IAEM welcomes lifting of threat of Industrial Action
The decision of the Irish Nurses and Midwives Organisation (INMO) to defer planned strike action starting in 7 Emergency Departments (EDs) around the country on Thursday 14th January 2016 is to be welcomed. The Association acknowledges that INMO ED nurses have yet to be ballot on the proposals, prior to the lifting of the threat of industrial action.
As the doctors who staff the country’s EDs and have clinical responsibility for the care delivered to patients by Emergency Medicine, we share the intense frustration of our nursing colleagues that the problem of crowding by admitted hospital inpatients lodged in EDs has been allowed to continue for so long, particularly as we know how harmful this is to patients. We have long highlighted that this practice is internationally recognised as causing avoidable patient deaths and poorer outcomes.
The hope is that the agreement brokered by the Workplace Relations Commission (WRC) will ensure that consistent, effective escalation policies are in place around the country, meaning that individual hospitals respond in a more timely fashion when a proportion of ED clinical spaces are occupied by patients who have been identified as requiring hospital admission. The Association welcomes the requirement for there to be both Hospital Group and individual hospital oversight to ensure the consistent and appropriate implementation of such escalation plans. Such mechanisms must avail of the expertise of Consultants in Emergency Medicine in each hospital and we welcome the commitment of the WRC to assess compliance with these commitments with this caveat in mind.
From a patient safety perspective it is entirely inappropriate that EDs are expected to simultaneously function as an Emergency Department and as an acute ward for admitted inpatients. The burden of each hospital’s admitted inpatient workload must be shared between the ED and hospital wards rather than the current approach whereby patients are lodged in crowded EDs while much of the rest of the hospital continues to function, oblivious to the patient safety risks faced by these patients.
All those who work in Ireland’s EDs look forward to the day when the spectre of large numbers of unfortunate patients being inappropriately kept on trolleys in EDs instead of being admitted to a hospital bed is a thing of the past. Hopefully this agreement will represent one more step on the way to achieving this goal which ultimately will ensure that patients requiring emergency hospital admission have a safer and more humane experience.