Hours of waiting: A day at A&E

By Samantha Alleyne
Stabroek News
December 30, 2003

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A Stabroek News reporter recently spent the better part of a day at the Accident and Emergency Unit of the Georgetown Public Hospital observing the day's proceedings. This was not during the recent sick-out by doctors.

"When you all finish collecting you all paper bring them to me and I go sign it. Ask for Mr Williams. My office is outside," these were the words with which a man of unsound mind addressed patients waiting to see a doctor at the Accident and Emergency (A&E) Unit of the Georgetown Public Hospital Corporation.

Though a trail of laughter from the patients followed him out of the building, many persons there might have wished that his words could be true as it would have cut their waiting time at the unit.

The pace at which staff move at A&E Department is anything but urgent and one could be forgiven for thinking that the use of the word patient to describe people who are ill might have been coined there.

Stabroek News spent an entire day at the unit on December 3 and witnessed first hand some of the agonies experienced by persons who are forced to visit the unit for treatment. It was immediately apparent that some persons had learnt that the trick to being attended to with any speed was entering in a wheelchair or on a stretcher. Don't walk in.

However, this does not always work as one young woman found out; she sat in a wheelchair crying out in pain for over half an hour before she was attended to. But she was still lucky.

One woman and her son, who had a problem with his foot, waited from 8 am until 1 pm before he received medical attention.

Some persons who visited the hospital without the assistance of a relative or appeared to be of unsound mind were left to fend for themselves and some left without being attended to.

Tempers sometimes flare at the unit when patients get weary of the waiting, but at the same time some people find that the unit is a stress reliever, since there are many funny scenes and utterances during the day.

Persons who have visited the unit before are easily recognisable as they arrive prepared. One woman was observed crocheting as she waited for her daughter to be attended to.


"Hello! you paper [with information taken by the triage nurse] just go in. Look y'all don't start me up early this morning," were the words uttered by a female security guard to a man who wanted to be seen by a doctor about half an hour after arriving at the unit. It was obviously his first visit. The patient, not bothered by the guard's outburst, laughed it off and told the woman not to make noise.

The security guards stationed at the unit take their responsibilities very seriously, as they ought to. They try to keep the patients on a tight rein and at times this results in verbal clashes riddled with profanities, the use of which the guards fail to caution against. And in one instance a female security guard was overheard using a vulgar term as she spoke to a man outside the unit's door.

At around 8:30 am, there were a number of persons at the unit waiting to be seen by a doctor and others kept entering the building.

When a person visits the unit they first have to visit the clerk where information is taken. He/she then has to visit the triage area to be assessed by the nurses there.

There is a written notice that all patients who can walk must be seen by these nurses before being attended to by a doctor and one would have thought that separate arrangements would have been put into place for the immobile patients.

However, Stabroek News observed patients in wheelchairs also visiting the area, some assisted by their relatives. Others without relatives were helped by the female security guard or left to fend for themselves.

The hospital's attendants (porters) for the unit, from all indications, focus on the arriving patients and are rarely seen in the unit.

And even when they are called by the guards or nurses they either don't show or take a while before they do so.

One man, who visited the unit with an ailing female, decided that instead of sitting and waiting that he might as well take one of the benches for his bed. He slept for a while until the female's name was called for treatment. He was not the only one to take advantage of the empty benches. Persons who might have left their home early without having breakfast purchased snacks to munch on while they waited.

One security guard was observed eating boiled channa from a white plastic bag as she walked around the unit carrying out her duties. As she did this, a little girl began to walk behind her with longing in her eyes.

The guard stopped eating and handed the plastic bag to the child who devoured the channa.

Humane side

As the morning progressed, a woman arrived who appeared to be either in a state of shock or semi-conscious. She was alone and sat with her head hanging on one side. A nurse approached the woman and asked if she was allergic to any medication, but the woman, who did not hear or perhaps did not understand, stared at the nurse blankly. The nurse then asked her if her body reacted to any medication. She had to ask this question at least five times before the woman shook her head slowly. She was then attended to.

At one point, it began to rain and relatives waiting outside flocked inside the unit to shelter.

After the rain abated, and even though there was space in the unit, the guard asked persons who were not there to see the doctor to leave the building and wait outside in the shed.

While asking persons to leave, the same security guard showed her humane side when she observed a patient who seemed faint and used a newspaper to provide some air. However, her decision to send persons out the unit did not go down well with her colleague stationed outside the door.

The colleague later informed her that the persons she had sent out were refusing to go under the shed because the rain was still drizzling.

This saw the two guards becoming involved in a heated argument. It was around this time that a man asked a question of the infuriated guard outside the unit. She used profanity in her answer and this was later reported to her colleague.

Their supervisor later visited the unit and the guards were involved in a fact-finding fiasco with the input of other persons. This nearly escalated into a ruckus, which ended after a stern warning from the supervisor.

Persons continued to wait and others kept streaming in. One man who appeared to be of unsound mind was rude to all and sundry.

When asked by the security guard what was wrong with him he responded: "Nothing ent happen, I got a flapping bullet wound that is wha happen," even though he had no such wound.

He later made rude remarks to the nurses and clerks obviously not paying attention to the notice in the unit, which informed that, the hospital reserves the right not to treat anyone who misbehaves. He later told the guard: "I am speaking. Shut up! I know wah does go on in hey. Y'all does treat who y'all want treat." He was not turned away and was seen by a doctor about an hour later.

More waiting

When persons were called in to be seen by a doctor most breathed a sigh of relief as they figured that their wait was almost over.

However, this was not always so. Many patients were then sent by the doctor to have x-rays or blood tests in other parts of the hospital or for further observation. These areas also have a build- up of patients and there is usually another interminable wait. After this, the patient then has another long wait before the doctors see them again.

Some impatient patients tried to question the guards as to when they would be seen by the doctor. One guard responded: "We come as the interpreter. When the doctor pass a order we carry it out."

However, the same guard was seen helping out some patients who she felt had been waiting a long time by taking the slip which they might have received from the x-ray department or elsewhere into the emergency room.

When Stabroek News left the unit late in the afternoon, persons who had been there since early in the morning were still waiting.