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LAST UPDATE | 4 May 2023
MOIRA WYNNE HAS been an emergency department nurse in Dublin for fourteen years. In her own words she can “cope with a lot”, but she reached a breaking point when a man punched her in the face while she was on duty.
“It wasn’t the patient’s fault,” Wynne explained.
“I want to be able to go into work and provide an environment for patients where they are looked after, and I am not concerned about being able to keep them safe.
“There’s been many times when someone comes in who is experiencing mental health issues, and they are waiting in a hall where it is noisy, bright lights are on constantly, it’s crowded, doctors are coming in and out, ambulances are arriving.
“For vulnerable people that is the worst situation to be in. We should have quiet spaces where they are able to be assessed, and staff are there to do that, and we do have one of those spaces, but sometimes three or four other people should have a safe space as well. That is what really gets to me,” Wynne said.
“I am usually very calm, but when I got punched I went and sat down in an office and cried. My colleague came in and said ‘Oh my God, you never cry!’, but that day I couldn’t hope,” she added.
The Clinical Manager said that she believes that there is no real “appetite” for industrial action amongst the Irish Nurses and Midwives Organisation (INMO) member’s at the conference this week, but that “it might be the only way to see changes made, but I hope not”.
“When we talk about the safe staffing framework, it is not some made up plan. It is facts-based. We want to see it implemented with some weight behind it. That means that if, as part of the framework, there needs to be four nurses in your team, there are. When one person leaves, no one is able to turn around and say ‘Well maybe you will be okay with three,’ and then not replace them,” Wynne added.
INMO has voted in favour of holding a national ballot on industrial action if sufficient progress is not made on a safe staffing framework that is underpinned by legislation.
This move comes despite Health Minister Stephen Donnelly promising an extra 25 million in funding for 854 additional nurses in acute hospitals across the country.
“Where is he going to get them from? We’ve heard promises like this before, but we know that the recruitment process is unnecessarily slow, and we have approved positions that are vacant in the health service,” Wynne said.
“Migrant nurses are being made to come here and pay to do a test that isn’t like anything I did when I got my qualifications – and if they fail it twice, by even getting one station out of fourteen wrong, they are out.
“For people looking to move to practice in other parts of the country, you’d think that that would be fairly simple, but it isn’t, it can take six or nine months and you need to go through all of the paperwork again, including garda vetting,” she added.
The Dublin-based nurse said that she believes the lack of investment in older people’s services is contributing in a serious way to the backlog for discharges and transfers in acute settings, and has a knock on effect on the entire health system.
“It is like we are on a hamster wheel.
Older people go through deconditioning, and they are able to be discharged, but there is no availability for homecare hours to make sure that they will be looked after at home, they can’t even get twelve hours a week.
“Families try to do it, and we see them exhausted, but in many cases they cannot do it all by themselves. So one thing knocks into another. That patient continues to stay in an acute bed, we end up with overcrowding, the staff cannot cope with the demand, and non-urgent surgeries get cancelled.
“That means that by the time a patient who is pushed back on a waiting list comes to us, they are sicker, and they are then also in hospital for longer.
“In some cases, an older person can come in for something like a chest infection, and because they can’t get homecare hours, they end up going into a private nursing home. We are paying a very large amount of money to these private facilities, when we should be invested in helping people to get back home,” Wynne said.
Being redeployed to other wards that are short staffed is an issue that is affecting emergency department nurses up and down the country – a motion was passed calling for the practice to end within the health service at INMO’s conference.
“It is not like a site manager would redeploy us just for the sake of annoying someone. They come into the ED and think things look under control, and then people get asked to go to other areas.
“The thing is, things can look under control one minute, and there can be a very urgent situation, like patients coming in after a car crash, the next.
“It also affects us retaining staff. Some nurses have gone on to complete postgraduate study specifically in emergency department work, and they don’t feel they can do that to the best of their ability when they are redeployed, or we have patients coming into us who should be able to get seen by a GP,” Wynne said.
Bernard Gloster, the CEO of the HSE, made a number of promises on changes to critical care planning, and changes to the structure of the HSE, which should see more senior managers reporting directly to him.
Wynne, who has attended many INMO conferences, said that listening to Gloster she felt some “hope that things will change”, because he “recognised the problems we are facing, and spoke about solutions and deadlines”.
“We are so used to being told that we are so hardworking, that we are the cornerstone of the health service. We are tired of that. It seemed to me that he is someone who wants to confront the reality of the situation.
“I like what he said about scrapping the winter plans, because they are a joke. We follow them each year when in reality, we go back after Christmas and it is just as bad, and the situation isn’t getting better during the rest of the year either. Then we are meant to act surprised that people are in unsuitable conditions.
