Emergency Department Saturday night The ‘phone call came on Saturday afternoon. The relative was in a bad way, not talking a lot of sense but in the middle of it did say that perhaps they needed to be in care. Ring Mental Health and get asked if I had called the CAT (Crisis Assessment Team) – my response “you mean the Can’t Attend Today, Call Again Tomorrow” team? Silence! “Perhaps you could go across there and have a look, assess things and ring us from there.” I agreed. It is across this sprawling metropolis, about forty minute drive on a good day. I get there and yes they are in a bad way – detritus everywhere, no washing up been done for a long time, half drunk cups of coffee everywhere, opened tins of food everywhere, milk slowly separating in containers. Relative lying down, non-rational, incoherent and hallucinating. Ring Mental health, explain the situation and they suggest I take them to the Emergency Department that is in their health area. It is a hospital that a previous government decided would be a good one to shift from middle suburbia to outer suburbia, supposedly to where the people are. The problem is they built it and the people have yet to arrive. It is cut lunch, thermos, map and compass territory to get there - another forty minutes drive. Arrive at Emergency about 5.30 pm – long queue for triage. Eventually leave the relative curled up in a foetal position on a chair and make it to triage. Explain the situation – “Yes Psych have contacted us, we are top do an assessment first – go to the next window and ensure the administration details are correct.” This is through slots in centimetre thick glass. Next window is even more remote. Centimetre thick glass and a box you talk into – it must contain a microphone. You talk normally – they can’t understand. You talk loudly - they can’t understand. You lower your voice, talk slowly and distinctly – they understand. Then you go and wait. Relative would like a cup of coffee – you find your way to the coffee shop in main reception. It closed at 5 pm! The friendly person closing up the volunteer shop suggests you go to the staff cafeteria – “to the end of this corridor, turn left, half way down and behind the lifts.” This is a one-story hospital, unbelievably spread out; you wonder why they don’t hire bicycles at reception. I eventually find it – Greasy Joe would be proud. No such thing as healthy eating for the staff in this hospital. The pleasant lady makes me two coffees – superheated but taste OK – my fingers burn through the cardboard cups in the ten-minute walk back to Emergency. This is a new hospital, scarcely eight years since it opened but it has such an air of neglect. The people however, make up for the deficiencies of architecture and maintenance. Emergency Department. High on the wall above the array of split upholstery seats is a Bogan sized Plasma TV, permanently, compulsorily tuned to channel ten – well not quite according to the picture quality. Sound off! People star at it as if hypnotised. The obligatory vending machines offer a selection of stale crisps, chocolates and high fat products or Coca-Coal Amatil drinks. I find a coffee vending machine near the main hospital reception – out of order written on yellowing paper still stuck to it with decaying Sellotape. Time passes. People keep arriving, walking past the empty out of hours, bulk-billing GP clinic set up next to the entrance to Emergency. In it two pleasant looking but bored receptionists, not behind centimetre glass, survey an empty waiting room. In emergency it is standing room only. A family group arrives; they look barely out of adolescence with red faced infant in pusher. Mum anxiously clutching a can of paint, her hands oozing red from the outside of the can, red the same colour as that on the child’s face. Child screams if a nurse comes near, so eventually the parents are given soap and water and towels to wash the paint off. Time passes it is now four hours since we arrived. I go back to the triage queue, and when I get to the nurse explain that we have been hear a while, I am fatigued, on medication and was in hospital for a procedure the day before. They had a risk of having two patients not one. Ten minutes later we are seen. Relative is incoherent, but there is a mind-body dichotomy – psych will not see them until a medical assessment has been made. Blood assays are ordered, urine tests are ordered, chest and abdominal X-rays are ordered. Have you tried to get urine and blood from an incoherent person who is dehydrated? Eventually they succeed. After seven hours waiting X-rays are taken. Everything is clear, now the psych team can be called in. Two a.m. – psych nurse comes, looks at history and says – “with your diagnosis it is amazing that it is two years since we have seen you. You need to be admitted.” Then to me – “they will have to be sectioned and it will be another thirty minutes before I can get security to walk them to the psych ward”. So we wait another thirty minutes. Two security men and the nurse come and take the relative down the ten-minute corridor. They apologise that we have had to wait so long. Three am I leave and drive through rain and fog the hour home! Sailor
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