Christmas in A&E is a time like any other. Just take off the deely-boppers when giving bad news

If you’re the kind of person who thinks, “It’s Christmas – A&E will be empty,” and comes in to have their verruca treated, you are wrong.

Merry Christmas. It’s that special time of year. For 18 years I’ve worked in A&E, on the ambulances and at an urgent care centre, and been at work plenty of Christmases. It’s a busy time, with the normal injuries and illnesses joined by “seasonal” problems such as drunken behaviour and more wounds caused by partying.

Most of the NHS works over Christmas and this year we’d like a nice, quiet one. So, in an effort to reduce the strain on the service, let me give you a few tips, based on my experience, for avoiding heartache, injury and ill-health over the holiday.

1) If you have children and have bought them toys, I would recommend that you forgo bare feet and wear some sort of boot with thick soles instead. Small toys are not always the best thing to step on in bare feet. I don’t mind pulling a bit of shattered plastic from your foot, but it might be a bit painful for you.

2) If you are 19 and have wolfed down a huge dinner, topped it up with booze and then jumped around on your brand new pogo stick . . . it’s probably indigestion and not a heart attack. If Dad does the same and feels “funny”, it might be.

3) Alcohol: I know people like a drink, but if Uncle John turns into a bit of a daredevil when he’s tipsy, it might be best to keep him away from the strong lager. And the sledge. If Gran gets a bit punchy on the sherry, best keep it out of her reach.

4) When the usual family arguments start just walk away. It will stop you punching a wall in anger or frustration and fracturing your hand. It’s no secret that A&E staff can easily spot when someone has punched a wall. We know you haven’t “fallen”.

5) If you’re the kind of person who thinks, “It’s Christmas – A&E will be empty,” and comes in to have their verruca treated, you are wrong. Here’s a hint: many of the alternatives to A&E are closed at Christmas, so if you find it hard getting a GP appointment normally it’s not going to be any easier over the holiday period.

If you follow these simple rules you should have a nice Christmas. Except, of course, that there’s no escaping bad luck. Maybe the dog trips you up as it chases a wayward Brussels sprout, maybe you come out in a huge rash from an unexpected allergy to tinsel.

What should you expect when you end up in hospital?

First, hope that you haven’t actually developed an allergy to tinsel, because you’ll meet a lot of people wearing uniforms that have been modified with the stuff (please don’t tell the infection control team). Sometimes it’s subtle – a little piece wrapped around the end of a pen – but there are those who go to seasonal extremes and turn out in a necklace of tinsel, tinsel round the glasses, bauble earrings and reindeer antlers on their head.

Christmas bauble deely-boppers should be outlawed, I’m afraid. It’s very distracting to see a nurse giving chest compressions with a pair bouncing around on her head. We should always, always, take them off when breaking bad news to relatives.

For the staff, things are often a little bit more relaxed, mainly because most of the managers and other folk with clipboards just happen to have Christmas off. But beware the manager who comes in for a stealthy unsocial-hours bonus payment. The only time I ever saw the upper management of my old hospital was when they “worked” the millennium and all vanished ten minutes after midnight.

There are a lot of staff who have a love of Christmas (the ones wearing tinsel) and they’ll bring in food and sweets and fizzy drinks and turn the staffroom into a little party zone. It’s a weird party, though, as people rotate in and out in order to keep up staffing levels, and the food lasts for at least two weeks because most of the staff are too busy to do anything but run in and pop a solitary fig roll in their mouth before dashing off again.

Once upon a time, a national supermarket chain would give the local ambulance station a little hamper. This is a tradition that I’d like to see continued.

One of the more surprising reasons for pressures on A&E departments is that of street sleepers. Over the Christmas period, homeless organisations like to gather them all in one place to keep them warm and fed. Although they often provide health services at their shelters, it still increases the burden of work on local hospitals and the ambulance service, which has to transport them between shelter and hospital. On the positive side, it does give the hospitals a chance to catch some rather nasty stuff early on.

In the run-up to Christmas, about three months in advance, staffing rotas will be inspected to find out who gets to see their family and who gets to work (the staffing is the same as at any other time of year). You’ll find previously warm-hearted nurses capable of the most Machiavellian manoeuvring in an effort to get the “big day” off and spend some time with their family.

For those who work, it will be a day much like any other. Doctors will doctor, nurses will nurse and radiographers will take pictures of bones. Ambulance crews will pick up patients while cleaners sweep the floor and HCAs do the mucky work. The NHS is staffed by people who are willing to work on Christmas Day – for them it’s just another day of the year. But even for those working, there will be one consolation: at least we aren’t a patient.

