Specialist GP Nikki Vadgama provides some tips to make your next paediatric eczema consult easier. She includes a review of new guidelines, resources, websites and medications for paediatric eczema management
Waiting hours in a plastic chair
Waiting hours in a plastic chair
![Fraz Lucy Urgent Care](/sites/default/files/styles/cropped_image_16_7_/public/2022-07/Fraz_Lucy_Urgent_Care.jpg?itok=StiLJ4AZ)
JUST WONDERING
Long waits are normalised in urgent and emergency care and clinicians need to know what this does to the long-suffering patient, writes Lucy O’Hagan
All my sense that I might be worthy of any attention was gone. I just wanted to be in bed
The health service is stressed; everyone is doing their best. The patients are pretty patient considering a five-hour wait is now within target at most services known as urgent or emergency.
My brother-in-law recently spent hours overnight crouched on the floor of an urgent emergency place with his head and arms resting on the plastic chair because he was so uncomfortable, exhausted and breathless. He is not a man who asks for much.
I then worked a Saturday at one of these urgent and emergency-type places. We felt rather good because our wait was only three-and-a-half hours, a trifle. In a mere blink of an eye, you are out of your plastic chair and in with the doctor.
Three of the people who walked in my door asked to lie on the bed. Two of these were not the patient.
I spent some time trying to work out whether they needed a bed before they got to our waiting room or whether, in fact, they were okay until they had to wait for three-and-a-half hours and needed a bed after that.
I was wondering this because the Saturday before, I had myself waited four hours in an urgent care-emergency place with a simple but aggravating sore eye. (It had seemed better on Friday so I hadn’t bothered my GP, but on Saturday it was awful. Of course.)
I had gone prepared for the wait, armed with my laptop, book, phone charger, packed lunch and water bottle but, even so, it’s hard to describe what four hours in a plastic chair does to the body and soul.
By the time I was called through to a cubicle, I was so stiff I had to sort of jack-knife my way up and mechanically move my legs to get up the corridor. You might think at that point I would be happy to be in a cubicle; it is a sign of progress. But I was starting to get this strange brain fog, where I simply stopped caring. So what if I had a sore eye? My brain could barely string a sentence together.
I experienced the same phenomenon a year earlier, when I took my partner to an urgent emergency place at 7pm on a Saturday.
I sensibly made sure we had eaten first but, by the time we saw a doctor at 1am after a trifling six-hour wait, I was strangely inarticulate. All my drive had disappeared, all the reasons I had worried about my partner seemed immaterial, all my sense that I might be worthy of any attention was gone. I just wanted to be in bed.
The mistake I made with my eye visit was not taking a hot drink or a blanket or even a down jacket. Sitting in a plastic chair for four hours seriously chills the body.
The cubicle was cooler, so for the final hour I paced up and down and tried doing star jumps to warm up while hoping no one would notice through the gap in the curtain.
I can also imagine increasing levels of dehydration if you were dumb enough to not bring water or a wallet.
I’m not relating this for pity, or to make you healthcare workers feel bad, but just to let you know that a four-tofive hour wait might affect the clinical picture or the ability of the patient to give a coherent history or make sense of any of the options or instructions you give them.
Capable people may have lost a sense of date and time and agency, and those are the ones with a sore eye or the whānau supporters.
Heaven knows what happens if you are really sick in that plastic chair.
It’s weird that long waits are normalised and patients sit in rooms where signs say, “We value manaakitanga and we care about your wellbeing”.
But, as I say, most patients know we are under extreme pressure, so they won’t complain. Spare them a thought or offer them the bed when they finally get to your room.
And please don’t spend half the consultation telling them about the health service and the staff shortages; they know, they just want to get out of there.
Lucy O’Hagan is a medical educator and specialist GP working in the Wellington region
We're publishing this article as a FREE READ so it is FREE to read and EASY to share more widely. Please support us and the hard work of our journalists by clicking here and subscribing to our publication and website