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Dublin: 3 °C Sunday 17 November, 2019
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'A patient could come in with a heart attack and wait on a trolley': Life for Ireland's emergency department nurses

Last minute negotiations have seen strike action averted.

Updated 18.20

LATE-NIGHT NEGOTIATIONS yesterday saw action by Ireland’s emergency department nurses averted.

It had been set to take place to oppose under-staffing and overcrowding and would have affected seven of the country’s emergency departments.

Despite the last minute agreement between the HSE and the Irish Nurses and Midwives’ Organisation (INMO), action could still go ahead in January – and the situation on the front line has not been improved.

As of today there are 226 patients on trolleys or in wards around the country.

In St Vincent’s Hospital alone there are currently 32 patients on trolleys – and this does not factor in the number that will be passing through its emergency department’s doors.

Speaking to TheJournal.ie, John, Ciara and Jane* – all of whom are emergency department nurses – have described what life is like on the front line.

Absolutely no room 

Trolley counts can seem abstract until the human suffering involved is highlighted, like last month when it emerged that a 91-year-old man with Parkinson’s had spent 27 hours on a trolley waiting to be moved.

“That happens at least two or three times a week in A and E departments,” explains Jane.

Seeing a 70- or 80-year-old man or woman on a trolley for two days – it is just heartbreaking.

nurses - 1 INMO nurses protesting outside St Vincent's Hospital last week Source: RollingNews.ie

The problem arises from the sheer number of patients the emergency department has to accommodate.

A department may only have 40 beds, all of which are taken up by patients who should have been moved to other parts of the hospital – but aren’t due to overcrowding.

The lack of beds means that it becomes a process of filling trolleys, then armchairs, and then hard plastic seats.

“When we use up the first batch of trolleys,” explains John, “We’d rob a few extra trolleys from where we can, the x-ray department maybe.

“The rest of the patients that come in have to sit in a chair. If someone comes in on say a Monday and the allocations of beds are gone, they’re going into a chair.

If you come in with a heart attack or a brain haemorrhage, you could be going onto a trolley or into a chair.

‘You try and treat everyone as if they were your own mother or father’

Dealing with the patient is not always easy, as Ciara explains:

“What can be very difficult is families getting annoyed and becoming aggressive, because I completely understand where they’re are coming from. I have been threatened, I’ve been verbally abused.

People always come back and say they’re sorry, but because we’re the front line, we’re the ones that hear it.

This difficulty in providing good enough quality care for patients is one of the biggest issues for the striking nurses.

“I say the word sorry probably about 50 times a day,” says Jane, speaking about the service offered to patients.

nurses - 3 Source: RollingNews.ie

“You know what day you’re going to have before you walk in depending on certain things. How many ambulances are outside. How many beds you might have free. But there is no let up right from the start.”

For John it can be distressful to see the conditions that some patients are left in.

“Every nurse is taught empathy,” he says, “You’re always taught during the training to treat everyone as if they were your mother or your father. As you’re walking around there you’re saying ‘if this was my mother, I’d be going absolutely mental’.”

I’ve seen patients getting a dialysis sitting in a hard plastic chair outside the staff toilet.

Not in it for the money

One thing that comes up for these emergency department nurses is a complete rejection of the idea that they’re striking for pay increases.

The HSE has previously said that a prominent theme in the dispute is outstanding issues relating to pay, saying that the union’s demands would cost €40 million a year and breach the Lansdowne Road agreement.

nurses - 2 Speaking last month INMO's general secretary Liam Doran described Irish nurses as the most patient group of public servants ever known to man. Source: RollingNews.ie

For these emergency department nurses, this was difficult to hear reported in the news.

“That was one thing that really annoyed me last week,” says John, “I worked with Leo Varadkar many years ago as a nurse. And with the talk of industrial action all I heard was [Varadkar] talking about pay. [I wasn't going to be] striking tomorrow over pay.”

“Nurses are the cornerstone of the health service, or so they keep saying,” says Ciara.

Well do not insult the cornerstone when we’re standing up for our patients.

*The names of these nurses have been changed to protect their anonymity. 

First published 6am 

Read: Psychiatric patients killed in hospital fire had been given tranquillisers

Also: Operations cancelled ahead of strikes in Ireland’s emergency departments

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