Friday, March 16, 2012

Irish hospitals, where overcrowding kills

By Emily Bowman
Copy edited and produced by Laura Straub

Ireland is full of luscious landscapes, folk music and friendly citizens. Many citizens say the island is a safe and welcoming community to live and prosper… until you are faced with a medical emergency.

Gary Gomringer wasn’t aware of the overcrowded and disease-stricken conditions in local hospitals -- until he needed medical care.

Last June, Gomringer arrived at the Letterkenny General Hospital, in Northern Ireland, where he had an angiogram to evaluate the condition of his heart arteries. It wasn’t until after the procedure however, that he noticed a rapid decline in his situation.

“I was taken into the recovery room and told that in one or two hours I would be ready for release,” Gomringer said.

Instead, Gomringer watched in horror as his already occupied room filled with more and more patients, flooding into the hallway, some not even able to receive a bed.
Hospital beds flooding into the hallway of  an Irish
hospital.  Photo courtesy of Irish Echo.

“I heard a nurse say they were short of beds for the patients,” Gomringer said.

Gomringer waited patiently until he was assisted by a nurse and released from the hospital, about 10 hours behind schedule. Although his procedure was not critical or life-threatening, medical officials say their biggest concern is for others who need more serious treatment.

“The biggest problem exists in the 15 largest hospitals in the country all of whom have Accident and Emergency Departments,” said Dave Hughes, Deputy General Secretary of the Irish Nurses and Midwives Organisation.
Why are hospitals so crowded?
Ireland has battled hospital overcrowding since the late 1990s. It came to a crisis level in 2002 because of the extreme congestion in A&E departments, the Irish term for Emergency Room.

“These hospitals experience a problem because they are open 24 hours a day and are obligated to accept all presenting accidents and acute medical emergency needs of patients,” Hughes said.

Patients seeking acute care are rushed to the hospital at all hours of the day, but care is not readily available to those who need it most.

“Many nurses report leaving the workplace frustrated at the end of a shift because they have not been able to provide the quality of care to their patients that they aspire to,” Hughes said.

According to Hughes, one of the biggest issues that contributes to hospital overpopulation is the lack of beds. Because of Ireland’s increasing population, the demand for beds is significantly higher but the bed capacity has been reduced.

“Large hospitals operate almost constantly on the basis of a 100% bed occupancy which inevitably means there are no beds available or there are insufficient beds available for admitted patients on a given day,” Hughes said. “There is a competition for beds between elective admissions and emergency presentations.”

The sickest patients are often transferred to the wrong ward because it may offer the only bed available. On many occasions, there are no supplementary nurses on staff to help with the additional patients, Hughes said.
Consequences of overcrowding
The President of the Irish Association for Emergency Medicine, Fergal Hickey, reported last summer that there are often as many as 350 deaths in Irish hospitals each year as a result of emergency unit overcrowding.

The issue has become so extreme in many hospitals, that A&E patients are being forced to lie on trolleys that line the hallways of emergency wards.

“The Irish Nurses and Midwife Organisation identified, in mid 2011, that the number (of patients) on trolleys were at record levels and are a daily reality in some hospitals that have previously avoided this indignity to patients,” Liam Doran, General Secretary of the Irish Nurses and Midwives Organisation, said in a press release.

About 500 patients around the country are waiting on trolleys at a given time, Ireland’s main television network RTE reported.

“In two of the major hospitals (trolleys) have become the norm and there is no significant decrease in the number of trolleys waiting in their emergency departments,” Hughes said.

For over a decade, Ireland has battled its way through the lack of acute care.

Although steps are being taken to help decrease the overpopulation, including increasing the rate of discharging patients, an end is not yet in sight.

“The problem remains as bad today as it was ten years ago,” Hughes said. “The impact of overcrowding is one of demoralisation.”


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