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Dublin: 10 °C Thursday 23 May, 2013

Nurse staffing levels “critical”, says INMO

The organisation said that nursing staffing levels in Ireland are at “critically low levels” compared to the UK.

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NURSE STAFFING LEVELS in Ireland are “critical” compared to the UK, the Irish Nurses and Midwives Organisation (INMO) has said today.

It has published comparative figures on staffing levels in Ireland compared to their UK counterparts, and say they have also drawn together international evidence that confirms a reduction in nurse staffing levels “negatively affects patient care in terms of higher mortality rates, increased adverse events such as patient falls, medication and transfusion errors, and delays in treatment.”

It also found that inadequate staffing is associated with longer lengths of stay and increased rates of readmission, both of which lead to increased healthcare costs. It says that this research “showed that poor staffing levels increase the risk of burnout amongst nurses which in turn increases the risk of poorer patient care”.

The figures show that in elderly care wards in Ireland, there were 121.87 less total care hours available on the ward per week, compared to the UK. On medical wards, there was 131.25 less hours per week in comparison, while in surgical wards there was a deficit of 225 total care hours compared to the UK.

Admissions and assessment units had two less staff on at every part of the day compared to their equivalent in the UK.

Standards

Speaking today, INMO General Secretary, Liam Doran said that all of this evidence, coupled with the inquiry into deaths at the Mid Staffordshire NHS Foundation Trust which found that the period investigated was characterised by cuts in staff and changes in skills ratios, “cannot be left unchallenged”.

He said:

Our members, without exception, are under unbearable pressure striving to provide safe practice and safe care to their patients/clients.
It is now time for the Minister for Health and the Government to take stock, look at the evidence which confirms our staffing levels are unacceptably low and to acknowledge that where there are poor staffing levels, patients suffer. They must, once and for all, lift the recruitment ban on frontline staff and put the ‘health’ back into the health service.

Doran said that the INMO will now be seeking an early meeting with the Oireachtas Committee on Health to present to them the results of this comparative study, together with the international research findings of the value of a registered nurse.

It will call upon them to initiate a process leading to safe nurse patient ratios in all areas of the Irish health care system.

Speaking in the Dáil today, Fianna Fáil Social Protection Spokesperson Willie O’Dea raised the report, and asked the Tánaiste if he was going to organise risk assessments for these staffing levels.

Read: Irish nurses and midwives to march against health cuts>

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Comments (30 Comments)

  • To put this into perspective: the ratio should be no more than one nurse per 5 patients. (High dependency / observation care excluded – HDU, ICU, CCU etc.). In Ireland the ratio is very often one nurse per 8-10 patients, and God help you if you’re on the night shift.

    Reply
    • Megan 30/11/12 #

      I’m starting my internship in January as a general nurse and I am dreading it!! HR have put the fear of God in us! This is what we were told a few weeks ago in preparation for our internship;
      - no horse riding, skiing or any activity that could cause injury leading to you missing time. It’ll look bad when you apply for a job.
      Basically, the impression that HR left us with is that nurses don’t have lives outside the hospital, the clinical placement coordinator even told my friend (who’s a competing rower) that nurses tend to go for hobbies that don’t require such commitment.
      I left the hospital that day wondering what the hell am I at, going for a career that apparently expects you to give up everything for it. And a lot of my class felt the same.
      We know girls starting internship in Galway&they can’t wait for it, they love being on the wards! But for us, in our Dublin 4 hospital, we’re dreading it!!

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  • As if the workload & pt to nurse ratio is not enough to deal with!!! They no longer care what pts go where!!! Surgical nurse working on surgical ward with surgical experience now expected to look after stroke patients, along side our high dependant surgical pts just out from icu post major bowel surgery & sure if that not enough throw in the confused wandering, awaiting long term care pts as well!!! And sure what the hell if we short staffed!!! Never get out on time because we do care!!! Evening breaks on 12 hr shift are thing of past!!! & anyone that says nurses wages are too much lol come down for one shift & do our job!!!! We are doing our best for ur family members under extremely difficult conditions!!!

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  • I work on a very busy surgical ward with a high turnover of patients. Never get out on time, regularly skip breaks cos I’ve too much to do and often don’t get to provide the best care possible because its impossible due to time constraints. We’d regularly be short staffed. On days that we’re short staffed u can be caring for 12 patients, even days with a full compliment of staff I cud have 8-9 patients. It’s madness but the management don’t care once they keep the costs down!! We try get our voices heard and advocate for our patients but they don’t listen once they’re saving money…only qualified a year and it won’t be long before I’m burnout from the hectic stressful days!!

