British-based freelance journalist and author Diane Taylor visited a friend at Tallaght Hospital's AE last week. She was shocked by what she saw
I WAS impressed by the modern, spacious, hospital buildings at the Adelaide and Meath hospital in Tallaght. Sensible health promotion posters covered the walls of the reception area and dispensers of disinfectant hand rub were clearly visible in triplicate throughout the public areas.
Only the huddles of visitors and dressing gown-clad patients at the entrances inhaling deeply on their cigarettes sullied the wholesome image of the place.
I had just flown in to Dublin from London to spend a few days working with Kathy O'Beirne on the sequel to her book Don't Ever Tell, a story of childhood abuse in various institutions in Dublin.
But the work plans had to be abruptly halted when Kathy called me to say she had been rushed to hospital with complications to a chronic medical condition. I headed straight to the Adelaide and Meath to see her.
The hospital has the largest emergency department in the Republic, with 80,000 patients streaming through its doors every year. The AE waiting area was full, but not bulging the way I'd often seen AE departments look at London hospitals.
Those waiting to be seen appeared remarkably resigned and those administering the triage system seemed to be working in a calm and ordered way.
I explained to the two security guards that I had come to see someone receiving treatment in the department and was nodded through the swing doors.
What I found on the other side of the doors shocked me. Lined up on trolleys stretching as far as the eye could see along the corridor were seriously ill patients waiting for beds.
Some lay on bloodied sheets, many were attached to one or more drips and quite a few were elderly.
It wasn't clear who was unconscious and who was sleeping, but what was clear was that everyone on the trolleys - 35 people in all - were very unwell and needed to be in a proper bed in the relatively tranquil environment of a ward rather than in the frenetic setting of a corridor in AE.
Kathy lay groaning with pain on one of the trolleys. There were some splattered drops of dried blood on the floor under her trolley. She had a tube up her nose running down her throat and into her stomach, a tube in her arm and a bag attached to a tube running from her abdomen draining out some foul liquid, which was causing her intense pain.
A cocktail of drugs had been administered to her and she was extremely distressed to be so exposed when she was feeling so ill. Sometimes she cried, at other times she appeared to be slipping in and out of consciousness. The other patients on the trolleys appeared similarly discomfited by their surroundings.
Now and again, ambulance staff hurried past the patients lying on the trolleys, dodging the drip stands and other bits of medical equipment as they delivered the emergency cases they had decanted from their vans to the waiting doctors and nurses.
It was distressing for both the patients being rushed in and the patients who were lying, prone, on the trolleys to catch glimpses of one another.
When doctors or nurses examined or administered treatment to those on trolleys, there was no privacy for the patients. Everything was carried out in full view of whoever happened to be walking past at the time.
The nurses kept on shaking their heads when patients and anxious relatives asked them when a bed was likely to become available.
"We just don't know, we've got 35 people waiting. It's terrible but there's nothing we can do," said one.
"I used to work in a hospital in London and people there complained about the state of the NHS - but they don't know how lucky they are with conditions there, compared with the kinds of things going on here," remarked another.
"The average waiting time on a trolley before getting a bed is 24-48 hours, sometimes longer," explained a third nurse.
While all hospital emergency departments expect spikes in admissions at certain times - such as after a major accident or during a winter flu epidemic - neither scenario was in evidence when I was in the hospital.
On the contrary, it was a beautifully sunny October day - nothing out of the ordinary seemed to be happening. The staff said that this situation was not a blip - but, rather, the norm.
When the noxious substance had finished draining out of Kathy's abdomen, the nurse said that she could remove the tube snaking its way from her nose into her stomach.
"You're not going to pull the tube out of my stomach here in the corridor, are you?" asked Kathy, aghast.
"Well, where else am I going to take you?" replied the nurse. The tube was duly pulled out of Kathy's stomach in full view of whoever happened to be walking past. Kathy was mortified.
I'm no health service expert, but during my various visits to AE departments in London over the years I have never witnessed the kinds of scenes I saw at Tallaght.
After 24 hours on a trolley, with no prospect of a bed on the horizon and only the offer of another trolley in a day ward as a substitute, Kathy could take no more.
Her resistance to infection was low and, with various tubes stuck into different parts of her body, coupled with her extremely close proximity to other sick patients lying on trolleys and the new emergencies being rushed through the corridor, she feared leaving the hospital sicker than when she arrived.
So she opted to go home. She was warned that she was leaving against medical advice and was asked to sign a form accepting responsibility, should any medical complications arise.
She flicked through the "signing out" book and was amazed by the large number of other patients in recent weeks who had also decided to get out before their treatment was complete.
In the six hours that I spent in the corridor I saw nothing but dedicated professionalism and kindness from the doctors, nurses and auxiliary staff in the AE unit, all working in intolerable conditions.
But it did not stop me from leaving the hospital with the impression that what I had witnessed in Tallaght Hospital's emergency department was more reminiscent of a makeshift field hospital hurriedly established in the wake of civil war or some other disaster in a developing country, rather than the biggest AE department in a thriving European country.
• If you would like to talk about your own health experiences, good or bad, e-mail healthsupplement@irish-times.ie