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Treatment needed for Emergency Department

ED

by James Hollings
The accident happened about 9.10 on a Sunday morning, two weeks ago now. One minute we were chatting in the sunshine on the grass at Kilbirnie Park. Next minute we were on the way to hospital. One of our children was injured, and paramedics told us we had to go to Wellington Hospital emergency department immediately.

We arrived there about 10.30. My partner and my child went in, while I found a carpark. There was a delay while I paid the parking fee. Fumbling with an unfamiliar machine while worrying about my child ratcheted the anxiety levels up another notch. Then into emergency department reception, only to be told to go out and go through the covid screening room outside. Then back in.

The waiting room was like a scene from a disaster movie.

If you haven’t been to Wellington ED, you need to know this place is not intended to be comfortable. It’s a bare, harshly-lit room with about five rows of hard chairs, all facing to the front, like a classroom.

In them, across them, sometimes beneath them were sprawled about 20 people, all obviously sick or injured. Some were bleeding, some coughing, some looked pale, others anxious. One elderly man had a badly swollen nose and a smear of blood down the side of his face. A woman had a huge black eye and blood on her face. I was worried that seeing them would make our child, already anxious and in semi-shock, more worried. Fortunately, there is a small screened-off children’s area, which gave us some privacy.

In there, a woman sat cradling her young toddler. The child looked hungry, but she obviously couldn’t leave him. We offered them a smoothie. She seemed embarrassed but took it.

I had to go out to the car, which meant walking across the front of the seated rows. I was conscious of eyes following me. I tried not to look at the injured, not wanting to add to their humiliation. Then I realized they weren’t looking at me – their eyes were fixed imploringly on the glass screen at the front of the room, willing those behind it to call their names. Because when your name was called, you got to go through the large double doors, electronically locked. Behind them was help, pain relief and above all somewhere to lie down.

There’s something very grim about this place. If this is the front line of 21st century healthcare, you can’t help wondering why it’s necessary for so many to be kept waiting for so long, in pain, in such a comfortless place, in full view of anyone.

Why, in the midst of such a modern hospital, barely 10 years old, is the primary reception area for often badly injured and sick people so bleak? Why, in a billion dollar facility, was there not enough money to build a couple of dozen cubicles, with beds, where people could rest for what seemed to be the inevitable hours while they waited to be seen? And why is the wait so long? Are we really so poor we can’t afford three or four more nurses on duty to help triage?

Then our name was called. The magic doors opened, and we were ushered through to the inner sanctum. Once there, there was another two-hour wait. But at least it was on a bed, and our child could rest, in peace and quiet. She immediately relaxed, which meant we could. The nurse, when he got to her, was excellent. As was the rest of the care. Of course, we were grateful and relieved at the competence, kindness and professionalism.

As we left, the waiting room was still full, with many of the same faces. Some looked at me with what could have been envy, or hope, or pleading.

A few days later, I was telling a friend about our experience, half expecting to be told off for being ungrateful. Turned out, she’d had a similar experience – she was in there for severe back pain and waited four hours, lying on the floor in between the rows of chairs, in full view of everyone. She also happened to be a nurse, and told me she was as shocked and appalled as I was at the third-world conditions. At one point she wanted to go out and lie in her car, but was worried she’d lose her place in the queue.

Last week it was reported that Wellington Hospital’s emergency department is too small to meet the increasing acute demand. Capital and Coast District Health Board director of provider services Joy Farley told Stuff that people were arriving at hospital in a worse condition and needing longer stays, which left fewer beds free.

The hospital also put out a plea on its website for people with non-emergency illnesses to go to their GP. That’s a perennial problem. In a perfect world, there would be enough GP services open at the weekend to take the pressure off ED. But there aren’t, and many people can’t afford the $80-90 for a visit to a private after-hours clinic. Why we have to make the waits so long at what is often the only place in town that will take people in an emergency, I can’t understand.

In any case, it’s not just wait times at Wellington Hospital ED that are the problem. It’s the place you have to wait in. Can’t we do better?

6 comments:

  1. Claire, 4. April 2021, 17:42

    The times I have been at the emergency department I have been triaged, given pain relief, then waited the appropriate time relative to my injury. In my two cases under two hours. I cannot complain. I don’t go to the hospital for minor things as will have to wait a long time as anyone with a more serious injury can arrive and step up the queue. I wouldn’t over-dramatise the situation except on a Friday or Saturday night.

     
  2. Jane, 6. April 2021, 19:43

    I agree, Claire, my experience was similar to yours, having made two visits since 2015.

    James, it seems you’ve had a bad experience, not nice. It also reads as a stressed and anxious parent wanting to receive help for their child quickly, something I think most would empathize with. However, the ED waiting room is also a place where you’re faced with extreme reality and not a consumer experience that can be carefully crafted, due to the nature of its business: accidents.

    We are extremely lucky to receive free healthcare here in New Zealand. Calling the conditions “third world” is unkind to those who helped you.

     
  3. Peter, 6. April 2021, 20:36

    The current ED is a new temporary replacement. It was instigated by Winston Peters after he experienced its archaic predecessor. Believe me, that was 10 times worse. I would be surprised if anyone believed the temporary statement at the time.

     
  4. Cushla Thompson, 7. April 2021, 9:09

    Massive thank you to Wellington Free Ambulance staff and Edward O’Connell and Tiffany in Wellington Hospital’s ED for last night when our 16yo had a bad allergic reaction to dairy. You were amazing and made it all a bit less scary… But
    Wellington ED clearly under pressure. [via twitter]

     
  5. D'Esterre, 9. April 2021, 16:19

    Jane: “Calling the conditions “third world” is unkind to those who helped you.” The author is criticising the conditions in which people must wait, not the staff who deliver care. In any event, he’s right about the state of the Wellington Regional Hospital ED waiting room. It surely isn’t a pleasant place in which to have to spend any time. As anyone knows who’s been obliged to use it recently, the ED is too small for the numbers of people who flood into it. I feel compassion for the staff, who do a sterling job in cramped conditions. It isn’t their fault.

     
  6. Jane, 9. April 2021, 21:32

    D’Esterre, I appreciate the distinction but it’s still criticism by proxy. Vocational positions tend to confer pride and a strong sense of self-identification with an organisation’s mission. I absolutely agree it is not the fault of staff. I wonder if there is an ED in the world that isn’t “too small”?

    I’m not convinced the author’s suggestions for improvement are feasible. For example, providing “a couple of dozen cubicles, with beds, where people could rest” — how would this work? Who would clean the beds/cubicles after each tenancy? It’s actually a sensible idea to have everyone in view of each other, for safety and “friendly” surveillance reasons. Being hidden in a cubicle means you’re less likely to receive attention if your affliction worsens suddenly and nobody is in a position to notice.

     

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