Miriam Donohoe recounts her and her daughter's 14-hour visit to St Vincent's A&E
It is 3.30am on a Sunday in the new Accident and Emergency Unit of St Vincent's Hospital in Dublin. The scene is chaotic.
Sick patients on trolleys take up all corridor space. Nurses, porters and the two doctors on duty are rushing around. Many of the patients are elderly, but there are also a half a dozen or so young people, some the worse for wear. One man is causing a rumpus roaring in a foreign language. He quietens down when an interpreter arrives.
Chaotic or not I am relieved to be here. My 14-year-old daughter, Catherine, had developed a very high temperature the previous evening and was semi-delirious. I telephoned the doctor-on-call service from home at 10.30pm and was told there was a three-four hour wait that night. They advised if I went directly to A&E I could be waiting eight hours. A doctor finally arrived at the house at 2.30am.
With a referral letter from the doctor we are able to skip the long queue in the A&E waiting room. A non-national nurse takes Catherine's details. He seems not to have a great grasp of English, asking me the same question three times as he takes notes on her medical history. He takes her blood pressure and says it is very low. Twenty minutes later Catherine is put in a wheelchair and taken into the A&E and put on a trolley.
Her trolley, and the one alongside her, are blocking access to a lift door and three fire hoses. I can't but help notice the sign on the wall stating that the fire hoses are to be kept clear at all times, but I say nothing.
Hours later, when a new patient is moved in beside Catherine in the corridor the porter wheeling his trolley points out the fire hose sign to a nurse. "Well, I don't think we are going to have a fire here today now, are we?" she replies sarcastically.
It is 4.30am before one of the two doctors on duty examines Catherine, and says all the signs are that she has a chest infection. The plan is to put her on an IV drip to get her temperature down, and then give her antibiotic intravenously. She is also to have a chest X-ray.
The nurse who admitted Catherine returns to insert an IV line into Catherine's arm. After struggling for about five minutes with the task (during which time he dashes off to tend to someone else), the doctor comes over, tut tuts and tells the nurse he will do the job himself. Some time later I see the same nurse bandaging the leg of a young man who has just been admitted after falling in a nightclub. An exasperated doctor ticks him off. "How can I see what is wrong with the leg if it is bandaged?" he asks.
An elderly woman on a trolley near us calls out for a nurse to help her go to the toilet. She says she has been looking for help for more than an hour, and has been lying on the trolley for a total of 36 hours. It is clear all the nurses are under huge pressure. A nurse comes over and in a brusque tone says this is the first she has heard the woman wants to go to the toilet.
All the cubicles in the A&E unit are full, and it seems to me these patients are the lucky ones. At least they have some privacy and dignity. At one stage I count 21 trolleys on the corridors and I am able to hear the medical history and diagnosis of many patients around me. A lot of detail is personal and embarrassing. If you don't have a relative or friend with you, getting to the toilet or even getting a drink of water is not easy.
One lady asks for a glass of water three times so she can take a tablet. Each time a nurse says she will get one but gets diverted with some other emergency. The patient gets a glass of water when I intervene and ask a porter.
Once she is on a drip and has her chest X-ray (which confirms a chest infection) Catherine doses off on her trolley, managing to ignore the chaos and noise around her. I am propped up on the end of the trolley for a few hours before finding a chair. At this stage it is 6.30am and I've been up all night. Every time I ask a nurse how long Catherine will be in A&E I get the same reply. "She will be reviewed in a while."
I pass the time chatting to the man on the trolley next to us and hear a doctor telling him that his blood tests results indicate the severe pain in his back and breathlessness is probably due to a blood clot. The man is big and is extremely uncomfortable on the trolley. Four hours later he is told by a different doctor that he is reviewing his diagnosis after looking at X-rays taken when he was first admitted hours earlier. The doctor says the X-rays had been overlooked and he thinks the pain is a result of serious constipation rather than a clot.
Breakfast is served around 8am to patients in A&E. The man beside us wants toast but is told all that is available is plain slices of white or brown bread or cereal. No toast. I manage to escape to the waiting room for 10 minutes for a machine coffee to help me keep awake.
There is no let-up for staff during the morning and I see patients coming through to A&E who I saw in the waiting room outside hours earlier when I came in. At midday Catherine's temperature comes down but the doctor says he isn't happy to let her home and there is no chance of her being transferred to a ward. A nurse explains there is one woman in A&E waiting four days for a bed and she is priority. I understand perfectly that Catherine is by no means an urgent case.
A nurse gives Catherine antibiotics intravenously. A half an hour later a different nurse comes over to the trolley and says she is going to give Catherine an antibiotic. "But she got it half an hour ago? Surely she isn't to get it again." The nurse looks at the chart, nods and wanders off. I am left thinking would Catherine have been given an extra dose of antibiotic if I wasn't with her?
Catherine's grandparents arrive to give me a break as my husband is abroad working and I am not going to leave her on her own. At 4.30pm I ask again is Catherine going home. A new doctor says he wants to see her chest X-ray before he releases her. I explain the doctor on duty when she was admitted saw the X-ray, but the doctor says he wants to see it himself.
A half hour later he tells me the X-ray has gone missing. He apologises for the delay and says he is happy enough for her to go home.
Before I leave I ask a nurse has the new multimillion euro A&E which opened in January made any difference.
"Apart from the fact that the surroundings are nicer and we have new equipment and trolleys, there has been no difference. The bottom line is we need more staff to treat patients who are coming through. You can see how rushed we are," she says.
I have nothing but the height of respect and regard for the staff in St Vincent's. It is clear the chaos has nothing to do with them, and they are working under extreme pressure. The one name I heard uttered by different patients several times during the night was that of Health Minister Mary Harney. And the comments were not flattering. It was an eye-opener to see the system at work. I am lucky my daughter was in A&E for something relatively minor and our time there was comparatively short.