A&E Galway

Sniipe

My daughter had an accident. She was 2 at the time of the accident (her birthday was the next day). We stated her age, the fact that she fell on her head and was complaining of a hand injury. We went into A&E at 6.30pm. This was our log (remember she is 2...).

20 min queuing to admit to A&E.
120 min waiting for a triage nurse to examine her.
220 min additional waiting ...

At the time of the triage it was obvious enough that it was probably a bad sprain or a broken hand. No tubi grib given, no sling, no immediate xray, no admission to a childrens A&E, no ultrasound...

It was late for her. She was in pain and she was wrecked. The A&E ward was busy. There were people getting sick, people acting the maggot and some people with bad rashes. There was no need to be adding this to a young child's list of things for her immune system to combat.

At 4 hours in we asked where we were in the queue. We were de-prioritised and there was 6 ahead of us.

2 hours later I went back in and I was told the exact same thing.

It seemed to me that there was no manager in A&E advising the situation.

Ideally, my daughter should have been given a quick look over in case of a head injury immediately. Then if that was all ok she should have been given some pain medication and a support for her arm and told to come back in the following day where it might have been less manic.

The Galway Clinic would have been handy, however it doesn't admit under 4's into its A&E. Also the Bons Secours don't have an A&E.

I think its mad for a city like Galway which caters a lot for the west to be so poorly managed. I think back to when I was in A&E, and I think its in a worse state now.

The next morning we were into A&E and out of it with a back slab cast within 3 hours... I've to back to the other hospital (Merlin) tomorrow morning for a full cast.

galah

And thats why we usually go to westdoc first; have a GP assess the situation and have them decide whether you need to go to A&E. Will save you some cash as well as westdoc charges 60 quid while hospital charges 100, but is free with a referral from GP.

But it's really tough with a small child, especially the waiting around, dunno how they can't see that and prioritise accordingly - or as you say, check for serious trauma and send you home if child is ok. That said, I was in with our 9 week old, and waited less than 20 minutes to see a doc in A&E, and had to wait about 4 hours for a bed in peds to be ready, was in the separate children's section. Could have been worse...

Hope your little one is ok!

jkforde

Sniipe wrote: »

My daughter had an accident. She was 2 at the time of the accident (her birthday was the next day). We stated her age, the fact that she fell on her head and was complaining of a hand injury. We went into A&E at 6.30pm. This was our log (remember she is 2...).

20 min queuing to admit to A&E.
120 min waiting for a triage nurse to examine her.
220 min additional waiting ...

At the time of the triage it was obvious enough that it was probably a bad sprain or a broken hand. No tubi grib given, no sling, no immediate xray, no admission to a childrens A&E, no ultrasound...

It was late for her. She was in pain and she was wrecked. The A&E ward was busy. There were people getting sick, people acting the maggot and some people with bad rashes. There was no need to be adding this to a young child's list of things for her immune system to combat.

At 4 hours in we asked where we were in the queue. We were de-prioritised and there was 6 ahead of us.

2 hours later I went back in and I was told the exact same thing.

It seemed to me that there was no manager in A&E advising the situation.

Ideally, my daughter should have been given a quick look over in case of a head injury immediately. Then if that was all ok she should have been given some pain medication and a support for her arm and told to come back in the following day where it might have been less manic.

The Galway Clinic would have been handy, however it doesn't admit under 4's into its A&E. Also the Bons Secours don't have an A&E.

I think its mad for a city like Galway which caters a lot for the west to be so poorly managed. I think back to when I was in A&E, and I think its in a worse state now.

The next morning we were into A&E and out of it with a back slab cast within 3 hours... I've to back to the other hospital (Merlin) tomorrow morning for a full cast.

I sincerely sympathise (got 2 under 2 but no A&E trip....yet!) but, while getting it off one's chest here is positive and promotes much needed debate, this needs to be said to our local and national politicians by everyone with a direct experience.... political types generally are people who instinctively only react when they're getting an ear bashing...

