Chronic understaffing in new ED results in increased waiting times

Chronic understaffing in the new ‘temporary’ Emergency Department (ED) at University Hospital Galway has left the unit unable to open to full capacity.

The temporary ED still suffers from long waiting times as fewer patients can be treated. Staff in the department are already complaining about overcrowding and reduced clinical space in the new department.

There are just 29 clinical spaces available, compared to 34 in the old building. Although the temporary ED is equipped with four resuscitation bays, one of these is not in use due to a lack of staff. An isolation room has also been left unused.

According to a senior nursing source in the department, who asked to remain anonymous, while there is technically more
space in the temporary ED, there are comparatively fewer clinical spaces, or enclosed areas equipped with trolleys for patients to be assessed and examined.

“We have less clinical space now than what we would have previously had, so that has an impact on the way we flow the patients and the way the patients are seen and waiting times for our patients. We don’t have enough staff to open all areas within the new department, so that’s also an issue,” said the senior nurse.

Irish Nurses and Midwives’ Organisation spokesperson, Beibhinn Dunne, commented on the ongoing understaffing problem in the temporary facility. “The introduction of extra beds needs to be accompanied by an appropriate increase in staffing. We’re currently seeing dangerously understaffed departments across the country and the impact on staff retention and patient safety is very serious.

“We need to see the safe staffing framework rolled out across the country as a matter of urgency if we want to maintain reasonable safety levels in our hospitals over the coming winter,” she added.

Persistent overcrowding

Staff working in the temporary ED maintain that the issue of overcrowding remains rampant. “It is a better facility than what we had, it’s newer, it’s cleaner, we needed a new facility. But, it’s still overcrowded with patients that are awaiting beds,” an ED staff nurse—who asked not to be named—said.

“You can build all the shiny emergency departments that you want, but there’s still going to be delays,” she continued.

The senior nurse agreed, stating: “The biggest problem in the new department is the same as in our old department—we don’t have enough space to see the amount of presentations we have every year. And we don’t have enough staff nurses to care for those patients.”

Referring to the Minister for Health, Stephen Donnelly, the senior nurse further explained that the overcrowding issue is not isolated to ED.

“It doesn’t matter how big he builds the Emergency Department unless he builds a matching capacity within the hospital system to meet the demands of the Emergency Department.

“Where we really run into problems, from an efficiency point of view, is when the patients are admitted and there’s no beds in the hospital system to move on from the Emergency Department, and they end up staying with us waiting for a bed upstairs.

“These patients who lie on trolleys for days on end—they take longer to recover in hospital. They have poor outcomes as a result of their stays. That’s the most frustrating aspect of it,” she concluded.

Saolta Group, which operates UHG, did not respond to a request for comment.

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