Thursday, March 28, 2024

Watching paint dry at A&E

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Last Tuesday morning just after 9:45, I got a call telling me my mother was not well.

All ready for work, I switched plans and headed to her home. I called her general physician, who suggested that I get an ambulance and take her to the hospital.

Well, there were no ambulances. I tried another nearby doctor, whose waiting area was full to capacity, so it was on to another doctor, who offered no hope. She would have to wait on the afternoon doctor. I then headed to another doctor who, like the others, was in St George. She did not like the patient’s condition, wrote a letter and sent us directly to the Accident & Emergency Department of the Queen Elizabeth Hospital (QEH).

At 1:40 p.m. I arrived at the QEH and spoke to a security guard, registered and went back outside and awaited for the orderly, who arrived in three minutes.

I was soon called to give some details about my mother. Things appeared to be going quickly. By 3 p.m. I was in the assessment centre with the nurse. I was embedded on the front line of one of the most dreaded places in Barbados, the A&E Department of our major health care institution.

My not-so-good experience started when I had to struggle with Nurse Forde to get my mother on the bed. I started to ask questions about the wheelchairs and their cleanliness. One of my first observations was that they shifted patients from wheelchair to a regular chair in the twinkling of an eye. There was no sanitising of the chairs.

James Gaskin, an orderly supervisor, had already completed his shift but was still on the job – “as you can see it is quite hectic in here”.

Nurse Forde did her part and indicated she was going to see the doctor. The wait had started in earnest. Up came Winston “Bop Forde” Boyce of the Caribbean Broadcasting Corporation, who indicated he was going to see his mother, who had been in the “Casualty” since Monday after she had what he said “appeared to be a mild stroke”. She eventually left many hours later, walking in the company of her relatives.

Nurse Forde returned and said that the heart test on my mother had not shown anything “unusual”.

Once again I observed something I did not like. The same sink which was used after cleaning the patients, was used to catch water for them to drink with their tablets.

This was the week when the focus was on infectious disease management at the QEH. Most of the dispensers along the corridors also had no hand sanitiser in them.

My hopes of quick attention were quickly shattered when I was told to take my mother back into the main waiting area and check back in about an hour.

I stood beside my mother and looked around. There was an elderly man, Francis Howard, formerly of New Orleans, St Michael, in a wheelchair with two young women ensuring that he was as comfortable as possible under the circumstances. In the main seating area, a woman said aloud that she had been “at the hospital since the previous night 10 p.m. and it is heading for that time again. This hospital too sweet.”

Around 5:45 p.m., a man grimacing in pain limped in accompanied by two females and got into the inner area (where the doctors are), but, as if through a revolving door, they were soon back into the main waiting area.

The elder of the women belted out: “Hold on pon Jesus. Imagine a man in this type of pain can’t see a doctor. If you don’t hold on pon Jesus, then we going to hold on pon de Devil.”  

The groaning man then proceeded to place his head in the unsanitary chair with his body and feet on the ground.

“Hold on a minute, Gary,” the woman said, and much to the surprise of all present came his retort: “Relax.”

Her response: “I hate this hospital.”

Once again, still bending over in pain, he said: “Relax. You talking too much.”

Some women in the waiting room agreed, with one saying: “Don’t keep so much noise; otherwise they’ll put you last.”

That did not turn out to be so as around 6:10 p.m. he was in the inner circle again.

Some of those in the reception area had been waiting in excess of 24 hours, and as long as 30 hours.

I was getting restless so at 6:05 p.m. I approached the desk and explained that I was supposed to see a doctor since 5:30 p.m. The lady politely took my mother’s name.

At 6:15 p.m. Lolene Kellman, the patient advocate, came out and apologised for the long wait, stating that there had been a number of emergencies. They needed to attend to those on the inside before turning to patients on the outside.

In the back of the waiting room was a woman, Melissa Holder, on the floor wrapped up in a sheet. Holder, of St Matthias, had been brought to the hospital 24 hours earlier, and after her assessment, was back in the main waiting area. She was not a pleasant sight.

