Tales from A&E: Limerick patients describe overcrowding

Mike Dwane


Mike Dwane

'Like a zoo': Ivan Morris outside Limerick University Hospital
AS University Hospital Limerick expressed its regret over the long waits faced by patients in the emergency department this week, the patients themselves have described a creaking and dysfunctional system.

AS University Hospital Limerick expressed its regret over the long waits faced by patients in the emergency department this week, the patients themselves have described a creaking and dysfunctional system.

It comes in a week when the Irish Nurses and Midwives Organisation again called for the activation of a major emergency plan to deal with the “catastrophic” overcrowding.

Mary Fogarty, INMO, said that at 8am on Monday there were 47 patients – who had been admitted over the precious 48 hours but for whom no beds were available – on trolleys in ED.

Ivan Morris, the Limerick Leader’s golf columnist, was soon to join them. Showing an admirable sense of humour for somebody awaiting an angiogram, Mr Morris said it was “the excitement of the Ryder Cup” that brought on chest pains on Monday morning.

“I went down to my GP, who did a cardiogram and said there was something there he didn’t like and he was sending me in here. I came up here at about 3.30pm and I was in A&E for 24 hours before I was sent up here. I have only just arrived up here now,” said Mr Morris on Tuesday afternoon.

“The place (ED) was like a zoo. There were trolleys all over the place. The nurses and the doctors were rushed off their feet. It was impossible to sleep with the noise, with banging and clattering and people being moved all over the place. I was on a trolley literally in the middle of the floor and people banging off me. I was moved, I’d say without exaggeration, every 10 or 15 minutes

“I finally got to sleep and I was woken up at 3am to check my blood pressure. At 11.30am, I saw a doctor who told me I would have to be referred to a cardiologist. It is now 4.30pm and I still haven’t seen a cardiologist but the worst part of it was how crowded the place was down there.”

Paramedics, Mr Morris said, who had brought people in on ambulance trolleys had been left waiting to get them back.

“It could be 10 minutes, half an hour or two hours and at one stage I counted eight ambulance men all waiting to get their trolleys back. They said to me sometimes it was better and sometimes it was worse and they could be waiting longer,” he said.

When the Limerick Leader visited the emergency department on Tuesday afternoon there were around 30 people on trolleys - most of them older people with medical conditions - crammed into every corner

A Kilmallock woman tending to her elderly father said he had been brought in by ambulance at 11am with slurred speech “and his blood pressure was through the roof”.

He had been referred to a specialist who he was still waiting to see at 4pm. His daughter had “no idea” whether he would be admitted or how long it might take.

“I had been warned about this. It wasn’t too bad when I got here this morning but it filled up extremely quickly and there were no trolleys to be found for the ambulance crews coming in handing over.

“We are concerned because he is an insulin-dependent diabetic, he has got a spinal abscess and he is uncomfortable. He should really be on a bed.”

Instead, he was in a row of six patients of different ages and genders tightly packed in A&E. Bleary-eyed relatives complained that it had proven impossible to get privacy or rest.

Around the corner, a middle-aged man who had been involved in a traffic collision near Rourke’s Cross was being discharged after waiting five hours to see if doctors had successfully managed to pop in a dislocated finger.

“I’m lucky I wasn’t killed,” said the man in a torn and bloodied shirt “but I’m thankful I can slip away and don’t have to wait day and night like the poor old people in here.”

A woman from Garryowen with a chest problem said she had been waiting for over 12 hours to be admitted.

She laid the blame on “whatever brains came up with the idea of closing the A&Es in St John’s and in Ennis”.

“There is no room at the inn,” she rued.

“It is not acceptable that there were 47 patients here last night on trolleys when Ennis or Nenagh or John’s could have taken some of the load. I know for a fact now that Limerick people are going up to Galway. It’s €100 here for the A&E charge so they would rather go up to Galway for an hour and a half and pay the charge there.

“You would not be waiting as long and get royal treatment compared to here although I am not giving out about the staff here, who are only doing their best.”

And a man from Dromcollogher who contacted the Leader this week blamed “a lack of communication” between the ED and doctors on wards upstairs for the pressures.

Admitted – after a 24-hour wait in the ED – to UHL with a kidney complaint three weeks ago, he said he had seen three beds on an upstairs ward unoccupied for 12 hours while sick people languished on trolleys in the ED downstairs. He also believed people who would be better cared for in nursing homes were not being discharged soon enough.

“Whoever is upstairs don’t see the problem downstairs and if they do, they are closing their eyes to it. It’s lack of communication and it’s down to management to get it together. I’m in business 35 years and the management in that hospital, you wouldn’t put them in charge of chickens,” he said.

My Morris, meanwhile, wished to emphasise “how kind and hardworking the nurses and doctors are under impossible conditions”.

“Excellent people - but no centre of excellence,” is how he summed it all up.

In a statement issued this Wednesday, UL Hospitals said it had“experienced a high number of patients attending the hospital over a number of days”.

“This led to delays accessing beds through the emergency department resulting in excessive wait times for patients. The situation has improved and delays have reduced, however numbers remain high. University Hospital Limerick regrets that any patient has to wait to be admitted.

“UL Hospital management recognise the need for additional bed capacity at UL Hospitals. Over the last year, UL Hospital Limerick has added 21 additional beds and St John’s Hospital Limerick added an additional 20 beds. A plan for a new 96-bed ward forms part of the 2014-2016 UL Hospitals Strategic Plan. In the meantime, UL Hospital management is seeking to identify opportunities to relocate existing services to provide additional bed capacity.

“The public are reminded to keep the emergency department for emergencies only and to contact their GP or GP out-of-hours services in the first instance. Local Injury Units are open in Ennis and Nenagh Hospitals from 8am to 8pm, Monday to Sunday, and 8am to 6pm at St John’s Hospital. Patients with minor injuries, for example sprains, strains, wounds or cuts, are encouraged to visit these units for treatment.”

Editorial, page 16