Patience with patients is key says nurse at Cork hospital's busy emergency department

An inspiring emergency medicine nurse is urging people to show compassion for victims of addiction after losing several regular patients to overdoses, writes Sarah Horgan
Patience with patients is key says nurse at Cork hospital's busy emergency department

Michelle Kingston is a nurse at the Emergency Medicine Department in Cork University Hospital. Picture: Eddie O’Hare

MICHELLE Kingston, who forms part of the Emergency Medicine Department (ED) team at Cork University Hospital (CUH), is among those being celebrated on International Nurses Day today.

Ms Kingston acknowledged that those complaining about ED waiting times are unaware of what is going on behind the scenes and how it is affecting hospital staff. While some members of the public argue that drug and alcohol issues are only contributing to long delays, Michelle has a different outlook. Having come to learn their painful stories she urged people to show compassion for those in the grip of a battle with drugs or alcohol.

The Irish Nurses and Midwives Organisation (INMO) representative for emergency department nurses at CUH is seeing the effects of this first-hand with patients who have overdosed on medication and alcohol. Many, Michelle pointed out, are well known by medical staff. Sadly, she said the numbers of people presenting with such issues have only increased since the pandemic’s onset.

Michelle spoke of one woman she grew to know well who tragically lost her addiction battle.

“I remember her sitting with me just two nights before she died,” she said.

“She asked me for a paracetamol and I had to explain that I couldn’t give her one. A lot of the time she used to overdose just to get in here. I have no doubt that as a little girl of five or six playing with her dolls she was not dreaming of becoming an addict and dying before her 30th birthday.”

Despite a dedicated ED support team for patients with mental health issues, repeated efforts to save the person are often in vain.

Michelle Kingston, who works at the A & E department at the CUH.
Michelle Kingston, who works at the A & E department at the CUH.

“One young woman came into resus [resuscitation] and had to be tubed,” Michelle said. 

“I can remember thinking she is not going to make her 30th birthday. It turned out that she did make her 30th. However, she died that same year. She was never going to make it but her death still stunned the whole lot of us. You would cry over something like that because you get to know and like these people so well.”

She described how every patient who comes through their doors has their own story.

“Anyone complaining about people coming in with addiction issues has no idea about the background of these other patients. I switch off from it because I know that every single person who comes into the department has their own story. We could have someone coming in who was very successful in their life before addiction took all that away from them.”

Michelle stressed that sufferers of addictions come from every walk of life.

“A few names pop into my head who were into us on a regular basis but have since passed away. One man had a very good job but alcohol was his demon. Functioning addicts can be hooked on anything from prescription drugs or alcohol to codeine. That person might function for a certain length of time but unless they are able to get clean it always wins.

“I love hearing about the success stories of people but they are rare. It’s really heartbreaking but you have to adopt an inbuilt coping mechanism so you don’t take it on board. You are conscious of the young nurses coming in because they haven’t seen half of what you have seen. As nurses we all talk. You might hear that a patient you have got to know well has overdosed and this time it’s more serious.”

Death from drug and alcohol or unrelated traumas often makes it more difficult for nurses to cope with complaints about delays.

“You are often trying to hold yourself together when someone has passed away after a trauma,” she said. 

“In a situation like this, all the doctors are pulled to resus leaving only nurses. You are then faced with a barrage of angry patients who have no idea what’s happening on the other side. In the ED department, there is a front door and a back door. The backdoor is where the ambulances and serious traumas come through. It’s the side that people don’t see so it’s understandable that some would complain about waiting times.”

The frontline worker emphasised that the majority of people are understanding.

“You are limited to what you can tell them because if it is something very serious you don’t want it coming out in the media. You explain that there is an emergency and doctors had to be pulled away but sometimes that’s not enough for people. You have to plough on and do what you can to avoid confrontation. 

"Ironically it seems to be the sickest people who are the most understanding. Some of them are exceptionally patient which I envy because I’m not always the most patient person myself. People like that make up for the belligerence you experience as an ED nurse. You meet some really lovely people. They are among the many reasons why I love my job.”

Every day in the CUH ED is different and presents new and presents unique challenges for Ms Kingston and her colleagues.

Michelle Kingston, who works at the A & E department at the CUH.
Michelle Kingston, who works at the A & E department at the CUH.

“We have had young people coming in after jogging on their lunch break who came to ED and experienced a cardiac arrest five minutes later. You just never know what you are going to be faced with. We still have the broken toes, arms and missing fingers. One person brought along their finger in a lunchbox but we would always advise people to bring it along in a bag of ice. Another lost fingertips in a lawnmower they thought was switched off.”

Monday is currently one of the team’s busiest days in the ED.

“A lot of people who come in don’t need to be there and that will never change. With Covid people with head colds were terrified to come to the ED so understandably it was very quiet. We find that Mondays can be very busy as people assume that it will be too packed over the weekend.

“We would advise anyone who needs to come to the Emergency Department not to wait until Monday.”

She admits that the hardest part of her job is seeing a child’s life cut short.

“When a child dies it does set an atmosphere. It happens more often than it should and always leaves everyone devastated. Seeing an elderly person suffer always makes me cry too. You don’t like to see any granny or grandad suffer.”

International Nurses Day is celebrated around the world every May 12, to commemorate the anniversary of Florence Nightingale’s birth. Organised by the International Council of Nurses, it commemorates the day with the production and distribution of the International Nurses’ Day (IND) resources and evidence.

The theme for the 2021 resource is Nurses: A Voice to Lead and focuses on a vision for future healthcare.

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