Mrs OBumble

Was it WestDoc or CityDoc that sent you to A&E?

Sniipe

jkforde wrote: »

I sincerely sympathise (got 2 under 2 but no A&E trip....yet!) but, while getting it off one's chest here is positive and promotes much needed debate, this needs to be said to our local and national politicians by everyone with a direct experience.... political types generally are people who instinctively only react when they're getting an ear bashing...

I'm in the middle of filing a complaint with the HSE. I will follow up with the politically aligned shortly.

Mrs OBumble wrote: »

Was it WestDoc or CityDoc that sent you to A&E?

I went straight to A&E, it was a head injury.

Goofy

I do sympathise with you as it must have been very stressful for both you and your child. But you have to realise that a sprain or break are near the bottom of the priority list in an Emergency room. These injuries are not time dependant. If you treat them now or in 6 hours time, the outcome will be the same. You said yourself that it was busy there. There could have been any number of critical patients with time dependant injuries or illnesses where 10 mins could be the difference between life and death. Things like heart attacks, stroke, serious trauma. These patients have to be seen first.

challengemaster

Sniipe wrote: »

I'm in the middle of filing a complaint with the HSE. I will follow up with the politically aligned shortly.

Complaint won't get anywhere, doubt it'll even get a response - considering letters from consultants to the HSE went unanswered for a year.

If you do get a response you'll probably be told 6 hours is normal.

What day was it? That can have a huge affect on how quickly you get seen. You also caught the changeover to night shift which didn't help.


Triage nurses can't give anything, it's up to the doctors to order any tests (x-ray, ultrasound, etc) or give any treatments - because something could be done at time of triage that could just exaggerate the injury or make matters worse for the doctors treating the patient. Unfortunately there's only so many doctors, and while your daughter is the most important thing to you... there's a reason for ranking seriousness. Not too long ago I was visiting someone in Tullamore ED, at night, there was only 1 reg and 1 locum SHO running the entire department, with maybe 3-4 nurses. I doubt its much different anywhere else in the country.

They also can't tell you to go away and come back tomorrow incase something serious happens during that time frame. You can discharge yourself and sign a load of forms saying you know what you're doing, but they can't advise you to leave. It's a legal minefield.

I can think back too, and I don't think anything has changed that much. I remember >10 years ago (not in galway), I was left for hours without even seeing triage with a fractured skull and broken jaw, face covered in blood.

gordongekko

What exactly are you complaining about?

dan hibiki

First off, glad there was no head injury. Everyone, myself included has a horror story about waiting in A&E UCHG. Is this a problem unique to UCHG? Is this down to the cuts enforced by the government? All I can tell you is that I have been in this A&E on multiple occasions and have been waiting for a ridiculous length of time despite the severity of the pain (i wont go into details). I have actually threatened to burn the hospital to the ground if they dared to send me a bill (stupid thing to say - i know, but again, pain and frustration induced). I even have some tepid links to staff there, but have never been seen by the triage with any sense of relevant urgency. On top of this, every triage nurse has been unsympathetic to the point of nonchalance. I hate getting broken in Galway.

flazio

Can I ask why you didn't call an ambulance if you suspected a head injury?

galah

Not the op, but I doubt the injury was severe enough for an ambulance; if the child is conscious, coherent and not bleeding profusely or showing other signs of serious injury, an ambulance would surely be a bit much (not sure if you also have to pay for that if you don't have a medical card).

Also just because you get an ambulance to A&E doesn't mean you'll wait less. Have first hand experience with that.

PucaMama

Goofy wrote: »

I do sympathise with you as it must have been very stressful for both you and your child. But you have to realise that a sprain or break are near the bottom of the priority list in an Emergency room. These injuries are not time dependant. If you treat them now or in 6 hours time, the outcome will be the same. You said yourself that it was busy there. There could have been any number of critical patients with time dependant injuries or illnesses where 10 mins could be the difference between life and death. Things like heart attacks, stroke, serious trauma. These patients have to be seen first.

this. people need to realise certain injuries and ilnesses are more serious than others.

