Patient A was referred to Antrim A&E by the Out Of Hours Doctor services with suspected blood septicemia.
When we got to the A&E there were 3 ambulances parked outside, and after going through the initial reception point the waiting room was nearly full to capacity. Both the main waiting area and area that used to be the children's waiting area was full of patients and carers. As the patient was ill and could not sit up right finding 2 seats to let the patient lay down required other people to stand.
The traige process was surprisingly fast, and was triaged within 15 minutes, however when asked asked for a trolley to lay the patient on while we were waiting we were told there were no trolleys and that there is a 2 hours wait to get seen by the doctors.
Another 15 minute wait and Patient A was brought into the main treatment area to be placed on a trolley, but in-between the time it took to call Patient A and get inside the treatment area, someone else had been placed upon it.
This led to Patient A and carer having to sit on chairs that were placed against walls beside the entry to the short stay ward. With more patients being brought into the treatment area more chairs were placed at the entry to the treatment area and some carers and family members were asked to leave the area to make room for patients.
Patients and carers were forced to push 2 chairs together for makeshift beds, at this stage I left the A&E via the x-ray department, within the waiting area at x-ray were several trolleys, all with elderly patients on them, some were calling for help, despite this the nursing staff were doing an implacable job despite the high pressure.
After another wait, the patient was taken to a room far from the A&E to be assessed by a Doctor, after this process the patient was taken by to the A&E, this time a bed was available inside on of the cubicles. The patient was to be isolated and given IV drip with antibiotics.
At this stage the A&E department still had patients waiting on chairs for beds and to be seen by doctors I went outside via the waiting room to make a phone call and witnessed a doctor treating patients who had been waiting inside the A&E department in the triage rooms, and still the waiting room was full on patients Some of whom had been there since before I arrived and other new ones.
Most notable was the parent of a young child no older than 3 who arrived at Antrim A&E earlier in the day who's nose would not stopped bleeding after a head trauma, the child was discharged yet the had to return as the bleeding would not stop. The child was again sent home with the bleed still occurring and I told the parent who lived in Ballymena to go to the Causeway Hospital as it will not be as busy and most likely will have in-patient beds available to monitor the child.
When I went back into the A&E I was informed that Patient A would have to remain in the A&E under isolation in the cubical as there were no isolation beds available within the hospital. The A&E cubicle is not a designated isolation room either and is shielded only by a curtain, the isolation rooms in A&E had patients in them, in one room I witnessed 2 patients sharing, the doors were left open and family/carers where coming and going freely.
After waiting 2 hours of the IV drip to be given to Patient A I was finally able to get home, this process took in all 4 hours, yet for Patient A the A&E experience would last into the next day before finally being admitted. Through this the A&E was extremely busy, as I was leaving 2 patients were on trolleys in the middle of the A&E department another was in a wheelchair and on a drip. other patients where still waiting in chairs, most notably a young child being comforted by her mum. While leaving I also noticed other cubicles in the A&E department that had warning signs that the patient was isolated. This type of actions immediately reduces the capacity of the A&E.
While I was exiting the waiting areas, some of the patients who arrived at the same time as Patient A were still waiting to be seen by doctors, including an elderly lady in a wheel chair. As I left the mother of a young man approached me to ask if there was anything I could do for her son, he had been waiting in the A&E waiting room for over 5 hours waiting to get admitted to the hospital. At this stage I knew there was nothing that could be done to speed the process up as the the hospital was nearly at capacity, I do believe that there was a limited amount of beds available but there were being protected in-case other seriously ill patients arrived later in the night.
This is not the worst state I have ever witnessed the A&E at Antrim in, this was merely the same as any other busy night, in where it showed that despite the claims of the past Antrim Hospital simply cannot cope with the demand placed on it.