A day in A&E: Embarrassment, frustration, anger, sympathy

Embarrassment was one of the emotions I experienced this week in an emergency department (ED).

I realised that the supervision and management of livestock marts, and the conditions that exist there for animals, was superior in many ways to the chaos that ensues in EDs.

And among the other emotions were frustration, anger, and sympathy.

Sympathy, especially, for the frontline staff. How do they cope hour after hour, day after day?

They deserve more than public admiration for their professionalism in dealing with minute-by-minute crises and still managing to smile and show courtesy to patients, and especially show restraint when continually pestered by worried people accompanying patients.

Nurses and doctors in EDs do not, unfortunately, have the respect of their management and certainly not politicians and their administrators in government.

I attended Cork University Hospital accident and emergency unit after experiencing symptoms relating to a cardiac condition. I had a heart attack over four years ago and, although I have a defibrillator device inserted, certain symptoms persist.

I wish I had taken more time before deciding to attend the ED.

It was just exasperating. But, to emphasise, that’s just a personal opinion.

And a day or two later, I’m none the wiser about any likely risk to my health, if there was one.

The waiting may have been frustrating but it was also an eye-opening experience. 

Patients with broken and twisted limbs, children with head wounds, workmen with fingers severed, frail wheelchair-bound elderly with partners looking equally disorientated, and many others showing obvious signs of distress with stomach pains.

The sight of terrified mums and dads cradling sick babies really tugs at the heartstrings.

And this, I witnessed during my nine hours in an ED — on a weekday.

God help those admitted over any weekend period, especially a bank holiday.

I had arrived, this week, just after 1.30pm. Within 30 minutes I had an ECG and was advised by the nurse to return to the waiting room for a doctor’s assessment of the electrocardiogram test.

I waited, and waited, and waited and, even as my mobile phone battery expired, still waited and waited, in vain, before discharging myself at 10.38pm — without seeing a doctor.

The person at reception advised: “If you leave and anything happens, it’s your responsibility” before adding: “You’ve only been here nine hours!”

A couple, probably in their 40s, who had arrived at the ED around midday with the husband having suffered the first signs of chest pains, said matter-of-factly: “We’re not happy but we’ll stay to 5am if we have to. We’re not taking chances.”

My feeling of embarrassment as I took a good look around me stemmed from the presence of so many sick children, and other young people with worried parents and many elderly who were in a distressed state.

Showing no visible signs of injury or pain, I felt so out-of-place as there were so many others who desperately needed urgent attention.

With continuing pains in my left arm more bearable, I decided to vacate the waiting room as the number of arrivals was increasing significantly.

On arrival initially, there were about 30 people in the small waiting room but, by 10pm, I counted 77 with about 20 or more people in a nearby corridor.

Of course, you don’t expect a relaxed ambience in a hospital waiting room. There were 30 hard plastic and very uncomfortable chairs and a poorly-stocked soft drinks and chocolate dispenser. 

The nearby canteen had closed around 6pm. Some children were sprawling themselves out on the floor. 

Wheelchairs added to the mayhem. The room, effectively, was stuffed with people.

An ED is just not a place for the faint-hearted.

And, despite claims that socially-deprived people without private health insurances are treated as second-class in a hospital waiting room, being a VHI subscriber for 30 years or more didn’t give me any priority — and I didn’t expect it when I viewed the chaos around me.

In CUH, the triage examination room is adjacent to the waiting area.

The triage system was introduced as a process of setting priorities, from 1 to 5, of treatment of patients in EDs.

At one stage, a doctor emerged from the triage room and pleaded with people to stop asking staff about likely waiting times.

The doctor admitted: “We’re all frustrated — but we’re trying to do our best to treat people.”

Yesterday, the HSE’s national director of emergency management Damien McCallion said after a “difficult” few weeks, he was hopeful of some improvement in EDs this week.

The heroic workers who staff EDs will be so pleased to hear such comforting words!

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