A&E trolleys are not the issue, argues nurse Florence Horsman-Hogan. What goes on in the wards is far worse
It's gloves on and scalpels at dawn as far as this particular nurse is concerned. While the main spokesmen and women for health, ie those representing the doctors and nurses (the IMO and the INO), appear on the surface to be addressing the main areas of concern very effectively, those of us working at the coalface of the Irish health services, ie the hospital wards and the A&E departments, are scratching our heads wondering what on earth is going on, why they are not addressing the real issues, and why are they leaving us, the real front-line defence open to attack by our Minister, the media, and the public at large.
We are the ones who receive the bloodbath and carnage results of the many road traffic accidents; we are the ones who fight desperately to save them, and when we fail, as is sometimes inevitable, we are the ones who have to try to put the poor broken bodies together in such a way their families can say goodbye and be traumatised as little as possible.
We are the ones who hold the heads of the dying elderly, as they vomit violently into the emesis bowl, stripped of dignity and privacy in a busy A&E, and we're the ones who have to speak face to face with the families of these people, and mutter meaningless drivel to the effect that because of the vomiting bug, and lack of isolation rooms, we couldn't admit their granny/ grandad, mother/father to a main hospital ward.
And we are the ones who shout and scream for better facilities for our patients on the wards, but in that act of sometimes perceived "troublemaking", instead of patient advocation, can suffer the wrath of hospital management.
We are the carers, the doctors and nurses who came into this profession, because we wanted to care. We all wanted to make a difference.
Contrary to our nature, we're finding ourselves the subject of attack on all sides.
The reality of A&E and meaningful solutions are ignored in favour of political scoring.
The situation on many of the wards in our hospitals with a lower than acceptable nurse-to-patient ratio, is also ignored, as is the spread of iatrogenic infections, because there's more drama and votes in A&E.
Yes, hospital A&E departments are busy, however, in my opinion, they are no busier than they were back in 1987, when I worked in the Meath Hospital A&E. Back then, we knew what real trolleys were. The luxury models I've seen these days, particularly in St Vincent's hospital A&E in Dublin were what we would have called beds.
What's the real agenda? What we know to be an ongoing, but certainly not crisis point issue, is being pushed to such a high position on the list?
Why has the issue of Irish bed percentage usage (110 per cent to 120 per cent, as opposed to approximately 85 per cent in the remainder of Europe) not been addressed in conjunction with nurse/patient ratio figures? Successive health ministers have refused to handle this hot potato, and with good reason.
The failure to set a safe ratio leaves the nurses open to unsafe levels of practice. But even worse, it leaves the patients wide open to poor standards of care, at a time when people are at their most dependent.
I have witnessed one nurse looking after 14 patients alone, most heavy and bed-ridden, almost all in need of dressing and feeding, six with MRSA, one with VRE (vancomycin-resistant enterococcus). The obvious impossibility of safe and hygienic care in this situation is what should be sending alarm bells ringing across the nation.
This is the issue that's being totally overridden by the so-called trolley crisis, but its repercussions are far, far more serious.
Even taken in isolation, the MRSA issue alone was serious, the VRE and VRSA issue is terrifying (wait until this mother of all super bugs hits the public).
But the fact that patient safety, once on the ward, is not ensured by a safe nurse/patient ratio is nothing short of totally bizarre.
The potential here for death to occur on a massive scale should this particular bug find its way into the public, is explosive.
So what's the real agenda behind the hype?
No more than our medical colleagues, we nurses must not fail our patients by allowing unacceptable issues to go unchallenged. If we fail to advocate for our patients, we fail to care for them, and in that case, should get a job well away from the caring profession.
Florence Horsman-Hogan runs the website www.nightingaleforum.com as a forum where healthcare employees may share their concerns