"Conditions in the department"

My daughter 37 weeks gestation was sent to ED by her Community Midwife/ GP due to a very thrombosed haemorrhoid. She was in a lot of pain and they were concerned about the stage of the haemorrhoid with delivery pending. They arranged via Phone first for her to attend the Surgical Ambulatory unit.

At 6pm she rang me to see if I would come sit with her as her husband was with the other 2 children .

On arrival I noted a very busy waiting room for a weekday evening and I thought oh dear this will be a long wait.

After a few hours she became very sore sitting , I suggested she ask for Pain relief. At that stage the Clinical sister brought her through to an examination room in the Green Zone, we were very thankful.

After a period of time a young doctor arrived, they appeared very stressed and commented on the fact that they were there on their own. They took some history but kept referring to the pregnancy. My daughter kept assuring the doctor she was not in labour. They examined her bottom , requested to do a PR but she declined this . The doctor stated that they will just document that she did not allow them to do their job. We thought .. oh dear!

After another period the doctor returned to take blood, that's ok, then they proceeded to prepare for cannulating her. I intervened, asking why are we cannulating her? The doctor stated it was in case she was in labour and needed transferred to AAH. I again said but she's not in labour, they then threw the white tray onto the examination couch, placed their hands on their hips and stated that they're just doing their job. My daughter was so upset she just said ok put in the cannula.

During all this period in ED Causeway I could see the stress of the staff and as a nurse myself my heart went out to them. However, I could also see the conditions of the department ... It was filthy!!

1-Waiting Room toilets - Paper towels on floor had obviously dried up urine and were stuck to the floor , The toilet was full of toilet paper , urine and faeces, unflushed.

2- Dried blood on the floor of ED main area -  I was able to follow a trail of blood spots dried on the floor.

3 - Blue counterpane given to cover her dignity had blood on it .

4 - In examination room there were used Sterets on the floor below the examination couch, there was a paper hanky with obvious mucous on the floor below the desk , there were empty butterfly packaging on the floor, there was a Hibiscrub pump on the wall with no bottle attached.

5 - The doctor never washed their hands at any stage, they put gloves on in the room to do the examination. To do bloods they arrived into the room with blue gloves already on and they left with them on.

During my career I have worked in very busy Medical wards, chaos is a mild word on a busy day . No-one expects it to be tidy and an ED department will present in a similar fashion . But I do expect cleanliness. The staff were under pressure I have no doubt, but I feel the cleanliness of a department lies at the feet of the Manager and they should hang their head in shame.

Staff are expected to work in busy chaotic conditions which is Soul destroying , I know I do it myself, but to not have the pride or privilege to say at least it's clean and we're trying to maintain, that is a disgrace not on the staff who work there but the person managing the Department, in my view.

The nursing staff we encountered were lovely , the doctor was very stressed and conveyed this to their patients, which is not a good start to their career, but in busy conditions such as they were could be forgiven.

But for the first time in my career I left a department ashamed to be a Nurse, not for the service we had received but for the neglect to the conditions the department had gotten into through lack of the Basics - and I don't believe this is the fault of staffing or Encompass or anything else that is used as a mode of Blame. In my view, these conditions are a direct result of poor management and taking responsibility for your department and having pride in the fact I do my best for my staff to work in a clean and safe environment in challenging times.

My biggest regret is I had no phone to photograph the situation .