During a recent hot spell that saw parts of Ireland climb to over 30 degrees, healthcare workers and patients in poorly equipped hospitals, clinics, and nursing homes experienced searing temperatures, leading to unusual rashes, fainting, and difficult working conditions, according to doctors and nurses.
Cashel Older Persons Residential Services Heat Conditions
Nurse Alice Carew, who works at Cashel Older Persons Residential Services in County Tipperary, compared her working conditions to “the meat in a toasted sandwich” as high temperatures gripped the facility. Speaking to The Journal, Carew reported that the building dates back to the 1930s and is poorly equipped for extreme heat. The facility houses approximately 60 patients over the age of 65. Carew’s ward, Croí Óir, accommodates 19 patients across the first and second floors of a two-storey structure featuring large windows that open only a fraction of an inch and no air conditioning. According to Carew, the building features a massive concrete roof from a COVID-era renovation that draws in heat during the day and releases it at night, boxing in staff and patients from all angles alongside rising heat from the ground-floor kitchen.
Hospital Infrastructure and Building Design Challenges
Dr Mick Molloy, chair of the Irish Medical Organisation Consultants Committee, told The Journal that similar conditions occurred in his hospital, noting that many Irish hospitals were built in the 1950s, 60s, 80s, or 90s with engineering focused on retaining heat rather than expelling it. Molloy explained that small waiting rooms featuring numerous windows let in large amounts of heat, creating uncomfortable environments for individuals already suffering from heat or sun exposure, a situation worsened by a lack of blinds. The Health Service Executive (HSE), when asked about the Cashel home, stated that older facilities present challenges in maintaining consistent temperatures due to orientation, fenestration, and older heating systems, adding that while air conditioning is present in many facilities, passive cooling can also be achieved through solar shading, thermal mass, and natural ventilation.
Ventilation, Morale, and Equipment Challenges
Staff members faced ventilation hurdles during the hot spell. Carew noted that the one or two fans on her ward only circulated warm air rather than providing active cooling, and posed infection prevention concerns by blowing the infection around. On the neighbouring ground-floor rehabilitation ward, Niall Kennedy stated that staff brought in their own fans because the HSE provided none. “The fans raised the morale,” Kennedy told The Journal. “You have to problem-solve the whole time in the health service – it’s how you get along.” Carew added that requests for air conditioning units in previous years went unanswered due to funding, time constraints, and legislation affecting older building updates. Furthermore, Carew described medical-grade mattresses and cushions as unsuited for hot weather because their coated, waterproof materials trapped heat and perspiration, while nurses wearing medical-grade clothing during eight- to 12-hour shifts dealt with heat, sticky conditions, and menopausal hot flushes.
Medical Impacts on Patients and Emergency Admissions
The heat caused a rise in emergency department admissions. Dr Molloy reported an uptick in patients arriving with dehydration and adverse medication side effects, noting that certain antibiotics for chest and skin infections—specifically Doxycycline, Ciprofloxacin, and Tetracycline—increase sun sensitivity and can cause extreme rashes if patients do not avoid the sun. Molloy stated that two patients were admitted in the last week with these symptoms. Orlagh Gaynor of Irish Doctors for the Environment noted that heat links to more emergency department visits for heart attacks, strokes, kidney injuries, and other conditions, warning that many patients remain unaware of health dangers at temperatures as low as 25°C. Additionally, Molloy stated that an average of six to eight patients per week were admitted to the ED for fainting caused by low blood pressure, explaining that the body expands blood vessels near the skin to lose heat, which can cause blood pressure to drop when standing for long periods or taking blood pressure-lowering medications.
Vulnerable Patient Care and Future Outlook
In Tipperary, nurses had to closely monitor vulnerable residents who lacked mobility or the cognitive capacity to communicate thirst due to conditions like dementia, multiple sclerosis, or stroke. Carew explained that staff relied on closing blinds and curtains to block sunlight, though it reduced residents’ view of summer, and faced challenges ensuring non-verbal patients received adequate fluids. To address these extreme conditions, Dr Molloy recommended installing more fans and air conditioning, making structural amendments to improve airflow, and engineering future buildings differently to prevent heat accumulation, while the HSE emphasized that its focus in healthcare settings remains on early recognition of heat-related illness, maintaining hydration, and keeping patients and staff cool.
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