Nurse??!!

Ever since the Black Saturday fires some years back, 774ABC radio is the designated emergency ratio station for Melbourne.  As a result, if there’s fire, flood, funny smells- then 774ABC goes onto ’emergency’ footing with frequent warnings and advice interspersed with its normal programs (unless of course it’s a REAL emergency, at which time usual programming is suspended).

There was a fire at a recycling centre in suburban Melbourne this morning, and this triggered  774ABC emergency warnings right in the midst of “Making Christmas Gifts with Craft”- quite a surreal juxtaposition!  I was interested that at the end of the warning about toxic smoke, keeping your windows shut, turning off the airconditioner and staying inside etc, there was advice to call Nurse- On-Call if you had any concerns.

Nurse-on-Call is a telephone service that provides 24 hour a day advice from a registered nurse. I’ve never used it.  From what I have heard from people who have used it, they’re normally told to go to hospital.  This may reflect the demographic of my sample- i.e. old codgers primed for heart attacks, and perhaps it’s different when people ring with a baby or young child.  But I can’t help thinking that in these litigious times, it would be unwise to advise to “just wait and see”.

Perhaps in a situation like this though, when people are wanting reassurance as much as anything else, there might be a role for nurse-on-call as a way of deflecting unnecessary panic.  But it did make me wonder about the statistics on Nurse-on-Call: is my perception that they always advise ‘go to hospital’ valid? Has it saved hospital visits or increased them?  I did actually go to the Dept. of Health webpage where they had their annual report, but it would have taken 8 minutes to download and I thought…..nah.

On to The Conversation website and blow me down….there’s a report on telephone medical advice lines. In a Medical Journal of Australia article, researchers looked at the difference in  ‘appropriate referrals’ from GPs, a telephone medical advice line, and self-referral.  I’m a bit disconcerted by their definition of ‘appropriate referral’ which ranged from  admission to hospital, referral in an inpatient or outpatient clinic, transfer to another hospital, performance of radiological or laboratory investigations- or death in the Emergency Department. (I’m hearing echoes of Monty Python’s ‘I told you I was sick!”)  As might be expected, GPs scored the highest in ‘appropriate referrals’ but interestingly telephone-line and self-referrals were ranked much the same- in fact, the self-referrals scored slightly higher.

Moreover, the study found that people when do receive advice to seek medical advice in a non-Emergency Department (so there goes my theory),  50% of people ignored the advice and turned up anyway. The conclusion of the study? The MJA editorialized:

It is not clear that, if offered an informed choice, the community would choose to pay for telephone advice that makes little difference to their behaviour over other health service priorities. In relation to whether an ED visit is required, it appears that a phone call will not answer the question.

Advertisements

4 responses to “Nurse??!!

  1. While I heard the nurse on call remark, I missed what it was about. Low clouds prevented us from seeing the smoke early, but by 10am, we could see the rising smoke. I don’t have an opinion on Nurse on Call, but I read this yesterday.
    http://www.woogsworld.com/2012/11/the-human-atm.html

  2. I used Nurse-on-call during a bad episode with our teenaged son. He had already been hospitalised with debilitating headaches after a GP saw him and diagnosed possible meningitis after observing spots on his chest. I had a good look at those spots, and I thought they were acne, and so did the ambulance staff who attended. But he needed to be hospitalised with the headaches. A day or two after my son was sent home from hospital a very strange rash appeared low on his back – at night of course – so I rang Nurse on Call who could not be sure what the rash was without seeing it, but referred me back to the GP the next day. The GP then diagnosed shingles and was very grumpy with me bringing the patient back because he had “already seen the rash”. (Oh no he hadn’t, he only saw the acne on the chest the first time, and hadn’t diagnosed shingles that time.) He then rang Canberra for permission to prescribe an expensive antibiotic or whatever it was for the shingles. I thought the Nurse on Call was helpful in the process. The hospital hadn’t worked out what the problem was, and the GP didn’t in the first instance. The Nurse didn’t advise me to ignore it, or go to a hospital again, but to return to the GP the next day. I was grateful for the advice that she gave because it did allow us to resolve the problem. Her advice was appropriate. It enabled us to get a reasonable night’s sleep after a few days of anxiety. I’m good with Nurse on Call.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s