'Your heart hopes tomorrow will be better but your head knows it will be crazy' - Irish nurse on reaching burnout point
An Irish nurse has said that the pressure of the job severely impacted on his ability to eat, sleep and maintain a family life.
The man, who does not want to be identified, works at a busy Irish hospital in the west and said that the hospital crisis is only getting worse and nurses are being pushed to the point of burning out.
The male health worker, who has been nursing since 1998, explained how things came to a head two years ago when he felt his family life was suffering.
He told Independent.ie: "Lots of nurses feel like leaving but there is an in-built gene that says, 'we'll go again tomorrow.'
"You have that hope that tomorrow will be better, your heart says it will be better but your mind knows it will be crazy again.
"You're caught between that but I don't think I'd seriously consider leaving.
"Burnout is difficult because when you're in the middle of a situation it's hard to see the ins and outs of it.
"So when you're working in that environment you will question whether it is you or the system, I can safely say I completely lost my ability to sleep.
"I would go to bed at ten and be awake again by 2am and that would be me awake then until work the next day.
"I was trying to have energy to be a dad and be there for my family but I was also trying to have energy for work but it was just not working.
"I would never give up my family so about two years ago I applied for transfers and I got a decent one, I have a much better work-life balance but I know that doesn't work for everyone and that's when burnout happens."
He continued to say that the job is "wearing nurses down" and too much is being asked from them.
He said: "You know the workload is huge and you are an experienced nurse you look around and know your client needs to be cared for but you're also looking at the quality of that care.
"Junior nurses should be allowed to acknowledge their limitations and ask for help but they can be thrown into the deep end and feel like there's a get on with it attitude.
"When you're a senior nurse you're probably not aware of how much it's wearing you down, you lose your appetite, you cannot sleep and there are other stress points."
He said that the situation is getting worse and he claimed this is due to factors such as a lack of home care services and patients being referred by "over-cautious GPs" to try to prevent them facing lengthy outpatient waiting lists.
He noted: "Wards might not even necessarily be overcrowded but under-resourced.
"Nurses are caught out because they want to deliver timely care but you have to spread yourself thinly because of the resources.
"The norm is that you're allocated six to eight patients but now some nurses are looking after twelve patients and there is no security about how acute or dependent your patients are.
"So you could have twelve patients but four could be totally dependent on one nurse, that's when the trouble starts and it leads to delayed discharge as you're trying to put out fires all day long.
"Every day is chaotic, the way to describe it is the ideal situation is that you run at 80pc capacity but some hospitals can be running at 99pc to 11pc capacity at any given week and that's when patients are on trolleys."
The concerned man said that a bigger budget and more beds won't make the problem go away and that we need to look at the bigger picture.
He said: "The health budget is huge and it's getting bigger, are they doing enough? Even if they got close to enough it'd probably still never be enough.
"It's how you manage what you have I guess, at the moment we're providing more beds but we're not providing resources like doctors, nurses, dietitians, porters, diagnostics and so on.
"If you gave me 100 beds in the morning I could fill them no problem but say if there were no extra dietitians then that's probably going to be another 50 patients who will need to join a waiting list to see a dietitian, who is probably already overstretched.
"You're stretching the resource, giving the 100 beds looks beautiful but if you're increasing capacity without matching it with people and resources then you're going to run into delays."
Damien McCallion, HSE National Director Emergency Management & National Ambulance Service, empathised that the situation is difficult for both patients and staff but said that there are some improvements.
He said: "It's true to say there are less hospital beds than there were previously, I would say it's close to 2,000 beds but we have lived through austerity and we are trying to claw back some of those acute beds.
"The recent Slainte all party report on health care said that we need to grow capacity, not just hospital beds but also social care - so services like home care beds and transitional beds so that people aren't delayed in hospitals when they shouldn't be. That's not good for them and it means a bed is available.
"In the last two years attendance at emergency departments are up 7pc (83,000 patients per year), admissions are up 8pc (around 500 per week).
"With additional capacity the system is actually being quite productive but it is a balancing act.
"Nobody is happy having anyone on a trolley, we are trying to make improvements, while increasing the overall capacity long term."
He also said that measures have been put in place as health chiefs prepare for winter.
He said: "At the end of last winter we looked at the lesson from the previous few months to see what worked and what didn't, those plans have been used in conjunction with other bodies to try to prepare for this winter from hospital to hospital.
"There's an investment annually by the government both for the winter and also in part of the service planning process.
"There's two strands to it - one is getting the hospitals to work closely with the ambulance service to prepare for winter and secondly there's investment that comes from government."
He also said that the HSE is working to try to attract and keep staff.
Mr McCallion said: "Staff in frontline services are under pressure, there's no denying that and as many supports as possible are put in to help staff.
"We have done a lot of work in terms of recruitment and we are opening beds in some of our key sites over the winter.
"There are parts of the country that are still hard to attract staff but the overall situation has improved.
"There has been a lot of progress in terms of trying to attract and retain process, although there are ongoing challenges."