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Urgent Care Waiting Times at the Royal Victoria Hospital, Belfast

The author is an Honours graduate of Queen's University Belfast in Ireland.

The Royal Victoria Hospital

The Royal Victoria Hospital

Patient Experiences at the Royal Victoria Hospital

As we are all aware, we are in the midst of a global pandemic that places medical resources under tremendous stress. As a knock-on effect, hospital staff, whether medical, surgical, nursing, auxiliary or security, are under enormous pressure. The aim of this article is not to criticize the performance of medical staff or other hospital staff but to chronicle the experiences of patients unfortunate enough to have to negotiate the processes involved in seeking treatment in the North of Ireland's largest and busiest hospital, the Royal Victoria Hospital (RVH) in Belfast.

The RVH is a sprawling site with a mixture of state-of-the-art buildings contrasted with buildings from Edwardian times. The RVH began as an amalgamation of several smaller medical units in 1797. Twenty-five years after gaining its 'Royal Charter', it moved to its present site, straddling the Grosvenor and Falls Roads, named after the British monarch Victoria who had died two years previously in 1901



The RVH Accident & Emergency Experience

Irrespective of what time of day or night a patient enters the RVH's A&E, it is invariably packed with a large cross-section of mainly ambulatory patients seeking treatment. Sometimes the queues for getting booked into the system are enough to make one turn on one's heel and seek some kind of respite at home. Enormous pressure is placed on this first tier of A&E, as many General Practitioners are either not accepting new appointments, are fully booked for weeks in advance or are referred to A&E by General Practitioners' receptionists.

During the day, it is usually relatively not so noisy with less intoxicated potential patients in attendance, but even during the daytime, it is not unusual to see hospital security called for unruly, often intoxicated patients and the PSNI/RUC (the north of Ireland's heavily armed paramilitary police force) in attendance. I must say that hospital security are extremely well trained and do their best to de-escalate any potentially violent situations.

After Triage, one is usually sent back out to the waiting area again to wait for possible treatment, depending on factors such as the time of day, the severity of one's injury, the number of patients and new, more serious admissions. With the RVH being the regional centre for major trauma and with a busy helipad situated on the North Tower for the north of Ireland's two air ambulances, Helimed 1 and Helimed 2, waiting times can be severely affected. Depending on the severity of the injury of the patient in the RVH's A&E and the factors mentioned above, waiting times of 14 hours are far from unknown, especially at night with a smaller amount of stuff on duty. Medical complaints such as chest pains are often what they call 'fast-tracked', but I will deal with that in a later paragraph.

The RVH Emergency Department

The RVH Emergency Department

Night Time in A&E

Arriving by foot, ambulance or private vehicle to A&E can be a daunting prospect. There will invariably be inebriated, highly vocal patients demanding treatment and the place is scarily reminiscent of a 'wet hostel' I once worked in.

Often the most vocal patients are harmless, many suffering from severe mental illness, many I recognize from my work as a support worker with the city's homeless addicts and alcoholics. Others can be quite aggressive, and although hospital security is well trained in de-escalating potentially violent situations and would know some of the frequent flyers' by name, it would not be unusual to see the PSNI/RUC arriving several times during one's wait to the point that one would be forgiven for thinking they have one of their forts/stations situated in the building somewhere!

Once one's name is called at the waiting room, patients are just moved up to another waiting room on the next floor called 'A&D'. In this particular part of the hospital at night, it is not unusual to hear patients saying that they have been waiting for eight, ten or even fourteen hours for treatment. Obviously, the staff are under unprecedented pressure due to the Covid-19 pandemic and with much fewer staff available. waiting can be, as one patient stated, almost Purgatorial.


The RVH's A&E Process: A Personal Account

I spoke to a Power Lifting friend called Seán Lynn who had endured the waiting process at the RVH's A&E department following a fall that fractured part of his shoulder. The following is his account, and he is a trustworthy fellow, not someone who exaggerates experiences for effect:

'I honestly was in quite a lot of pain and mistakenly thought once I was ushered on to the next floor it would be a mere short prelude to being treated, how wrong I was! I counted at least sixty patients in this latter phase of A&E. Periodically I would ask nursing staff how long I would have to wait and was always told at least two hours. When I asked some patients how long they'd been waiting I was told times like eight, ten or even fourteen hours. On several occasions, I was just about to leave, there was a real ambience of despair.'

I asked was he offered any pain relief while waiting:

'Eventually I was offered two co-codamol (30 mg Codeine/500 mg APAP) which did nothing for the level of pain I was experiencing. I will not mention any names but while I was there several patients asked me if I wanted to buy 'blues' (small blue 10 mg tablets of Diazepam invariably made in underground labs in Eastern Europe or the Asian sub-continent|), 'Beeps' (a local street name for Pregabalin), Skunk (a very THC potent variety of Cannabis) and alcohol.'

It would seem that petty dealers have found a market in the large waiting room which can be accessed if not seeking treatment by bypassing the first waiting room via the main entrance or at one of the side doors. When I asked if there was much belligerent behaviour at the second waiting room, he told me:

'One intoxicated dude made a racist comment at a middle-eastern Muslim couple which I remonstrated with him about. Thankfully, the place has CCTV cameras all over the place and security, who knew him by name from being there before arrived and ushered the guy out. They returned with him about twenty minutes later and he apologised for his racist comment. To be fair to him, he was relatively quiet the rest of the night and was probably just seeking shelter as he was homeless.'

I asked him how long he waited for treatment and I was told that he first arrived at A&E at approximately 7 pm and did not get treated then discharged until 10 am the next morning.

This Is No Indictment on the National Health Service

This article is by means an indictment on our National Health Service, rather a snapshot of how the Conservative Party (Tories) has starved it of a fit-for-purpose budget, viciously privatised as much of the public services associated with its infrastructure, corporatised its upper strata and generally run it into the ground as they are determined to implement an immoral, Malthusian model similar to what exists in the USA. And that was even before the time of the pandemic!

On a personal note, I have the deepest respect for the staff at our hospitals, from cleaners to consultants. They are now facing unprecedented pressure due to both the pandemic and the Victorian Poor Laws ethos rampant within the Tory Party regime headed up by a Prime Minister who is quite clearly a far-right idiot, a racist and a dishonest buffoon.

Contrary to what private medicine corporations and medical insurance companies in the USA would have one believe, all citizens here contribute through National Insurance contributions at source to our National Health Service(NHS). The Beveridge Report that was commissioned prior to World War Two promised to care for our sick and elderly 'from the cradle to the grave' funded by our collective payments. The Tories, the party of the rich, have done everything in their power to destroy the NHS, and the pandemic has given them an even greater opportunity to do so.

As outlined in the paragraphs above, these situations are but a symptom of the Tory party's means to introduce an American-style healthcare system where before medical staff even feel your pulse, their staff will feel your wallet to see if you have the financial means to pay for medical treatment. This approach to healthcare is anathema to us and immoral. Not to mention that people like myself with two lifelong chronic medical conditions would perish in a matter of weeks or months. I spoke to a medical professional from the Midwest, and I could not believe the price of a simple Salbutamol inhaler in the USA!

The struggle for the retention of the NHS will be one the proletariat will not give up as so many of our lives are at risk if placed under an inequitable private healthcare model such as exists in the USA.

The former British Prime Minster engaged in one of his oafish stunts

The former British Prime Minster engaged in one of his oafish stunts

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Liam A Ryan