‘He had no privacy, no dignity’: Life and death at University Hospital Limerick

Senior staff nurse Ann Noonan, who is nearing retirement from her post in University Hospital Limerick (UHL), now has the freedom to say publicly what many of her colleagues in the Dooradoyle hospital cannot.

“Every member of staff that are any bit mobile that I talk to are leaving; it’s in their plan to go. Those that have commitments, including children, a mortgage or a husband, are staying, but anyone who is mobile is going,” she says.

Noonan (55) says staff are “burnt out, and they are absolutely and totally demoralised”, adding that the overcrowding crisis is being worsened by the hospital’s inability to hold on to staff.

“It’s totally understandable. Who would want to stay working in this environment when you could work elsewhere for the same money with less hassle?” asks Noonan, who is also an Irish Nurses and Midwives Organisation representative.

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A damning report by the State’s health service watchdog on Friday cited chronic overcrowding and significant nurse and bed shortages at UHL’s emergency department (ED), saying this was placing people at risk of harm and compromising the dignity, privacy and confidentiality of patients. Recently, the hospital said it is short 68 non-consultant doctors and at least 200 beds.

Things that used to be part of normal nursing care are no longer possible, Noonan says. “The days of washing the patient’s skin, cutting their nails and brushing their hair are gone; that’s the way we did it, but we had time to do it,” she says.

“We had time to look after them, we had time to care for them but nurses don’t have time now because there isn’t enough of them and there are too many patients.”

Criticising the diagnostic services offered by the hospital, she says it is “ridiculous” that it is open only between 8am and 5pm “unless in emergencies”, leaving patients unnecessarily occupying beds.

“There are people in beds waiting for diagnostics that do not need to be in beds. I know for a fact that a patient [recently] sat in a bed from Tuesday to the following Monday for nothing else other than the fact they needed an MRI.”

More nursing home beds are needed to get patients discharged, she says. “Our demographics are getting older, there are a lot of patients who are not able to go home but they are not sick enough to be in hospital.”

In a case later described by coroner John McNamara as one filled with “missed opportunities,” Eve Cleary (21), daughter of Melanie Sheehan and Barry Cleary, died in UHL in July 2019 of cardiac arrest.

Cleary was readmitted to the hospital four hours after she had been initially discharged by the doctor, having spent the previous 17 hours on a trolley, suffering from multiple, but undiscovered, blood clots.

Saying she had believed her daughter’s death would force change, Ms Sheehan says: “Trolleys are on top of each other in there and the pictures keep coming out of the place show that nothing has changed and it is still the same.

“Eve was treated very, very badly there and it just seems to be getting worse,” she says. “Even if someone else dies, will it change things out there? I don’t think so. I think we will still be talking about this next year and the year after.”

The reopening of accident and emergency services in St John’s in Limerick, in Ennis and in Nenagh would help, she says. “Maybe we could have brought Eve to St John’s or to Nenagh. Maybe she would still be alive.”

There are widespread calls in the region for ED services elsewhere. Among those speaking out is Marie McMahon from Ennistymon, Co Clare, whose husband Tommy Wynne was admitted to UHL with stroke-like symptoms and spent 36 hours on a trolley before he died.

[ No solutions in sight for UHL, Ireland’s most overcrowded hospital ]

“If a farmer was treating his livestock in the same way that we are allowing human beings to be treated in UHL, it would be closed down,” says McMahon. “I’ve gone through it and it’s a horrendous experience, absolutely horrendous.”

One of many in Clare seeking 24-hour ED care in Ennis, McMahon argues that having patients lying on trolleys in corridors, as frequently happens in UHL, poses a “fire risk” but “nothing changes” despite warnings from the fire brigade.

Limerick Fire Service has gone so far as to threaten legal action against UHL over its concerns, especially after it found 38 patients on trolleys in aisles in the ED in a follow-up inspection in 2019.

UHL has admitted that the maximum number of 79 patients allowed in the ED, including in cubicles, has been exceeded on a number of occasions, including in April 2019 when there were 104 patients there for a time.

Father of two Eddie Moloney (73) died in a busy public ward in the hospital in 2015 after being left for 12 hours with a bleed on the brain on a trolley next to a drunk person in a corridor.

He took his last breath lying beneath a loud television blaring out the commentary of Ireland v France in the Rugby World Cup as other patients and their visitors “shouted and roared” at the screen, his daughter Joanne Moloney says.

“Seven years on and nothing has changed, in fact, it appears to have gotten worse at UHL,” says Joanne Moloney, still unhappy that the family’s requests for a room to say their goodbyes were unmet because none were free.

Later, UHL said services for bereaved families had been improved by renovations to the mortuary and the opening of a family room, but it admitted “end-of-life” rooms are not always available.

“He had no privacy, no dignity, and I remember thinking afterwards that our pet cat had been put to sleep in a more dignified way. At least the cat had privacy at the vets,” Joanne Moloney says.

Protests calling for extra ED services in the midwest are now being planned, says Mary Cahalane, one of the organisers of past marches, “because nothing has changed”.

UHL overcrowding undermines the region’s ambulance service too, sources say, since crews must often wait for up to an hour to hand over patients once they arrive at the hospital, causing delays for subsequent patients.

“The whole place can be full, literally full. You have ambulances parked where cars are supposed to be parked, you have ambulances blocking in other ambulances because crews are with their patients waiting to hand them over to nurses,” one paramedic says.

Still trying to cope with the death of her husband, Marie McMahon sums up the mood of many: “It’s everybody’s worst nightmare that they will end up in UHL, especially people in west Clare.

“I know of people who have refused to go to UHL and they would rather die at home than on a trolley. That might sound really dramatic but it is actually the truth, that’s how bad it is.”