Emergency department doctors have warned that patients could deteriorate and even die during the nurses’ strike unless arrangements are made to promptly identify those most at risk on arrival at hospital.
With members of the Irish Nurses and Midwives Organisation (INMO) set to stage two further one-day strikes this week, emergency department doctors say their concerns are growing over the lack of adequate triage arrangements for patients presenting during the strike.
The Irish Association for Emergency Medicine says hospital emergency departments risk becoming "battlegrounds" during the dispute because of the difficulties in deciding which patients get prioritised.
The association’s president, Dr Emily O’Conor, repeated a call for the nursing union to grant a derogation to emergency departments during its industrial action. Failing that, she said the HSE needed to put in place a clear and properly-resourced alternative plan.
The standard triage procedure operated in Irish hospitals, which is computer based, is entirely delivered by nurses, but during last week’s strike this function was provided manually by senior doctors in most hospitals.
The INMO said its members were not providing triage during the strikes “as a matter of course”, but that last week nurses at two sites provided cover due to a surge in patient demand or emergency issues.
The HSE said it was continuing to engage with the INMO to put in place arrangements for the safe provision of services in advance of Tuesday’s strike.
Inconvenience
Taoiseach Leo Varadkar on Sunday rejected calls for an independent review of the striking nurses' pay claim, but said the Government does not intend to withhold payments due to them under public sector pay agreements.
Mr Varadkar said he regretted the enormous inconvenience to patients caused by the strike. Even if the next one-day strike was to be called off, it would be too late to reverse the cancellation of thousands of patients’ appointments and procedures.
Following a 24-hour stoppage last week almost 40,000 INMO members plan to hold one-day strikes on Tuesday and Thursday.
The HSE said it expected all hospital outpatient, inpatient and day-surgery appointments scheduled for Tuesday to be cancelled.
More than 50,000 patients will be affected by this week’s industrial action.
Members of the INMO are also planning work stoppages for three days the following week, on February 12th, 13th and 14th. On Saturday the union announced two extra days of strike action on February 19th and 21st.
It is also increasing the number of nursing services on strike from 82 to 240 from Tuesday. Most of the additional strike sites are respite services for people with intellectual disabilities and day services for the elderly.
The announcement followed a meeting of the INMO executive in Dublin on Saturday.
Widen the strike
Plans by the union to extend the dispute to GP out-of-hours services and community nursing services remains the subject of discussions with the HSE.
The HSE said on Sunday it remained available to engage in any efforts to avert industrial action. Minister for Health Simon Harris expressed regret at the union's decision to widen the strike.
The INMO is seeking pay parity with other graduate-entry health professional grades such as physiotherapists who it maintains are paid about €7,000 more than nurses.
The union argues such increases are necessary to deal with recruitment and retention issues in the health service.
Further disruption in the health service is expected when hundreds of GPs take part in a protest outside the Dáil on Wednesday. The National Association of GPs is campaigning to have cuts imposed on family doctors during the economic downturn restored.
A dispute involving some ambulance staff is expected to be escalated shortly, while industrial action by psychiatric nurses is ongoing.
