Family angry at shortage of ward nurses at UHG

Coroner for West Galway, Dr Ciaran MacLoughlin, agreed with the family of Kathleen (Katie) Ludden, of Ballinaboy, Clifden, that when the ward was full to capacity, with 30 people, it would be obviously difficult for staff to cope.

Mrs Ludden’s daughters, Geraldine and Ann, were forced to leave their mother’s bedside due to an outbreak of the Norovirus (Winter Vomiting Bug) in St Enda’s Ward in February last year – Geraldine said that their mother would still be alive if they had been able to stay with her and give her the one-to-one care she so desperately needed.

They claimed that their mother suffered four falls – obvious by bruises on her body – during her time in the acute medical ward, but only three were recorded.

And they disputed claims that they were informed after each of these falls – one of which caused a bleed in her brain.

“We were informed of two falls – she would not have been left there if we had been told (about the others),” Geraldine Ludden said.

The family also said that their mother should have been restrained, as she was at risk of falling, but were told that there was strict protocol in this regard.

Mrs Ludden was initially admitted to UHG on February 7 last year, with a long-standing cough. She had a history of battling oesophageal cancer, but the post- mortem examination showed that her past medical complications had not actually caused her death.

Helen Hanrahan, assistant director of nursing, told the inquiry that during the daytime there were seven nurses available to care for a total of 30 patients – at night-time that number dropped to between three and four.

In this particular ward, there are 13 beds in the ‘long ward’, eight in another, and more in single rooms.

Geraldine Ludden said that in all the time she had spent with her mother, in the two weeks before her death, she never saw the full complement of staff on duty.

“I’ve seen patients left there who were not given food, no one cared – that’s why I stayed with her,” she said.

“Then I was put out (due to the virus), and brought back when she was dying. It was not just my mother, it was every other patient – I’m sorry they didn’t have anyone looking after them.

“When she was moved to the private ward, no one came to her. We did the full nursing, the nurses only came in to take her blood pressure, unless we specifically asked.”

Ms Hanrahan, who was not personally involved in Mrs Ludden’s care, said that she was sorry that her family felt that their mother did not get the care she needed.

She said that St Enda’s Ward, being an acute ward, had never been without the full complement of staff during the recent embargo. And, she advised the Coroner that a national task force was currently examining the staff-patient ratio in Irish hospitals.

Dr MacLoughlin remarked that this was an issue that was not going to diminish, referring to an earlier witness, Dr Anthony O’Regan, a consultant in respiratory medicine. He had said that there was a huge proportion of elderly patients over the age of 80 occupying beds in Irish hospitals.

“There will be ‘end of life’ issues for a lot of these people, because of their age,” the Coroner said.

“Safety with falls is a huge issue, and for one person (nurse) to look after eight people is a lot. Four staff for 30 patients seems a lot.”

Mrs Ludden died on February 20 last year, two weeks after her admission. In the subsequent post mortem examination, carried out by Dr Birgids Tietz, she found that the tumour had been successfully treated, and that the cause of death was her last fall.

Dr MacLoughlin returned a verdict in accordance with the medical evidence that Mrs Ludden died from cardio respiratory failure due to an intracranial haemorrhage due to an accidental fall. He added that while there were existing comorbidities when she was admitted to hospital, these did not cause her death.

“I’d like to make this observation – that in a ward where there are a number of people acutely  ill, the authorities may look at staffing numbers, and see if it is sufficient to meet the needs of the patients,” he said.

“It is important that we all know there are protocols to restrain people’s freedom. It is taken very seriously, and can be the subject of disciplinary proceedings. I wouldn’t like to see myself restrained if I didn’t feel it necessary.

“In hindsight, people do fall, maybe if they were restrained they wouldn’t have fallen, but how would a patient have felt if they were restrained against their will, if they were compos mentis. There is no doubt you have to take into account the patient’s wishes in a hospital environment.”

He expressed his sincere sympathies to Mrs Ludden’s family on the tragic circumstances of her unexpected and sudden death.