Highly skilled emergency department staff are leaving their jobs because of the “impossible and dangerous” situations in the country’s hospitals, a doctors' group has warned.
The Irish Association for Emergency Medicine made the claim in its response to the Health Information and Quality Authority's (Hiqa) recent report on overcrowding and patient safety issues in University Hospital Limerick's emergency department (EDs).
The Irish Association for Emergency Medicine said the issues in University Hospital Limerick are replicated nationwide and are leading to a flight of staff.
It said the main cause of overcrowding is: “Ireland’s well-established shortage of acute hospital beds" but it said there has also been a surge of presentations at hospitals post-Covid.
“While ‘emergency medicine’ accepts that EDs are the safety net for patients, EDs should not be the safety net for failing medical services,” the Irish Association for Emergency Medicine said.
“EDs are attempting to deal with this onslaught in the face of significant medical, nursing and other staff shortages.
“While some of this is Covid-related, more and more staff are leaving as they feel they cannot continue to work in such an impossible and dangerous environment.”
Earlier this month, Hiqa published a report following an unannounced inspection of Limerick's emergency department which found that conditions there were insufficient to meet the needs of patients and compromised the delivery of safe care.
Hiqa inspectors were not assured the hospital had adequate measures in place to address overcrowding, there was ineffective patient flow, insufficient nurse staffing levels and prolonged ED wait times.
In a statement yesterday, the IAEM said Hiqa's report had generated “significant furore" and "much ill-informed comment” and that it was now appropriate to set out its position on the issues raised.
It welcomed the report and accepted that the UHL situation is unsafe, both for patients and staff, but it said the situation is replicated countrywide.
It said the number of presentations to Ireland’s emergency departments is increasing at "an alarming rate" since the temporary drop early in the pandemic, with daily attendances now that were “unimaginable" a decade ago.
It said patients are attending EDs because of difficulty accessing other services, such as primary care and community services and that means ED staff have to work harder to address deficiencies elsewhere in the healthcare system.
It pointed out that Ireland has just two-thirds of the OECD average of acute hospital beds and said that impacts on patient flow through the system.
“The current dysfunctionality, therefore, promotes even greater levels of dysfunctionality and even greater risk,” it warned.
The group also praised “the Trojan work” of emergency department staff at UHL for “keeping an intolerable situation from being far worse” for individual patients.
“The criticism of the situation that ED clinical staff find themselves in, and as Hiqa has acknowledged this is due to circumstances outside of the control of the ED, should not be allowed to demoralise the very staff that are attempting to keep patients safe in such an unacceptable environment,” it said.