Life's traumas

Dr Sue Robinson: Emergency medicine needs to be taken more seriously

The accident and emergency (A&E) department is a life or death arena.

Its work has become glamorised by hit TV shows such as ER and Casualty. And yet, this is a field that has become marginalised by the medical profession.

Experience counts in A&E

Go into any A&E unit at night and it will be staffed by some of the most inexperienced doctors in the hospital.

It is a worrying state of affairs for Dr Sue Robinson, an A&E consultant at Addenbrookes Hospital in Cambridge.

"We don't have enough senior people to provide 24-hour care," she says.

"They can come in acutely sick or they can come in with symptoms that a more experienced doctor would pick up as being suggestive of a very serious illness or disease.

"And if you are inexperienced you can miss those and some patients may be inappropriately treated or inappropriately discharged."

Central role

Sue Robinson's working day has been recorded for the BBC TV series Medicine Women.

The hospital sees 55,000 emergenices a year

Trained in advance trauma techniques, she is a passionate exponent of the need for emergency medicine to be taken more seriously.

Only 4% of A&E consultants are women. The shortage of experienced cover means she has to be on call every third night and every third weekend. It is not uncommon for her to work a 20-hour day.

Hers is one of the country's busiest trauma centres in the UK. Addenbrookes will see 55,000 emergencies a year - from heart attacks to the aftermath of car crashes, industrial accidents and violence.

Relatives are allowed into the resuscitation room

She feels she fills a central role in the community.

"What I love about emergency medicine is the interaction with police services, the ambulance service, even the fire service for that matter. So it's not just the clinical workload, it's the whole picture. The interaction with the whole of the emergency services."

Sudden death

Inevitably, working in such an environment means Sue has to deal with death on a regular basis.

Bad weather means a busy day in A&E

"I think what's sad is the effect it has on the relatives and having to tell them someone they loved has died, particularly when it's sudden and unexpected.

You suddenly see someone's whole life blown apart by the loss of a loved one and that I think is something you never get used to."

Controversially, Sue encourages relatives to be present in the resuscitation room, the place where the dangerously ill patients are taken.

"I firmly believe it can minimise the shock of their bereavement," she argues.

"We have to look after both the patient and the relative, and I don't think you can always isolate the two."

Family struggle

Sue has just returned from a period on maternity leave. Her struggle to combine both professional and family commitments is a familiar one for working mums.

"I don't think you ever realise how hard it is to combine motherhood with working until you've had children yourself.

No regrets since leaving medical school

"I think what's difficult for women is that at the end of the day, if there is a problem at home, a problem with the children, it is ultimately your responsibility. And if you are going to go to work, you have got to have very clear-cut child care arrangements."

She is lucky. The job allows her to afford a live-in nanny. But she knows the hectic, pressurised life in the A&E department cannot continue for ever.

Balancing professional and personal lives

"I don't think that I will be able to continue at this pace into my 40s.

"I don't think I will be able to work 19 or 20 hours a day for very much longer. Perhaps I don't have the same rosy-coloured spectacles that I used to have before I became a medical student. But knowing what I know now, I still wouldn't want to do anything else. I love it."

Sue Robinson is featured in Medicine Women, a major new series from BBC TV. The programmes look at the motivations, politics and humanity that have driven women to the top of their profession.

They are broadcast on Thursday nights at 22:20 BST on BBC1.