Stay black!

Posted on September 3, 2008. Filed under: Apply topically, Journal from behind the desk... |

Following on from my rather random post about traffic signs last week, this week I’m going to be ranting about traffic lights, this is slightly more related to my work than last week – I promise!

I feel a little bit rotten picking on this subject having been on both sides of it now, but it just winds me up and thus I shall get it off my chesticles.

On fairly regular occasions the (not so) local hospital has what we used to call a “Bed crisis!”  This is not as the name suggests a bed having a nervous breakdown… but in fact a hospital admissions crisis.  In the most biblical sense there is “no room at the in- patients”.

From my Accident and Emergency (A&E) days this meant we would have a patient in the department for 48 hrs +, as there was no-where else for them to go.  The whole reason I worked in A&E was so that I wouldn’t have to do “drug rounds”, and yet bed crisis meant I had to, as well as cope with all the usual A&E goings on. 

There were days when we had the “Plaster room” and corridors full of patients and yet still more patients arriving. This was a time before “Admissions Units”, so every emergency patient admitted whether from a GP surgery or self referred came via A&E.  Very occasionally we’d shut the hospital to new admissions, meaning that patients had to go to the neighbouring hospitals, which were themselves bordering on having a crisis.

But now I am out of all that, and the hospital (not the same one I used to haunt) has a traffic light system which reflects it bed status.  This is what gets on my dematones!

It used to be that:

Green” meant “Find a bed you like, it’s your’s! Would you like a nurse to help you with the crossword sir!”

Amber” meant “it’s a little cosy, the staff will do there best to attend to you”,

Red” meant “you get a nice view of the car park from the corridor and once a day the cleaner will say “hello””. 

But this wasn’t good enough, so they introduced “BLACK“.  So red is inflammed and infected and Black is necrotic – the walls have gone to slough and the hospital is falling down around our ears!!!

So that kind of makes sense.  It does beg the question of “Why bother?”

What effect does this colour coding have on the hospital??

Is it so the hospital staff can come for a day at work, check the bed status, identify that it is red or black, and then go into the drug cupboard and medicate themselves to the appropriate level?  Hmmmm, I doubt it helps staff morale.

Is it so that the bods sitting in a board meeting have something to  demonstrate the extent of trouble the hospital is in, using simple colours that dumb ass chief executives will understand?  Well maybe.

Is it so the hospital can send messages to the primary care clinicians saying “we are on black alert…don’t admit anyone, and if you do it’s all your fault… we warned you!!!” Hmmm, yep I think so, and this is what gets on my nougats.

Do the hospital managers sit in their nice excutive offices on the umpteenth floor and look out across the county, thinking that the clinician in the various surgeries scattered all around the local countryside sit their telling their patients…..

“Hmmm, the hospitals Green today, well Ms Jones you’ve had that ingrown toe nail for a full 24hours, lets call an ambulance and get the surgeons to see you urgently”


“Well Mr Smith, it sounds like your Aorta is leaking into your abdomen, unfortunately the hospital is on black alert, so pop down to the staff room, I’ll get the cutlery out the drawer, cut you open and see if we can’t put a nice plaster on it for you”.   

Well…do they????

Quite frankly I, as with everyone else in the surgery, don’t want to admit patients, and we will do everything we can to keep them out of hospital. But whether the hospital is on indigo alert and ultra violet, if patients need admitting – they are going in…  I am not being accountable for my patients demise because the beds are full, and I’m not neglecting my patients needs, and no sweety, you can’t come home with me so I can monitor you…. (and no, I didn’t shut the community hospitals to fund a super-dooper centralised hospital with less beds).

Deep breathes dude….deep breathes!

And there endth my 80th post!!


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5 Responses to “Stay black!”

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Oh boy….can I relate! We have a system called “ED Overcrowding.” It gets overhead paged at least once every 8 hours in an attempt to let the primary care doctors know that we don’t have any beds and the ED is overflowing. The problem? Well…the primary doctors aren’t there 24/7 to hear our pages, the floors want to keep all their patients so they don’t have to do new admissions and I can’t tell the ambulances to keep circling the block until we get a bed. So…the announcement just serves to let the ED staff know that we are too busy…as if we didn’t know that already.

[…] from It Shouldn’t Happen in Health Care believes that being a good nurse has nothing to do with traffic lights. Read his post and find out why he’s not a big fan of colored lights. By the way, Max, […]

Dear Maxie Nurse,

Isn’t a black traffic light an indication that the system has failed? That somewhere in the local machinery or the regional electrical grid something is just fundamentally wrong?

And, if I may ask, are you all (you over there across the pond, which I think is where you are, correct, Maxie?) suffering another bout of the Black Plague? Or is it really that healthcare resources are so sparse that multiple hospitals in a region get into “black light” crises at the same time? It sounds horrific!

Jeffrey B

Thanks Jeffrey.
Black traffic light generally suggests the bulb has blown…Good thought – like it.

No plagues that I’m aware of, just another fun packed example of what happens when “they” decide to close down lots of local hospitals to open one big “super” hospital (with “super” bugs and all!)

A few years ago, it was decided that the district hospital needed updating, so they build this new super hospital. With less bed spaces…corridors too narrow to get two beds down at once and copious other problems.

I’m not sure, but I think these “they”‘s are related to the “they’s” who knocked down the local school to build a housing estate, which brought families to the area and then “they” suddenly realised there were not enough school places! NUMPTIES!!!

Hi Max..interesting read.

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