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Column My night in the emergency department

Hospital staff say emergency departments are in crisis – but how is the experience for patients? Clare Kleinedler writes about the night she found out…

WHEN IT COMES to healthcare in Ireland, the news isn’t good.

The headlines in the papers and the television news reports are ripe with exclamations of how badly the system has broken down in recent years. Stories of patients waiting for beds, tests and appointments are featured daily in the Irish media.

As someone who has no private health insurance here, my own experience has been quite good. For €50 I can see my general practitioner and she’s available with one or two days’ notice. My prescriptions cost about €10 on average. Of course I have never needed emergency hospital care – which according to the news reports is a whole different story all together – until recently.

Last week I went to my GP complaining of chest pain, rather a tightness in the middle chest area, for the previous few days. She surmised it was likely esophageal spasms caused by an upsurge of stomach acids. While I was there she took my blood pressure, which was surprisingly high; I’ve always had perfect readings and my last check was only a few months ago, also perfect.

She prescribed meds for the spasms and told me to come back in a few days. When I returned with the same symptoms and high blood pressure, she sent me to the emergency room at Beaumont in Dublin.

And that’s where I got my first dose of the reality that is public healthcare in Ireland.

‘The larger emergency room looked like a war zone’

Because chest pain is something that is typically considered serious, I was actually seen relatively quickly by the nurse. She took my vitals and sent me back into the waiting room, where I sat with Mountaineering Man. There were a good number of people there, some with visible injuries and some without, but the atmosphere was relatively calm. There was one man who moaned out loud every five minutes, but otherwise it wasn’t a terrible place to be.

Once I got called into the urgent emergency section, it was a different story all together. I had to leave MM – they wouldn’t let him come in with me – so I told him to just go home as it looked like I’d have quite a long wait. The area that I had to sit in was just behind the larger emergency room, which looked like a war zone.

There were gurneys everywhere – so many that I had to wiggle my way in between them to get past. The patients in that room were suffering; some had bleeding head wounds, others had swollen stomachs and one woman looked like she’d been cut quite severely in the arm. She cried out loud as I walked by.

The room smelled of urine and the loud complaining from patients was jarring. There was remnants of blood on the floor, which looked like it had been haphazardly mopped up with a dry cloth. Nurses were multitasking, many running between four or five patients at a time; interns tried their best to help out wherever and with whatever they could. There must have been at least 50 injured in that room, which was built for about 20 patients. “Beirut looks better than this,” I heard one paramedic say.

‘There were also armed gardaí in bullet-proof vests’

There were also armed gardai, who sported bullet-proof vests and guarded the one exit door. I’m not really sure why, but I assumed there was an injured criminal in our midst. Then again, there were plenty of unruly patients, some wanting to leave against doctor’s orders, others so wasted they walked around aimlessly. To say the place was chaotic would be an understatement.

Though it took a total of six hours and a second round of blood tests (thanks to a “mix-up” of bloodwork), I can’t complain about the care that I received at Beaumont. I got a chest x-ray, a heart echo ultrasound and a thorough questioning of symptoms from the doctors there. The nurses were friendly and they took care of us. At one point, a woman came round with a cart and fed us biscuits, sandwiches and tea for no charge. I was utterly grateful to see her as it’d been a good seven hours since I’d eaten at that point.

In the end I got a proper diagnoses (swelling of joints in my ribcage plus viral infection – serious enough for meds and time off work but not life-threatening) and a new prescription. But moreover I got peace of mind, which is priceless.

I can’t say that the experience was entirely wonderful…there were a lot of people suffering there who were not going to get the help they needed in a timely manner. The doctors and nurses were struggling to do what they could with the limited resources available to them. And really that’s what it comes down to, we need more resources and funds for the healthcare system – a statement that will garner me the award for stating the obvious!

In any case, that is my first-person account of an evening in the A&E.

Read more by Clare Kleinedler on her blog: An American in Ireland>

Column: ‘The system is sick’ – inside a hospital emergency department>

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