Surge in overcrowding sparks row between doctors and nurses

The latest surge in emergency department overcrowding has sparked a row between groups representing doctors and nurses.

The Irish Nurses and Midwives Organisation (INMO), responding to record trolley figures last month for the month of August, called for senior clinical decision-makers to be rostered on an extended day basis, seven days a week.

The suggestion prompted an angry response from the Irish Medical Organisation (IMO), which said it amounted to “blaming the wrong people again”.

“The notion of stretching very limited resources even further when we are struggling as it is, is nonsense,” said Dr Peadar Gilligan, chairman of the consultants committee of the IMO. “The hospital doctors of Ireland are weary of being blamed for trying to deliver care in an under resourced system.”

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At a meeting on Monday of the national Emergency Department Implementation Group, the INMO called for senior hospital managers to be present on a 24/7 basis as well as extended hours for clinical decision-makers. It also wants fines imposed on hospitals that do not implement the national directive on escalation agreed by the HSE and the Minister for Health last year.

Dr Gilligan said overcrowding was caused by too few hospital beds and inadquate numbers of consultants. “The key to progress is hiring more consultants and restoring beds that have been closed. If there are insufficient beds to put patients in then we will continue to have crowded emergency departments and crowded wards.”

Trolley targets

Some 7,781 patients were accommodated on trolleys during the month, up 27 per cent on the same month last year, according to the INMO’s TrolleyWatch count. Overall trolley numbers are up 7 per cent so far this year compared to 2016 .

However, the HSE, which maintains its own count of patients waiting for admission, said the numbers on trolleys so far this year was about the same as in 2016.

The INMO claimed hospital managers are more interested in monitoring and reporting trolley targets than taking action to ease overcrowding. "It is clear that setting of targets, whether they be for patients over 75, patients waiting to be seen or patients waiting for a decision to admit/discharge has not had any positive effect upon the management of the overcrowding crisis," said general secretary Liam Doran.

Hospitals with the worst levels of overcrowding in August included University Hospital Limerick – where a new emergency department opened in May – University Hospital Galway, South Tipperary General Hospital and University Hospital Waterford.

There were 357 patients on trolleys or on wards waiting for admission to a bed on Monday, according to the INMO. The worst affected are University Hospital Limerick with 44 patients waiting, University Hospital Galway with 28 patients and Letterkenny General Hospital with 23 patients.