Scary hours in the emergency department

Scary hours in ambulance

Scary hours spent in public hospital emergency departments seem to be the norm in Perth. We’ve been proud of our ‘world class hospital system’, but that description no longer holds.

People with experience in other states assure me this condition is widespread across Australia. Several people, including a child, have died recently while waiting for an ambulance or hospital treatment.

I’m one of the lucky people. My injury, in the scheme of things, was not devastating and I had good support and care.

I’ve had two experiences of waiting in an emergency department this year, which makes me feel like a pro. Both times we were there with a referral from general practitioners. The first was when John suffered the onset a serious eye condition on New Years Day. The second, more recently, was when I fell over on the road and hit my head. (I wrote about that in ‘Domestic drama for old folk‘.) This blog expands on that experience.

The kindness of strangers

Two men ran to help me, first by making sure cars and trucks on the busy street didn’t run over me. They made sure I could stand, then took me into their workshop and applied a pressure bandage to my head wound. Someone called the dentist to tell her I couldn’t keep the appointment to which I’d been hurrying.

Although they wanted to call an ambulance, I preferred, instead, to go to the medical clinic nearby where I knew the doctors. No one chooses to go to a hospital if they can be treated a general practitioner. One of the men kindly drove me and made sure I got inside safely.

My doctor decided I did need an ambulance. The practice nurse applied another pressure bandage – an almost impossible task because the wound was a gouge near the crown of my head. She called my family, and my son-in-law, Simon arrived within minutes.

Paramedics

Paramedics in our state are constantly and relentlessly busy. The pressure under which they work is patently unfair.

But those who came for me were unfailingly kind, apparently unhurried and, of course, competent. When we got to the hospital, they handed me, my diagnosis and observations over to a nurse. During the long scary hours of waiting, I saw these young men several times as they treated and transported more patients to the hospital.

Ambulance ramping

They parked my stretcher in what used to be a pleasant foyer of a tertiary. These days the area holds patients awaiting urgent treatment who lie on stretchers until hospital staff becomes avilable.

This, and ambulances parked outside, is the practice known as ambulance ramping. Paramedics from the ambulances keep watch and treat patients for as long as needed.

The verb ‘to ramp’ describes the action of fuming or storming with anger. There is a correlation. We need the custom of ambulance ramping to change. Soon.

My daughter, Jenny, arrived. Simon went back to work.

A registered nurse bundled me from the stretcher on to a waiting wheelchair. She trundled me into a corridor off the main waiting room which was packed with waiting patients.

Seering so many people in the space reminded me of my previous experience of the waiting room with John at the beginning of the year. We watched with interest and sometimes horror as people bled onto the floor from their wounds.

Scary hours

Wrapped in blood-stained blankets, I sat in the corridor outside the doors of the toilet for many scary hours. Stunned from the blow to my head, I would have preferred to be lying, not sitting.

At one stage, another ‘visitor’ told Jenny the blood was dripping down my back. She caught the attention of someone who brought more dressings to staunch the flow.

Nurses, doctors, patient assistants and orderlies came and went about their business in haste. Patients and their helpers in a continual procession passed by on their way into the toilets in pyjamas, work gear, uniforms.

Someone stopped to talk to Jenny.

I brought my neighbour here. I hardly know her,‘ she said. ‘And we’ve been waiting seven hours already.’

My oldest granddaughter called to say she’d bring dinner for her mother and me, and Jenny went outside to meet her in the car park. Sharing a delicious meal in a corridor outside a hospital toilet makes an interesting talking point.

More scary hours

Eventually a registered nurse wheeled me to the radiology department for a CT Scan. Someone there took off my blood drenched T-shirt and gave me a clean, dry gown to replace it. Such a good feeling to be dry and warm at last.

More waiting. Two hours later, a cheerful young man I took to be an orderly came to wheel me to a minute cubicle. On the way he asked me about my accident, health, medications and I recognised his role as an emergency department doctor.

Why are you wheeling me?‘ I asked.

If not me, then who?‘ he countered. ‘I’m free to see you, and it’s time-saving for me to wheel you where I need you. It actually saves time.’

Who, indeed in that mayhem.

My CT Scan showed no evidence of strokes. No brain haemorrhage, but a ‘boggy’ swelling over my ear. I was good to go home.

Every single member of the hospital staff treated me with patience and great courtesy. I couldn’t help but wonder how they managed to stay cheerful in the face of the pressure and drama of their work.

Jenny took me to her house where she showered me and washed the blood from my hair. She applied another pressure dresssing, held on with a khaki beanie borrowed from my grandson. I stayed at their house for a few days, until the worst of the concussion subsided.

The following morning, the nurse practitioner at the general practice poured surgical glue into my wound and redressed it.

My wound healed quickly. I’ve almost recovered from the concussion. But I’m left with a lingering malaise and fear about falling. I don’t have time for that luxury, so here’s hoping all will be well. Soon.

Queued ambulances

Apparently the practice of ramping ambulances occurs every day. Every. Single. Day. Not only in Perth, but also across Australia.

Shortages of staff and beds

All categories of staff are in short supply for several reasons.

  • Staff sickness due to COVID-19 and influenza.
  • Increased resignations from doctors, nurses and others who can no longer work under the stressful conditions.
  • The inability to recruit new workers from overseas when our borders closed.
  • Additional patients due to COVID (although fewer people are now hospitalised)
  • More patients because of catch-up surgery for those whose operations were postponed.
  • Increased mental illness in the community and the urgent need for hospitalisation of people seriously ill.
  • Patients who need aged care beds which are also in short supply remain in acute wards awaiting placement.
  • Dare I say, poor past planning and insufficient funding for the Health Department.

Whatever would Sister Broadbent say about those scary hours?

Sister Broadbent ruled the emergency department at Royal Perth Hospital where I trained as a nurse in the late 1950s. She ran that place with a kind heart and a will of iron. Patients may have experienced scary hours, but they felt safe. An atmosphere of calm pervaded the space.

No patient who needed a bed sat in a chair. People sat in an orderly manner in the waiting room or out of sight in cubicles with clean, starched curtains. Visitors expected staff to look after patients who needed care, not the visitors themselves.

A neat triage system ensured patients felt understood and treated according to their need. No blood remained visible to others. Cleaners mopped and scrubbed floors, toilets, even walls when necessary hour in and hour out.

Everyone thought of doctors as way high on the heirarchy. Neat nurses, scared of the bark of an irate resident or registrar, anticipated their needs as much as those of patients.

We may never get back to that level of regimentation, order and calm in any hospital emergency department. But we can only hope for considerable improvement in the present system.

Copyright, Maureen Helen 2022
Photo, Maureen-Helen

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4 Comments

  1. So glad that you are almost fully recovered but I can feel your anxiety now about falling & share this feeling. However, you are resourceful & will soon regain the joy of going out & about. I fractured an ankle & hip some years ago & now try to observe where I’m going more intetionally. A very thoughtful article, thankyou.

    1. Thank you for your comment, Maureen. I hope I’m resourceful enough to be able to walk around Subiaco again soon. It feels quite daunting, and I need to do just a little every day.

  2. Wonderful post, Maureen. What an ordeal you went through. And your piece is very topical. I had a fear of falling too, for a long time after the two falls when I fractured my back. I’m still careful!

    1. Thank you, Christina. Yes, emergency departments are really frightening places. I didn’t know you’d fallen and fractured your back! My head wound and concussion pale into insignificance. I hope one day I’ll lose the fear of falling again.

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