p.m. rush of patients after the hotels close, a rush which is always heavier on Saturdays. These patients have mostly fallen over kerbs or cut themselves on broken bottles. They are put into one of the larger rooms in the department, where, according to one of the nurses, "they sit and com. pare notes and tell each other to sit down and be quiet and not worry the sisters—quite funny if you're in a mood to take it.” Seven of the department's total staff of nine are on duty

on Saturday afternoons. In charge is either the senior sister. Sister F. C. Childs, or her assistant, Sister S. McCaffrey, the other six including at least one of the two staff nurses. The sisters have a comparable status with the sisters in the hospital wards. The staffing of the department is always a worry to the administration because, as Dr. Paterson explained, if the staff are too few they are too often involved in a rush, which is no good for patients or staff, while if there are too many they have little to do most of the time, which makes them bored. The practice of “borrowing” staff, from the wards to meet emergencies was not entirely satisfactory, as it

could upset ward routines. The medical staff consists of a senior casualty officer. Dr. J. R. Inder, assisted by two junior casualty officers who are house surgeons. Dr Paterson takes over when the senior casualty officer is off duty. Although all casualties report originally to the casualty department any patient with an injury which might be a fracture is sent to the orthopaedic department, or where the suspected fracture concerns the ribs, skull, pelvis, or spine, to the main X-ray unit. Both these units are busy with casualties on Saturday afternoons. The orthopaedic department may fix up 20 or more fractures on a busy Saturday.