Crisis in drogheda ed impacting on cavan hosp

Nurses in Northeast threaten strike action

With record levels of patients on trolleys in A&E departments around the country yesterday (601) and the Irish Nurses and Midwives Organisation (IMNO) declaring a crisis situation, Cavan General Hospital was bucking the national trend as it has regularly over the past year.

There were five people recorded on trolleys by the IMNO today (Tuesday), despite ambulances being diverted from Drogheda to Cavan on Monday night after Our Lady of Lourdes hospital was forced to go off-call (scroll down for HSE response).
The INMO Industrial Relations Officer for this region, Tony Fitzpatrick said: “We now have a scenario whereby in excess of 600 people are on trolleys and this Government is failing to deal with the crisis. It is getting worse and Minister Varadkar now needs to put a plan in action. We need to see if there is depth to the Minister with regards to ensuring that this issue is resolved.”
He made the comments after nurses at Beamont Hospital - to which Cavan is a feeder hospital - voted in favour of a work-to-rule in order to force hospital management to tackle what they described as a crisis situation there putting patients and staff at risk.
Of the situation in Cavan specifically, Mr Fitzpatrick told The Anglo-Celt that, while Cavan still has a bed capacity problem, they are moving patients to the Medical Assessment Unit, where they are being looked after, rather than on the corridors of the Emergency Department. “The situation in Cavan has improved. They still have pressures within the Emergency Department but they don’t have the same amount of people waiting on trolleys as Drogheda and elsewhere”.
Despite this, he still maintained that there are not enough acute beds in Cavan General.

Eighty on trolleys in Drogheda
In Our Lady of Lourdes Hospital in Drogheda today (Tuesday) there were 45 patients on trolleys.
Mr Fitzpatrick said on top of that number, they have patients within their day ward, the Medical Assessment Unit and the Endoscopy Unit.
“There are about 80 patients on trolleys in Drogheda throughout the hospital, waiting for a hospital bed. I think they have invoked their Ambulance By-Pass Protocol, which means that ambulances are now being diverted to Cavan, Connolly and Beaumont, away from Drogheda. They did that yesterday (Monday) and it appears that they are doing it again today, because the Emergency Department is so overcrowded,” explained Mr Fitzpatrick of the situation.
The diversion of ambulances puts pressure back on hospitals like Cavan, he said. “Again this goes back to what the HSE did over the last four or five years - where they removed services from Monaghan, from Louth County and from Dundalk and directed all the traffic to Drogheda. Now, Drogheda simply can’t cope with that patient traffic,” contended Mr Fitzpatrick.
He added that they were to build a Regional Hospital and they have not done that and now Drogheda is bearing the brunt of that. All Orthopaedic patients are all directed to Drogheda said Mr Fitzpatrick because they can’t be looked after in Cavan.

LRC talks
He pointed out that Drogheda had voted for industrial action back in November and that is in an LRC Talks process. “We have written to the LRC today, looking for the urgent reconvening of the conciliation conference under the LRC, because of the unprecedented numbers on trolleys. There are ballots ongoing throughout several hospitals in the country and it is inevitable that there will be industrial action, unless something urgent is done to address the problem,” said Mr Fitzpatrick.

Protest
He also revealed that there is a protest planned to take place outside the Dáil on January 14 about this overcrowding.
When asked how this problem can be solved, Mr Fitzpatrick said: “The HSE has indicated that they require €100m to solve this problem (delayed discharges). Minister Vardkar has allocated €25m, which we believe is inadequate. If hospitals are operating in excess of 85% bed occupancy, they can’t operate efficiently. Cavan and Drogheda are all operating in excess of 100% bed occupancy. That indicates that there is a need for acute bed capacity in Cavan and Drogheda. There is also a need for additional step down beds – community nursing beds, nursing home beds etc. They also need to stop the cuts they are imposing in the community setting – for example Home Helps etc – all those services are being cut, and that is exasperating the problem of overcrowding.”

More nurses required
“If additional bed capacity is brought on stream, they will need nurses to staff those beds and there is currently an acute nursing shortage in Ireland. This is down to flawed policies of the HSE, letting them all go overseas over the last number of years,” added Mr Fitzpatrick.
He said that the HSE has started recruiting nurses, but they can’t recruit nurses fast enough.
In the context of 601 patients on trolleys, in Emergency Departments or wards, today, the Irish Nurses and Midwives Organisation (INMO) is calling for an immediate meeting of the Emergency Department Taskforce, established by the Minister before Christmas, to consider, and agree, measures to alleviate this crisis.

HSE Response

“The HSE acknowledges that there have been sustained pressures in the Emergency Department at Our Lady of Lourdes over the past week and we apologise to patients and their families for any distress caused by the delays experienced.
“Amongst the key factors contributing to the increase in pressure within EDs is the older age profile of patients presenting and the complexity of issues they have. As a result, hospitals are experiencing delays in discharging these patients to home or other appropriate settings.
“This morning, there were 39 patients in the Emergency Department in Our Lady of Lourdes Drogheda awaiting admission.
“The Hospital has a policy for dealing with surges in activity, as have been experienced in recent days, including increasing the number of clinical ward rounds being undertaken to ensure that any patients who are ready to go home are discharged and supported as necessary by community based care services, implementing ambulance by pass protocols and managing the volume of elective surgeries being undertaken in the hospital.
“As part of our winter plan there were no routine elective surgical procedures booked for this period as this is one of the mechanisms to manage surge. We also had no elective day cases surgical procedures booked for this period.
“Seven endoscopies were postponed on Monday, none today and there will be two procedures postponed tomorrow. All senior clinicians are on site doing rounds and every avenue to support discharges is being explored. We are utilising enhanced home care packages and nursing home beds where available and suitable. “Staff are working with senior clinicians to utilise all resources effectively. This means that the most critically ill patients are prioritised for treatment and available beds. As a result some patients may experience delays in being seen and where necessary admitted; patients attending with minor injuries will experience longer wait times in the Department.
The HSE would encourage the public to attend the Emergency Department for emergencies only and would advise people to contact their GP or GP Out of Hours services in the first instance.The Minor Injuries Unit at Louth County Hospital Dundalk is also open from 9am to 8pm daily and most patients with minor injuries will be seen, assessed and treated in under one hour.
Hospital Management wish to acknowledge the hard work, commitment and dedication of all staff at this time.”