Reflections on ‘firefighting’

A thought came to me while watching the trailer for Deepwater Horizon at our local cinema recently. We use the term “firefighting” in the Emergency Department almost daily – as a way of explaining our focus on immediate shop floor crises, often at the cost of proper planning for the future. But what exactly does “fire fighting” involve ?

Certainly a team of people – we generally don’t expect a single fireman to deal with a burning house on his/her own.

It needs specialist training, and constant updates in best practice.

Finally, firefighters are inherently heroic, aware they may be called upon to sacrifice their lives every time they get called out.

Looking at EDs across the UK, and at our own, how often do we send a multidisciplinary  team of both emergency and in-hospital specialists (doctors and nurses) to deal with episodes of shop floor overcrowding and severe clinical risk  ? How often are those of us leading the response really trained in managing critical imbalances between emergency demand and available resources ? (good article by Damian Roland on unconscious incompetence at scale). How far are we ready to go in sacrificing career progression, even job security by speaking out when the situation calls ?

There are reasons why even with our best intentions, the fire in UK Emergency Departments continues to burn …



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