Accident and Emergency management
You may or may not know, but one of the 'healthcare targets' is that no one is in the A&E system for more than 4 hours. The idea is that once the 4 hours is up, you either get discharged home, or to the wards.

Stay longer that 4 hours, and you've 'breached', and the more breaches a A&E department has, the less money they get. This principle works from a checkout teller point of view, where the aim is to get customers out as quickly as possible --- however, in an A&E, you can't send people home without knowing that they will be safe. Hence why some may stay longer, and breach. Sadly, this fact doesn't show up on targets, and you get a lot of senior management getting very worked up when we don't 'patch them up and shunt them out' --- which might all be well and good if you're a fan of budgets over the welfare of your patients, but that isn't the point of medicine. But I digress.

So --- it's a very busy evening in a central London teaching hospital, and it's packed --- there are no beds to send people to the wards in, and the pharmasist can't quite give out medications quick enough to send lots of people home.

Cue one of the consultant managers rearing her head to one of the mid-grade doctors, who rather busy trying to put stiches in the head on one person, whilst trying not to be shouted at by the rather ridiculous patient in cubicle 7.

Consultant: You know, ok, we've got 3 who are about to breach.
SHO: Yes.
Consultant: [a bit taken aback by this] You do know that?
SHO: Yes.
Consultant: And aren't you going to discharge them?
SHO: We've got no beds to send them to the wards, and they're not being sent home, because they're not well enough, and I'm not comfortable about discharging them. So no.
Consultant: But they're going to breach!
SHO: Yes, you said.
Consultant: [exasperated] And don't you care?
SHO: [thinks about this concept] No.

As the student, I thought it was best that I should leave.
(witty_ditty has made multiple miaows since, Fri 13 May 2005, 13:36, Reply)