Never mind the excuses – swine flu, bed closures or bad weather – what’s the fallout for people attending emergency departments?
LAST WEEK was always going to be busy for emergency departments. With many GPs’ surgeries closed over Christmas, January 4th saw their waiting rooms bulge. The consequent post-Christmas spike in referrals to the emergency department is a new year phenomenon that seasoned hospital staff can set their clocks by.
But this wasn’t just any ordinary Christmas. Ireland had experienced the coldest December since the 1850s. The freezing temperatures not only tested the immune systems of the vulnerable, but icy footpaths also made short work of the fit.
Emergency departments in Dublin, Cork, Limerick, Galway and Donegal last week said they were inundated with fractures resulting from falls on snow and ice. Sligo General alone reported a tenfold increase in such cases.
Into the mix came the HSE’s statement that rates of swine flu infection in the community had doubled in a week and that the numbers of patients hospitalised with flu had increased from 36 a fortnight ago to 114 last week.
In the first week of the new year, this perfect storm made landfall in the country’s emergency departments. The Irish Nurses and Midwives Organisation (INMO) reported a record 569 people on trolleys, each one waiting for a ward bed.
Cork University Hospital had the unenviable honour of topping the nationwide trolley leader board with more than 48 people waiting for beds in its emergency room.
The hospital’s emergency medicine consultant, Dr Chris Luke, however was quick to reject HSE suggestions that the overcrowding was due to seasonal factors such as strains of the flu virus and ice-related injuries. His verdict on the reason for the preponderance of patients on trolleys was bed closures.
The Irish Association of Emergency Medicine agreed, saying the failure to provide adequate hospital bed capacity “is the primary problem and should not be blamed on seasonal flu”.
As rates of swine flu sky-rocketed, the association’s statement that “boarding hospital inpatients in emergency departments results in increased numbers of deaths among this group of ill patients”, brought little comfort to those on the emergency department trolleys.
But as consultants, nurses’ unions and the HSE jostled to diagnose the problem and name and blame its causes – the cold weather, icy footpaths, a new wave of the flu virus or an overzealous culling of beds – what about those in the eye of the storm?
INMO figures showed that St Vincent’s Hospital in Dublin recorded a peak of 39 people on trolleys last week. We spent last Thursday in the hospital’s emergency department to find out how the crisis was affecting those on the ground.
SUSAN GILSHINAN, DRIMNAGH
My mother-in-law has been on a trolley in the AE department since Tuesday. She’s 73, but she’s fairly frail.
Her blood tests came back to her GP that day and he was concerned and said she should go to the AE department as soon as possible, so we went.
We came in at around 5pm. She was seen to at about 6pm. Everything went fairly quickly.
You go to see the triage nurse first and usually you come back out and wait – but she didn’t come back out, she must have been a priority.
We couldn’t go in with her to get her sorted or see how she was , she just went straight through and we went home. She was just left, kind of.
She got to see a doctor about four hours later.
It’s two days later and she’s still on some kind of a trolley in the AE department, waiting to get to a ward. We couldn’t see her until now because of the bug, they said.
She was very feeble going in and she hasn’t seen any family yet – this is the first time we’re getting to see her.
We’d have preferred if she got a bed on a ward, but I suppose with the swine flu, what can they do? Maybe it can’t be prevented, I suppose.
They are trying to make her as comfortable as possible. Everyone in there is doing their best, but they are working against the system.
CHRISTY McDONALD, RATHDRUM
I had a fall in the snow two weeks ago, but my leg was too swollen for anything to be done. I was just out for a walk and I fell.
I went to my doctor yesterday and he gave me an appointment for an X-ray at Loughlinstown for first thing this morning. That X-ray showed up nothing, so they sent me here for a specialised ultra-sound.
I got to the AE here at about 11.30am. They told me the person to ask for and I was seen within half an hour. It’s 3pm now and they’ve said the man who is in charge, the consultant, won’t be here until later and they want him to look at me.
They’ve said he’ll be here at 7pm – but he mightn’t be able to see me at 7pm. Maybe 8pm hopefully.
We’ve travelled from Rathdrum, maybe 30 miles away. The knee is sore. I can’t walk on it; it’s painful enough when you move it around.
It would be fine now if they let me go home and come back, but they’ve kind of said the man could be here at anytime – if I went home now, I might miss him.
I’m just like everyone else here – it’s the system, it’s the way it is and that’s it. You have to go with the flow.
They might keep me here tonight because they’ve said I have to have surgery tomorrow – unless this consultant says different, but I don’t know if I’d get a bed.
STEPHEN AND LOUISE DOHERTY, NEWTOWNMOUNTKENNEDY, WICKLOW
Stephen: My mother suffered a stroke last night and she’s under observation inside.
She came in at 8.30pm last night. She was brought in by ambulance and she was seen within about 20 minutes, which was grand. But she’s on a trolley still. She’s 89.
She’s not really too lucid as to where she is, but they’re hoping to move her to a bed that they can wire up so that they can monitor her heart properly.
That could take up to 48 hours – it’s in the main hospital and they have to wait for a bed to become free. Unfortunately, it seems to be a fact of life these days.
There’s about 15 or 20 in there on trolleys at the moment. They’re a mix of all ages. Most of them seem to be just accepting it.
Louise: I personally have seen three or four people come in to the AE department while we’ve been waiting, saying they have the flu – why aren’t they at the doctor?
I’m sorry, but they are holding up beds, they are holding up queues and they are spreading it out to us, and that I think it’s appalling.
FRANCIS LACEY, TALLAGHT
I’m here with my son. He slipped on the ice on a night out – he was going to a bank machine and there was ice on the steps and he slipped and fell forward. He broke his nose and four front teeth. It was the Friday before Christmas.
He was unconscious when he was brought here. It was the early hours of the morning; they treated him and let him out. They didn’t keep him in overnight.
Last week would have been his first time back for a check-up. I brought him down for the appointment. He was told by the girl at the desk to wait in the accident and emergency room – then he was called up a couple of minutes later and told that there was no one to see him.
They never phoned us or anything – they just told us to go back home and to come back again today. There was nothing more said. So we were here again today at 2pm and he was called about five minutes later.
He thinks they may have to reset his nose, remove the piece of tooth that’s embedded in his gum, and have a look at his bottom lip – that’s in a bad way as well.
We haven’t been given any indication of how long he’ll be now. We’ll just have to see what happens.
SAMANTHA NULTY, BALLINTEER
I’m here with my sister Danielle. She’s 20. She developed a pain in her lower right side last night. It worsened and she didn’t sleep, so I took her to our GP this morning and he immediately said to take her into AE.
We were seen in about 15 minutes. She was in obvious pain. She couldn’t sit down on the chairs or anything, so they took her into a trolley.
From what I know, she’s just getting pain meds – they’ve said she won’t see a doctor for an hour.
They’ve just said they are very busy and that if an emergency comes in during that time, it might even be longer.
They are just trying to make her as comfortable as possible, take blood tests and do all that.
The pain is getting worse. I wouldn’t even say she’s in discomfort – she’s in serious pain.
They haven’t said anything about whether a bed is available. I was only in there for five minutes with her; I can’t get in there because there are no visitors.
I think she’ll be admitted. I don’t think they’ll let someone out in that pain anyway – even if it’s not appendicitis, they’ll have to kind of look in to it.
It’s a worry that she might not get a bed. We’ve been hearing all about it on the news, but if she has to get an operation, then there would have to be a bed for her, wouldn’t there?