Mrs OBumble

galah wrote: »

Not the op, but I doubt the injury was severe enough for an ambulance; if the child is conscious, coherent and not bleeding profusely or showing other signs of serious injury, an ambulance would surely be a bit much ....

... and initial assessment by a GP would have been an appropriate first step in seeking treatment.

Red Pepper

I have had 4 experiences of Galway A&E in the past 5 years - all relatives.
For 3 of the 4 "visits", the treatment we received was terrible and in one case, negligent. I cant say too much because we have one complaint under investigation.
I did learn that the secret to getting the best care in the A&E is that he/she who shouts/harasses the most will get the best treatment/attention.
I blame under staffing and a very inefficient "system".
Don't get sick in Galway.

Zzippy

Mrs OBumble wrote: »

... and initial assessment by a GP would have been an appropriate first step in seeking treatment.

Initial assessment by a GP for a suspected head injury in a toddler? Are you serious? Straight to hospital is the only sensible option, head injuries can deteriorate very rapidly and speed is important, not faffing about with GP visits...

Funny how we get it so wrong in this country, yet a so-called poorer country can get it so right when it comes to A&E

flazio

Hence why I suggested an ambulance, a paramedic would be able to assess the child before setting off to hospital.

Meteoric

I was assessed by a consultant as needing to be in the hospital, referred me to a ward for observation that day, sent to hospital with the recommendation, I waited hours as apparently the examination and letter from the consultant could not book me in, I needed to be examined by A&E a) taking up time someone else could have used and b) obviously not a priority as had already been assessed and c) doing the same tests he had done. My doctor had phoned ahead of me arriving, making sure there were beds available and written the letter. To me that is paperwork gone mad. I was dealt with wonderfully in the A&E apart from the wait but that duplication seems mad to me

Edgedinblue

Had to get emergency surgery 2 years ago as my appendix was severely inflamed and ready to pop. I arrived at 11am, was left sitting around as a nurse and two "doctors" didn't believe I was in so much pain. Apparently EVERYONE with appendix problems vomits, not me! Has to be constipation they told me!

They flaffed about leaving me out in the waiting room until around 4ish. I was in severe pain wasn't given a thing. They brought me into the a&e gave me panadol (which never even works for a headache never mind this) and ordered an ultrasound and took bloods to finally realise my white cell count was through the roof and my appendix was huge. Only then was I admitted fully around 6, told I needed to be in surgery by 10pm that day! They went from not believing me to immediate emergency open surgery. After that though I have to admit I was treated well, bar the food but that's another rant in itself.

I was also brought to a&e over mental health issues, which I won't go into here and was told I was fine and to go home. If that's not neglect then I don't know. Useless cnuts over there.

Mrs OBumble

Zzippy wrote: »

Initial assessment by a GP for a suspected head injury in a toddler? Are you serious? Straight to hospital is the only sensible option, head injuries can deteriorate very rapidly and speed is important, not faffing about with GP visits...

Yes, because 140 minutes spent waiting to be seen by the triage nurse - never mind a doctor - is hardly speedy!

thesandeman

Had to go there twice in the last twenty years due to work related cuts.
Staff in Casualty were brilliant. Administration were not. I had one person trying to get me to sign her form while there was still half a bottle of Jack Daniels stuck in my hand and blood dripping all over the place. Even the Taxi driver on the way up didn't expect to be paid.

Sniipe

Just some clarification. Would you believe I was in the middle of doing my first aid course at the time (2nd day of 3). My Daughter fell from a height of approximately 1meter. She landed on her head (and hand so it seems) but in a backwards position - almost like a partial front flip. I didn't touch her, she got up about 3 seconds later with no loss of consciousness. I did fear the worst immediately, but that subsided. About 20 seconds later she started bleeding from the nose, but thankfully only for about a minute. I was in total panic, she was standing and crying which was something. I tried to assess the damage, however I was alone and my one year old son was screaming and was all over us (in hindsight I should have put him in his cot). I never considered calling the ambulance. I probably would have only done so if she wasn't moving. I have no idea how much an ambulance costs (not on medical card).

