NationStates Jolt Archive

This is more for the UK than other countries as I dunno exactly how other systems work. But as you may know, in the UK, there is a network of hospitals which provide free healthcare on the National Health Service for all who are eligible (which is pretty much every UK Citizen and some European Citizens).

As the main (or possibly only) revenue is from the Government, the NHS can't employ extra doctors without extra funding, as they won't be able to0 regain it by charging patients.

At the moment, there are long waiting times (the actualy statistics are innacurate and can make waiting times look shorter - by having a person see a nurse for an initial assessment for example, but without any actual treatment being administered, thus being able to claim that the person has been "seen" withing a short period of time) and a shortage of beds.

A lot of the time, people go to hospital for minor injuries that they are actually supposed to see their GP (General Practictioner - a local doctor) about (GPs can be contacted for urgent cases that are not so urgent as to require immediate hospital treatment - though most people seem to just head straight to the Accident and Emergency Ward). This of course uses up valuable doctor's time that could be better used elsewhere (in more serious cases for example).

So how about introducing First Aiders into hospitals? They could deal with less serious injuries (minor burns, certain types of bleeding, etc.) that they have been trained to deal with as part of their First Aid training, without requiring any extra training. This would free up time for doctors. In addition, as there was a very successful campaign to get people to VOLUNTEER as Constables for the Police Forces across the U.K. (these people are known as Special Constables and have extremely similar uniforms and virtually the same powers as ordinary Police Constables), and as people seem to usually learn First Aid because they want to help people, rather than for any money they may receive from helping people, it is probably very likely that they could be encouraged to volunteer for free. They could maybe call them "Special Nurses" or something like that, and for people who want to join the scheme but are not trained in First Aid, they could be pointed to places taht offer First Aid training (most people who are unemployed may be able to get First Aid training for free - unfortunately though, the "Jobshop" (part of JobCentre Plus I think) for some strange reason considers unemployed students to be "employed", despite the fact that the money they get from a Student Loan works out at less than £40 a week after rent, and despite the fact that it's a LOAN, and despite the fact that not every student takes it out.

Can anyone see any downsides to this?

P.S. and yes, I know I'm not part of the government so couldn't implement it, but maybe it could be suggested to the government.

In the US, we have First Responders (pretty much what your suggesting). Only thing is, they are not in a hospital, they live among us, and come to the rescue when duty calls, much like Superman. Firemen and policemen also do it, and I would think that ambulance crews already do it as well, but since I think you're talking about people that go to ER by themselves to get something looked at, First Responders would not really be able to cover everything (in my opinion) as its merely their job to respond first (id est: First Aid) and stabilize the situation to allow time for professionals to get there and professionals to make the calls (as they may require X-rays, pain killers, et cetera).

America seriously needs this too. It seems anyone with minor problems head straight for the Emergency Room. Here anyway.

In the US, we have First Responders (pretty much what your suggesting). Only thing is, they are not in a hospital, they live among us, and come to the rescue when duty calls, much like Superman. Firemen and policemen also do it, and I would think that ambulance crews already do it as well, but since I think you're talking about people that go to ER by themselves to get something looked at, First Responders would not really be able to cover everything (in my opinion) as its merely their job to respond first (id est: First Aid) and stabilize the situation to allow time for professionals to get there and professionals to make the calls (as they may require X-rays, pain killers, et cetera).

That does seem similar to what 'm suggesting, except even if those people existed in the UK, people would still head to Accident and Emergency, or A&E (pretty much the equivlant of the Emergency Room (ER) in America - after all, they could call out a doctor as things stand now, but most don't seem to bother). so that's why I'm suggesting putting them in hospitals.

The First Aiders I'm suggesting wouldn't deal with anything above their level of training - they would pass the person straight onto the appropriate person (doctor for example), OR, instead of that, there would still be a nurse who does an initial assessment, and he/she would decide whether the person just needed a First Aider or a doctor. If the person was wrongly passed onto a First Aider, the First Aider would simply tell the initial assessment nurse, who would stick them on the waiting list for the appropriate person (eg. a doctor).

Whilst it wouldn't be likely to stop people going to A&E, it would at least get them dealt with and "out of the way" quickly, freeing up more time for doctors to deal with more serious problems. Now what to do about that bed shortage....?

And does anyone see any problems with my First Aiders suggestion?

