Trauma Department Crisis: A Life-or-Death Situation
We cannot guarantee that the patients will receive the treatment they should have, says Iver Anders Gaski. Well, isn’t that the icing on the cake? You go to the hospital expecting to be whipped back into shape and they tell you, “How about we just wing it?” Such comforting words from the trauma center at Ullevål Hospital, the largest in the country! When you’ve been on the receiving end of a bus, trust me, you don’t want “a little luck” on your side.
Imagine being one of the 2,000 patients a year that shuffle through Ullevål after traffic accidents, violent altercations, or, as some might call it, a Saturday night out in the wrong part of town. This place has more serious injuries than a rugby match gone wrong. What’s even scarier? Trauma is the leading cause of death for people aged 1 to 45! So, if you’re under 45 and living life to the fullest, just remember, you’ll ideally need more than a good luck charm this summer.
Demanding Job or Demanding Future?
Meet Joakim Jørgensen, senior physician and vascular surgeon, who spends half his time in the trauma department. He’s like the Swiss Army knife of doctors, multitasking like a pro! But here’s the kicker: he’s feeling a little bit anxious. “There are no new trauma surgeons on the way to replace those who are gone,” he says, which is basically doctor code for “We’re in deep trouble, folks!”
Now, Joakim, I appreciate your enthusiasm, but when the job description makes it sound like you’re waiting for an emergency to smack you in the face, you’ve got to wonder if there’s a help-wanted sign sitting somewhere in the hospital that no one’s looking at. It’s like the Hunger Games — but for surgeons. Last one standing gets to save the day!
Good Results… But for How Long?
This trauma scheme, established in 2013, has performed miracles—well, somewhat. The mortality rate for seriously injured patients reliant on blood transfusions has been halved! But hold your applause, because despite those glorious stats, it looks like the whole thing is on a razor-thin edge. The hospital should have ten trauma surgeons. Right now, they’ve got seven. And that’s like trying to create a delicious pizza with only three toppings instead of five — something’s bound to get left out!
About to Crash?
Joakim warns, “This is in the process of weathering and breaking down.” You know things are bad when even the doctors start sounding like they’re discussing a neglected car more than saving lives. Joakim and Iver Anders Gaski are concerned their illustrious trauma department is actually headed for a spectacular crash landing.
And when surgeons are taking on extra shifts just to keep the place afloat, you know you’re in trouble! They’ve worked late nights and weekends to keep the numbers up, but now they’re left twiddling their thumbs as calls for help go unanswered. What’s odd is that the management offered promises years ago, which are apparently sitting in a file called “Best Laid Plans.”
Warm Words, Cold Reality
Per Oretorp, from the Personal Injury Association, has sent a report of concern to the Ministry of Health. “More will die, and patients who survive will not have the chance to get as well as patients get today,” he warns. Talk about a vote of confidence!
What do the powers that be have to say? Øyvind Skraastad, the head of the emergency clinic, acknowledged the crisis with warm words that feel like a wet blanket. “We share the concern about the situation,” he stated, still searching for a solution like a kid looking for their missing sock. Time is tight, folks. Can we get a move on?
Minister of Health, Where Are You?
The situation at this trauma department needs serious intervention from the Minister of Health. In a world where organizational skills and management creativity are in short supply, Oretorp believes this is a challenge that can be conquered if someone would just pick up the phone! But for now, we’ve got all the makings of a potentially disastrous sit-com, set in a hospital with a cast full of overworked and underappreciated heroes.
In all seriousness, this isn’t just about drama; it’s about lives. So let’s hope the powers that be begin solving this crisis before someone gets the bright idea to make a reality show out of it. Because frankly, it might get a bit too real for our liking!
– “We cannot guarantee that the patients will receive the treatment they should have,” warns Iver Anders Gaski, underscoring the grave situation.
Gaski serves as the spokesperson for the supervisory team responsible for the trauma department at Ullevål Hospital, which is renowned as the largest trauma center in Norway.
