A 5.30PM DOCTOR’S appointment in a small town in Tipperary on a Monday evening is where the first dreaded mention of the word ‘hospital’ is heard. For my 10-year-old sister the word hospital is not terrifying in itself but rather the associations that go with it – and not the ones you might think. It is the fear of the long wait in the emergency department in Limerick whilst in considerable pain.
So we head home to pack an overnight bag for a case of suspected appendicitis and know that there is indeed a long wait ahead of us. At 6.30pm and we arrive at the emergency department to a room full of sick and injured people. The waiting time? An hour and a half before being called to triage, after which we are returned to the waiting room. In the words of Jack Johnson we are sitting, waiting, wishing that when the doors open again her name will be called.
The time is now creeping ever closer to 9pm and the pain is only getting worse. So we approach the nurse as soon as the electronic door swings open to ask for some pain relief only to miss our chance as the door swings shut after one of our comrades from the waiting room slips through. At 10.30 pm the waiting room is filling up, and it seems fewer and fewer people are being called through those doors. Every time a nurse does appear, they are accosted by family members or patients from the waiting room asking about how far down the list they are. “It will be at least a couple of hours yet” is the standard reply.
11pm and the pain has reached crisis point so, again, we make an attempt to catch the attention of a nurse who thankfully calls us through the doors. At least she is given a bed on which to wait for the doctor. The scene behind those doors is one of controlled chaos. There are people on trolleys at every turn. Everyone is waiting news from a doctor on whether they will be admitted or sent home. For my sister it takes a total of six hours before she has been seen by a doctor and given any kind of pain relief. At 12.30pm, with a diagnosis that isn’t appendicitis, we are free to leave.
Six hours is a reasonable wait compared to what some people faced that evening. However this is a clear demonstration, not that we need it, of how bad the situation in Irish hospitals is. The staff members dealing with the sheer number of people each evening do a very good job, but everyone has limits. You can’t expect to run a packed department with the bare minimum of staff when the potential of those you do have is already stretched to the limit.
There are already deterrents in place to stop people from abusing the emergency department service such as a €100 charge if you haven’t been referred. It is arguable that such waiting times are also an added deterrent – if you are willing to wait six hours to be seen by a doctor then you must indeed be ill or injured.
The question is: do the people who find themselves stranded in that waiting room not deserve better than the health system is willing to give? You can tell me that it is all about resources, cut backs and the recession, but what if it goes back to a more fundamental level of systematic management?
Emergency departments are so busy that 6/7 hours wait is standard practice. Clearly there are too many patients for the staff to handle. So hire more staff, but the counter argument to that is the HSE can’t afford to pay more staff. Why? Because there is some other part of the budget that is being used for much more urgent services. Which leads to the question: is an emergency department not an urgent service?
Vicious cycle isn’t it? But who am I to complain? I can hear the rhetoric already…
“Everyone is doing the best they can with what they’ve got.”
Aren’t we all?
“Every hospital is understaffed and under resourced”
That’s evident.
“You’re lucky you have access to an emergency department at all!”
Lucky? Surely it’s a basic enough requirement to have an emergency department?
From a cynical point of view, it makes you wonder if the Irish public matter a damn to those who have any kind of control or say in the development and improvement of the health system. Yes, money doesn’t grow on trees but what we need (in addition to cash) are innovative solutions to the increasingly dangerous and frustrating problem that is overburdened emergency departments.
Lauren Joslin is a 21-year-old Law student at the University of Limerick.
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