Dialogue: A&E: it's not the wait that hurts, it's the not knowing

Delays in hospital emergency rooms are to be expected, but for patients and their loved ones being ignored is unacceptable, writes CHERYL LILLY*.

Although I can't condone the verbal abuse of emergency room nurses by relatives frustrated by the lengthy delays their loved ones are forced to endure before finally seeing a doctor, I can understand why it happens. And I have a very simple solution to help to ease some of this frustration.

Last year I spent nearly eight hours in the emergency department of Auckland Hospital with one of my daughters who had received a couple of blows to the head at a tae kwon do competition. Concerned that she might have a serious injury, we immobilised her neck and she was transferred by ambulance to hospital, where initially she was quickly and efficiently assessed.

X-rays showed no major neck fracture, so she was transferred from the resuscitation room to the regular rooms.

So our lengthy wait began. Now don't get me wrong, I never expected a speedy visit. I knew there would be delays. I also knew that delays and emergency room visits go hand in hand. They always have - even back in the late 1970s when I was working as a nurse in a very busy Sydney metropolitan hospital.

But here, my wait was made far worse by a lack of communication between relatives and staff.

Hours passed. Patients in trolleys began to line the hallways. Those lucky enough to see a doctor were forced to share the most personal of information within earshot of strangers. We, in turn, felt uncomfortable and pretended not to hear.

Relatives paced the corridors and hovered in doorways. Waiting times were compared. Sympathetic and knowing glances were exchanged. The braver among us tried to seek information from staff at the nurses' station. We tried to make eye contact with the staff scuttling past. Had they perhaps forgotten about us? Had our notes been accidentally misplaced? Perhaps direct eye contact would prompt them to remember us.

But this day, the staff seemed determined to avoid any contact that would require them to stop and perhaps offer an explanation. Pain relief was repeatedly requested. "I'm not responsible for your daughter but I'll find the person who is." We waited and we waited and we waited. Pain from the initial injury and the subsequent back pain from having to lie flat and immobile for hours began to take its toll. Understandably there were tears on her part and my frustration was becoming apparent.

Look, we relatives understand the difficulties and pressures facing medical and nursing staff today. We really don't like to hassle or cause problems. We know you lack resources. We know that you are truly overworked and that many of the people clogging the emergency department should be seen by their own GPs. And we understand that you are doing your best in a highly stressful situation. But without good communication, our frustration can quickly turn to anger.

People generally feel anxious and rather vulnerable when they go to hospital emergency rooms for treatment and as the delay in seeing medical staff lengthens, negative feelings can intensify.

It doesn't cost anything for staff regularly to remind waiting patients and their relatives that they have not been forgotten. Simple things such as eye contact, a sympathetic smile that shows you acknowledge the situation, and an explanation or reminder of the emergency room process, reassures far more than one might imagine and can quickly damp down growing anger.

* Cheryl Lilly is an Auckland writer and former nurse.