The general practitioner refers a patient to the hospital in case his state is too serious to be coped with in the polyclinic. Emergencies are taken to the hospital even without the family doctor's recommendation. List patients are normally admitted straight to the department or ward concerned.
On admission the patient's history is taken as part of the clinical case-taking. This includes complete physical examination and laboratory studies, the systematic classification of the common symptoms and signs as well as compilation of the patient's case record (clinical notes). Apart from the patient's personal data (name - both Christian and surname, address, age, social status, occupation etc.) the case record should contain the date of admission and discharge, the historian's name and diagnosis.
A general hospital is usually divided into two parts, an outpatient department and an inpatient department. The outpatient department has a number of surgeries and consulting rooms, waiting rooms, a filing cabinet where records are kept, and laboratories and X-ray units unless such services are provided by the inpatient department.
The basic component unit of the inpatient department is called the ward where patients are admitted for treatment. The number of wards will differ according to the size of the hospital, but in general there will be several groups of wards: medical, surgical, special surgical, obstetric and gynaecological, paediatric etc.
A ward unit consists of rooms for patients, a treatment room.
sisters' room, bathrooms and lavatories: there may also be an admission room, a kitchenette, a small laboratory. In addition to beds and bedside lockers, the equipment of a ward usually includes washbasins, bedpans, urinals, commodes, spittoons, scales etc.
In charge of each ward is the ward sister. She is responsible to the head nurse (or matron in British hospitals) and to the medical staff (staff nurses, probationer nurses, auxiliary nurses as well as night sisters).
The duties of the nursing staff include menial tasks and nursing proper, such as doing bedpan rounds, bed making, washing patients, dressing wounds, giving out medicines, taking the temperature, managing transfusions, conducting certain investigations and, in general, carrying out medical orders.
The medical staff of a typical English teaching hospital consists - in order of seniority - of the consultant (roughly the equivalent of the head physician or head surgeon) who acts as the head of a medical team known as a firm, the registrar, the resident medical or surgical officer (RMO or RSO), and the housemen - the house physician and house surgeon.
The patients are seen daily by the medical staff, usually during the morning ward round. Most of the operations are also performed during the morning; the place is the operating theatre with the surgeon being assisted - among other staff - by the instrumental sister and theatre sister. In Britain, the same medical staff see the outpatients as give them treatment if they subsequently become inpatients. In other words, the inpatient team and the outpatient team is the same and is in close contact with the general practitioner who has referred the patient to the hospital.
Among all the departments and wards, a place of particular importance is taken by casualty department. It has its own staff and most of its work is surgical. It has its own X-ray department and plaster room to treat all kinds of fractures, except perhaps minor injuries which can be treated without actual hospitalization on an outpatient basis by the orthopaedic surgeon at the fracture clinic.
In some larger hospitals it has been found expedient to have special wards and departments with their own permanent staff. These are likely to include an accident unit, an intensive care unit, a chest surgery unit, a head injuries unit, plastic surgery and burns units, a rehabilitation department, a department of. physiotherapy, a blood transfusion department, and other special purpose units.
Attached to some British hospitals are also medical social workers (MSW) who help patients with personal or domestic difficulties, that may arise from illnesses, and who work closely with the medical and nursing staff.
Psychiatric social workers (PSW) do similar work with the mentally ill patients and are, therefore, found in mental hospitals or the psychiatric departments of large hospitals. Both are meant to act as a link between doctor and patient.
VIII. Answer the following questions on the text:
1. What happens to sick people whose condition is too serious to be treated on an outpatient basis?
2. What is the position of list patients?
3. What does clinical case-taking involve?
4. How is a general hospital in Britain usually organized?
5. What is the relation between the outpatient and inpatient departments in a typical British hospital?
6. How is the outpatient department organized?
7. What is a ward?
8. Who is in charge of a ward in British hospitals?
9. What is the difference in ward management between a Ukrainian and a British hospital?
10. Which types of wards can you name?
11. In what way is a ward organized?
12. What categories of health workers belong to the nursing staff?
13. Which are the ranks of the medical staff in order of seniority in a British teaching hospital?
14. What does the term "doing the morning ward round" mean?
15. What are the duties of the casualty department?
16. What are the main points of a standard daily programme of a medical team (firm)?
17. What kinds of special units are likely to be incorporated in a large general hospital?
18. What are the duties of medical social workers?
