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.