I didn't consider westdoc or a doctor for two reasons. A doctor can't tell if a bone is broke or not unless its apparent, only an x-ray can (it turned out to be a Torus fracture of the Radius). The second reason was because she landed on her head and her landing made her neck look totally abnormal.

I think out of normal hours A&E obviously have much less staff in every department. With this case in mind this is how I think things should have been done:

Triage nurse assess her straight away and given her a tubie grip/soft bandage. If not serious, then re-assess her in an hour in case it is a head injury. We only live 10 minutes away so we could have gone home with the instructions of coming back if things deteriorate.

When we did see the doctor the next day, all she did was send her to an Xray, read the xray and prescribed back cast for the weekend followed by a cast (in Merlin) on Monday.

Sniipe

Zzippy wrote: »

Funny how we get it so wrong in this country, yet a so-called poorer country can get it so right when it comes to A&E

Nice link there Zzippy. Ultrasound would have been a better option for our child also according to the one study that I read over recently.

folbotcar

You should complain, not that it will do any good. If you do get a reply it'll just be waffle because in these institutions nobody is ever at fault. If there's any excuse it will be because of lack of resources or staff and government cutbacks. The standard excuse now for incompetence and inefficiency in the HSE and the wider public service. The fact that they were always incompetent and inefficient even when they were heavily resourced is ignored.

It's my longstanding belief that the HSE is largely run for the benefit of the staff who work in it. Not the patients.

My own experience was classic. I needed an X-ray on my back. With a Doctor's referral I rang the hospital for an appointment. I was told the next available appointment was over a month away. I said I'd pay for it. I was in and out the next day in less than half an hour. I'm pretty sure I didn't bump a public patient out of the queue. It would have sat empty.

Wompa1

I watched a young man bleed out and die in A&E in the regional.

It's partly our own fault. When the money was rolling in, we weren't demanding the change.

Look at all of the money that's gone into the University over the last 15 years....our priorities are all messed up

Mrs OBumble

Wompa1 wrote: »

It's partly our own fault. When the money was rolling in, we weren't demanding the change.

Look at all of the money that's gone into the University over the last 15 years....our priorities are all messed up

I agree.

Also, I see another issue: Anecdotally, I have heard about high levels of census non-compliance in Galway as well. Some of it is just bloody-mindedness ("they pay my benefit each week, they know where I am, why do I need to fill out another form"), some is students who don't feel like they live here, even though they spend more time each week here that at home. And of some of it will be BS - they really do fill the form in, but don't admit it in public. But I have a strong suspicion that our population is actually larger than the official figures say.

The problem with that is that it undercounts the official amount of people that UGH is serving.

Now I have no idea to what extend the funding is population based, but it's likely that it does affect the calculations in some ways.

Mrs OBumble

Zzippy wrote: »

Funny how we get it so wrong in this country, yet a so-called poorer country can get it so right when it comes to A&E

Just got around to reading that link.

I've had what that kid had.

The article underplays it, but as my GP said "this is one of the few true orthopaedic emergencies". Untreated, you can have serious joint damage quickly, and will be dead in a few days.

My experience was at home, where there can be similar A&E delay stories as we get here. I saw the GP at 2:30, got to the outpatients by 4pm, and was in surgery at 11pm that night. Amm pretty sure that I bumped several people, including one woman with a very bad fracture, down the theatre queue.

Which is part of the reason for the fast treatment.

Wompa1

Mrs OBumble wrote: »

I agree.

Also, I see another issue: Anecdotally, I have heard about high levels of census non-compliance in Galway as well. Some of it is just bloody-mindedness ("they pay my benefit each week, they know where I am, why do I need to fill out another form"), some is students who don't feel like they live here, even though they spend more time each week here that at home. And of some of it will be BS - they really do fill the form in, but don't admit it in public. But I have a strong suspicion that our population is actually larger than the official figures say.