“I love what I do. I feel very honoured that peoplFe trust me to look after their relatives. I’m proud to make a difference and to work with such an amazing team. I just want to be able to do my job well,” Wynne said.
“We also need to end the disconnect between the people making the plans, and the people working on the frontline. Look at what has happened with the new Limerick ED. My colleagues are working there and it is like a war zone, but it was meant to be a solution at the time. We need to bring together the interested parties and have an honest conversation about the way forward in order to future proof our hospitals,” she added.
Minister Donnelly is set to address the INMO conference tomorrow.
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While we all have sympathy with people fleeing conflict and poverty, why should Europe be the default destination for everyone? In the case of Syria, Iraq etc, they are bordered by oil rich nations such as Saudi, Dubai & Abu Dhabi, countries who they have more in common with in terms of culture and religion. I don’t see those countries stepping up to the plate to help their immediate neighbours yet we’re expected to? I accept that a lot of the problems in these countries originate from Western meddling in their affairs, namely the US and their lapdogs in the UK but of course they conveniently forget their culpability when the chips are down.
@Paul Shepherd: you do realize the biggest intakes of refugees from these regions are countries in those regions, e.g Jordan, Lebanon and Turkey, ?
@Purdo: biggest hosts and nations that take in refugees *
@Paul Shepherd: I had this very same conversation with someone from the middle east on Facebook. He was complaining that Europe didn’t treat Syrian rufgees as well as Ukrainian. I pointed out that Ukraine is part of Europe and that none of the rich Emirate countries took any refugees from the region. Incidentally I had no issues with us taking Syrian refugees but I got pissed off when their wealthy neighbours did nothing.
@Purdo: yes those countries stepped up. Of the 3 only Jordan could be considered wealthy. But many countries with more wealth than any European country did nothing.
@Gearóid MacEachaidh: Why should we want to emulate the Saudis and the Emirs?
@Gearóid MacEachaidh: Bosnia is part of Europe, how much did we help them? Oh yeah, they are not ‘white, Christian Europeans’
@Paul Shepherd: the vast majority of refugees from Syria and Iraq ended up in neighbouring countries, just not the US client states that you mentioned.
It was very polite of you to admit that the refuge crises in both countries were as a result of western(US) meddling, but surely you can understand how it must be very annoying for Asian countries to see the west continually fight wars in Asia that have an adverse affect on the whole of Asia, but, when a war erupts in Europe(again as a result of US meddling)the west expects the whole world to come to a standstill because the people getting killed are white European instead of expendable Asians and the refugee tide is flowing into Europe.
You must realise Europe looks a very small place when viewed from Asia.
@GClare: the West did help Bosnia. They went to war against an Orthodox country to protect a Muslim country. They created no fly zones to protect the refugees. You might say a bit late but it was done. And now the West are blamed for starting so many wars.
@Richard Williamson: and yet gave half the country to the Orthodox aggressors. The UN turned back civilians as they reached no man’s land and sent them back through the mine fields. How many countries took in any real number of Bosniaks, bar Germany.
One of the key distinctions between Ukraine and other parts of the world is that this was a clear invasion. Syria and Yemen for example are Civil wars and there is far more of a grey zone. Ukraine’s martial law has also prevented military age men from leaving, which is one of the bugbears of those against refugees from other conflict zones who have fled. Predominantly women, children and elderly refugees has been more palatable for western Europe.
@SilexFlint: civil war and invasion can and do sometimes interlink, Syria is under a civil war, but has being invaded, at least in regions ypg/sdf controlled areas, and for some opponents of assad in Syria, they see russian, and Iranian assistance of assads regime and troops there as invasion for their country.
@SilexFlint: Protecting refugees should be about protecting individuals from disaster. What relevance has the geopolitical context to whether these are people worthy of protection?
@Nicholas McMurry: Because we can’t take everyone, and their neighbours should take them in more so than us if they are from a far off region.
@SilexFlint: It’s not a bugbear, it’s an obvious sign of economic migration vs refuge. If it’s mostly young men arriving seeking “asylum” then you know it’s bogus. No one seeking genuine asylum leaves their women and children in the country they had to flee. That’s preposterous tripe that we ought not to swallow.
@SilexFlint: I’m surprised that military age men were prevented from leaving Ukraine. Many refugees from Ukraine included men of military age though not necessarily born there. You say that women, children and elderly refugees are more “palatable” but surely the most vulnerable are most in need of help. Many refugees in past years have been men of military age who sometimes have problems integrating to their host countries and following laws there. This means that host countries cannot always guarantee safety for more vulnerable refugees such as women and children.
