Hospital trolley diary – I'm beyond exhaustion and find myself crying
The noise, discomfort, every corridor jammed with trolleys, it’s a waking nightmare – because you sure as hell won’t ever be asleep
John Keogh: ‘Always, always new trolleys, where the sick, the hurting, the elderly – people at their lowest ebb, some perhaps with life-threatening conditions – will languish for God knows how long.’
I thought it was a virus, so I wasn’t that concerned. I had a high temperature and a swimmy head, as if I had the flu. I rested, took paracetamol and drank fluids, the usual prescription. This would be sorted by the time the weekend was over.
Except it wasn’t.
I travel from Thurles to University Hospital Limerick three days a week for dialysis. That Monday morning, I told the nurse how I was feeling, and she said she’d let the doctor know. In the meantime, she took a gallon of bloods, including cultures from my dialysis line, a catheter in my chest.
The doctor agreed it was probably a virus, and I went home. But that evening a nurse called to tell me the cultures had come back positive. I had some kind of bacterial infection, and would have to be admitted the next morning. Which doesn’t mean simply turning up at the hospital and going upstairs to a bed. I would have to be admitted through A&E, because that’s how we do it in a broken health service. And not just any A&E, but the new emergency department in Limerick, which has been setting national records for trolley numbers and overcrowding.
The following is my diary of what happened next.
The reception area of A&E is quiet. This might be a good sign. I check in, and a few minutes later a nurse calls me back to record my vitals and stick a hospital tag on my wrist. Then a porter puts me on a trolley and wheels me down to ground zero.
The quiet reception was deceiving. Down here it’s bedlam. Trolleys line both sides of every corridor, ill and distressed patients packed in head to foot. It’s a tight squeeze to get a trolley down the middle, and more than once the corner of my trolley clatters off another. It’s a sound I will become familiar with. That and the alarms. And the shouting. In A&E, there is always shouting.
The porter parks me on a corner beside a toilet that’s shared by every patient in sight, and their family members. It’s the only free space on the corridor.
My renal consultant, Dr Liam Casserly, comes down to tell me I have a staph infection in my dialysis line. It might be a difficult one to shift, and hopefully it hasn’t spread to my heart or my spine, where this bug likes to go for extra fun. This doesn’t help the mood. In the meantime, they tell me I’m “listed for a bed”.
That evening, they wheel me up the corridor and into a cubicle, for infection-control purposes. But I still share a toilet with everyone on this corridor, along with their family members, so I’m not sure what they’re controlling.
I have this cubicle to myself, which makes it marginally better than the corridor. I imagine I might even be able to sleep in here. But I don’t, because these hard and narrow trolleys were not designed for sleep. And because the noise never stops.
The clattering, the alarms, the shouting, the staff on constant go.
In A&E, it seems the patient’s rest and comfort are not priorities.
I hate dialysis, absolutely despise everything about it. But today I’m looking forward to it, because it will get me out of A&E for four hours. The dialysis unit is not renowned for being quiet, but compared to Casualty it is an oasis of peace and calm.
Back in A&E, I try to nap. On the best of days, the treatment wipes me out, but an hour or two of sleep gets me back to feeling half normal. In here, that’s impossible. And there’s still no sign of a bed.
They take me for an echocardiogram, an ultrasound of the heart. I’m terrified of what they’ll discover but it turns out everything is fine. With that massive relief, along with the utter exhaustion, surely I will sleep tonight.
The noise and discomfort are too much. And now cabin fever is setting in, too. I’d go for a walk around the unit but every corridor is jammed with trolleys and nurses and doctors, and family members trying to be there for their loved ones but constantly finding themselves having to get out of the way of staff and of trolleys. Always, always new trolleys, where the sick, the hurting, the elderly – people at their lowest ebb, some perhaps with life-threatening conditions – will languish for God knows how long.
This is the scene that will greet Taoiseach Leo Varadkar if he bothers to drop in here today during his visit to Limerick.
But he doesn’t.
Again, I haven’t slept a wink. I’m beyond exhaustion and find myself crying for no reason. And sometimes for actual reasons.
There’s an elderly lady on a trolley across the corridor who’s been moaning and crying out for hours. It reminds me of how my grandmother was when she was dying, calling out for her deceased sister, talking as if they were both young again, in England after the war. I cry for my grandmother, and for the lady across the hall. Alone, confused, perhaps in great pain. And left there on a trolley outside the toilet. No comfort, no privacy, no dignity.
In here, that’s business as usual.
It’s Saturday and still no bed. I’m told it’s been this long because I need an isolation room and there are no available isolation rooms. Why not? Well, the same reason there’s a shortage of other beds.
But hey, there’s a brand new A&E unit, and we all get to stay in it. When this €25 million building opened two years ago, UL Hospitals Group chief executive Colette Cowan said this was “an emergency department the whole country can be proud of”.
I’d laugh but I’m afraid I’d get hysterical and they’d carry me away to a secure unit. Though I might get some sleep there.
My back and shoulders and hips are killing me from lying on this trolley.
My doctor tells me the infection seems to be under control but I’ll have to stay a few more days to finish the course of IV antibiotics. And it looks like those days will be spent here on the trolley. He’s not pleased about the bed situation but there’s not much he can do.
I don’t feel up to exercise but I step outside for a short while anyway, just to breathe fresh air. To clear my head, to try and feel human again, But I have to go back, and when I do, it’s like stepping into a third-world country. A waking nightmare.
Because you sure as hell won’t ever be asleep.
I’ve become ratty with the staff, snapping and growling at the nurses, or just plain ignoring them. I feel guilty because none of this is their fault. They’re working in impossible conditions and there’s not a thing they can do about it.
I write an email to the hospital chief executive, informing her that I’ve spent a week on a trolley. It’s not a very pleasant email but I couldn’t care less. No guilt here.
I don’t expect a response but now and then I check my phone anyway. Then I realise it’s a bank holiday and nobody’s in the office.
Down here, you lose track of these things.
To my great surprise, a quite pleasant woman from management comes down to see me, “to address your complaint,” as she puts it. She’s all apologies and agrees that this whole situation is unacceptable. She doesn’t quite admit that building a new A&E unit without also addressing bed capacity might have been a bit on the stupid side, but she does insist that they are going ahead with building a new 60-bed modular unit. This will be ready some time next year, and will definitely include isolation rooms for patients like myself.
Okay, but that’s not much good to me now.
She apologises again, and tells me I’m definitely prioritised for a bed. I try not to laugh, for fear I will sound insane. But a few hours later a nurse tells me to get my stuff together, I’m going upstairs to a bed. Coincidence? I don’t know.
In the bed upstairs, I sleep like a baby.
Unlike the patients on trolleys on the corridor outside my door. Yes, up here on the wards, they keep them on trolleys too.
I almost feel at home.