Under-pressure staff at loggerheads over transferring of people to wards
Tensions between nurses and doctors on the kind of measures to be used to ease bottlenecks in accident and emergency units remain unresolved, despite the scale of overcrowding.
Nurses who work on wards are vehemently against patients on trolleys being transferred to their section in order to provide more space in clogged emergency departments downstairs.
They insist they are already under pressure and over-stretched looking after sick patients in beds.
However, emergency consultants insist that most wards in the hospital should take one or two patients on trolleys to reduce the risk of infection and alleviate congestion.
An analysis of the trolley watch figures for each hospital yesterday revealed that even in a hospital as overcrowded as Beaumont in Dublin, a total of 34 patients were on trolleys in the emergency department - while only four were placed in wards.
In Our Lady of Lourdes Hospital in Drogheda there were 25 patients in the emergency department and just two on trolleys in wards.
And in Galway University Hospital, where 28 patients were crammed into trolleys in the emergency department, only five were on wards.
Dr Peadar Gilligan, emergency consultant at Beaumont Hospital in Dublin, said there needed to be a "whole hospital" response to the trolley crisis.
"If each ward took one to two additional patients, it would significantly decrease the level of overcrowding in the emergency department."
Some hospital managers are slow to press for more to be placed on wards because it may lead to industrial action by nurses.
The nurses want to see more actions by consultants across the hospital to ease overcrowding, including carrying out more ward rounds to see which patients can be discharged.
Asked why so few patients on trolleys were being placed in wards, a spokeswoman for the Health Service Executive (HSE) said it had been agreed by the Emergency Department Taskforce that the placement of additional patients on trolleys on hospital wards should be a last resort.
She said that the HSE issued a directive to hospitals prior to Christmas setting out the steps required of them if trolleys and waiting times in emergency departments reached a certain level.
The spokeswoman also insisted that the HSE and hospitals have both put in significant effort to prepare for the surge period.
"It should be noted the numbers on trolleys are 15pc lower at present than last year and this improvement shows improved processes," she said.
She added that a small number of hospitals were experiencing exceptional issues including outbreaks of winter vomiting bug and flu.