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Opinion: 'An enormous burden falls on the shoulders of our nurses in Ireland'

Our healthcare system in Ireland needs our nurses more than ever but measuring their performance has not been a priority, says former INMO General Secretary Liam Doran.

Liam Doran

SO OFTEN ONE hears the same comment from friends, relations or neighbours here in Ireland who have had a brush with illness and needed hospitalisation. And it’s always about nursing.

“I never realised how much the nurses do,” they say. That’s not to lessen the work of anyone else within our healthcare system in the Republic. All perform essential tasks. But the truth is that an enormous burden falls on the shoulders of our nursing staff and they cope with it with extraordinary humility, strength of character and skill.

Our healthcare system in Ireland needs our nurses more than ever but measuring their performance – and understanding where their efforts are most needed and how our dwindling resources can be put to best use – has not been a priority.

Hopefully the Futureproofing Healthcare Index, for which I have been an official adviser, can change that. Data has been collated from thousands of separate points across Europe to better understand which departments, systems and nations perform best. By analysing the figures, we can learn from each other and Ireland can seek to make the improvements it needs to create a more sustainable healthcare system.

Sustainability

The data shows that Ireland is performing well in terms of sustainability, setting it firmly in the top half ahead of countries such as France and the UK. But there is still much work to be done if we are to emulate the success of nations such as Sweden.

There’s a danger sometimes that we can be too satisfied with our own performances to make the kinds of changes we need to make. Complacency sets in. Measurements such as those that the Index provides help us to see the bigger picture. And they can also remind us of how proud we should be of the service we provide – our palliative care for those with breast cancer is rightly judged the best and hopefully other nations can learn from us.

The Index can be a tool which also helps us tell the difference between appearance and reality. That whilst we might appear to be doing a great job – and are able to convince ourselves that we are – the reality of people’s experiences might be different.

Clearly, the Index shows that when it comes to use of innovation and access to care, Ireland’s healthcare system falls short of our own expectations and needs to emulate the success of some European neighbours.

Equally, whilst organisations such as the media might focus on apparent problems within Ireland, data from the Index can show that the reality is very different. The perception we have here is not always reflected by the accuracy of the data.

Tumultuous 

Our healthcare system is in the midst of one of the most tumultuous moments in its recent history, and the scenario is being replicated across Europe. We’re living longer, hospital beds are being cut, staffing crises are reported, more of us are suffering from lifestyle diseases of our own making and a greater proportion of the elderly will be succumbing to dementia with every passing year.

If we are to make healthcare systems fit for our future – and enable nursing staff to do their jobs – we need to make decisions now. Not just in Ireland but across Europe. If we can inform that decision-making with detailed, well-analysed, simple to understand data, I’m convinced we can transform things for the better.

The Index’s data clearly shows that in Ireland we need greater access to diagnostics. On top of that, we need to be more efficient and focus on greater reuse. I think this is manageable within the cost space.

More significant reuse of the nursing profession in the area of the specialist – breast care nurses, advanced care practitioners in oncology, for instance – is also vital to make them more accessible. There is a target now of 2% in nursing going forward into advance practice. I think we can speed that up for the benefit of the patient in providing information, aftercare programmes and the like. And you can do that without it bursting the bank, within the existing resources.

By assessing the data, we can fulfil one of the primary needs in nursing – better workforce planning that will greatly improve the access patients get to the right care. This is especially true amongst the elderly. The sustainability of healthcare systems here across Europe is very much dependent on how we cope with the impending avalanche of care needs associated with dementia.

In addition, projects such as the Index – which is not perfect but is a much-needed step in the right direction – can encourage society to start taking care of itself. By measuring mortality rates and analysing the care costs of leading lifestyles that often create health problems in the future, citizens will be more likely to take their own preventative steps.

Healthcare does not begin at the GP surgery or hospital waiting room. It begins at home – what we eat and drink, how we spend our spare time and treat our bodies. We all know we must take better care of our health but sometimes we need the data to show that, to educate us and give the best advice to future generations.

Put simply, greater use of Ireland’s superlative nursing profession will improve patient care. But how we use those nurses, in what capacity and where, perhaps with the aid of certain technologies and handing them different responsibilities – all of these factors need to be considered. The experiences of other healthcare systems and how their nursing departments perform can be an indispensable guide to improving care.

The changes that need to happen will not be instant but they will be effective – because they are grounded in data. Hopefully, projects such as the Index can inspire Ireland’s decision-makers to have the debates and conversations amongst each other over how we can not only meet today’s healthcare needs but those of tomorrow.

Liam Doran is former General Secretary of the Irish Nurses and Midwives Organisation

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