@SilexFlint: our media says it was a clear unprovoked invasion….that’s why most people say, and believe the same. The media is controlled by the establishment…. all other views are demonised, ignored are the US funded overthrow of a government the rise of Ukrainian nationalism and russophobia … the defensive breakaway by, Crimea, donbas, Luhansk , the election promises of Zelenskyy the Minsk agreement, the issue of NATO…. were the Russians expected to stand by and witness the reported killing of 14 000 people in Donbas?? the most dangerous development is the demise of judicial thinking….
@Fergus Quinlan: are you for real? What Russian propaganda feed have you signed up to? Crimea, donbas, luhansk are all part of Ukraine and Russia has effectively funded dissidents in these regions to foment an uprising so they could kind of justify going in and invading a sovereign country. It doesn’t matter if some of these people feel more Russian, the point is they are living in Ukraine. If they want to live in Russia and be Russia move to Russia. It would be like UK invading us because some people here felt brittish and didn’t like the establishment government. Your a few slices short of a full pan if you think anything different.
Even I’m not taking this on! But I will say, asylum seeker/economic migrant/refugee from conflict are not interchangeable terms, nor are they interchangeable statuses. When you get a music journalist to write on such things, maybe it should be borne in mind.
No matter the circumstances, the woke will always take the opportunity to play the race card.
@Shaner Mac: Every day. Every minute. It’s a mind virus.
@Shaner Mac: What does woke mean?
@Tommy Berry: you don’t like white people (even if you’re one), you believe there is only one gender, anyone who transgresses must never, ever be forgiven etc
The media a few months ago telling us we shud open our homes to refugees from Ukraine. Now they’re telling us we’re racist for doing so.
@Simon: Where does he say that we should not be opening our homes to Ukrainians?
Why are only progressive opinion pieces published on the Journal??
Do these progressives ever get sick of peddling guilt?
I am a progressive, but the author clearly has a divisive and utterly false agenda!
Bore off.
I work with refugees and it is very obvious that there is a two tier system. This article states the truth and it does not throw blame if you read it carefully.
I can’t help but think this article is based on idealism and fantasy in its naivety. It operates on tbe idea that Ireland is actually capable, by design, of helping any refugee, evacuee or Joe looking for a better life. Any dog on the street knows Ireland acts and reacts purely by default (let’s not even mention at the behest of its overlords) and is always and forever on the back foot. The proof of this is how it manages its own business (re: the usual list of dire fails). How can it truly help x when it fails at y? Oh yeah!… It’s house proud.
Worth pointing out that Saudi Arabia, UAE, Turkey etc or China, Japan elsewhere have not offered to take in Ukrainian refugees nor did they take in refugees from Syria either except for Turkey. I doubt there is a debate going on about this in those countries. It makes sense refugees would be primarily accommodated in countries close to their home country.
Very well said. Thanks. The hypocrisy is awful and the unfairness unacceptable.
There is indeed a two-tier system – and it is for a logical and justifiable reason. Ukrainians are fleeing a war on the borders of the EU, of which jurisdiction Ireland belongs. We know exactly where they are coming from, and the fact they are genuine refugees. In the circumstances, to subject Ukrainians to the asylum assessment process is unnecessary, and would be a complete waste of resources.
On the other hand, people turning up on our borders to claim asylum alleging persecution in far away places are in a different situation, and it is necessary to assess the credibility of their claims as to their veracity before giving them refugee status and the rights which go with that status. That is the rule of international law. It is also noteworthy that upon assessment, more than two thirds of this latter group are found to have no credible claim to refugee status, and have abused a system that exists to protect the persecuted of this world. Of course, for the one third of this cohort who can show a credible case for asylum or international protection we provide the same rights as we give to Ukrainians (in fact, we give them permanent residency status with a route to full citizenship – Ukrainians have a mere two year’s residence) – regardless of race, creed, or colour.
The writer of this piece ignores the real difference between Ukrainian refugees and the migrants appearing at our frontiers claiming asylum or protection. We already know where the Ukrainians are coming from, and the fact there is a war in their country. Given these facts it would be a complete waste of resources to require Ukrainians to have the credibility of their refugee status assessed.
Not so with asylum seekers generally – three quarters of whom are found on assessment not to have any credible claim to asylum or protection, and who often falsify their countries of origin.
The writer also speaks of asylum-seekers coming from Syria and other war-zones. Two points. Firstly, those genuinely coming from war zones generally get asylum or protection once their claims are verified. Secondly, only a small percentage of Ireland’s asylum-seeking population comes from war zones. The vast majority comes from places like Georgia and South Africa which are safe countries, or from Nigeria where the UN considers internal migration perfectly feasible for those claiming to be fleeing local sectarian strife.
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