A person spent more than three days waiting on a trolley at University Hospital Galway's emergency department this week.
The patient was eventually admitted after being assessed by the medical/surgical team on Tuesday, a day which was described by a nursing union official as "horrendous" in terms of emergency department overcrowding.
There were 31 people waiting for beds in the ED on the day - seven of whom were oncology patients. One patient spent 75 hours on a trolley before being admitted. Some of the overall group were waiting on trolleys for 50 and 60 hours, according to Anne Burke, the Irish Nurses and Midwives Organisation's industrial relations officer in the west.
"Tuesday was horrendous in the ED," she said. "Once upon a time patient numbers rose in winter, it was a seasonal thing. Now it is seasonal 365. We went from years ago having a cohort of patients from Galway, Mayo and Roscommon to then adding Donegal and Sligo. UHG is the only centre of excellence for those counties in the Saolta group. The catchment area is massive now and there is an increase in the number of specialist services being provided to patients. The INMO welcomes that, if these new services are properly resourced and the setting in which they are provided is robust enough."
Her comments came as the INMO reported earlier this week that there were record levels of ED overcrowding nationally last month - 6,751 admitted patients were on trolleys in emergency departments. There were 447 patients on trolleys and inappropriately accommodated in wards at UHG's ED in July.
Ms Burke described the figures as "disappointing" and said they are an indication that the health system continues to underestimate the challenges arising in EDs.
The rising number of patients on trolleys is a direct result of the failure of the health service to increase bed capacity due to an inability to recruit staff, a period where home care packages were curtailed leading to an increase in delayed discharges and the reality that there has been an increase in the number of patients presenting to the country's EDs, according to the INMO.
The nursing union official says ED figures are only a manifestation of the true problem that exists in hospitals in terms of capacity.
"The ED is the front window and it is symptomatic of a much deeper ailment within the system. The provision of care is suffering a very deep malaise at the moment. Last year alone the attrition rate was nearly 11 out of the ED, seven nurses went to the Bon Secours Hospital. These were people with huge experience, educated to higher diploma level. This attrition is happening because of the conditions people are working in. Staff are at their wits' end. The abnormal has become the normal. The only incentive that ever really talks is money. To get nurses back from England, for example, their conditions there have to be matched here. Over the last two years there was any amount of overtime available in the ED. Yet, slots available for overtime at weekends remained unfilled because no money would pay staff to work in these conditions. And it is not just the ED which is a issue, where you have two or three additional trolleys in wards it means there is a lack of privacy."
Ms Burke outlined that there are 29 patients in UHG, who have been there in the medium and long term, who cannot be discharged because they have nowhere to go.
"They cannot be discharged because the resources and facilities are not there in the community to deal with them. The bed complement of a ward is 30 so this 29 patient group represents almost one ward. Some have been there from eight weeks to seven months."
The ED Taskforce will meet early next month to consider plans for a winter initiative. But the INMO says it must also consider immediate measures to alleviate the continuing crisis.
