Exhausted emergency department nurses ‘checking in’ as overcrowding persists

Mike Dwane


Mike Dwane

Crisis: University Hospital Limerick
EXHAUSTED emergency department nurses are “checking in” to their own workplace as they struggle to cope with overcrowding at University Hospital Limerick.

EXHAUSTED emergency department nurses are “checking in” to their own workplace as they struggle to cope with overcrowding at University Hospital Limerick.

Irish Nurses and Midwives Organisation representative Mary Fogarty said she was aware of one young woman who needed to admitted after suffering palpitations while on duty in A&E in the last week.

“There are significant wellbeing and stress related issues now affecting nurses. They are exhausted and facing complete and absolute burnout and we are very concerned about their health and safety and for the health and safety of the patients,” she said.

Ms Fogarty was speaking following a meeting this Wednesday with hospital management, who she accepts are making sincere and serious efforts to deal with overcrowding in the emergency department.

It also comes during a week in which A&E consultant Damien Ryan appealed to members of the public to go to their GP, Shannondoc or the local injury clinics at Ennis, Nenagh and St John’s before considering a trip to the emergency department in Dooradoyle.

Forty patients were waiting on trolleys in A&E or on wards this Monday morning - the highest number in any acute hospital in the country - while the tally was 39 on Tuesday and 24 on Wednesday.

When the details of the HSE service plan for 2013 were announced by hospital management last March, the Mid-West acute hospitals director of medicine Con Cronin said the ambition was that nobody would have to wait on trolleys in the emergency department by the end of the year.

“We would be very upset if there are any trolleys by the end of the year. We are working towards a target of no trolleys,” the consultant said at that time.

But a nurse who spoke to the Leader this week said that: “if anything overcrowding is worse now” than when the INMO and SIPTU Nursing picketed the gates of the hospital on the issue of patient safety and overcrowding two years ago.

She pointed out that despite the advice from the HSE, many of the patients now presenting at A&E have already been to Shannondoc or their GP. The replacement of the daytime emergency department at St John’s Hospital with a local injury clinic had compounded matters, she added.

“At this point we have been through a lot (since the industrial action) and we have been waiting to see if any improvement would occur,” Ms Fogarty said.

“But the patients who are coming - because they can’t go to Ennis or St John’s - to the emergency department are sicker than what used to be the case. They are too sick really to even be waiting in the emergency department and should be admitted straight away,” Ms Fogarty added.

A spokesman for the HSE said that “pressure on emergency departments at this time of year is common in every major hospital in the country”.

“There is traditionally an after-Christmas surge covering the entire spectrum of minor injuries/illness to more serious medical complaints such as chest and abdominal pain, shortage of breath and sepsis.”

“Patients with minor injury are encouraged to avail of the local injury units in Nenagh, Ennis and St John’s. All others where the presentation is not deemed to be life-threatening should seek advice from their own GP in the first instance.

“We continue to work towards having no trolleys and acknowledge the dedication of all our staff in the current difficult circumstances. Work is progressing on our new emergency department,” the HSE spokesman said.

A source close to hospital management also told the Leader this week that “consultant attitudes” were part of the problem and claimed that senior medics resistance to new rosters were causing the system to back up throughout the hospital, increasing the pressure on A&E.

Fianna Fail’s Deputy Niall Collins, meanwhile, said that the government and the Minister for Health had to take some responsibility for the crisis at Limerick’s emergency department.

“I have been speaking to individuals coming in and out of the hospital and from what they tell me there is complete mayhem and chaos being experienced by the patients and staff in A&E at present,” said the County Limerick TD.

“The system appears to be on the brink of collapse and James Reilly needs to get to grips with the situation - and fast. It is simply not an option to tell very sick people to go to their GP or to Shannondoc while a ‘CLOSED’ sign is put up outside the door of the A&E at the Regional”.