PATRICK K. PLUNKETT,
Sir, - As consultants in emergency medicine, working side by side with our nursing colleagues, we are deeply disturbed by the proposed nurses' strike on Wednesday. It can only be described as a national crisis, with the potential for collapsing the entire health service.
This is the first time there has been a total withdrawal of nursing cover for patients. The only glimmer of hope is that two members of nursing staff will remain immediately available in each department to assist their medical colleagues with resuscitation.
This action is likely to further affect the most vulnerable patients, many of them at limits of age and survival, already suffering social isolation and lack of resources. That our emergency nursing colleagues feel compelled towards this action is a symptom of deep frustration, even desperation at the dangerous situation in hospitals' emergency departments.
This "A&E" crisis is a symptom of problems at all levels within the healthcare system. We, in the specialties of emergency medicine and nursing, are the innocent bystanders in this shambles. Neither the source of the crisis, nor its solutions, lie within the realm of the emergency departments. They are due to inadequate and delayed resource allocation in both the hospitals and in the community service.
The issue has been flagged to the Minister for Health and Children, and to his predecessors, time and again, with no visible delivery on any proposed solutions.
The Government has pledged funding for some initiatives and capital developments, which hospitals have already proposed to alleviate the crisis. The experience of funding for the Cardio-Vascular Strategy, however, leaves us sceptical of its willingness to continue funding for any longer than it takes to defuse each crisis.
The Minister himself, through previous efforts such as the appointment of additional consultants in emergency medicine, has shown some appreciation of the problem, despite a naïvety about the appropriate statutory mechanisms for consultant appointments. This, however, is only a small part of the immediate investment in human and other resources needed to undo decades of neglect by successive governments.
With respect to the strike itself, we are concerned that the precise goal to be achieved has not been defined. As far as we can understand, even if local hospital demands have been met, nurses in their emergency departments are expected to remain on a work to rule, with the threat of recurring withdrawal of labour, as long as demands in all hospitals around the country have not been met.
Despite the enormous personal input of its staff, this is not a health service to be proud of. Lest there be any doubt in this matter, the consultants in emergency medicine must declare that the working conditions for both doctors and nurses in emergency departments throughout this State are intolerable.
But at least the doctors and nurses can go home to their own beds at the end of their shift, instead of waiting on a trolley until another patient has vacated a bed in the main hospital.
To see such patients still present at the beginning of the next shift is to enter a vicious loop of despair. It is that which has driven our nursing colleagues to the precipice. - Yours, etc.,
C.P. O'LEARY,
Consultant in
Emergency Medicine,
Limerick Regional Hospital;
President, Irish Association
for Emergency Medicine;
C. GERALDINE McMAHON,
Consultant in
Emergency Medicine;
PATRICK K. PLUNKETT,
Consultant in
Emergency Medicine,
St James's Hospital,
Dublin 8.