Hospital staff raise fears for patients who may have to have overnight dialysis at UHL

University Hospital Limerick

UNIVERSITY Hospital Limerick (UHL) is moving ahead with proposals to tackle heightened demand on dialysis services by offering patients treatments through the night, despite concerns that such a practice is not safe for some patients and will put huge strain on others.

A source at the hospital told the Limerick Post that staff on the haemodialysis unit are deeply concerned that the proposed night-time services are not sufficiently staffed and, if a patient becomes very unwell, doctors on call will not have the required expertise to deal with the emergency.

The hospital source said that management “has been unwilling to provide proper nursing management and medical cover in the evenings and during the proposed nights”.

Haemodialysis is a medical treatment given to patients suffering from kidney failure. It is usually a long term treatment option requiring the patient to attend the unit for approximately four hours three times a week.

“Every patient reacts to dialysis quite differently. Many patients can remain stable across their either treatment session, but some can have severe side effects and become very unwell,” the source said.

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The hospital source – who asked not to be named – said staff in the unit fear that many of the patients who will be dialysed at night will be elderly and frail and away from home most of the night between a four-hour treatment and travel time.

On top of night dialysis being extremely bad for patient wellbeing, staff have said, they have serious concerns for patient safety as, should they require additional medical care, “it will be suboptimal”.

The staff and the union which represents them, the Irish Nurses and Midwives Organisation (INMO), have said they want to see movement on plans to provide a new unit in Ennis to cater for the large number of patients coming the Dooradoyle unit from Clare.

a spokesperson for the INMO told the Limerick Post, “The practise of nighttime dialysis was ceased in 2015 when a new renal dialysis unit opened in University Hospital Limerick and also because of the inappropriate practice of undertaking patient treatments at night.

“Nine years on and demand has increased in UHL without a commensurate increase in facilities. A dialysis unit was due to come on stream in Ennis but it appears to be stalled. We do not have a date for the new unit but nurses are concerned that this service will again be provided at night time and impacting on safety and well being of their patients.

“When receiving dialysis at night the patient must remain awake most of the night, which has a profound impact on younger patients who are trying to hold down jobs and family carers.”

Sources at the hospital say there are patients waiting to begin dialysis who cannot, due to lack of a capacity.

In response to a query from the Limerick Post, a hospital spokesman said that “due to the growing number of patients who require this treatment, we have reached maximum capacity in the Dialysis Unit at UHL”.

“We continue to support patients who are suitable for home dialysis therapies and we are also proposing to establish a second satellite haemodialysis centre in Ennis, County Clare.

“The tender process for this contracted satellite haemodialysis unit in Ennis is now complete a preferred supplier has been identified. While the tender procedures are finalised, the HSE Mid West has identified funding to support the commencement of this vital service as soon as possible. The steps to finalise these arrangements are ongoing.

“In view of the current capacity constraints, we are considering the extension of the out-of-hours service to ensure patients who require dialysis continue to have access in the region.

“We are currently engaging with staff on this proposal. Among the determinants for offering this extended out-of-hours service would be that the patient is able-bodied and preferably living in close proximity to the hospital.”