Patients on trolleys still a problem, say nurses

THE NUMBER of patients on hospital trolleys has fallen generally over recent months but nurses have said the problem is still significantly worse than when it was declared a national emergency in 2007.

On the opening day of its annual conference in Killarney yesterday, the Irish Nurses and Midwives Organisation also said care had been compromised by the departure of thousands of nurses from the health service who had not been replaced.

Analysis carried out by the union showed that, nationally, the number of people on trolleys in the first four months of 2012 fell by 17 per cent compared to the same period last year.

The union also said over 2,400 public beds were closed around the country. Of these 1,300 were acute beds, with the remainder being continuing care beds.

General secretary Liam Doran said while good work was happening, there was much more to do.

He said it was no surprise that there were still a number of “black spots” with regard to emergency department overcrowding.

“You simply do not have enough bed capacity to cater for demand. That means the trolley figures are getting worse in some hospitals but those same hospitals have significant bed closures. This cannot continue if we are to address the overcrowding problem.”

Mr Doran said 5,000 nurses had left the Irish health system in the last 3½ years, and 2,000 in the past year.

He said no amount of reassignment, reconfiguration, rerostering or redeployment could cover the gaps.

Mr Doran said such gaps were increasing. “It is the view of the executive of this organisation that care is now being compromised. And senior management in the system are not listening to nurses and midwives as they articulate their concerns about patient care and the ability to meet demands of patients; to provide the full care plan drawn down for patients.

“Management have their own pressures but they have to give more primacy and priority to nurses and midwives at the frontline who say, ‘we are too short, we are now in an unsafe environment where safe care cannot be provided on a 24/7 basis’.”

Asked about where care was being compromised, Mr Doran said in some facilities for the elderly one nurse was looking after 30, 40, or 50 patients for 16 hours a day with one healthcare assistant because staff were not replaced. He said individual examples would emerge during the conference.

Mr Doran said that among the reasons for the fall in the numbers on trolleys was that the Department of Health’s special delivery unit was requiring local hospital management to accept that this was a problem that had to be managed on a full-time basis. He said, in addition, funding was being provided to open some extra beds.

Mr Doran also said some hospital managers had been trying to “hide” the extent of overcrowding by putting those on trolleys into inpatient wards, a practice that was supposed to be reserved for major emergency situations.

While the numbers on trolleys fell in most areas over recent months, the study found there had been increases at the Mater in Dublin, the Mid-Western Regional Hospital in Limerick and Our Lady of Lourdes Hospital in Drogheda. He said Drogheda was “downsized too quickly”.