Photo: Getty

This article first appeared in the 19 December 2013 issue of the New Statesman, Christmas Triple Issue

Photo: Getty Images/Richard Stonehouse
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Here's how Jeremy Corbyn can win back the Midlands

The Midlands is where elections are decided - and where Jeremy Corbyn can win. 

The Midlands: this “formless” place is where much of Labour’s fate lies. The party witnessed some of its most disappointing 2015 results here. In those early, depressing hours of 8 May, Nuneaton was the result that rang the death knell of Labour’s election chances. Burton, Cannock Chase, Halesowen & Rowley Regis, Redditch and Telford weren’t far behind. To win here Labour need to build a grassroots movement that engages swing voters.

Luckily, this is also a place with which Labour’s new leader has a natural affinity. The bellwether seat of Nuneaton is where Jeremy Corbyn chose to hold his last regional rally of the leadership contest; just a couple of counties over you’ll find the home Corbyn moved to in Shropshire when he was seven. He cut his political teeth round the corner in marginal constituency The Wrekin; it was in this key seat he did his first stint of campaigning. Flanked by a deputy leader, Tom Watson, who represents Labour stronghold West Bromwich East, Corbyn has his eye on the Midlands.

As MP for Islington North since 1983, Labour’s leader has earned London-centric credentials that have long since overshadowed his upbringing. But Corbynism isn’t a phenomenon confined to the capital. The enthusiasm that spilled out of Corbyn’s summer leadership rallies across the country has continued into the autumn months; Labour’s membership is now over 370,000. It’s fast catching up with 1997 figures, which are the highest in the party’s recent history.

London is the biggest beneficiary of this new movement - with 20 per cent of Labour’s members and 19 per cent of new members who signed up the week before conference coming from the capital. But Corbynism is flourishing elsewhere. 11 per cent of all Labour party members now reside in the southeast. In that same pre-conference week 14 per cent of new members came from this mostly Tory blue area of the country. And since last year, membership in the southwest increased by 124 per cent. Not all, but a good deal of this, is down to Corbyn’s brand of anti-austerity politics.

A dramatic rise in membership, with a decent regional spread, is nothing to be sneered at; people are what you need to create an election-winning grassroots movement. But, as May proved, having more members than your opposition doesn’t guarantee victory. Corbyn has spoken to many who’d lost faith in the political system but more people need to be won over to his cause.  

This is clear in the Midlands, where the party’s challenges are big. Labour’s membership is swelling here too, but to a lesser degree than elsewhere. 32 per cent of party members now and 13 per cent of those who joined up in seven days preceding conference hail from this part of the country.

But not all potential Labour voters will become card-carrying members. Corbyn needs to speak to swing voters. These people have no party colours and over the summer they had mixed views on Corbynism. In Nuneaton, Newsnight found a former Labour turned Ukip voter who thought Corbyn would take Labour “backwards” and put the economy at risk. But a fellow Ukip voter said he saw Corbyn as “fresh blood”.

These are enduring splits countrywide. Voters in key London marginal Croydon Central gave a mixed verdict on Corbyn’s conference speech. They thought he was genuine but were worried about his economic credibility. While they have significant doubts, swing voters are still figuring out who Labour’s new leader is.

This is where the grassroots movement comes into play. Part of the challenge is to get out there and explain to these people exactly who the party is, what it’s going to offer them and how it’s going to empower them to make change. 

Labour have nascent plans to make this reality in the Midlands. Tom Watson advocated bringing back to life this former industrial heartland by making it a base for manufacturing once again – hopefully based on modern skills and technologies.  He’s also said the leadership team will make regular regional visits to key seats. Watson’s words chime with plans floated by shadow minister Jon Trickett: to engage people with citizens’ assemblies where they have a say over Labour politics.

But meetings alone don’t make grassroots movements. Alongside the economy, regional identity is a decisive issue in this – and other – area(s) of the country. With the influx in money brought in by new members, Labour should harness peoples’ desire for belonging, get into communities and fill the gaps the Government are leaving empty. While they’re doing this, they could spread the word of a proper plan for devolution, harking back to the days of municipal socialism, so people know they’ll have power over their own communities under Labour.

This has to start now, and there’s no reason why the Midlands can’t act as a model. Labour can engage with swing voters by getting down to a community level and start showing – and not just saying –  how the party can make a difference. 

Maya Goodfellow is a freelance journalist.