'Tis the season to be trolleyed

Most of us enjoy seasonal cheer over the holidays -- and a fuzzy head the morning after will be the worst of our problems. But before you push the boat out too far, an A&E nurse offers her perspective on Christmas drinking ...

Bernie Stenson an A&E nurse manager loves her job, but she also dreads this time of year.

While the rest of us get ready to party, she will have to deal with the effects of our worst excesses. And it isn't pretty.

"People really let go at Christmas," she says. "We'll have rows of people on trolleys who are totally out of it. They'll be puking and incontinent, and so wasted they wouldn't know if you were standing on them. They may be mouthing off too and, meanwhile, the person in the next trolley may be dying."

Amazingly in spite of this, Bernie adores being a nurse. Now 31, she has worked in A&E since she qualified back in 1999, and she can't imagine, ever, doing anything else. She is now a nurse manager at a busy Dublin hospital.

"I love the diversity of the work," she says. "You are making a big difference to these people. You have a huge input into their care, and there will always be a lot of hands-on work. I love that."

Bernie just wishes people would learn when they have had enough to drink. It's not just at Christmas that drunks cause trouble, "it's every day of the week," says Bernie.

"And to compound the problem, there are often a load of their friends and relatives in the waiting room. And they're often drunk and causing terrible problems too.

"They demand attention for their friend. They get louder and louder. And it's terrible for the relatives of the people who are really sick," she says.

"People who have no option but to be there have these drunk people, shouting and swearing, and sometimes kicking the walls and knocking things over," she adds. "They occasionally threaten us, and it's terrible for the other patients. They think, 'they are going to get me next'. You can see the fear in their faces."

"Everyone knows that you don't touch a needle on the ground in case you get HIV or Aids. But I don't think the message of drink has been hammered in. Anyone who ends up in A&E has a problem with drink," she says.

It worries her, too, that there is no follow-up. "Some people wake up remorseful. Occasionally they'll come round with chocolates and say, 'I am sorry I was so out of it.' Usually, though, they wake up, grab their clothes and run. Or if their clothes are soiled they'll wait for a relative to come in and collect them."

The worst thing, though, is that it makes it harder for the doctors and nurses to provide a good service for their other patients -- those who didn't choose to make themselves sick with drink. And that breaks Bernie's heart, because her job is hard enough with the current lack of beds and poor staffing levels.

"The overcrowding is terrible. We are dealing with people who are in pain, people who are grieving and people who may have been on a trolley for two or three days. You can only agree with the relatives who complain. Nobody should be on a trolley. Nobody should be in the corridor. When I get into my bed at home I feel guilty."

If the drink problem cleared up overnight, you would still get people on trolleys. "It wouldn't solve the crisis, but it would mean that the sick people on the trolleys would get more care from us.

"A relative of mine died recently in a hospice. The facilities and staff levels were amazing. She died with so much dignity. We won't ever have those facilities in A&E, but if there were no drunks, we could give some dignity back to the dying."

MEAS, the organisation that encourages responsible drinking, has launched a campaign aimed at making drinking in Ireland less socially acceptable.

In a series of TV advertisements, viewers can see how alcohol impinges on the people who have to deal with the consequences.

Titled, Had Enough, the adverts show a girl feeling harassed in the street, a taxi driver with obstreperous passengers, a young lad clearing vomit off the streets, an old man disturbed by the antics of neighbours and an A&E nurse. All say they have had enough.

Fionnuala Sheehan, CEO of MEAS, hopes the advertisements will make people think before they go off on a drinking binge.

"In Ireland, we have a particular drinking culture," she says. "We have a culture of excess, and we have tacitly, given social permission to anti-social behaviour around drinking.

"We want people to challenge that behaviour, and to withdraw that social permission. We need a multi-faceted approach," she believes. "The campaign alone will not solve the problem, but it can add to initiatives like the Garda power to apprehend and convict. "Through challenging the culture, we can create an environment more receptive to embracing change."

Gerry Hickey, a psychotherapist and addiction counsellor, feels that the best way to reduce people's drinking is to increase the cost and reduce advertising. The trouble, though, is that none of these initiatives have much impact on the problem drinker.

"Problem drinkers will pay whatever they have to for alcohol -- they will go to the ends of the earth to get it," he says.

So what is the answer?

"We will not get anywhere until the drinker is confr-onted with their problem, and their families are informed that they have a real problem with alcohol," he says.

"My thinking is that everyone who turns up in A&E and everyone who ends up at a Garda station should have some form of intervention before they are let out. There should be an intervention specialist there, or on call.

"There are some people who ought not to take alcohol at all. This is what we need to recognise," he adds.

What about the rest of us, who intend to let our hair down at Christmas? How should we keep ourselves safe?

"If someone is going out and knows they might go over the top, they should have a plan," says Gerry.

"If they could lose their facilities, they should know who they are going home with. They should plan how they are going to get home and what time they expect to get home.

"Alcohol is a mood-altering chemical," he says. "There is no problem with people going out and enjoying themselves, and doing so on rare occasions, like Christmas, is fine.

"But remember, 84pc of all public order offences happen at the weekend and involve someone who has had alcohol.

"Those people did not want that trouble, but they drink too much and they get it anyway."

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