Dr James Gray tells management of ‘nursing crisis’ with facilities set to close as a result
Dr James Gray said there was “a nursing crisis” in the emergency department at Tallaght hospital and it was short four nurses on Wednesday. File photograph: David Sleator/The Irish Times
A consultant at Tallaght hospital has written to management stating that “it remains dangerous and unsafe today” in the emergency department.
Dr James Gray emailed management on Wednesday morning outlining there were 17 patients waiting to be seen by accident and emergency department clinicians adding the “longest one is almost nine hours languishing”.
“It is only a matter of time before there is the next cardiac arrest, serious morbidity or mortality in the waiting room and/or amongst the admitted boarders when the care cannot be provided safely and particularly when there is a critical shortage of nursing resources on the floor,” he said.
Dr Gray said there was “a nursing crisis” in the emergency department at Tallaght hospital and it was short four nurses on Wednesday. He said he had been informed that nurses intended to close six cubicles while the rapid assessment unit in the emergency department would not open on Wednesday and the ambulatory care unit would close in the evening.
He said as a result of seven cubicles being blocked by admitted patients and another six expected to close due to staffing problems, the emergency department would have only five cubicles, two psychiatric bays and four resuscitation bays to see 140 patients on Wednesday.
Dr Gray, who is on duty from 8am until 6pm, said he would not be remaining on call after 6pm “if it’s unsafe and the risk is not spread more equitably across the institution”.
“Nursing staffing is not at a safe level, expected to look after both ED patients and 14 admitted boarders with significant closed sections of the department,” he said.
“I will not allow myself to remain vicariously liable for an unsafe department out of hours. Contractually I am not obliged to provide an on call service in an unsafe environment. A contingency will be required. The onus is on the employer to provide a safe place to work.”
Tallaght hospital said it had appropriate on-call emergency department consultant cover and that was continuing to operate as normal.
“The hospital is currently seeing a large number of patients being admitted via ED and as a result has activated its full capacity protocol arrangement,” a spokeswoman said.
“As of this afternoon, there were 12 patients on trolleys in ED with 33 additional patients being accommodated in escalation beds/trolleys elsewhere in the hospital in accordance with the agreed escalation procedures.”
The hospital added that it was “working at all times to minimise trolley numbers”.
The Irish Nurses and Midwives Organisation (INMO) said the situation in the emergency department at Tallaght hospital “remains intolerable” and that ongoing staffing difficulties and overcrowding issues were raised at a meeting with management last week.
Joe Hoolan, an INMO industrial relations officer, said “like every other hospital, they’re finding it difficult to get staff in”.
“Tallaght [hospital] is in a difficult position at the moment, they acknowledge that. They are struggling on a day-to-day basis to maintain safety as best as they can,” he told The Irish Times.
“The last couple of days have been extremely difficult, there have been ventilated patients in the emergency department for a long number of hours. That is not acceptable. Those patients should be in an intensive care unit and it is not safe nor it is good practice that they would remain in the emergency department for significant lengths of time.
“I understand some ventilated patients have been there eight and nine hours before being transferred to other hospitals where there is intensive care capacity.”