My spirit was broken and the tears began to flow

I still shiver at the memory of the night I spent in A&E

IT WAS in the middle of the night, roughly eight hours into a stay at my local Accident & Emergency room recently, that I gave up hope and began to cry. Until then, I had held it together rather well, despite the late hour, the lack of sleep and the sick feeling that had brought me there in the first place.

It hadn’t exactly been fun, but I had taken some heart from at least being close to doctors and nurses and hoping that they would figure out what had been making me feel so unwell for the previous few weeks.

I had started out believing that I was, as they say, in the right place. At roughly 5am, I began to suspect that this may not in fact be true, just after I had been “admitted” to the care of the hospital and seated in my first chair of what was to become a lengthy stay. Realising that a bed would not be coming my way any time soon was enough to beat me – just like that, my spirit was broken and the tears began to flow.

I had entered the waiting room of A&E at Beaumont Hospital in north Dublin at around 9pm the night before, having been referred by my GP because he suspected a ruptured appendix. Things moved fairly efficiently at first – the receptionist was business-like, the triage nurse calm and thorough as he assessed me. The television was even programmed to Scrubs, which I presume was accidental but still provided a touch of ironic humour in an otherwise fairly dreary environment.

I was told the queue in front of me would probably translate into a six-hour wait and, having expected something of this order, I couldn’t really claim surprise. And so I settled down, immediately jealous of the pillow a more enterprising fellow patient had brought with her, but still not in immense discomfort.

By midnight, alone after my husband had gone home to allow a babysitter to leave, misery had begun to seep in a little bit, but there was still the prospect of seeing the doctor and diagnosis to keep me going. I had been unable to eat for many days and had developed a dull tummy ache that had persuaded me I needed medical attention. A history of ovarian cysts had made me nervous about letting things go too far, plus the suspicion of appendicitis was in the background. I needed to persevere, despite starting to feel fairly rotten.

Six hours in, as the triage nurse had predicted, the trauma of waiting was brought to an end by hearing a doctor call my name. By now, at 3am, I was feeling very rough indeed and obviously looking just as bad, although I wondered how much of this was simply due to fatigue.

In any case, the doctors seemed to take me seriously and, treat of treats, allowed me to lie flat on an examination bed as they discussed my still vague symptoms. They decided I needed to stay while they worked out what the problem was, by which point I was happily snoozing in the curtained cubicle, sheer exhaustion having overtaken all other complaints.

I wasn’t allowed to get away with it for long but still didn’t mind too much when the doctor woke me because I presumed a proper hospital bed with white sheets and a comforting smell of disinfectant awaited me. Not quite. I was led into the main A&E area, a cramped, square room that, even at 5am, was teeming with humanity. Sick people were everywhere – the floor was barely visible – and I was to be added to their number.

I learned afterwards, from the local newspaper, that this night had been a particularly overcrowded one in A&E. Forget a trolley in a corridor – that would have been like a four-poster compared to the accommodation I and many others were allocated.

Remember the hard, plastic, stackable chairs your school kept for concerts and assemblies – well, mine was a bashed, brown colour. It was located next to a photocopier and in front of a storage cupboard, just opposite the busy nurses’ station.

The doctor must have laughed to himself when I asked if my chair meant I wouldn’t get a bed until morning (remember it was 5am by now) and he replied, “Um, probably not”, without quite meeting my eye. A quick intravenous antibiotic later and he was gone, his work with me completed.

He left behind him a growing sense of despair as unwieldy tiredness combined with feeling very unwell to make my situation seem very hopeless. And once the tears came, there was no going back – from then until the next evening when I managed to get moved, my spirit was broken.

This translated into my becoming very quiet, weepy and just slightly unpleasant to the nurses who were doing their best to help me. They, of course, bore it all with equanimity and gentleness, ploughing on through the disarray to do their jobs. A note about payment being due for their Christmas party was on the notice board, perhaps to remind us all that a normal life did exist outside this godforsaken place.

