Poor funding just adds to suffering of our patients
We can't continue to operate a healthcare system that is failing on so many fronts, says Janice Smyth
Health service reform, increasing pressures and not enough nursing staff are all issues that have been facing the health service here for the past few years.
In spite of promises to support frontline staff and well-intentioned measures to change the system, patients are still not getting the quality of care they deserve - or, indeed, that nurses want to provide.
The Royal College of Nursing (RCN) has already said that it supports Health Minister Edwin Poots' vision of shifting the focus of care-provision from acute hospitals towards greater reliance on treating people in their homes and communities. And nurses must be right at the centre of this process.
Several of our emergency departments are at breaking-point, with patients waiting on trolleys to get hospital beds and nurses left facing the public and apologising for a system that is not working.
Nurses voices are either not being heard or are being ignored. Directors making decisions around a boardroom table need to listen and act when nurses raise concerns about patient care, as they are professionally required to do.
Nurses are operating within a financially-driven system that appears to care little about the impact upon frontline services, patient care or patient experience.
It is a system that de-humanises care, is preoccupied by targets, trolley waits, delayed discharges, waiting lists, length of stay and breaches; a culture that describes cuts in staffing as staff productivity.
Staff productivity in nursing has meant leaving nurses working in teams short-staffed, or with caseloads that are unmanageable.
The RCN is concerned about the lack of appropriate care pathways for patients suffering from chronic conditions. When these patients require hospital admission, or diagnostic tests, often the only way they can access the hospital is via an emergency department.
These departments are not designed to provide facilities to enable dignified care for patients, such as personal care, toileting, eating and drinking. Emergency departments are for the assessment, diagnosis, treatment, discharge or admission of patients.
These issues are compounded by inadequate nurse staffing-levels to deal with such a high level of demand. Unlike other professional groups, most nurses have little control over their workload.
Nurses co-ordinate the care of patients and work with other professionals to ensure that the patient receives the care and treatment they require.
When this is not available, it is nurses who are left to pick up the pieces and to monitor and care for the patient until such times as the other services required by the patient are available.
Cuts to other services impact negatively on nursing care when an already-overloaded nursing workforce is required to carry out additional tasks, such as administration, or portering.
The RCN believes that the people of Northern Ireland and their elected representatives must accept that the existing structure of the service cannot be maintained.
There is an urgency to progress implementation of the Compton Review. The RCN is up to the challenge of building a health and social care service that is focused on patients and clients.
We need leadership and support from our leaders to ensure no other vulnerable members of our society are waiting for hours on treatment.
The time has come to stop trying to make the unworkable work and the unacceptable acceptable.