This critical facility caters to the most seriously injured patients who arrive after experiencing severe incidents such as traffic accidents, falls, shootings, stabbings, and acts of violence.
As a vital part of Norway’s healthcare system, the trauma center takes charge of providing specialized medical care for the Eastern and Southern regions overseen by Health South-East.
Each year, the center receives and treats approximately 2,000 patients who are often in life-threatening conditions.
Tragically, trauma remains the leading cause of death among individuals aged 1 to 45 in the country.
This summer, alarming concerns were raised by the tenant regarding the center’s functioning.
Now, the situation is escalating in severity.
Demanding job
Joakim Jørgensen, a senior physician at Ullevål Hospital, specializes as a vascular surgeon but also possesses additional training in trauma surgery. He dedicates half of his time to the demanding role within the trauma department.
In his capacity as a trauma surgeon, Jørgensen bears the significant responsibility for treating critically injured patients. His role encompasses reviewing all X-ray images of incoming patients and coordinating the range of treatment they will receive based on their injuries.
Moreover, he remains on high alert, as an alarm signals the arrival of new patients, prompting immediate response from him.
While Jørgensen finds his job exhilarating, he acknowledges the immense demands it places on him personally and professionally.
“We are standing with perhaps some of the sickest patients we see in Norway, who come here,” he states, highlighting the gravity of the situation faced by his team.
Joakim Jørgensen is a senior physician in vascular surgery and serves as a trauma surgeon for 50 percent of his time.
Photo: Hallgeir Braastad / NRK
Despite his passion for the job, Jørgensen is expressing increasing concern.
“There are no new trauma surgeons on the way to replace those who are gone. It takes a long time to train people, so this is serious,” he emphasizes, shedding light on a pressing issue.
Good result
This trauma surgeon program, which Jørgensen is an integral part of, was initiated back in 2013 and involved years of careful development and implementation.
The benefits of this program have been profound.
The mortality rate among seriously injured patients needing blood transfusions has significantly declined, nearly halving since the program’s inception.
Inside the trauma room, there are three specialized treatment areas dedicated to patient care.
Photo: Hallgeir Braastad / NRK
The trauma center at Ullevål holds a crucial position not just locally but nationally, serving as the leading trauma center in the country with substantial responsibilities across regions.
Moreover, the center’s expertise has gained international recognition.
– “Ullevål has a system that trauma centers in several other countries look to learn from,” Jørgensen points out, showcasing the center’s exemplary practices.
– About to crash
However, the trauma department has been grappling for an extended period with the challenge of retaining experienced trauma surgeons and attracting new talent.
Staff members have frequently taken on extra shifts, covering rearguard duties during evenings, nights, and weekends, to ensure that patient care remains uncompromised.
Currently, there is a looming threat that the entire trauma surgeon arrangement could collapse.
Although the ideal team size should reflect ten trauma surgeons, the reality is that there are only seven available practitioners at present. Furthermore, by February 1st of the upcoming year, that number will dwindle to just five.
The superiors Joakim Jørgensen and Iver Anders Gaski share deep concerns regarding the future of the trauma center.
Photo: Hallgeir Braastad / NRK
No new surgeons are expected to join the team.
Jørgensen expresses grave fears, believing that the trauma department is on the brink of disintegration.
“This is in the process of weathering and breaking down,” he laments, pinpointing the lack of sustainable working conditions for supervisors who are overstretched by splitting their focus across two departments.
The trauma department has proactively proposed multiple solutions aimed at addressing this escalating crisis.
Iver Anders Gaski, acting as the trustee for the supervisors in the trauma department, is also a specialist in gastrosurgery while contributing 37 percent of his time as a trauma surgeon.
Photo: Hallgeir Braastad / NRK
“We have asked the management for help to ensure that the necessary measures are carried out,” asserts Iver Anders Gaski, echoing the urgent call for action.
