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When will we shout stop?


AT BREAKING POINT A full hospital waiting room. It is all too regular a scene in Mayo University Hospital's Emergency Department. Pic: iStock

Edwin McGreal

As soon as we left the ambulance, it was clear we were entering a chaotic environment.
No fewer than seven people were lying on ambulance stretchers waiting to gain admission to Mayo University Hospital’s Emergency Department.
Some of them had no choice but to lie in a draughty corridor – and the weather outside was far from mild.
I was in the ambulance with my four-year-old son, Éamon, who was having breathing issues that turned out to be caused by pneumonia. Our doctor in Achill put him on oxygen straight away, and didn’t want to take him off it, so we were dispatched in an ambulance rather than driving up ourselves.
His age and his need for oxygen meant we jumped the queue, bypassing all the other ambulance stretchers to get into the physical Emergency Department (ED) straight away.
As a result, we were more witnesses to the chaos than victims of it. Part of me felt bad for jumping the queue but, hey, when your son is having breathing issues, those feelings go away pretty fast.
Once inside, it was clear it was bedlam.
You could see the stress writ large across the faces of the staff, as well as the faces of those who were lying on trolleys in the main ED corridor.
I could not see where on earth they could fit us into such as scene, but the staff are very resourceful and managed to squeeze us into one side. We had to remain on the ambulance stretcher in ED for two hours until we got a bed in the Paediatric Unit because there were no beds or trolleys left in the Emergency Department. That also meant the ambulance crew who brought us in had to wait two hours for the stretcher before they could go again.
The ED staff were really concerned about what would happen if a ‘resus’ came in – a patient requiring resuscitation – as there was nowhere left to treat them. Everywhere was full. I’m choosing my words carefully, but it is hard to argue that what was going on wasn’t dangerous.

Off call
We heard one nurse plead with her superior to put the ED ‘off call’, which would mean diverting all ambulances in the county to hospitals in Galway or Sligo.
From talking to staff in the days that followed, it’s not a request people make lightly. However, it is being made more and more in recent times, as the ability for the Emergency Department to fulfil its role becomes more and more compromised.
The request is rarely acceded to.
Some staff we spoke to feel this is because MUH management does not want to accept that the hospital is under such pressure that it has to come ‘off call’.
So, instead, people who have been brought to hospital by ambulance from all over the county must lie on a stretcher in a cold corridor waiting for space to clear. While we were there, some had to wait for over six hours before being seen. This is, sadly, not uncommon.
That’s not to mention the other people who were languishing for hour after hour in the waiting room (I didn’t get to see how bad it was because our entrance point was at the other end of the ED, but one staff member said it was ‘manic’ there too).
I’m not sure which is worse – that the hospital would refuse to go ‘off call’ or that things are so bad that the staff feel the need to argue for it.
Imagine coming from Achill, as we had, or Belmullet, and having to go all the way to Galway or Sligo for emergency treatment? It is simply a health service not fulfilling its responsibilities.
Wonderful staff
The staff? They were amazing. From the ambulance crew that brought us from Achill to the nurses, doctors and healthcare assistants in the Emergency Department and, subsequently, the Paediatric Unit, they were all brilliant.
They put Éamon at his ease so much that he left the hospital telling everyone about his ‘big adventure’.
Having reporting on issues in MUH ED for this newspaper, I was acutely aware going in of the pressure the staff were under, and I did not want to add to it.
I articulated this to an ED nurse before the pneumonia was diagnosed, and his reply was, ‘Don’t be daft, boys like this are why we do our job’. In the midst of such chaos, it was a reminder of how many people are just made for the caring profession.
Unfortunately, not every patient saw it that way.
It is understandable that someone’s patience might wear thin after waiting for treatment on a trolley, but watching one man lose it with a healthcare assistant, calling her a ‘bitch’ and trying to go for her physically, was awful. It was a stark reminder of the horrible anger that staff must also endure. They don’t get paid half enough. Thankfully other staff and a security guard stepped in quickly to protect her.
You could see the stress in many other patients. Some were confused. One patient kept triggering the fire alarm. Some had family with them. Others did not. You would think twice if someone belonging to you needed to go in, because what I witnessed last Monday was not an aberration. The next day was worse, one ED staff member told me, and days like those are all too common.

It’s not just in Mayo that this is happening. It is happening in Emergency Departments the length and breath of this country.
I thought I was aware of how bad things are in there from talking to staff in the course of my work, and to people who had been in there, but you have to experience it for yourself to really understand it. We were only in the Emergency Department for two hours. I can only imagine what it is like for staff there all the time and for patients who have to wait hours or days on trolleys.
It gives me no pleasure to say this, but our health service is failing our people. Our politicians have repeatedly failed to adequately address the issues. You have to wonder how bad it has to get before there’s any meaningful action.
Enough is enough.