19th April 2022

You are the consultant in charge of A&E, on a night shift

You are the consultant in charge of A&E, on a night shift. The department is very busy, and there is only one bed left available for an admission to the Acute Medical Unit. This means that patients requiring admission after this bed is filled will instead have to be cared for in the A&E department, until more beds become available.

One of the junior doctors discusses a patient with you – the patient is a 55-year-old man with a background of prostate cancer, with new severe back pain, and leg weakness. The doctor is concerned that the patient has metastatic spinal cord compression – and requires an urgent MRI scan. They are currently in too much pain to mobilise. You agree that an urgent scan is needed, and ask the doctor to arrange an admission.

One of the senior nurses then approaches you – her elderly aunt has been brought in following a fall. They sustained no significant injury, and have been deemed fit for discharge home. However, there is no transport available during the night – and the nurse asks if her relative can be admitted to the hospital to await transport home, rather than wait in the A&E department.

Which of the following is the most appropriate course of action?

Select the SINGLE most appropriate option from the list below. Select ONE option only.