Trolley crisis: 'You’ve elderly people in there and they have no dignity'

Chronic overcrowding continued across the country’s hospitals as 531 admitted patients languished on trolleys in emergency departments and wards today.

Trolley crisis: 'You’ve elderly people in there and they have no dignity'

Chronic overcrowding continued across the country’s hospitals as 531 admitted patients languished on trolleys in emergency departments and wards today.

University Hospital Limerick (UHL) was the most overcrowded hospital with 76 patients on trolleys, according to figures published by the Irish Nurses and Midwives Organisation (INMO).

Yesterday, nurses recorded 81 patients on trolleys at the Limerick hospital, the highest ever in an Irish hospital.

Later the figure rose to 92, INMO representative Mary Fogarty.

Today, a hospital spokesperson confirmed that the hospital’s own figures - published yesterday and showing 52 patients on trolleys - related only to the numbers on trolleys in the Limerick ED and did not include trolley numbers on general wards.

At 2pm today, patient Dean Fitzgerald, from Shannon, Co Clare said he was “still on a trolley” in the Limerick ED seven hours after arriving by ambulance with severe stomach pain.

“I came in about 7am this morning and I’m still sitting on a trolley, and, nothing done,” he said, whilst taking in some fresh air outside the overcrowded A&E department.

I came in by ambulance this morning. At 6am this morning I literally woke up in agony, in excruciating pain in my left abdomen.

"Hopefully it’s (not serious). I don’t want to be going in for operations.”

Dean said he felt lucky as he had been placed in an ED isolation pod, due to infection control procedures, in case he had a contagious stomach bug.

A few feet away groups of elderly patients continued to bear the “busy as hell” conditions.

Along the cramped corridors nurses and doctors fought for standing room to treat the never-ending stream of sick and injured.

The order from the floor was “only one” relative per patient.

“It’s not the staff’s fault, it’s as busy as hell in there. They’re doing all they can,” said Dean.

His mother, Marianne, told how patients were literally camped head to toe just beyond her son’s pod.

“There are people on top of each other on trolleys, and you’re not able to pass by it. There’s so many, it’s so cluttered,” she added.

Ms Fitzgerald watched on as nurses desperately searched for a few inches of space for another trolley: “I overheard one of the staff looking to know had they any spaces (elsewhere), they’re obviously ringing around other parts of the hospital looking to put (patents) in.”

She continued to observe plucky staff persevere through the naturally chaotic environment of the emergency department, while still coping with grenades of overcrowding, being relentlessly lobbed on top of them.

“They’re under pressure big time,” she added.

Along the under fire ED trench lines, trolleys were continually parachuted in and out by tired and stressed staff.

“I think it’s disastrous the way people are on top of each other, you’ve elderly people in there and they have no dignity,” she said.

Some of them were crying out with their hands out - a cry for help I suppose. It’s sad to see it, god love them.

Despite the mayhem, Dean is impressed by the resilience of frontline staff on his “first time in A&E”.

The hospital advised the public to attend local injury units instead of presenting the ED, for non-serious and non-life threatening conditions.

In a statement yesterday UHL said it “sincerely regrets” any delays for patients.

“UHL has just over 450 inpatient beds; this is recognised as not being sufficient for the needs of the MidWest Region,” it added.

Enabling works are underway on a modular 60-bed structure situated on the grounds of the hospital.

Management have also sought government funding for a permanent 96-bed unit.

More than 350 people will die this year because of hospital overcrowding, a consultant in emergency medicine has warned.

Dr Fergal Hickey said they know from studies conducted in Australia and elsewhere that the mortality rate increases as a direct result of overcrowding in emergency departments.

“With Ireland's population at almost 5m, the number of deaths would be in excess of 350 per year,” said Dr Hickey, the Irish Association for Emergency Medicine's communications officer.

“There is lots of medical evidence to show that treatment delays contribute to bad outcomes,” he said.

This is unacceptable and all we are doing is causing people to have bad outcomes, increasing their lengths of stay, increasing the costs to the system.

"Ultimately, it is devastating for individual patients.”

Dr Hickey said demand for hospital beds is increasing but capacity has not improved, despite what the Minister for Health, Simon Harris, and his department has claimed.

There has been very few additional beds, he said. And only of a fraction of the beds lost during austerity have been replaced.

According to the Irish Nurses and Midwives Organisation, there were 531 admitted patients waiting for hospital beds yesterday.

The worst-hit hospitals were University Hospital Limerick (76); University Hospital Galway (60) and Cork University Hospital (43).

The INMO's Trolley Watch counts the number of patients who have been admitted to acute hospitals and are waiting for a free bed.

Of the patients waiting 383 were in EDs and 148 were being treated on wards and elsewhere.

Some images from the University Hospital Limerick trolley crisis.
Some images from the University Hospital Limerick trolley crisis.

Dr Hickey said the overcrowding problem has become more obvious in recent weeks because elective admissions have started again: “There is no hospital in the country that is flush with beds. There are delays to admission every single day. It is bad every day.”

Dr Hickey said attempts are often made to cloud the issue by blaming inappropriate ED attendees.

“We deal with inappropriate attendees and we send them home or they sober up and they go home. They are not the people who end up on trolleys.

The people who end up on trolleys are the people who we decide require hospital admission. The main problem is simply a lack of bed capacity.

Dr Hickey said University Hospital Limerick is always short of beds.

The hospital has a new ED which is probably the biggest in the country but the fundamental problem – a shortage of beds, has not been addressed.

Patient advocate, Stephen McMahon, is concerned that there has not been a meeting of the Emergency Department Task Force since January.

The task force was established by the Taoiseach, Leo Varadkar, when he was Minister for Health in 2014 to develop long term solutions to ED overcrowding.

Mr McMahon, who is co-founder and chairman of the Irish Patient's Association, is the only member of the task force solely representing patients' interests: “We do have a crisis in our EDs.

"In some situations, the hospitals are a danger to patients and staff.

"I know Brexit is looming but the healthcare system still needs the same level of attention.”

Additional reporting by David Raleigh

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