Patients wait on trolleys while loved ones hang around in fear

More information on waiting times in hospitals would save everybody a great deal of anxiety, writes Terry Prone

THE numbers of patients on trolleys in hospital emergency rooms is at a record high. Which, you will agree, is not the time for the man in my life to decide to get sick. But this is exactly the time he decides to get so sick that he has to visit the VHI SwiftCare Clinic in Swords.

Now, if I tell you the VHI SwiftCare Clinic is bright, clean, friendly, speedy, and staffed by people whose expertise is matched only by their kindness, you will assume that I work for them. I don’t, but every encounter with them has been good. I’d prefer it to Starbucks.

The man in my life was diagnosed, handed his documentation and X-rays, and advised to go to A&E in the hospital that had treated him the last time this problem beset him. This he obediently did. Not good on timing, but top of the class for compliance.

There he was, in a room at one end of which is a reception area so heavily glassed-in that it must be to protect staff from drunken or high patients coming across the desk.

At the other end of the A&E receiving area are the vending machines. Now, there’s the first problem. Patients and their relatives need snacks and sangers and cups of hot stuff, but I observed dozens of people in front of the vending machines, examining the contents and the instructions, and then backing off. They all retreated as if threatened by the technology. I tried out one of the machines for a can of soft drink, and began to understand. Claw hands appeared from one side, a can toppled off a cliff, the claw dumped it on the other side and the entire Heath Robinson contraption made the level of noise you would expect if a seven-storey building were being demolished. Nobody down that end of the room was the better of it for about five minutes.

I understood, thereafter, why patients’ relatives kept departing and coming back with papier mache trays of coffee, tea, and hot chocolate from elsewhere. You don’t want to take on a vending machine. Also, the temperature in A&E is good for the shivery, sick people, but sauna-hot for the rest, who yearn for an excuse to get out in the freezing cold.

Now, I hear you mutter that my particular patient can’t have been that sick, if I had the time to survey the vending machine and note the population patterns and traffic in A&E, but that would be to underestimate the therapeutic value of distraction for the terrified. It would also be to underestimate the time available.

Once you enter A&E, the timeline is somewhere between infinity and forever, and some sadist designed the chairs so they render sleep by the occupant impossible. Someone is missing a great commercial opportunity in A&E.

They should sell little kits like you buy in the airport: Blow-up pillows and blankets and fans, so the lengthy chunk of time you spend there can be spent in comfort on the floor.

Hours and hours after he had arrived, my patient was triaged. Bad experience? No. Great experience, at the hands of a smart doctor who described him as having an “interesting” issue.

While I was trying to work out whether ‘interesting’ is a better bet in emergency medicine than run-of-the-mill, a nurse uttered the quote of the night, in response to a question likely to enmesh her in another doctor’s ‘interesting’ problem.

“I’m not actually here at all,” she told the potentially exigent doctor. “I’m across chest pains.”

He retreated and I learned off that sentence as the ultimate get-out.

Who’s going to argue with you when you’re not really present and, instead, are across chest pains?

The man in my life was promised he was first on the list for the next phase, and put back out into the room with the chairs, the vending machines and the heavily protected receptionists. This pattern seemed to apply to all three doors labelled ‘Triage’.

You went in. You came back out. Unchanged, as far as the rest of us were concerned. Even the 8ft-tall lad hobbling in the rugby boots. Hours passed. I knocked on a door and told the nurse who wasn’t really there that my old man had been told he was in pole position for the life-saving procedure that had been slated for him.

“Three strokes and a heart attack have come in by ambulance,” she said, and I allowed that this might make him slip down the list. No point in complaining to her that we could have been been told. If she wasn’t really there, she was doing me a huge favour just by speaking to me when she needed to get back across the chest pains.

More hours passed. Darkness fell, as darkness always does. Eventually, his name was called, and he disappeared, leaving me with his little case, which contained pyjamas, shaving gel, various chargers and the minutiae of hospital incarceration, which was inevitable, given his interesting condition.

I waited. Nothing happened. Hours passed, during which I worked out that the area into which the patient had disappeared was guarded by doors that did not respond to knocks or pleas. If you didn’t have an electronic pass, you had no chance. Unless… unless you hovered near the doors, and, as someone exited, snapped into action and slid in. I tried it. It worked. I got into the third circle of hell. Trolleys to the right and left, fore and aft. Shouted instructions and moans of pain.

I walked purposefully through the chaos, as if someone had summoned me, and eventually found the patient, who had undergone a procedure and was on the trolley he would occupy for a long time thereafter. Nothing wrong with a trolley, he opined. He was grand with the trolley.

Never mind what happened afterwards, the point is this: Overworked professionals were achieving wonders almost everywhere. Nobody would expect them to break off from life-saving to come out and say to a waiting patient: “OK, I know you expected to be dealt with in an hour from when we talked to you last, but it’ll be three hours before we get to you. Here’s why. We haven’t forgotten you.”

However, that information would drop the anxiety levels in the waiting area enormously, because, unless you slip under the radar to find out what’s going on, you’re left convinced that nothing is going on and that you have been forgotten.

A smart journalism student could do it, perhaps sponsored by communications companies, newspapers, and TV/radio programmes. It would make everybody’s life easier. Including that of the nurse who isn’t actually there.