Beaumont Hospital is short 143 full-time staff, out of a total of around 3,500 at the hospital. That includes 62 nurses, 26 clinical staff, and 15 medical staff.
That’s what the regional health forum for Dublin and the North-East was told last week.
This, and also that 39 of the hospital’s 820 beds were closed – just under 5 percent. Refurbishments saw the closure of 37 since April, and staff shortages resulted in another two.
“It’s been getting worse, it really has,” said Sinn Féin councillor Ciaran O’Moore, who is on the board of the regional health forum. “It’s more short-staffed and has longer waiting times too.”
Over Capacity
If the number of patients waiting on trolleys is anything to do by, then O’Moore may have a point.
On Monday, the Irish Nurses and Midwives Organisation (INMO) released its monthly trolley-watch figures. Beaumont Hospital had 732 patients staying on trolleys in September. Once again, the highest figure in the country – a title repeatedly swapped with Our Lady of Lourdes in Drogheda over the past year.
This represents a 136-percent increase since September 2006, the year when then Minister for Health Mary Harney called a national emergency over the situation.
Many constituents have complained to O’Moore about Beaumont Hospital, he said, but it’s not always about the waiting times in the emergency department. Many complain that they can’t get appointments.
It has gotten to the stage where even trolleys are running short. Some patients attending the hospital’s emergency department have to wait for hours on chairs.
One patient who was at the hospital late last month said he spent two days waiting on a chair for treatment. “The A&E was pretty crowded during my stay,” said Conan Kennedy. “Trolleys [were] all full up and maybe another 15 or so were on chairs overnight.”
But he also commended the staff on duty, and said the treatment was well organised. “At least I’m alive,” he added.
INMO’s industrial relations officer at the hospital, Lorraine Monaghan, says staff there “are faced with unmanageable workloads”. “I’m getting increasing contact from members in Beaumont Hospital in regard to staffing levels,” she said.
Conditions have impacted on patient care, and increase the risk of mistakes, Monaghan said. She sympathises with staff as well as patients, particularly those who are on trolleys in the emergency department. “It’s noisy, it’s bright, it’s chaotic and some people are terrified,” she said.
Trying to Recruit
Beaumont Hospital acknowledges the difficult conditions that its staff and patients face during busy periods.
The hospital is currently trying to attract new staff, said a spokesperson, especially nurses. It also offers an education programme to nurses, from foundation to diploma level, in an aim to increase numbers in the future.
With the ban on recruitment lifted over a year ago, why does the shortage continue?
Beaumont Hospital is currently looking for registrars for six vacant positions in general medicine and then an additional two for the emergency department, according to Martin Varley, secretary general of the Irish Hospital Consultants Association.
As he sees it, the big problem is that Irish hospitals are not internationally competitive. Places like New Zealand, Canada, the UK and the US are more appropriately funded, he said.
Monaghan also says that “inferior pay rates” saw huge numbers leave the country. Roughly 5,000 midwives have left the country since the recruitment ban began in 2009, she says, and since it was lifted only 500 have been recruited. Pay and conditions here just don’t compare.
“There’s no real incentive at this point in time,” she said.
A Downward Spiral
With all the hospitals trying to attract medical staff who do want to work in Ireland, doctors and nurses can have their pick. And well-known for staff shortages and overcrowding, Beaumont Hospital is less than appealing.
It’s a cycle that has the hospital in a downward spiral.
The emergency department is one of the busiest in Ireland and serves more than 50,000 patients each year, said its spokesperson.
A position here is “much more onerous than in other regions,” said Varley.
“Beaumont is one of the blackspot hospitals in the country and suffers from extreme levels of overcrowding,” said Monaghan. She puts this largely down to the population in North Dublin being older than in other parts of the city and even the country. With more elderly patients comes more admissions, she said.
At present, there are 60 beds in Beaumont Hospital unnecessarily occupied. It has a high rate of delayed discharges, says Monaghan, and this is down mainly to a lack of community supports in the area.
Winter Is Coming
By December, the hospital expects to reopen the 37 beds now closed for refurbishments, but this does little to reassure those dreading winter.
Last December saw the number of delayed discharges reach 110 – nearly twice the current level – but Monaghan is expecting the situation to be much worse this winter.
If last month’s trolley watch figures are anything to go by then she’s probably correct. The number of people on trolleys in the hospital due to overcrowding has increased year on year since 2012. Since last September, the figures have increased 14 percent.
With fewer beds available, this is likely to lead to more overcrowding and an increased reliance on trolleys.
“We’re due a harsh winter,” agrees O’Moore. “The winter flu or anything will put a terrible strain on the hospital. It’s bad enough as it is.”
He isn’t predicting any drastic improvements in the near future. “Money has to be put in and they need to get rid of the high-paid top management,” he says.
Monaghan called for additional beds, community supports and staff to deal with the crisis; she said all three are necessary to stop overcrowding.