Safety fear chaos at hospital’s psychiatric unit

The acute psychiatric unit at University Hospital Galway (UHG) descended into chaos again last weekend with nurses refusing to go on duty due to safety concerns caused by staff shortages.

The stand-off is similar to the one which led to industrial action last May. A deal brokered in June led to a commitment from the management about specific numbers being rostered on duty.

On Friday evening last, the acute ward was short four staff to care for the 44 in-patients four of them considered seriously ill and requiring one-on-one care.

Night staff refused to begin their shift claiming they feared for their safety.

It took three hours to locate three additional staff to plug the gap, explained Psychiatric Nurses Association spokesman Noel Giblin.

“There was a known requirement for staff on Tuesday morning and nothing was done. The problem as we see it is management went off duty on Friday evening not realising – or, more worryingly, not caring – that the unit was dangerously understaffed and only started looking for those staff at 8pm.”

The last empty bed was filled early that morning by an agitated patient escorted in by gardaí.

“That ward has the ability to be very volatile. Staff have to be very mindful on a Friday or Saturday night they are very likely to have guards escorting in patients and must have the full complement of staff. They’re not being listened to.”

Another mental health worker called in to assess the situation – who asked not to be named as he worked elsewhere in the HSE – said he understand it was the fourth such standoff.

“Does it need to take a staff member being killed or maimed before they listen? There are already two staff off on long-term sick leave due to injury caused by patients. You’ll see staff going off sick because they’re too afraid to come on duty which will compound the situation,” he told the Galway City Tribune.

An acute 50-bed unit is scheduled to be built late next year but planning permission has not yet been secured.

Since the closure of the acute 22-bed unit in Ballinasloe built at a cost of nearly €3m the acute unit in UHG has been at breaking point.

To offset the closure, home-based treatment teams were promised for Galway City and Oranmore where nurses would visit patients with a mental health crisis at home several times a day, keeping them out of the acute unit. However the teams were never set up.

As well as extra staffing, under the June deal the HSE agreed to open a secure six-bed mental health unit at UHG which was built but never used and could take some pressure off by accommodating  the most volatile patients. That too has not happened, explained Mr Giblin.

The PNA’s Derek Cunningham – involved in brokering the last deal – admitted there were “teething problems” with the implementation of the agreement.

At last month’s Regional Health Forum West meeting, councillors were told that nursing staff had been increased from 50 to 64 in the unit, with an additional five one-on-one specialists brought in to care for the most acutely ill.

Mr Giblin said staffing levels were the same as last May.

In July, a patient started a fire in the locker room in the psychiatric unit which staff were alerted to by a smoke alarm. There have also been cases of high-risk patients wandering off.

In one, a patient was found in his pyjamas walking along roads late at night in Menlo. In another, a high risk patient absconded only to take his own life shortly after, which is being investigated by the Mental Health Commission.