Ergh - what a day...

There is a reason why so many of us who work in emergency healthcare hate Mondays, it's because they are one of the busiest times for us. Us ambulance types are run ragged, the A&E department is packed solid with few people moving up to the wards and I would imagine that GPs get a lot of 'emergency' appointment requests.

The reasons for this are many, and I may miss one as I'm writing this while my brain is still recovering from this particular twelve hour shift.

It's mostly to do with the weekend. Hospitals tend not to discharge many patients on the weekend as a lot of the 'non-essential' roles tend to keep office hours and aren't available during the weekend. Assessments for going home aren't done and there is often only one doctor team on call for for each of the specialities. Therefore one team is unlikely to discharge another team's patient.

So, over the weekend the patient's stack up in the wards and the nurses there are so busy trying to discharge them they are too busy to accept new patients from A&E.

This means A&E trolley waits go up which spills over into us ambulance staff waiting for a trolley to put our patient on, which means that ambulances can do less jobs in a shift.

From our end of things, we have three main types of patients, those who couldn't see a GP over the weekend and are now so ill they have to go to hospital, the patients that are finally seen by the GP who then sends them into hospital and the people who don't want to go to work or school or who didn't want to waste their weekend, but now they are off work, don't mind wasting that time.

So, Mondays are terrible and the sheer number of people going to the hospital tends to leak over into Tuesday.

We did do something unusual yesterday - we went to a little old lady who'd fallen out of bed, as she wasn't seriously hurt and didn't want to go to hospital we put her in her wheelchair and told her to call us if anything changed.

Seven hours later, to the minute we were back at her place because she'd fallen out of her wheelchair. This time she agreed to go to hospital as she'd skinned her arm.

What was quite sweet was that she was worried that we'd moan at her for calling us back. As I tell many of our patients, 'I'd rather be picking you up off the floor of this nice warm, clean and dry house than wrestling with some drunk by the side of the road in the rain".

And I'm serious about that.