I wrote a piece not so long ago about an experience my wife had in the emergency department of the Mercy University Hospital in Cork. She ended up there last August after she fell and broke her collarbone while playing tennis. The treatment she received was far from what we expected.
We arrived at the hospital at about 8.45pm and Gaye was seen by a triage nurse who suspected the collar bone was broken. She was asked to take a seat in the waiting area and despite being visibly in distress and shivering with the cold, that’s where she remained until about 4.15am. Almost nine hours since she had fallen and over seven hours since she had arrived in the hospital.
Nobody came to check on her. The waiting area wasn’t crowded but things were moving slowly. At around 4.15am we were called to another area where a doctor checked Gaye’s injury and sent her for an x-ray. She was discharged soon after that.
It’s hard to blame the staff. They’re under a lot of pressure and working under trying conditions. I was very critical of the treatment she received at the time, and I stand over everything I said in my criticism of the Health Service Executive (HSE). The problems within the HSE are well documented.
The Organisation for Economic Development and Co-operation (OECD) in an assessment of the health system last year concluded that healthcare in Ireland suffers from widespread inefficiencies, elevated costs and fragmented governance.
That’s plain to see but it’s only fair to highlight improvements in the system too when you see them, like those in the emergency department in the Cork University Hospital (CUH). That was our experience when Gaye presented there recently.
She was having some issues related to her original injury, so her GP referred her to the CUMH for tests. As soon as we arrived, we noticed the pod system. When we entered the hospital, we were given a ticket and shown to a seat in a pod in front of the triage area.
A few minutes later, she was called to give her details and shortly after that she met the triage nurse. Things progressed quickly then, and we were soon on the move into the Emergency Department proper where she was placed in another pod. There are about 55 of these things as far as I could tell.
For those who haven’t seen them, they are basically small cubicles with glass on three sides, and a seat to accommodate one person. The patient’s name is written on a whiteboard in the nurses, station alongside their pod number so gone are the days when nurses wandered around crowded waiting areas trying to locate patients. Now they know exactly where their patients are at all times.
The place was a hive of activity. It looked as if every pod was in use and when one was vacated, it didn’t stay empty for long. Nurses, doctors, porters, cleaners and other support staff were constantly on the move. It was hectic and while it looked chaotic there was a calm efficiency to the place.
Gaye had a number of tests including an MRI, so she disappeared for a couple of hours. When she returned, she took her place back in her pod and the doctor who had been dealing with her came to visit.
The MRI had taken longer than normal, and he apologised for the delay. He told her she was just unfortunate because they had a run of medical emergencies at the same time who required immediate attention, so she fell to the back of the queue. That’s as it should be. The most seriously ill should receive priority treatment and she understood that. No problem.
She wasn’t in her pod long when a trolly arrived with a lunch box for each patient and a bottle of water. Later on in the afternoon, the trolly appeared again with tea, coffee and a bun for everyone. It wasn’t expected but it was very welcome.
I have no idea when the staff get a break because they don’t seem to have time to scratch. With such a constant flow of patients through that department, there is little respite for the staff and that got me wondering why anyone would want to work in that kind of environment? The short answer to that of course, is that many of them don’t.
More than 21,500 Irish young people were granted Australian working holiday visas over a 12-month period since July 2022. The highest recorded number of visas in at least 16 years according to the Australian Department of Home Affairs.
That number includes some of our nurses and also includes a 44% increase in the number of Irish doctors granted visas since 2018. The reasons for emigrating to Australia include the opportunity for a better work-life balance, and the ability to progress into senior roles more quickly.
Journal.ie interviewed nurses about their experience of working in different healthcare systems. One emigrated to Perth and she said there was no such thing as a patient ratio in Ireland. She used to have eight patients on a day shift in a private cardiac unit at home and could have had 12 patients to herself on a night shift. In Australia it was strictly four patients to one nurse in the public hospitals.
Another nurse worked in two different hospitals before she went to Australia and echoed the sentiments about the lower patient load. She trained in a public hospital with staff shortages and long hours. To work in Ireland again she said she would need to see an improvement in pay and conditions, higher staff levels and a lower patient to nurse ratio.
We really need to start looking after these people.