Practice-related feedback

Doubt in paediatric team’s abilities prompted us to raise our game

When his trauma team was overlooked in an emergency situation, senior staff nurse Drew McDonald implemented changes to ensure it would never happen again

When his trauma team was overlooked in an emergency situation, senior staff nurse Drew McDonald implemented changes to ensure it would never happen again


Drew McDonald: ‘We have never been overlooked again.’ Picture: Newsline

My most influential piece of practice-related feedback came not from a direct comment, complaint or compliment, but from a decision made but never verbalised regarding the resuscitation of a teenage boy many years ago.

We were notified of a child coming to our paediatric emergency department (ED) who had been knocked off his bike and was deeply unconscious, so we prepared our resuscitation area. We were then alerted that colleagues in the adult ED were also setting up for the same child.

Slight distrust

I was confused so asked why and was told that the doctor attending to the child at the scene and the ED consultant wanted to use the adult space as it was larger. It was only slightly larger and I found this strange at the time, but worked alongside the adult team to resuscitate the patient.

After the incident was over I was curious to find out why this decision had been made. When I asked it was brushed aside as a space issue, but it was clear that there was a slight distrust in our department and its ability to handle such a major resuscitation.

Never again

We are a small paediatric ED and have few major trauma patients. I believe a perceived lack of experience in this area led the doctors to determine that the adult department had the equipment and skills necessary to help this child.

Concerned that our department was felt to be inadequate, I started to help my team make changes to ensure that we would never be in this situation again. We have a responsibility to the public to be able to deal with any paediatric emergency situation that arises.

I’m pleased to say that we now have a fully equipped resuscitation room, fully trained staff and our consultant’s trust. We have never, regardless of the severity of our patients’ needs, been overlooked again and we provide a safe environment for all of our patients.


Drew McDonald, a senior staff nurse in emergency care at the Royal Aberdeen Children’s Hospital. He won the Child Health category of the RCNi Nurse Awards 2017 for his development of a tool to identify sepsis in children. Read about it here

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