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University Hospital Limerick (UHL) was the most overcrowded hospital in the country for the third day in a row this week as nurses staged a massive picket at the hospital over their working conditions and pay.
As up to 400 nurses protested outside the hospital, patients were on trolleys on corridors in the emergency department (ED) and on wards. Despite a €25 million ED replacing the previous accident and emergency department over a year ago, it remains consistently overcrowded.
UHL is the only 24-hour ED in the midwest region, serving a catchment of 400,000 people across Limerick city and county, Clare, Tipperary, and parts of north Cork. According to HSE figures, there were 18 patients on trolleys in Limerick’s ED emergency department at 8am, however by 10am this had increased to 25, according to Irish Nurses and Midwives Organisation (INMO) representative Mary Fogarty.
Members of the INMO are staging the first in a series of six 24-hour work stoppages on Wednesday as part of a campaign to secure pay parity with other graduate-entry healthcare professional staff such as physiotherapists. The nurses maintain that such increases are needed to tackle recruitment and retention problems in the health service. The strike began at 8am.
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Patients suffering from ‘A&E delirium’
One emergency nurse said patients who face long delays in the Limerick ED suffer from “A&E delirium.”
“The lights are on 24/7,” Derek Cromwell said. “We can’t turn the lights off, which results in patients suffering from what we call ‘A&E delirium’. They are confused because they haven’t slept, they have sleep deprivation, and they’re still on a trolley.
“When they get up to the wards they’re still going to be on trolleys a lot of the time,” Mr Cromwell, a father of three said.
“It’s an awful pressure situation we are working in. There is constantly trolleys. During the winter months you can have patients on trolleys from between 80 to 100 hours, which is not uncommon. I can triage a patient on Monday and come back in Wednesday and the patient is still in the emergency department on a trolley.
“We are constantly looking for staff. There are texts going out for overtime constantly, so you’re working under awful pressure and the frontlines are pressurised areas to work in anyway.
“I might have only space for 20-25 patients and I come in and find I have 40 patients . . .You’re looking for patients, there’s trolleys everywhere, you can’t get to your patients because you can’t get through the trolleys.
“It’s very demoralising.” “We feel we are doing a very important and valuable job here and we want respect. We don’t get any respect from the Government.”
‘We need more staff’
Pamela Kelly, a radiology nurse, joined the picket line carrying her six month old baby daughter Zara in her arms. "I'm on maternity leave at the moment but we certainly weren't staying at home. We are here to stand with every nurse in the country to say we have had enough," said Ms Kelly (36) from Castletroy. "We are not taking it anymore and we are going to fight until we get what we deserve.
“It’s not just for us; it’s for the patients and it’s for the whole system, so that patients are getting the proper care that they deserve and we are working in the right conditions.
“Obviously the wages are very poor for nurses. We are always short staffed, we never have enough time; we are always on our feet. We go without breaks; but it’s never enough, we never have the time, we need more staff.”
Morale at ‘all time low’
A radiology nurse from Dooradoyle said "morale is at an all time low. The main challenges are giving the patients the time and giving them the care they need."
The nurse said he has seen €500 taken from his monthly wage in taxes and charges since 2008. “It’s a big whack on a house. I’ve one child and my other half isn’t working at the moment. I don’t want to be out here on the picket. I don’t want to be loosing a day’s pay, two days possibly next week and three days the next, but I’m willing to take the hit for the team and drive on, and I think we’ll succeed. The message to the Government is to engage. They’ll have to listen, just look at the crowds, if they don’t listen to us, its borderline ignorance.”
INMO representative Mary Fogarty said staff “have had enough of overcrowding and of nurses not getting equal (pay) with other allied healthcare professionals.”
“The hospital has been under significant pressure. Yesterday there was a huge push by management to try and discharge from the hospital,” she said. “The ED is busy today, (staff) have had two road traffic accidents in and they are providing all emergency life preserving care. We have backed up the department to give them extra support. Nurses are ensuring that no patient will deteriorate and not be attended to. It is the most overcrowded hospital in the country. It badly needs the (proposed) additional 60+ and 93 beds that are to come.
“It’s very unfair on the staff working here and all the patients using the service. The region is compromised because it just does not have enough beds and we are very concerned that there may be no money left because of the overspend on the (new) children’s hospital.
"Limerick has to be top of the list to get funding to have these issues addressed. We have suffered now for 10 years of gross overcrowding and that is so unsafe for patients." Nurses working at Limerick's maternity hospital on the Ennis Road also staged a full day's protest outside the hospital.