At 10:25 p.m., Howard was taken to the bathroom, but the lady with him came back to tell the general worker/cleaner that “the restroom is very, very dirty”. Five minutes later, that obviously angry cleaner went and dealt with the situation.

At 11:45 p.m., a man, bloodied all over, walked in with a woman. He had been stabbed. His was an emergency and he was rushed into the inner section.

At 2 a.m. the wait continued. Elderly patients were in the majority by far. But there was a crying baby who calmed down only when a man lifted him and walked around, as well as a little girl from St Catherine’s Primary, obviously hungry and restless; and a teenage student of the Frederick Smith Secondary School – all awaiting their turn.

Thanks to a very observant Sister Jacqueline Browne, these youngsters were quickly ushered into the inner area. Around 4:25 a.m., the little girl, her injured hand now attended to, came out with her beaming mother, who touched me and said her daughter had “got through” and was going home.

I had dozed off. So I got up and went outside, where I met Doreen Evelyn of Todds, St George, a rather unusual woman. She visits the A&E every evening and takes the 6 a.m. bus back home.

She looks after a big, rather healthy-looking cat, Ginger, which hangs out just outside the A & E. They were originally three of them but the dogs which roam the area killed two.

Just after 8:15 a.m., a Dr Rao came out and called the names of patients – something Sister Browne had done before 7 a.m. He indicated that inside was full and some of the patients had been there since the previous day. Some of the patients had left after not seeing a doctor and waiting for such long periods.

At 2 p.m., my mother was finally on the inside. Yes, 24 hours after arriving at the hospital.

I had struck up conversations with a number of people. They were the Leslies, the wife still carrying her Jamaican accent and clearly worried about her husband, who had been there perhaps an hour before me.

Gestures of kindness were always present, despite the frustrating wait. Take a young man, an employee of the Geriatric Hospital, who was there to get his back examined. He noticed that one of the elderly men needed to go to the bathroom and his wife was clearly in a predicament. The youngster quickly put on a pair of disposable gloves and came to their rescue.

Then there were the nurses from the St Lucy District Hospital, who came with an elderly patient as well as those from the Psychiatric Hospital with a well-spoken elderly man. They all displayed care and understanding.

Similarly, security guard Rommel Beckles, who not only apologised to all present for the long delays but showed that he was a multi-skilled employee, helping both patients and relatives, while keeping an eye on his main duties.

His disposition was completely opposite to that of another guard who was on duty around 6 p.m. He reminded me of “Watchie” at the plantation guarding the canes.

But it was the dignified and businesslike approach of Sister Browne which saved my day. She retook the necessary tests, applied the IV and offered words of support. She tried and did her best.

Once inside, I sought to walk around and see what had been happening. The asthma bay was active. Entertainer Margaret Bovell was there giving support to an elderly lady, while a number of beds were occupied by mainly elderly patients. The corridor was full with ambulance trolleys, about 12 of them, all with patients. There was really no room available in the place. This was the crux of the problem.

Then the emergencies added to the confusion; a baby had to be attended to, a shooting victim, and a stabbing one as well. I understood these critical care issues, but I had my own worries and concerns.

Shortly before 5 a.m., a young female doctor, Dr Alleyne, came to examine my mother. She was polite and professional. I was relieved.

I started to doze off again. Sister Browne appeared before me. We spoke briefly and I thanked her. She understood the anxiety and frustrations of the patients and more so of their relatives. It was her calling –as had Florence Nightingale and Mary Seacole before – to care and show mercy.

Just around 9:30, Dr Rao looked at me and indicated that the patient was being discharged. He did some minor things and I left. The orderly was courteous, took my mother out in a wheelchair and demonstrated the right way to place the patient in the vehicle.

My parting thought after 41 hours of mostly misery was that something needs to be done with these dirty wheelchairs and the A & E Department itself.

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