Nobody is ever prepared for A&E

There is never a proper outfit for A&E.

The same way there is never a complete funeral outfit in a wardrobe.

Every day around the county, there are people rushing to pick up a black suit or a dark tie or suitable tights and gloves to complete the mourning attire.

Some things in life happens because they are never timed, there is never a right moment.

And so it is with A&E; we know not the hour or the time when we will find ourselves there, and hence a sense of confusion is added to the panic and drama that unfolds.

I know the A&E dept in Mayo University Hospital well. I have sat there a few times, into the early hours, watching those doors for news or some development. Waiting for news of a bed, or a test returned. In here, there are the people who look like they need the place, and others who do not. Such are the vagaries of medicine. Often those who shout the most are least in need; often those who silently suffer are those who are in greatest danger.

And so you sit there, judging each other, wondering why so and so has been bumped up and you have not.

In here, as we sit among the bleary-eyed, the tired, the distressed, we get a sense of just how vulnerable we all are. Princes and paupers, kings and subjects, in here, we are all introduced to the levels of our mortality. Wealth and power count for nothing when you place yourself in the hands of those who have been given the task of getting you better.

A&E in Castlebar was designed to cope for an annual throughput of 20,000 of us. It can handle matters if a three-quarters full attendance from McHale Park comes through its doors spread over a 12-month period.

But alas, it is the capacity of the Aviva Stadium that is in reality coming through. And remember, these numbers refer only to the patients. Every patient has an entourage of big and small. And thus the shortcomings of the facility are highlighted.

The issue was raised this week because of the matter of its woefully inadequate parking area; albeit most of those limited spaces are for set-down only, the design is not of a nature that is cognisant of the drama that is in people's minds when they come to use this facility at all hours of the day and night. And thus a discussion on this led to a debate on the overall unit.

There is not one A&E in the country that is fully able to meet the demands of its patients. There is not one where patients can drive through like at a McDonalds; where people do not end up on trollies.

Larger issues such as the shortage of consultants; the impact of drunken misadventure; a more efficient discharge of patients procedure; and the consequent freeing up of beds mean that those who have to be hospitalised end up sleeping on trolleys in the corridors, with all sorts of affronts to their dignity, comfort, and health.

It is only when the bigger issues are addressed that we will ever have A&E facilities that fully meet all our needs, and enable us to be treated and/or hospitalised as needed.



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