Haven’t kept what they promised
As far back as three years ago, significant concerns regarding the trauma surgeon program at Oslo University Hospital were raised by specialists from across the country.
These concerns emerged during a visit organized by the National Center for Traumatology, where experts collectively acknowledged the need for a comprehensive strategy to tackle existing challenges.
Upon conclusion of the visit, assurances were given by the hospital’s senior management.
However, during a follow-up visit in May of this year to evaluate the alignment of organization and patient care with the National Trauma Plan, it became evident that the issues remained unresolved.
The other trauma centers are now demanding that the initial promises be fulfilled.
– Several will die
Per Oretorp, a representative from the Personal Injury Association, serves as a user representative on the specialist council for traumatology at Oslo University Hospital.
Per Oretorp is assistant general secretary of the Personal Injury Association and user representative on the specialist council for traumatology at OUS.
Photo: Personal injury association LTN
Oretorp warns that the impending situation following the New Year will be catastrophic.
– More will die, and patients who survive will not have the chance to recover as effectively as those treated today.
– Shares the concern
NRK has directed several inquiries about the situation to Bjørn Atle Bjørnbeth, the managing director of Oslo University Hospital.
Though no response has been received from him, Øyvind Skraastad, the head of the emergency clinic, has addressed the concerns.
Øyvind Skraastad is the head of the emergency clinic at Oslo University Hospital.
Photo: Bård Nafstad / NRK
– We share the concern about the situation and acknowledge that we have not yet been able to find good enough solutions to this, Skraastad admits. He also indicates that targeted collaborative efforts are underway across multiple professional sectors to stabilize operations both in the short and long term.
“We are operating under immense time pressure. Oslo University Hospital is the country’s leading emergency and trauma hospital, and we are committed to fulfilling our mission,” Skraastad asserts.
The Minister of Health must get involved
Per Oretorp believes that the predicament in the trauma department constitutes both an organizational and management dilemma that is solvable.
He has communicated his concerns through a formal report addressed to the Ministry of Health.
– We expect the Minister of Health to actively intervene and assist in preserving the trauma system we currently have in place.
In addition, the trauma department at Ullevål plays a crucial role in providing training support in both national and regional emergency responses, a responsibility that cannot be overlooked, Oretorp highlights.
This is why he has also submitted a report of concern to the Ministry of Justice and Emergency Preparedness, as well as the Ministry of Defense, regarding the crisis in the trauma department anticipated post-New Year.
– If conditions remain unchanged, we will find ourselves significantly less prepared in the event of a war or disaster, warns Per Oretorp from the Personal Injury Association.
Published 11.11.2024, at 06.41
Kraastad stressed the importance of addressing the alarming issues faced by the trauma department, noting, “We share the concern about the situation.” However, many are left wondering if these are just empty words without action.
As we sit in this precarious moment, the future of Norway’s trauma care hangs in the balance. The dire circumstances facing the Ullevål Hospital trauma center call for immediate attention from those in positions of power—the Minister of Health and the management teams responsible for healthcare administration. The dedicated staff, including doctors like Joakim Jørgensen and Iver Anders Gaski, are doing everything they can to hold the department together—but without significant structural support and resources, their efforts might not be enough.
Norwegian healthcare is at a crossroads. The community and patients should not have to pay the price for administrative shortcomings and unfulfilled promises. As Oretorp aptly puts it, “More will die, and patients who survive will not have the chance to recover as effectively as those treated today.” This stark prediction only emphasizes the urgency of the situation—the time to act is now.
The public must rally and demand that healthcare leaders address these critical deficiencies in trauma care. Lives are at stake, and the ongoing crisis can no longer be treated as a mere abstract issue—it’s a matter of survival for many individuals who rely on these vital medical services. Let us hope for swift action and the implementation of solutions to ensure that Norway’s trauma center can continue to provide high-quality care for those in their most vulnerable moments.