Treat inebriated in drunk tank not A&Es, pleads Ulster nurse
Drunk people should be kept out of A&E departments and treated elsewhere, a prominent Northern Ireland nurse has said.
Uwem Otong, from the south-east Northern Ireland branch of the Royal College of Nursing (RCN), was among those who called for such a move at the union's annual national conference.
Treating intoxicated patients in A&E is a "waste of resources", the RCN congress in Liverpool heard from the nurse.
Some at the conference issued a call for an investigation into the best location of care for inebriated patients, such as alcohol recovery centres and so-called drunk tanks and booze buses.
Drunk people can have a "significant" effect on other patients in the emergency room as well as on staff and they can increase waiting times, delegates were told.
But other nurses raised concerns that if drunk people are not treated appropriately, head injuries could easily be dismissed as intoxication which could lead to devastating consequences.
Others said that alcoholism is an illness and should be treated as such.
Uwem Otong said: "I do agree that people who are intoxicated need help. But the truth remains that alcohol intoxication is not an accident.
"A&Es in all countries are under intense pressure. At a time in which the NHS is facing financial burden, it is important that services are channelled properly.
"My own thinking is that somebody takes alcohol knowing exactly what he or she is doing. With that in mind, I would suggest a situation in which people who are intoxicated are moved to a different environment to give room to those who are actually having accidents, or those that require emergency care.
"With other ailments or problems, if a GP is capable of dealing with that problem that issue should not go to A&E. So why should alcohol intoxication be accepted in A&E? I think it is a waste of resources."
Nykoma Hamilton, from the RCN's Fife branch, said: "Sadly this topic is not new. We have seen a growth in the binge-drinking culture across the UK. Surely A&E being full of drunk people will slow down treatment times – there has to be a better solution.
"So what about setting up an area adjacent to, but separate from, A&E at the weekends, when it's the most busy, staffed by nurses – but not the A&E staff, they need to be in A&E.
"A journal article from New Zealand highlighted that at the weekend, alcohol-related patients were the main cause of violence to A&E staff, they increased staff workload, increased waiting times and increased the anxiety among other patients.
"This must have a wearing effect on staff morale – they didn't go to work in A&E just to treat a bunch of drunk people every weekend. It's time to step back and re-think. A&E is not appropriate but neither are wards full of vulnerable, elderly people."
But Mike Smith, who has been an emergency nurse for 23 years, told delegates: "How can we be sure that intoxicated brain injury patients receive the most appropriate care outside of A&E?
"Will other providers be able to detect subtle neurological changes? Will they understand how drugs and comorbidities can affect patients and their safe recovery?"