I very surprised that the UK doesn't have system like this already, or are you unaware of it? Anyhow, I'm too lazy to check, and will continue.
The First Aiders I'm suggesting wouldn't deal with anything above their level of training - they would pass the person straight onto the appropriate person (doctor for example)...
Which is exactly what they should do. Nurse thing is sort of a bad idea unless they are trained as a paramedic (I don't know if they are), in my opinion, as an EMT (Emergency Medical Technitians) comes in as firemen, medical and ambulance staff, and as well as in police units (sometimes). This is when I correct myself, as First Responders are civilian (in the sense they do not work as firemen, policemen, or in medical fields (in gerneral)). EMT are the professionals, which then turn over patients to doctors if neccessary.
Whilst it wouldn't be likely to stop people going to A&E, it would at least get them dealt with and "out of the way" quickly, freeing up more time for doctors to deal with more serious problems.
Depends really on what the case is, in general, a person should go to a hospital should something requiring an EMT occur.
And does anyone see any problems with my First Aiders suggestion?
No, I personally think that everyone sould be certified First Responders, but that'll never happen. As far as what you're suggesting in the UK, I really don't know.

I very surprised that the UK doesn't have system like this already, or are you unaware of it? Anyhow, I'm too lazy to check, and will continue.

As far as I'm aware, the UK doesn't have such a system. Apart from the fact that people who can't afford healthcare are not left without any (due to the National Health Service I mentioned), hospitals in America seem to be much better quality. But then, they are usually getting paid by the patients.



Which is exactly what they should do. Nurse thing is sort of a bad idea unless they are trained as a paramedic (I don't know if they are), in my opinion, as an EMT (Emergency Medical Technitians) comes in as firemen, medical and ambulance staff, and as well as in police units (sometimes). This is when I correct myself, as First Responders are civilian (in the sense they do not work as firemen, policemen, or in medical fields (in gerneral)). EMT are the professionals, which then turn over patients to doctors if neccessary.

First Aiders in the UK are NOT usually trained as paramedics. They are trained in CPR, and usually also in dealing with certain types of bleeding and burns. Obviously where CPR or other really serious things happen, they are supposed to get an ambulance regardless of whether they administer any First Aid.



Depends really on what the case is, in general, a person should go to a hospital should something requiring an EMT occur.


The people would already be in hospital though - as I said, most people head straight to the hospital even for injuries taht could be dealth with by their local doctor (their GP). Therefore, if the case is serious and requires whatever the UK equivlant of an EMT is, they would already be in the right place to get the help they need (unless of course they need to be referred to a specialist hospital for whatever reason - eg. a poison control centre or specialist burns unit).

...I personally think that everyone sould be certified First Responders, but that'll never happen. As far as what you're suggesting in the UK, I really don't know.
The scheme I'm suggesting would go hand-in-hand with more awareness of free First Aid schemes available, hopefully encouraging a lot more people to learn at least Basic First Aid.

So does anyone see any potential problems with the suggested scheme (having First Aiders in hospitals to deal with minor problems)?

P.S. What do you reckon to this potential advert? http://www.geocities.com/pjcroad/SAN

First Aiders in the UK are NOT usually trained as paramedics.
Just for clarification, they are not in the USA either.
Nothing else to add.

That does seem similar to what 'm suggesting, except even if those people existed in the UK, people would still head to Accident and Emergency, or A&E (pretty much the equivlant of the Emergency Room (ER) in America - after all, they could call out a doctor as things stand now, but most don't seem to bother). so that's why I'm suggesting putting them in hospitals.

The First Aiders I'm suggesting wouldn't deal with anything above their level of training - they would pass the person straight onto the appropriate person (doctor for example), OR, instead of that, there would still be a nurse who does an initial assessment, and he/she would decide whether the person just needed a First Aider or a doctor. If the person was wrongly passed onto a First Aider, the First Aider would simply tell the initial assessment nurse, who would stick them on the waiting list for the appropriate person (eg. a doctor).

Whilst it wouldn't be likely to stop people going to A&E, it would at least get them dealt with and "out of the way" quickly, freeing up more time for doctors to deal with more serious problems. Now what to do about that bed shortage....?

And does anyone see any problems with my First Aiders suggestion?


okay, I see what you are saying, in my area, we have Urgent care centers, which are opened after hours and have a few doctors and a lot of nurses so that if you need a doctor say at 3 am but it's not an emergency (if you broke your finger as opposed to cut it off) then you go there, so that you don't tie up the trauma center (also it's a lot cheaper, but you guys don't pay out of pocket so I guess that's not a driving factor)

also in the ER's they have what they call "fast track" for minor injuries and illness that can be treated quickly (like food poisoning, children with fevers, scorpion stings, ect.) that are mainly run by RN's and if they get in over their head they can consult with the ER doc. down the hall.



