Emergency ward: Up to 14 patients a day are ending up on trolleys at the new €10.8 million A&E department at Cork University Hospital (CUH) which was described as a "landmark in emergency medicine" when it was officially opened by Minister for Health, Mary Harney, last month.
The Irish Nurses Organisation claims staff are 'disillusioned', and INO industrial relations officer, Patsy Doyle, says that she has been fielding "frantic calls" from A&E nurses who are disturbed at the numbers of patients lying on trolleys in the department.
The new department is twice the size of the original area but only has 12 cubicles - the same number as in the old unit.
"Some nurses feel that they have no option but just to call it a day and move on to somewhere less pressurised. The patients are losing out in the end. We have already lost two nurses. Nurses saw the new department as an opportunity to cease the trolleys and that just hasn't happened. We took a leap of faith with the opening of the new A&E unit and it just hasn't worked out."
The INO says members have been left with little choice but to work without a promised new rapid transit admissions ward, which was to employ a clinical nurse manager, 15 staff nurses and five healthcare assistants.
They argue that without a rapid transit ward the "unacceptable sight" of patients being treated on trolleys in the A&E would continue.
Patsy Doyle says nurses are incensed at what she terms the "reckless disregard" which management has shown towards implementing a joint agreement reached on the opening of the new A&E on April 18th last.
The biggest breach of the agreement she argues is the delay in the opening of a separately staffed rapid transit admissions ward.
"They say that it will be open in a few weeks but we have heard that before. Our members had expectations that because we were getting a beautiful new building that the staffing issue would be sorted. Instead management have reneged on their promises. They just pumped money in to the unit with no thought to staffing."
Now the INO claims nurses are going to "vote with their feet" and resign unless the trolley crisis at the hospital is rectified. They say that their only option is to refer matters to the Labour Relations Commission.
Meanwhile, health officials at CUH say they are trying to fast track nursing appointments to open a rapid transit ward at the hospital.
Director of Nursing at CUH, Kay O'Sullivan, said since the new emergency department opened in April the number of patients on trolleys has reduced. Ms O'Sullivan said: "We are making good progress towards opening the new Rapid Transit Admissions Ward. Sixty per cent of the nursing staff needed have already been recruited, interviewed, Garda cleared and have worked their notice. Healthcare assistants have been interviewed and are currently undergoing garda clearance and medical assessment."
Ms O'Sullivan added that one of the biggest challenges facing the hospital has been the nationwide shortage of nurse graduates for 2005, because in 2003 a four year degree programme replaced the three year diploma course, meaning no new graduates will emerge this year.
Last October the Health Services Executive (HSE), Southern Area, began a recruitment campaign for 150 nurses to take up positions in Cork and Kerry on a phased basis.
A spokesman for the HSE in the South said the first group arrived last month and included 22 Indian nurses, five of whom were eligible for Irish Nursing Board registration and took up positions at CUH on arrival.
The HSE has also denied INO claims that two A&E nurses had resigned from the department at CUH because of pressures saying that one took up a promotional position in a hospital where she worked previously and the other moved to a permanent post in her nurse specialty elsewhere in the hospital.
The new accident and emergency unit at CUH is the only level one trauma unit in the Republic meaning it can back up all the specialist services needed to deal with multiple trauma.