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  • It gets pretty crazy when your 1 to 25 in long term care or ID with agressive behavour wards.. I remember the days of 1 to 10-12 in multi organ transplant but now they are 1-4-or 5 these days.. I feel for the patients, families colleagues and middle management.. HSE has alot of fine tuming to do! It’s getting too dangerous! It’s just not worth it to go home everyday not feeling you finished your shift or worked to your capabilities in person centred care.Thats with excellent time management and 20 years experience! hHh I feel for new grads, agency and the nurses not only working under those ratios but also guiding and directing all shift! Our professional practice enviroment needs enabling of new staff so other staff members are not overwelmed by the barage of needs and wants of patients, families , medical staff, collegues, .. the list goes on while maintaining quality of care! They say males can only do one thing at a time but I tell ya multitasking in nursing is basic surival these days with these unsafe nurse to client ratios!

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  • Aisling Mulvenny … your career has just begun.. the learning curve is on.. if you survive now your career will become better in time.. hang in there and all the best.. even after 20 years on crazy med surg wards the numbers are tough .. I can just imagine how you feel! just think how your colleagues feel when they have to guide and direct all day to students, agency etc! Personnally with these salaries .. 1 more year.. the game is on, if you have no ties get up and go! For 5 years I went to saudi and pay was better than a matron band 3 here today in 1999! No taxes, 52 payed holidays, paid trip home everyyear,.. great working conditions 1-4 ratios,,, 1-2 in ICU’s.. top quality care! Not driving and losing some freedoms is well worth the experience! I met my wife there,,alouped to cyprus, first son in ryadh. Man o man I would go back in a second if I didn’t have 3 young kids! All the best in you future endaevors! (ps a didn’t do a sp check)

    Reply
    • I went to Saudi in 2000! Spent 4 years there just after qualification! Amazing experience, definitely worth it! Spent 7 years in the US, returned in May to Dublin. Having travelled with MSF, and worked in many environments, I find it allows you to provide a far more wholesome level of care. Opens the mind if you will!
      Rgds! J.

      Reply
    • Travel and broaden your horizon Aisling the boys are right it’s a great learning experience and it also gives you a confidence that nurses that remain in their teaching hospital lack.

      Reply
  • From my personal experiences of being in hospitalisation I can only say that in my opinion nurses in this country are undervalued , under staffed and underpaid !!!

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  • Paddy too difficult to find staffing for 8 hour shifts! Skeleton staffing .. more stress then it’s worth!

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  • Sounds like 2006 numbers Gunn! Gunn from experience of 20 years nursing I’ll tell ya.. the numbers are bad! its not the numbers game.. it’s the quality of the enviroment and the safety of pts!

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  • These are the reasons I moved my entire family to Sydney. The pressure and stress your put under to continue to provide high levels of care to our patients, and management, right to the top of the Dept of Health, only care about money and saving their own asses

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  • Nurses are unsung Heros and most of them are hot

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  • @Ben.The WHO figures carry a caveate at the end re how the numbers are calculated on Ireland.They are based on numbers registered with Bord Altranais and NOT necessarily all those currently working in the HSE.

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  • Very odd numbers. According to WHO Ireland has 157 nurse per 10,000 population whilst the UK has 107 per 10,000. If they are not in the hospitals, where are they?

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  • 57 nurse per 10,000 population whilst the UK has 107 per 10,000 IS THE NOT ISSUE! How many beds are open, accessabilty, trolly numbers, safety….acuity v.s chronic care… all these numbers show how basic of calculations this 57/10,000 population by WHO… Include all the varables and odd ratios v.s acuity/hospital could get a clearer number of needed nurses then generalising what you need / population! daily ratios , acuity of care and amount of nursing/hrs / pt should be piloted with results of variances and improements being published…You can find some on the INMO website and the results of this collaborative study! We are at critical levels!

    Reply
  • More staff and more efficiencies needed badly! Things like electronic charts would be a start to help cut down on duplication, but the numbers need to be there too! Also would it not be better to have 8 hour shifts instead of 12. This way night shifts wouldn’t drain staff out as much. Same amount of hours but just better spread out. Don’t get me wrong, I don’t work in health but often wondered if it would be better to have shorter shifts

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  • PS sp. hope you don’t mind the typo’s!

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  • you have one intern doctor covering 4 wards… don’t think they have that much to complaint about.. Irish nurses get way too many breaks.. coffee tea 3 4 times a day. protected time, what more

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    • I’m a nurse, I cover an entire hospital. I work 36hr shifts, in fact this week I will work 72 hours. That’s assuming I leave on time today (Friday). The worst thing about that is the fact that I don’t know if I’ll get paid for the extra 32hrs of my time donated, as this is largely due to the mood of HR at the time that I submit my time sheet.
      My coffee break is my walk between patients, my lunch break (the protected one), is a 5min gap when I just happen to remember that I have to eat and am near the coffee dock at the same time as this realisation hits me.
      I agree interns have a difficult life, but not all nurses work 2 12hr shifts a week with protected breaks and lunches and leave time. Some of us work bloody damn hard, and I’d thank you to remember that. Regards, J.

      Reply
  • We’ll be fine folks Reilly has said Doran is wrong. Once James “stroke” Reilly has opened his 2 primary care sites in Balbrigian and Swords the ill of Ireland will be saved.

    Reply

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