Behind the 'chaos' at A&E in University Hospital Limerick

The Limerick Leader visits hospital to learn more about a crisis situation

Fintan Walsh


Fintan Walsh

Behind the 'chaos' at A&E in University Hospital Limerick

Ambulances backed up at UHL on Tuesday

PATIENTS stuck on trolleys at A&E in University Hospital Limerick have spoken of the “absolute chaos” present in the facility.

The Limerick Leader visited the emergency department at UHL this Thursday as it experienced the country’s second-highest ever rate of overcrowding in an Irish A&E since records began.

At 10.30am, 60 patients were being treated on A&E trolleys and on extra beds, trolleys or chairs in the wards at the Dooradoyle facility. On Wednesday, there were 66 patients waiting to be admitted to a bed — the highest rate ever recorded.

In the midst of all this, Limerick is battling one of Ireland’s worst flu and Norovirus (winter vomiting bug) outbreaks, with close to 150 infected and many more unreported since early December.

After the Irish Nurses and Midwives Organisation revealed the high trolley figures on Thursday, the Limerick Leader went to the A&E to witness the severity of the situation.

One woman, who had been in the emergency department since the early hours of Thursday morning, said that it was “absolute chaos” in the A&E.

“Instead of waiting on a trolley in the A&E, I decided to wait out here. It’s madness in there. There’s way too many people on trolleys in there, and the staff are doing the best that they can.”

Another woman, who was with her mother, said that there was one nurse who was looking after 13 patients that morning.

“The staff are brilliant in there, it’s just the circumstances that they are dealing with is the problem. We were kind of afraid to go to the A&E at first, but we figured we just had to,” they explained to this reporter.

On November 9 last year, the Limerick Leader witnessed more than 20 people on trolleys in A&E. The main concern for families attending the hospital was the length of time their loved ones would be spending on a trolley.

On this visit, however, it became apparent that fears specifically revolve around the flu and vomiting bug outbreak.

And though December has been an “upsurge” season for the outbreaks, the numbers are expected to increase further in January, the HSE has stated.

“People are piled up on top of each other, it’s no wonder the flu is being spread around,” said a patient.

Up to 16 ambulances were backed up outside the hospital on Tuesday, waiting to discharge patients - a situation that was captured on video and shared on social media, attracting thousands of views.

People with influenza-like illnesses are advised to not attend the A&E without a GP referral.

Dr Breda Corcoran, HSE national immunisation officer said: “Anyone who gets flu should stay at home, rest, drink plenty of fluids and use over-the-counter flu remedies to ease symptoms. People in high-risk categories should contact their GP if they develop flu symptoms.”

Inside the A&E this Thursday morning, frontline staff attentively assisted all 20-something patients; most of whom were elderly and trying their best to rest in what was a busy, cramped, fast-pace environment.

One man told the Leader: “There’s barely any space to move in there. They are double-parking the trolleys.”

And this was the case upon entering the A&E, with a pair of paramedics trying to find space for an elderly patient lying on a trolley.

And while chaotic overcrowding and severe viral outbreaks are creating problems in the hospital setting, nurses, porters and doctors have been “working so hard with the patients”, one family member said.

Of the half dozen interviewed at UHL, none had to wait for more than four hours for a bed or to be seen by medical staff.

On Wednesday, after overcrowding reached peak levels, a spokesperson for the UL Hospitals Group said: “The ED in University Hospital Limerick is one of the busiest in the country with over 60,000 attendances annually.

“The Christmas/New Year period has been exceptionally busy with many frail elderly patients presenting and requiring admission to hospital. Levels of influenza and respiratory illness remain high, as of today, the 4th of January 2017, there were 10 confirmed cases of seasonal influenza in UHL, and visitor restrictions remain in place at the hospital.

“Traditionally, average attendances at the ED have been approximately 150 over a 24-hour period from Monday to Friday and 120 per 24 hours at weekends. On three consecutive weekdays last week, the daily attendance figures ranged between 180 and 211 patients and this pattern has continued into this week  with 209 attendances yesterday (Tuesday).  

“Overcrowding at this level can unfortunately cause delays to ambulances when they arrive at UHL and the hospital regrets that any patient has to wait to be seen.”

A “full capacity protocol” has been implemented by management at the hospital, which includes the addition of 17 beds and a number of measures to relieve the situation at UHL.

These conditions have sparked outrage amongst local politicians and the public, with AAA councillor Cian Prendiville calling on the Government to “declare a national emergency” in all A&E services.

“The Minister is trying to claim no one could have foreseen this crisis, that this is a so-called 'perfect storm' but the reality is the crisis in our health service is an ongoing national emergency,” he said.

“At this time every year there is a spike in hospital admittances, but the trolley crisis is consistent all year round with the record being smashed numerous times in the last year. Limerick is always one of the worst affected, following the closure of Ennis, Nenagh & St John's A&Es,” he added.