By Eoin English
The Coast Guard and Civil Defence have been called in today to transport critical care staff and priority patients to Cork University Hospital (CUH).
St John's Ambulance were helping the HSE ambulance fleet with 4x4 ambulances across the city and county and farmers are organising a fleet of tractors in West Cork this afternoon to ensure that staff can get to work at Bantry General Hospital.
Dozens of volunteer drivers were using a fleet of 4x4 jeeps today to transport patients, including those who require dialysis, from snowbound areas in East, West and North Cork to CUH for treatment, and then home again.
Up to 48 nurses couldn't get to work at the hospital this morning and the available nursing resources were deployed to ensure continuation of care for the most critically ill patients.
Some staff stayed in nearby city hotels and bed and breakfasts last night, and will do so again tonight.
Staff rosters have also been changed to ensure that those who live closest to the hospital will be on call over the next 24 to 48-hours.
And the hospital's closed outpatients area has been converted into a makeshift hostel to accommodate up to 40 doctors, surgeons and nurses who plan to sleep on its couches overnight to ensure they are available for work in the morning.
CUH's director of nursing, Mary Owens, described the scenario facing management and staff as challenging.
But she said they are "getting on with it" with the help of the various voluntary agencies, in the knowledge that they can call on the Defence Forces if required.
She said their focus yesterday was very much on hemodialysis patients who need to have their treatment.
"We were very dependent yesterday on voluntary organisations like the civil defence," she said.
"We got 71 or the 72 patients scheduled for dialysis yesterday in. "There was only one man that we didn't get, but we got him in today."
The patients who were dialysed last night were kept in the hospital overnight, and were transported home this morning in civil defence and coast guard vehicles.
They also coordinated the collection this morning of up to 80 patients who were due to attend for dialysis today in three waves - at 7am, 1pm and 6pm.
"The same planning continues today. It's about managing our resources with the help of civil defence, in particular, and really strong teamwork," she said.
Ms Owens, who hasn't been home since Monday, praised staff who have been flexible and committed to their roles.
"We are flat out trying to get staff and patients in and out. But that's not all. We need staff in to feed patients, and to prepare up to 3,00 meals today alone, and we are working on that too," she said.
Victor Shine, the volunteer deputy area officer with Crosshaven Coast Guard unit, was involved in the transport operation and house calls.
"We have four vehicles and are going as far west as Skibbereen and as Far East as Youghal," he said.
He reported for duty as third officer of Cork City Fire Brigade at 2pm.
CUH chief executive, Tony McNamara, said the response by all has been phenomenal.
"It's a reminder to us all that the commitment of people who work in the public service, as public servants, is exemplary. We are seeing it first hand here," he said.
The uncertainty about the availability of staff is the most pressing issue over the next 24-hours, he said.
"That poses a serious challenge for us tonight and tomorrow," he said.
"There are arrangement nationally and locally to allow us access the resources of the state, if required.
"We have made contingencies, and cancelled surgeries and clinics, to make sure that the staff that we have are deployed to provide critical cover."
A total of 700 outpatient appointments scheduled for today and tomorrow have been cancelled, and 15 surgeries due to be performed tomorrow have also been cancelled. Five surgeries that had to go ahead will be performed today.
Mr McNamara said management are keeping the situation under constant review.