There are a few key lessons that a period as a patient in the A&E at Beaumont will teach you, the most important of which concerns the chairs. My hard, plastic seat was, I quickly learned, at the bottom of the hierarchy, which progresses up to trolleys and, for those very lucky inmates, beds.

The next step up from mine was a cushioned chair and, after that, there were some very fortunate individuals who had managed to secure a second chair on which to place their feet – a system which may even allow for sleep if it wasn’t for the noise.

As time went on, I progressed too, but only as far as the cushioned chair. There was a brief period where I did have two but one was stolen when I went to the bathroom. I tried not to get angry about my loss because I knew it was every man for himself in A&E.

This was reinforced later in my stay by a porter who reminded me to leave my jacket on my chair while I was having an ultrasound scan in another part of the hospital – my spot would be robbed otherwise, he said.

By mid-morning (12 or so hours in), the grimness felt so unrelenting that it was almost possible to forget the medical complaints that had brought me there in the first place. I was exhausted, I hadn’t eaten in days and I was ill – my energy was seeping away, leaving me listless. And to make matters worse, I realised after several hours that the fluids I was meant to be receiving through a drip weren’t making their way through the tube.

Getting this rectified took a very long time as I tried to attract the attention of a nurse and failed, repeatedly. The nurses were genuinely too busy to do all the things required of them. Eventually, the drip was fixed and the fluids started to flow.

By lunchtime, I was a crumpled mess. In one way, the progression of time made little difference to me – I was alone, unwell and sad. All perspective was gone and there was nobody around to bring me back to the reality that this was not how I was going to end my days.

Friends were at work, family were far away and my husband couldn’t leave our small children at home because our childminder was also sick.

I remember someone saying I needed a CT scan but that I probably wouldn’t be able to get one that day, so an ultrasound would be performed instead.

I knew from experience that ultrasounds work best when a patient’s bladder is full; this was not the case for me.. Unsurprisingly then, the scan (which is presumably an expensive business) didn’t reveal much except some errant fluid, even though there was, in fact, a large ovarian cyst lurking in the shadows, waiting to rupture.

Thank heavens for the fluid though because that persuaded someone, somewhere that I needed further investigation via a small operation called a laparoscopy, where a camera is inserted into the abdomen to find whatever might be hiding there. This provided my ticket out of hell because, thankfully, the A&E service does not extend to surgery.

As the doctor explained the procedure to me at about 7pm that evening (almost 24 hours after I had walked through the hospital’s doors), I found it hard to focus on anything other than the fact that I had been allowed to lie down on an actual bed.

I was so drained, so shattered, so exhausted that even surgery felt like a fair price to pay for a mattress. I felt relief as I was wheeled away from the disorder, even though I knew from experience that the next steps would be far from pleasant.

Another, more serious, surgery would follow in the Rotunda Hospital in Dublin’s city centre the next day, leading to a lengthy recovery. It is surely a bad state of affairs though that the worst aspect of the whole experience (and remember I had two surgeries) was sitting on that succession of chairs in A&E, sobbing. I still shiver at the memory.

I was lucky to get fixed in the end and to have no lasting health problems, thanks to the (mostly free) healthcare I received from the doctors and nurses I encountered, all of whom were kind and professional, even through my poor manners and very low moods.

It was they who made me better, not the sinking ship of A&E in which they were, and still are, forced to sail. There didn’t seem any point in making a complaint as I assumed my experience was typical of many others’.

As you read this, hundreds of people are sitting in chairs just like the ones I occupied, waiting and hoping to be fixed as stories like mine unfold around them.

* A statement from Beaumont Hospital said:"Beaumont Hospital regrets that Ms McCaffrey's experience in the Emergency Department was so distressing.

The hospital and its staff endeavour to ensure that patients are seen and, when necessary, admitted to wards, as quickly as practical.

In addition to providing trauma and emergency services, Beaumont provides a range of national and regional services in such areas, for example, as neurosurgery, renal transplantation, vascular surgery and symptomastic breast services. The hospital tries to achieve a balance between the many competing demands for its services.

It is hoped the new Fair Deal scheme for patients in need of long-term support will help reduce the number of patients in the hospital whose discharge has been delayed.”