I recieved an email today from an emergency department nurse in Tasmania asking for a story a wrote a while back about the importance of hospital orderlies. It is probably even more relevent in these days of COVID-19 than ever before. Here it is……

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In some hospitals they may be called orderlies or porters.
In Australia they are usually called wardsmen (or wards-persons, because there are females in this role as well), but they are more commonly referred to as ‘wardies‘ by the nurses. Out of a deep and affectionate respect.

Without them life in hospital would quickly unravel into a chaos of unobtainable medical equipment, unavoidable delays, unattended medical investigations, unacceptable outcomes, and uncurbed anger & aggression.

That is how important they are. Even so they remain an oft-forgotten and under appreciated arm of the healthcare team. Lets have a quick look at some of their roles and responsibilities:

Patient transport: Wardies are the red blood cells of the hospital.

You will most likely first meet one when they turn up to transport you around the hospital for clinical interventions, procedures or appointments. Taking you for an X-ray, or transporting you to physiotherapy or delivering you to theatres.

Despite the increasing use of motorised or mechanical devices to assist them with this, it remains a very physical work. They cover a lot of ground,
On beds, in wheelchairs, on foot, whatever your requirements, they will take you. Always ready to strike up a little conversation along the way.

Patient care. Without wardies many incapacitated patients would not get a proper wash, or be moved around the bed to prevent pressure ulcer formation, or be positioned correctly for X-rays or other procedures.
In specialty areas such as ICU or neruo or spinal wards, or burns units, they are an essential component of the patients treatment path each day.

Wardies require endless patience and carefully measured muscle.
From gently guiding confused or wandering elderly back to their beds in the aged care unit, to firmly restraining the combative, drug or alcohol effected patients down in the Emergency Department.

Getting stuff. Wardies are constantly utilised by medical staff to move and retrieve vital bits of equipment. Or to reallocate resources.
A typical telephone conversation requesting a wardie might go something like this:

Um, could you please quickly go waaaaaaay over to ward 11B on the other end of the hospital and drop off this doohicky. Its urgent.

Oh, and on your way back, could you please pop up to level 10 and pick up an infusion pump…and if you notice any spare wheelchairs laying about, we are a little short. And pillows, if you see a pillow or three that’s not nailed down, could you try and pinch it? We are all out.

But don’t take too long…..Ive got four patients that need transporting to medical imaging and a pack of unused red blood cells that needs to go back to the blood-bank pronto!

Keepers of wisdom. Those wardies that have been around a long time are repositories of both corporate knowledge and the mysterious ways-of-the-wards.

They move around and through the wards and clinical areas. They learn the ways things should be done. They spread the love.

And …they often know the latest news and gossip from all over the hospital. They are a sort of combination GPS, Swiss Army Knife and Facebook page.

Getting physical. Perhaps one of the most under-recognised and important roles wardies undertake is that of providing physical protection to staff and other patients.

Staff often rely on them to sit with a potentially aggressive or combative patient, and just be there for them, or to talk them down. They are there to repeatedly protect a confused patient that is trying to climb out of bed from harming themselves.

On occasion where patients or other members of the public do require urgent physical restraint due to aggression or altered mentation, it is our wardies who step up to the plate. Yes, many hospitals have security guards, but they seldom engage in any actual physical contact with patients. Somebody has to get hands on.

Providing quick and effective non-violent restraint of an aggressive ( sometimes dangerously so) patient within a hospital environment is incredibly difficult. I have watched them do this time and time again with coordinated professionalism and respect for the person they are handling that many police might take note of.

CPR: In many emergency departments (and throughout the hospital) wardies are used to perform chest compressions during cardiac arrests. They are good at it, and often form a CPR line-up, seamlessly rotating thru at frequent intervals to ensure uninterrupted quality chest compressions.

Wardies. They do not get a whole lot of money for the important work and varied roles they are called on to do.
They should at the very least get is our respect and gratitude.
Thank one today.