Staff at Landspítali’s emergency department in Fossvogur say conditions have reached a critical point, with more than 100 patients regularly being treated in facilities designed for just 36. In a resolution adopted at a meeting of 180 staff members yesterday, workers warned that overcrowding, understaffing, and inadequate facilities pose a serious and ongoing threat to the safety of both patients and employees, reports RÚV.
The meeting was convened by the chairs of the Icelandic Medical Association, Efling (the trade union), the Icelandic Association of Ambulance Personnel, Sameyki (public sector union), and the Icelandic Nurses’ Association. The state of the emergency department was described as worse than ever before.
According to the resolution adopted at the meeting, Alma Möller, former Director of Health, now Minister of Health, confirmed in a memo in June 2022 that the emergency department did not meet professional standards due to overcrowding, excessive numbers of patients, and understaffing. As a result, it was not possible to guarantee patient safety or the quality of care. The resolution also refers to Alma Möller’s statement that, in reality, the correct course of action would be to close the department — though this was not a realistic option, as it is the only one of its kind in the country.
“These serious statements by the Director of Health were ignored. Since then, the situation has not improved, but worsened,” the resolution states.
It adds that, on average, more than 100 patients are accommodated in facilities designed for 36.
“Isolation is impossible, the safety of agitated or unstable patients cannot be ensured, and oxygen cylinders and other equipment are stacked in the corridors of the emergency department like firewood, creating an obvious fire and explosion hazard. This constitutes a serious safety risk for staff and patients, and with this number of patients, working conditions for staff are completely unacceptable,” the resolution further states.
For a long time, the emergency department has been caring for inpatients who should already have been transferred to appropriate wards. It is not the role of the emergency department to operate a de facto double ward on top of emergency services. “This paralyses the emergency department’s response capacity and prevents staff from having the space and calm required to carry out their legally mandated duties in receiving and treating the injured and acutely ill.”
Staff are therefore forced to work in conditions that go against their professional knowledge and recognised standards of good and safe healthcare. “Staff and patients are placed in situations where the risk of infection, accidents, violence, and serious consequences is clear and ongoing,” the resolution states.
An outbreak in December, when eight staff members in the department were diagnosed with tuberculosis, underlines the consequences of inadequate infection control and facilities that do not comply with laws and regulations.
The meeting participants put forward several demands in the resolution: that the workplace comply with laws on health, safety, and working conditions, and that immediate action be taken, as a persistent and worsening state of emergency is in place. This situation must be addressed without delay.
They further demand that the authorities with statutory responsibility respond immediately and follow up on previous comments, assessments, and committee findings:
The Office of the Director of Health must firmly follow up on required improvements following its assessment of the department’s conditions.
The Administration of Occupational Safety and Health must conduct a comprehensive inspection of staff working conditions and respond to violations of occupational safety legislation.
The Environmental Health Authority must assess conditions with regard to hygiene and infection control.
Fire safety authorities must follow up on their assessment of fire hazards related to oxygen equipment and overcrowding.
The Data Protection Authority must examine conditions with regard to privacy and the protection of patients.
Health authorities must conduct an assessment of patient harm and mortality in relation to length of stay in the emergency department.
“The safety of patients and staff must no longer be treated as an acceptable sacrifice. It is wholly unacceptable that these conditions have been allowed to persist for years despite repeated warnings. Instead of promises, we demand concrete improvements. Those responsible for governance and oversight in the healthcare system must assume responsibility and exercise their authority immediately,” the resolution concludes.
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