Busiest casualty unit has spell of serenity

One of the country's busiest casualty units enjoyed two hours of peace during the nurses' strike

One of the country's busiest casualty units enjoyed two hours of peace during the nurses' strike. At lunchtime yesterday, the accident and emergency department at St James's Hospital in Dublin was reminiscent of those legendary continental hospitals where doctors and nurses actually wait around for patients to arrive.

Long lines of empty trolleys stood in serene silence in a department in which it is not unusual for patients to spend 24 or even 48 hours waiting for a bed.

The reason for yesterday's two hours of serenity was the obvious one - the patients stayed away in droves because they knew the A&E nurses were having a strike.

"We've only had two ambulances through this gate this morning," said Mr Derek Brown, a member of the Irish Nurses' Organisation who works in A&E as an advanced nurse practitioner.

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That is a post created in some Dublin hospitals after a previous controversy about long queues and overcrowding in A&E units.

Advanced nurse practitioners diagnose and treat certain injuries such as broken limbs. Their work speeds up the treatment of patients in A&E departments - but this has not stopped the queues which afflict patients and staff in hospitals like St James's.

Behind those queues, he says, is a shortage of beds - the number of beds in hospitals generally has not increased since the 1970s. The hospital itself has complained in its annual reports that it has never been given enough beds.

Nurses say St James's has 120 to 150 people attending its A&E department every day. Of these, up to one-third are seen and sent home.

Others need treatment on a trolley or admission to a ward. At any one time up to 30 patients are waiting for a bed in a ward.

That wait can be in a bay designed for one trolley but containing three.

The medium-term solution has to include more beds, said Mr Brown, but right now what's needed is to fund hospitals to contract extra beds in nursing homes for people who no longer need to be on the acute wards.

As he spoke, a car drove out the gate and the passenger, a man with a very cross, red face wound down the window and shouted something about waiting for hours. He sped off before the bemused nurses could work out whose side he was on.

Whenever he was waiting for hours it wasn't yesterday, the quietest day for years. But if he goes back today he'll have something to shout about, again.