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“It’s like a big black hole” – working inside overcrowded University Hospital Limerick

Following yet another stuffed month at University Hospital Limerick (UHL), Limerick Voice reached out to hear from staff what it is like to work in this environment.

Overcrowding in UHL has topped national charts once again, as 894 patients were treated on trolleys in September 2018 -making it the most overcrowded hospital in the country.

Stuffed Emergency Departments (ED) have been a national issue for the past decade, and ED Nurse Martina* says: “all the HSE have done is put a plaster over it, it’s like a big black hole, it gets bigger and bigger and bigger.”

Martina said that trolleys were originally a “short-term solution” to the overcrowding issues, but now “putting trolleys on the wards has become the norm.”

UHL doctor, Richard* said when asked about working conditions: “the nursing staff in the ED do a remarkable job under very, very, difficult circumstances at times.”

He believes the problems arise when “you don’t have flow through the hospital of patients.”

Coupled with that, Richard added: “you can’t reconfigure three emergency departments into one, then have a hospital the same size.”

UL Hospital Group acknowledges that the 400 inpatient beds they current have is not sufficient for the needs of the Mid West Region, stating they “welcome the commitment to increasing bed capacity at UHL in the Project Ireland 2040 plan.”

The current situation in UHL is upsetting for all, with Dr Richard* admitting: “I get upset going to the Emergency Department here -it’s not a nice experience.”

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Nurse Martina said that although the patients are still like “sardines” in the ED – something they thought would change when they moved from the old department- the idea that a patient could be labelled a ‘bed-blocker’ is “abhorrent”.

Dr Richard also commented: “It’s completely unfair to have an elderly patient on a trolley for more than a day – and I mean a daylight day.”

“No patient should be on a trolley for more than a working day it is inappropriate, it adds complications, and it increases the risk of infection,” he said.

So far this year nurses and doctors at UHL have had to treat over 8, 500 patients on trolleys, with Martina stating: “if there is only 20 or 30 patients on trolleys – that’s a good day.”

Speaking as a nurse who has worked in both the former and the new ED, Martina said: “it went from being completely and absolutely manageable to a third world existence for patients and staff” leading Martina to feel like there is “no job satisfaction” and she is dealing with “pure crisis management.”

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When people can’t go to their local injury unit for a twisted ankle or when Shannon Doc doesn’t know a patient’s history, which is held by their GP, it means more trips to the hospital, says Nurse Martina.

As part of their winter planning, the UL Hospitals Group also urges members of the public to use the Injury Units in Ennis, Nenagh and St John’s Hospitals for appropriate injuries, and not to attend the Emergency Department in UHL unless necessary.

Dr Richard said a bigger hospital is needed to circumvent the many problems facing UHL: “We need to be appropriately funded in terms of new builds and actually expand our hospital so it’s fit for purpose.”

According to the HSE permission has been being granted for the proposed extension to the existing hospital to provide a new 60 bed ward block at UHL and the expected development phase will take 12 months.

A HSE representative said: “We regret that any of our patients have to face long waits in our ED during busy periods and any distress or inconvenience this causes to patients and their loved ones” they also said that overcrowding was a “whole-hospital issue” and they are taking a “multi-faceted approach” to the problem.

UHL’s Emergency Department – the current situation: 

  • The Emergency Department (ED) at UHL is one of the busiest in the country and the numbers presenting continues to increase year on year.
  • Last year, attendances exceeded 67,800 – a growth of over 5% on the previous year. This increase in attendances has continued into 2018 and of those presenting, the numbers requiring admission include many frail elderly patients with complex care needs.
  • The ED at UHL has designated spaces for 49 patients, and admitted patients waiting for a bed are often in single rooms or designated bays, including isolation rooms for appropriate infection prevention and control.
PICTURE: LIMERICK VOICE

PICTURE: LIMERICK VOICE

 

*Names and identifying details have been changed to protect the privacy of individuals.

 

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