Death of Aoife Johnston (16) left nurse manager 'absolutely broke', inquest hears

The clinical nurse manager who was on duty on the weekend that 16-year-old Aoife Johnston died from sepsis, said the ordeal left her “absolutely broke” professionally and personally. 

Nurse Katherine Skelly told the Limerick Coroner’s Court at Kilmallock Courthouse that she “never worked in A&E after that weekend”. 

She confirmed to Damien Tansey, senior counsel representing the Johnston family, that she made that decision because of Aoife’s death. 

She described to the court an emergency department (ED) that was "understaffed and overwhelmed". 

Despite having sepsis markers, antibiotics were administered to Aoife at 7.15am the morning after she arrived to the hospital and Nurse Skelly agreed with Mr Tansey that at that point, she was "beyond recovery". 

She described the situation as constantly “fire fighting” saying they were in crisis and with the weather warning in place, there were a lot of injuries due to accidents or falls. 

Telling the court about her shift that weekend, Nurse Skelly said was she observed was "akin to a war zone". 

She said “trolleys were back to back” with “patients lying or sitting in every nook and cranny”. 

There were 130 patients in the emergency department on Saturday, December 17, which she described as being "a critical and unsafe situation".

By the time she returned on Saturday evening for her next shift, that had escalated and there were 160 patients in the emergency department. 

She told the court there were 15 nurses on duty, while the correct allocation should have been 20 and that weekend, they could have done with 30. 

On the night of December 17, she rang two consultants and asked them to come in, one declined saying they had already been in that day and would return in the morning and the other declined, but later came in. 

Nurse Skelly said the situation was so dire that a number of people left the hospital without being seen in “complete desperation”. 

She said: “This is the situation in the emergency department for far too long.” 

She said that overcrowding at UHL has become the norm, rather than the exception. 

The triage nurse, Ariane DeGuzman, said that Aoife had abnormal rates in her temperature, blood pressure and heart rate. 

Requests from triage for Aoife to be put into the resuscitation unit (resus) so that sepsis care could be started were not followed. 

The court heard that this was because the resus was overcrowded. 

She agreed with Mr Tansey that if she had been in resus sooner, she would have come to the attention of a doctor quicker. 

The inquest continues tomorrow in Kilmallock.