Nurses and midwives are working in "horrendous" conditions and are suffering from stress and burnout, as it emerged that more than 100,000 patients have been left waiting on trolleys in Irish hospitals this year.
The Irish Nurses and Midwives Organisation (INMO) has warned that staff are "stretched to the limit", with staff shortages reported across the country.
The INMO has called for the Government to bring in measures needed to retain nurses and midwives to help address the crisis.
In analysis released on Tuesday, the INMO said more than 1,903 children have been waiting on trolleys.
This is the earliest in the year that this high a number of admitted patients has ever been recorded, according to the INMO.
The INMO has been warning of unprecedented overcrowding in 2022 since early summer.
INMO general secretary Phil Ni Sheaghdha said there is not enough investment in adequate staffing.
Ms Ni Sheaghdha said the health service is now "completely dependent" on recruiting overseas nurses and midwives because of the exodus of such workers.
Midwives are being recruited from Ghana and other African countries to plug the staffing gap.
"A country like Ireland, because of its bad policy, because of its lack of investment is now going to these countries and taking their essential workers, and that, the Minister for Health has said, is a policy that Ireland will not tolerate," Ms Ni Sheaghdha said.
"But as late as yesterday, that situation was happening in Ireland."
READ MORE: Ireland's vulnerable elderly waiting 24 hours on trolleys for admission to Emergency Departments
The bigger hospitals are suffering the most, particularly in emergency departments, with departments down around a quarter of staff.
"We have a new children's hospital that's going to open very soon. The Children's Hospital have said to us, we know we're not going to get staff to work in it because it's just too expensive to live in this city," she added.
"We have exactly the same problem in Galway, we have exactly the same problem in Cork."
Ms Ni Sheaghdha called on the government to set a date to bring in the new public sector pay deal.
"We say to the HSE and the government that the thing not to do now is to not prioritise paying staff what they're owed on time, because that is essential," she added.
"We have to look after our students so that when they do qualify, they say, 'this isn't a bad place to work'. They're not saying that at the moment, and there is no evidence that that will change.
"This year we have registered just over 1,400 nurses who have qualified here and we've registered 3,500 from non-EU countries.
"We are forcing our own to emigrate and then going to non-EU countries and robbing them of their essential workers. There is something fundamentally flawed with that."
The five worst-hit hospitals so far this year are University Hospital Limerick with 15,322 patients left on trolleys; Cork University Hospital with 10,107 patients; Sligo University Hospital with 6,919 patients; St Vincent's University Hospital with 6,359 patients; and Letterkenny University Hospital with 5,366 patients.
The trade union has called for non-urgent elective care to be cancelled in public hospitals and private hospitals used for this work.
It calls for the introduction of retention measures, including provision of accommodation for essential workers such as nurses and midwives - particularly in rent pressure zones.
The union has also called for legislation to underpin the implementation of the safe staffing and skill mix framework, and the prioritisation of funding for publicly delivered long-term care in the community.
Karen McGowan, president of the INMO who works as an advanced nurse practitioner in a Dublin hospital, said that conditions are "horrendous".
"Every day they're fighting in the conditions that they're in and these are real people behind these numbers, real men, women, children," Ms McGowan said.
"Imagine if you walked into an emergency department, what that must be like to be that person, sitting on that chair, lying on that trolley and not knowing when you're going to get a bed or when your operation is going to be done.
"We're witnessing people on waiting lists becoming so sick, they have to come to the emergency department and then they have an emergency operation as a result of waiting so long.
"This is horrendous for our members. It is bearing a certain amount of trauma and this is a symptom of the last couple of years that they've been working through and they cannot stand it any longer. They are making the decision to leave this broken health system."
Mary Tulley, a public health nurse, said staff are "stretched to the limit" and are suffering from stress and burnout.
She said there are currently 600 nursing vacancies, with many of these in Dublin.
"There is a huge issue with staff shortages. There are 14,080 public health nurses to cover all of Ireland," Ms Tulley said.
"There are 600 vacancies at the moment. We are training 110 student public health nurses and that won't even replace the nurses who are going to retire next year.
"If we have a shortage of staff in the community, there is going to be missed care.
"Without adequate staff, services cannot be provided. Clients and patients end up back in hospital because of missed care."
Sinn Fein leader Mary Lou McDonald said that one in four beds that are publicly funded have not been delivered.
"Over 1,000 patients in the hospital can't get access to home care, so that delays their discharge. So what we have now is chaotic," Ms McDonald told the Dail on Tuesday.
"We need investment in our hospitals but also in home care and community care."
Minister for Public Expenditure Micheal McGrath said the Government needs to increase capacity of the healthcare system.
"It is the case that we are being faced with an unprecedented number of presentations.
"In our acute adult hospitals, we're seeing more older people and more sick presenting, and it just underlines the need for us to continue to increase capacity.
"I accept the point we have to build up the permanent capacity."
