The Emergency Department

Harrogate District Hospital Emergency Department had 45,000 patients through its doors in 2010. The resident population of the district is 180,000, covering 515 square miles. The department is staffed by four consultants: Dr Bill Hulse, Dr Helen Law, Mr Michael Smith and Dr Debbie Godden; three specialist registrars, six specialty doctors and ten junior grade doctors (two F1, two F2, four GPStr and one CT1 / one CT3 emergency medicine. Emergency Nurse Practitioners work alongside the medical staff to assess and treat a proportion of the patients.  A number of nursing staff have additional skills such as cannulation, iv drug administration and prescribing in accordance with Patient Group Directives.

Aims
The aim of the department is to provide for the diagnosis and initial management of acute and urgent aspects of illness and injury affecting patients of all age groups, with a full spectrum of episodes of undifferentiated physical and behavioural disorders.  There is an overlap in this spectrum with the patients and conditions seen in primary care.

What can the GPSTR expect?
As a junior doctor in the department you will become involved in the initial assessment, management and referral of patients with a wide range of conditions.  You will be assisted and supported by the middle grade and consultant staff as well as the experienced nursing staff and Nurse Practitioners.  You will develop skills in the rapid assessment and resuscitation of unwell adults and children, trauma management, practical skills such as fracture manipulation and wound care and an understanding of the function of and workings of the ‘front door’ of the hospital in relation to both primary care and other specialties within secondary care.  You will develop your referral skills, develop an appreciation of the interface and overlap with Primary and Urgent Care. You will work with allied health professionals such as paramedics, physios and radiographers.

Teaching and support in the department is the key to the delivery of quality care to patients. You will have shop floor supervision and teaching as well as a programme of teaching sessions on a weekly basis that will cover many aspects of Emergency Medicine work.  Many of these topics are relevant to the GP specialty curriculum. The training sessions are delivered by members of the department and specialists from other areas of the hospital.

Most of our junior doctors have an opportunity to undergo teaching on an Advanced Life Support course such as ALS, ATLS or APLS.

There are lots of resources available for accessing both local and national guidelines but if you want to buy your own quick reference text we would we recommend the Oxford handbook of Accident and Emergency medicine. You will be encouraged to complete an audit or small project during your time in the department and will have an opportunity to teach your colleagues in a formal teaching session and receive feedback on your own teaching skills.  Through the Clinical supervisor system you will have formal appraisal sessions to evaluate your progress and determine your training needs; you will also be allocated a middle grade mentor to provide additional support and advise.

And finally………
We hope you enjoy your time as part of the Emergency Medicine.  We ask for feedback from our staff and look forward to receiving yours! If you have any questions about the post, please contact Dr Helen Law, Dr Bill Hulse, Mr Michael Smith or Dr Debbie Godden on 01423 553295 / 553302.