Senior nurse Ann Noonan, who is nearing retirement from her position at University Hospital Limerick (UHL), now has the freedom to say publicly what many of her colleagues at Dooradoyle Hospital cannot.
“All the staff who are a bit mobile that I talk to are leaving; it is in their plan to go there. Those with commitments, including children, a mortgage or a husband, stay, but all those who are mobile leave,” she says.
Noonan (55) says the staff are “exhausted, and absolutely and utterly demoralized”, adding that the overcrowding crisis is compounded by the hospital’s inability to retain staff.
” This is quite understandable. Who would want to continue working in this environment when you could work elsewhere for the same price with less hassle? asks Noonan, who is also a representative of the Irish Organization of Nurses and Midwives.
A damning report from the state health services watchdog on Friday cited chronic overcrowding and severe shortages of nurses and beds in the UHL emergency department, saying it put people at risk and compromised the dignity, privacy and confidentiality of patients. Recently, the hospital said it was short 68 non-consulting physicians and at least 200 beds.
Things that were once part of normal nursing are no longer possible, says Noonan. “The days of having to wash the patient’s skin, cut their nails and brush their hair are over; that’s how we did it, but we had time to do it,” she says.
“We had time to take care of them, we had time to take care of them but the nurses don’t have the time now because there are not enough and there are too many of patients.”
Criticizing the diagnostic services offered by the hospital, she says it is “ridiculous” that it is only open between 8 a.m. and 5 p.m. “except in emergencies”, leaving patients to occupy beds unnecessarily.
“There are bedridden people awaiting diagnoses who don’t need to be bedridden. I know full well that a patient [recently] sat up in bed from Tuesday to the following Monday for nothing more than the fact that they needed an MRI.
More nursing home beds are needed to get patients out, she says. “Our demographics are aging, there are a lot of patients who cannot go home but they are not sick enough to be hospitalized.”
In a case later described by coroner John McNamara as one filled with “missed opportunities”, Eve Cleary (21), daughter of Melanie Sheehan and Barry Cleary, died at the UHL in July 2019 from a stoppage. cardiac.
Cleary was readmitted to hospital four hours after she was initially discharged by the doctor, having spent the previous 17 hours on a trolley, suffering from multiple, but undiscovered, blood clots.
Saying she had believed her daughter’s death would force change, Ms Sheehan said: ‘The trolleys are on top of each other in there and the pictures keep coming out of the place showing nothing has changed and it’s still the same.
“Eve was treated very, very badly there and it seems to be getting worse,” she says. “Even if someone else dies, will that change things there? I do not think so. I think we’ll talk about it again next year and the year after.
Reopening accident and emergency services at St John’s in Limerick, Ennis and Nenagh would help, she says. “Perhaps we could have taken Eve to St John’s or Nenagh. Maybe she would still be alive.
There are widespread calls in the area for emergency services elsewhere. Among those speaking out is Marie McMahon of Ennistymon, Co Clare, whose husband Tommy Wynne was admitted to UHL with stroke symptoms and spent 36 hours on a cart before he died.
“If a farmer treated his cattle the same way we allow human beings to be treated in the UHL, he would be shut down,” McMahon says. “I’ve been there and it’s a horrible, absolutely horrible experience.”
One of many Clare residents seeking 24-hour emergency care in Ennis, McMahon says having patients lying on trolleys in hallways, as frequently happens at UHL, poses a “fire hazard” but “nothing changes” despite warnings from firefighters.
The Limerick Fire Department went so far as to threaten legal action against UHL over concerns, particularly after they found 38 patients on carts in the aisles of the emergency department during a follow-up inspection in 2019.
UHL has admitted that the maximum number of 79 patients allowed in the ER, including cabins, has been exceeded on several occasions, including in April 2019, when there were 104 patients for a time.
Father-of-two Eddie Moloney (73) died in a busy public ward of the hospital in 2015 after being left for 12 hours with a brain haemorrhage on a trolley next to an intoxicated person in a hallway.
He breathed his last lying under a noisy TV playing the Ireland v France commentary in the Rugby World Cup as other patients and their visitors ‘screamed and roared’ on screen, said his daughter Joanne Moloney.
“Seven years later and nothing has changed, in fact it seems to have gotten worse at the UHL,” says Joanne Moloney, still upset that family’s requests for a room to say goodbye weren’t met because none were free.
UHL later said services for bereaved families had been improved with renovations to the morgue and the opening of a family room, but admitted that “end-of-life” rooms aren’t always available.
“He had no privacy, no dignity, and I remember thinking after the fact that our pet cat had been put to sleep in a more dignified way. At least the cat had privacy at the vet,” explains Joanne Moloney.
Demonstrations calling for additional emergency services in the Midwest are now planned, says Mary Cahalane, one of the organizers of past marches, “because nothing has changed.”
Overcrowding at UHL is also undermining the area’s ambulance service, sources say, as teams often have to wait up to an hour to deliver patients once they arrive at the hospital, causing delays to subsequent patients.
“The whole place can be full, literally full. You have ambulances parked where the cars are supposed to be parked, you have ambulances stuck in other ambulances because the teams are with their patients waiting to hand them over to the nurses,” says a paramedic.
Still trying to come to terms with her husband’s death, Marie McMahon sums up the state of mind of many: “It’s everybody’s worst nightmare that they end up in the UHL, especially the people of West Clare .
“I know people who refused to go to the UHL and who would rather die at home than on a cart. That may sound really dramatic, but it’s actually the truth, that’s how bad it is. Wrong.