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Overcrowding

'I'm exhausted': Frustration in the Mater Hospital's 'rammed' Emergency Department

The Mater was the hospital with the highest number of patients on trolleys in Dublin yesterday morning, according to the INMO.

“MORE PATIENTS THAN ever are on hospital trolleys across the country today.”

In the Emergency Department of Dublin’s Mater Hospital yesterday morning, patients sitting on chairs in the waiting area looked up at the television, some leaning forward so they could hear a news anchor say what many of them had realised hours beforehand.

It was the worst ever day for trolley overcrowding since INMO records began.

The Irish Nurses and Midwives Organisation (INMO) revealed yesterday that there were 760 patients without beds in hospitals across the country. 

At the Mater’s ED, there were 37 patients on trolleys overall, according to the INMO figures. When TheJournal.ie visited yesterday morning we counted around 10 patients, mostly elderly people, on trolleys solely in the department’s corridors.

One man who has a chronic illness and who was brought in by ambulance had been waiting for a bed on a trolley in the corridor of the ED overnight, for 12 hours.

A relative who was sitting on a chair beside him said, despite the long wait for a bed, she was happy with how quickly he had been seen when they came in and the care he was getting from medical staff.

“If you come in by ambulance it’s faster. He has a chronic illness so he’s back and forth in hospital but he can’t be left alone, he needs someone with him to represent him. He gets startled if people lean over him and things like that.”

His trolley was on a busy corridor, near the nurses’ station with two other patients on trolleys directly behind him. 

She said although the ED has been busy that morning she believed the system is working “better than it used to”.

I do think they have taken measures to improve the flow, I think they do the best they can with the resources.

Michelle Hennessy / TheJournal.ie Michelle Hennessy / TheJournal.ie / TheJournal.ie

Out in the waiting area, patients said they can see how busy the doctors and nurses are, but that they were exhausted – and frustrated – after sitting on hard plastic chairs all night.

One woman said she had been there for more than 13 hours. She had pain in her ribs and had previously had a brain haemorrhage so the doctor had sent her for a brain scan as well as an x-ray on her chest.

She was waiting with her husband in the reception area for her results.

“We’ve been here all night. It’s shocking,” she told TheJournal.ie.

Her husband said they had briefly been inside where the trolleys were the night before and said medical staff were “overrun”.

“It was absolutely rammed in there last night,” he said.

“I feel so sorry for her, though,” his wife said, gesturing to another patient who was sitting near them. This woman told us she had also been in the waiting area all night.

She has pancreatitis and was in severe pain the previous night so she went to the hospital. Blood and urine samples had been taken and she was given some pain medication, but told not to eat or drink anything. 

Food and drink can trigger the release of enzymes from the pancreas making pain worse for a patient with pancreatitis.

“I’ve been sick now for a few months so I’ve been in and out,” she told TheJournal.ie. I would have gone to my own GP but they’d only have sent me up here. It’s ridiculous, I’ve been here for more than 12 hours. I’m just exhausted now. No food and no water, I’m struggling to keep my eyes open.”

She said she had thought about leaving.

Visitor ban

At University Hospital Limerick, a visitor ban was put in place as it dealt with an influx of flu patients. There were 92 patients waiting for beds at the hospital yesterday morning, according to INMO records. 

The hospital said it had seen a marked increase in the number of over-75s presenting and requiring admission to hospital. 

A spokesperson said they “regret that any patient, especially the elderly, has to wait on a trolley for admission”.

Cork University Hospital, Mercy University Hospital, Mallow General Hospital,  University Hospital Waterford and South Tipperary General Hospital have also imposed strict visiting restrictions to try to prevent the flu spreading. 

Severe flu season

Speaking to reporters yesterday, Taoiseach Leo Varadkar acknowledged that hospitals were “severely overcrowded” and said the situation had been exacerbated by a “very severe flu season”.

The current flu season, which arrived three to four weeks early this year, had led to the deaths of 22 people as of Friday last; 17 of those were aged 65 years and older.

The Taoiseach said the HSE and hospital management had been assured of government support in taking any additional emergency measures necessary to alleviate the situation.

He said this overcrowding is “not a new problem” and that there is a “long term plan in place to deal with that long term problem”.

This includes increasing the number of beds, increasing the number of staff and increasing resources for primary care.

However the INMO wants more immediate action than this “long term plan”. 

The union has called for a major incident protocol to be adopted across the country, as was done in March 2018. 

This would potentially see non-emergency admissions stopped, electives cancelled and extra bed capacity sourced from the private and public sectors.

The INMO also called for an infection control plan, as the risk of this increases with overcrowding. And general secretary Phil Ní Sheaghdha said the HSE needs to immediately scrap its recruitment pause, “which is leaving these services understaffed and thus overcrowded”.

Ní Sheaghdha rejected any suggestions that “this is all down to the flu”.

“There are always extra patients in winter, but we simply do not get the extra capacity to cope,” she said. This is entirely predictable, yet we seemingly fail to deal with it every year.”

She added: “Behind these numbers are hundreds of individual vulnerable patients.”

Patients like those in the Mater Hospital yesterday morning, sitting on hard plastic seats overnight or lying on trolleys in noisy corridors with their worried and exhausted relatives perched on a chair next to them.

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