Giving praise when it is due
When my mum had a fall before Christmas, I was impressed by the prompt and competent care at the ED. My column from 9 January 2014.
I never write about personal matters or experiences; I am just not that type of journalist. However, on a Saturday afternoon before Christmas, I ended up with my mum in St Vincent’s Hospital’s emergency department (ED). She got excellent care in good time, and so I thought I should write about a good public health system experience.My mum is a healthy, well, independent, active woman in her late 70s. She had a fall on the Friday afternoon. With the help of friends, she was able to get up, keep going and drive herself home. When I saw her on Friday evening, her hand was very swollen and her second last finger (the one beside the little finger) was heading off in a direction of its own. I was worried that it was broken, but she said she was not in pain, so we decided to wait until the following day to see how it was.
I dropped back into her on Saturday morning and it was no better. I had checked online for the nearest minor injury unit and although St Vincent’s Hospital does not have one specifically, their website says that fractures and sprains are directed into these services within their ED. I checked the trolley waits from the INMO website the day before and there was no one on a trolley in St Vincent’s Hospital on the Friday. This influenced our decision to go to the ED rather than a private service, where access might be quicker.
We arrived at St Vincent’s ED at 11.10am. We spoke with the receptionist, who checked my mum in. Mum paid €100 as she gave back her medical cards in 2008 – one of the few who did on the basis that her public service pension pushed her over the limit.
Within 10 minutes we were seen by a kind, efficient triage nurse. Within another 20 minutes or so we were seen by a young-looking, senior emergency medicine doctor who treated my mother with respect and care. He told us he thought her finger was broken and an x-ray was needed. We were referred down the corridor (still within the ED) to radiology and waited about 10 minutes for an x-ray. We then went back out to the public waiting area, which was beginning to fill up with sports injuries and a range of medical cases.
After another 20 minutes or so, we were back in with the same doctor. He confirmed what he thought; she had a nasty break at the base of her second last finger. He decided to anesthetise the hand and manipulate the finger back into position, without hurting her at all. The doctor got called off to more urgent cases so this took about an hour. We were then sent back down for an x-ray and back up to see the doctor again. He was pleased with the outcome, strapped up the finger to a splint and referred my mum to hand clinic in St Vincent’s on the following Thursday. As a result of the manipulation, no surgery was needed.
My mum was diagnosed, treated and discharged in under four hours. By this stage (about 2.45pm) the ED had some trollies on the corridors, all the bays were full of people who looked very sick or out of it from the previous night’s admissions. Saturday sports injuries and others were beginning to fill up the ED public waiting area.
All in all, my mum got the best care in St Vincent’s ED. The only bit I really query is the fact she had to pay €100 for the excellent care she got. She could afford it, but others in her position may not be so lucky.
Health Minister Dr James Reilly came to power promising that never again would there be 559 people on trollies in EDs. He has been successful in this – according to the official figures there were 32 per cent fewer people on trollies in EDs in first nine months of 2013 compared to 2011. This is a result of concerted efforts by the Special Delivery Unit (SDU), as well as a policy of moving trollies up onto wards. However, there are still thousands of people on trollies needing a bed in hospitals that are operating at more than 100 per cent capacity. Continuing to hold on to and make improvements in EDs with fewer staff and beds is increasingly difficult.
Everyone is entitled to the prompt, extremely competent treatment and care that my mother received. Thanks to all the staff in the St Vincent’s ED that Saturday afternoon.