The problem with that is that it undercounts the official amount of people that UGH is serving.

Now I have no idea to what extend the funding is population based, but it's likely that it does affect the calculations in some ways.

I'm sure that's part of it. I'm living in Phoenix, Arizona at the moment. They estimate the actually population of the place makes it the fifth biggest city in the US but due to so many illegal immigrants scared to sign the census, we're close to a million shy on paper of the actual population. There's an amnesty in the state for the census so they can just get the real number but they still refuse to partake.

But...in a state that's roughly the size of Ireland. The Hospitals are actually very good. There's so many of them too! But, it's not socialized medicine. They don't turn people away without insurance but insurance and inflated prices are what keep the hospitals ticking along and able to easily cope with the numbers. I feel that during the boom period we had so much wealth and resources that we could have put a high class sustainable health system in place but we didn't.

Instead we have a bunch of teachers, lecturers and publicans in Office who funnel the money to investing in Education (Educating the young people who leave the country) and in conjuring up event and tourism to help the pubs and changing laws to help the pubs

El_Dangeroso

Wompa1 wrote: »

I watched a young man bleed out and die in A&E in the regional.

It's partly our own fault. When the money was rolling in, we weren't demanding the change.

Look at all of the money that's gone into the University over the last 15 years....our priorities are all messed up

I'd wonder if more money would really solve anything, it certainly didn't during the boom. I used to work with doctors in the hospital (not working for the HSE) and one thing that struck me is that the hospital is run with the staff in mind, not the patients. Not to say the front-line staff aren't being hammered, they clearly are. But what's really needed is root and branch organisational change, and where's the political appetite for that when ministers for health change about every two years.

I thought Limerick Regional was bad, and it certainly has it's problems. But UHG makes me want to get private health insurance sooner rather than later.

Sniipe

An update on this:
I received a letter the other day from the UCH saying that they haven't forgotten about my complaint and are still planning on looking into it.

I notice that the nurses are having a lunch time protest about the current situation in A&E Galway

_Whimsical_

On the news report this evening about the lunchtime protest/strike they featured patients who'd been on trolleys for days. One women mentioned that during her time on the trolley she didn't get so much as a drink or a cup of tea.

I can see why nurses and drs are very busy in A&E and bed shortages clog the whole area up but I'd expect that patients on trolleys be treated like patients and have their basic needs,like supply of drinks, catered for. Surely the place isn't so busy that one of the staff from the catering section could not bring drinks three times a day to people left on trolleys for days.

It sounds like ridiculously inept management to me. Emergency aid shelters set up in schools and community centres during serious crises can cater for the basic needs and comforts of hundreds of people.

Obviously supply of tea is the least of anyone's troubles down there but when nothing can be done but dump someone on a trolley then the small things like a drink do count.

ladiesman217

Hi all.
Reading over the stories here, the experiences sound all too familiar. My partner and I suffered a mis-carriage a number of months ago, and the treatment of us on the day we found out, was horrendous. There were many examples of a bad service that day, but the worst was being left in the corridor after getting the news, not even a cup of tea, just a"Sorry", and we were left to go home.

I know this is not related to the ED, but the lack of a user-centred service runs through all elements of the hospital, and the HSE as a whole. Now we all know there is money within the HSE, but it goes no further than the top. What the problems is, I feel, is how the rules and regulations are formulated by the powers that be within the HSE. Is it a collaboration between Nurses, patients and management?, this I doubt happens. There has been some work done across our shores in the UK, by the NHS and PearsonLloyd, working to reduce waiting times and aggression in the ED. If only our government could harness some of the research methods and thinking from a project like this, I feel we may see some improvements. Another interesting project is the patients first project run by the Health Design Lab
Emily Carr University of Art + Design in Canada. This type of Service design approach is badly needed in our healthcare system. Looking at the patient journey through each touchpoint, and highlighting all the pain points is something that should be done. This stuff is happing in other places why not here?

wwwabetteraandecom

researchecuadca/healthdesignlab/