I didn't read the whole thred so if I repeated something forgive me.

okay, I see what you are saying, in my area, we have Urgent care centers, which are opened after hours and have a few doctors and a lot of nurses so that if you need a doctor say at 3 am but it's not an emergency (if you broke your finger as opposed to cut it off) then you go there, so that you don't tie up the trauma center (also it's a lot cheaper, but you guys don't pay out of pocket so I guess that's not a driving factor)

Yeh, we have something similar - NHS Walk-in Centres, and you can call NHS Direct to get the most appropriate advice about your injury. Unfortunately though, a lot of people still turn up at hospital when they don't need to. Plus NHS Direct asks very personal details, which can be off-putting, especially as it's over the telephone.

also in the ER's they have what they call "fast track" for minor injuries and illness that can be treated quickly (like food poisoning, children with fevers, scorpion stings, ect.) that are mainly run by RN's and if they get in over their head they can consult with the ER doc. down the hall.

That's similar to what I'm suggesting. As far as I'm aware, they don't have that here. P.S. What's an RN? (Not everyone's American you know, ignorant people. ;) )

That's similar to what I'm suggesting. As far as I'm aware, they don't have that here. P.S. What's an RN? (Not everyone's American you know, ignorant people. ;) )
I'm pretty sure RN is Respiritory Nurse.
This does seem like a good idea though. Having some volunteers around to get people with minor injuries dealt with quickly would be helpful. They might want a little more training than a First Aider though. Maybe just basic diagnostic training, so that even if the injury is beyond the First Aiders training they'll have a general idea of where to send the person, and if they need immediate attention or not.

I'm pretty sure RN is Respiritory Nurse.
This does seem like a good idea though. Having some volunteers around to get people with minor injuries dealt with quickly would be helpful. They might want a little more training than a First Aider though. Maybe just basic diagnostic training, so that even if the injury is beyond the First Aiders training they'll have a general idea of where to send the person, and if they need immediate attention or not.

I think the extra training could complicate matters - plus cost more money. If something is beyond the First Aider's training, they could just refer the person back to the Nurse who had done the initial assessment. But in most cases, there would probably be no need, because as long as the nurse knows what knowledge the First Aiders have, he/she would most likely refer the patient to the right person in the first place. And doesn't an RN, if they are what you say, just deal with respiratory problems?

An RN is a Registered Nurse. I really don't remember the difference between an RN and an LPN (Licensed Practicing Nurse or something to that effect)

An RN is a Registered Nurse. I really don't remember the difference between an RN and an LPN (Licensed Practicing Nurse or something to that effect)
you are right. I was talking about registered nurses.

LPN's don't go to school as long as RN's do, here (not sure about other states) LPN's go to about 12 to 18 months of school, where RN's have bachelors degrees in nursing and sometimes they have a masters, they are very well trained and can take care of just about anything non-surgical, they aren't able to write prescriptions though, which is why they would need a doctor to sign off and write scripts.

It does seem weird, but in British Columbia (Canada) we have first aiders in Hospitals to treat minor injuries suffered by staff. I knew someone who was employed in this job and he would even treat doctors! It’s like having someone hand out blankets in hell, but I suppose there’s a logic there somewhere.

One of the things I really liked that was implemented in Ontario (Canada) was a new class of Nurse who could attend all but the most serious injuries. Let’s face it a Nurse with 10 years and some additional training is probably going to be more competent anyways than the junior doctor on duty; and it frees expensive doctors up to deal with more serious cases. I really wish that they’d implement this across Canada, but there are always going to be Doctors lobbying strongly against anything that interferes with their green fees or moorage for their yachts.

My question is why position them at the hospital? Have your first responders out in the community, and have the local people know where they can be found.

I work with several emergency crews. I lead rope rescue and confined space rescue crews in my community and surrounding counties. Where I live, the closest hospital is 30 miles away. For a non emergency, or for something that may or many not be able to wait, I know who I can call for an opinion, or for help while an ambulance is on the way.

A much better option would be to give out trained first responders aid bags that can be restocked at any hospital and let people know that they are there to help.

My question is why position them at the hospital? Have your first responders out in the community, and have the local people know where they can be found.

I work with several emergency crews. I lead rope rescue and confined space rescue crews in my community and surrounding counties. Where I live, the closest hospital is 30 miles away. For a non emergency, or for something that may or many not be able to wait, I know who I can call for an opinion, or for help while an ambulance is on the way.

A much better option would be to give out trained first responders aid bags that can be restocked at any hospital and let people know that they are there to help.

The reason for having them at hospitals is because, despite being able to call their GP, and despite having acces to NHS walk-in centres, people still turn up at the A&E when they don't really need to. So even if First Aiders of the type I've suggested were positioned in communities, people would almost certainly still turn up at the hospital when they could have been treated by a First Aider. Especially if their house is a mess.

So far, whilst people have suggested alternatives (and I thank all the people who responded for their opinions), nobody seems to have suggested it's a bad idea. So when I become Prime Minister, I'll implement it.