There are things that I know, and things that I don't know. Of the things that I don't know I know what I have to do.
Take them to hospital.
Take for example the patient with an unusual underlying illness that I attended to. She was having some strange symptoms that weren't specifically connected to her normal condition. Whatever ailed her I wasn't able to do anything about, so I knew I had to take her to hospital.
But which hospital?
You see, if the symptoms were caused by her bleeding into her brain then I'd bypass the nearest hospital and take her to one with a neurological unit. If not, then the nearest hospital would be the best place for her.
So you do a neurological assessment and make your decision.
But that's not all. Back when I was an A&E nurse, sitting in triage and making decisions on what priority a patient is I would often see a 'syndrome kid', a child with a strange collection of sypmtoms and underlying health problems that are often named after the Doctor who discovered it.
Now, paediatrics isn't my speciality and there was no way I'd be able to remember all the differently named syndromes, so I'd ask the parents – after all, in living with their child's illness, they would often be the experts.
So, with my current patient I asked her about her disease process, 'Was this normal for her?', 'Had she had this sort of thing previously and what did the hospital do?' and 'How concerned was she about her current symptoms?'
The decision I made was to 'Blue light' her into the nearest hospital, at her insistance I pre-warned the hospital and gave them the number of her specialist team at her own hospital.
By 'blue lighting' her in I was getting her to the experts as quickly as I could.