RCN director Pat Cullen: This was a first we didn't want but issues need to be addressed
This week, for the first time in the 103-year history of the Royal College of Nursing, nurses took industrial action.
And it was in Northern Ireland that this happened. Nowhere else, in England, Scotland or Wales, has this take place before. Northern Ireland was the first.
This is a first that we never wanted and certainly a first that I, as a nurse, never expected to see.
But it is a very clear indication of how deep the crisis in health care has become.
All of this has happened against a background of almost five years of pay inequality for health care staff.
So what is different now from five years ago?
There are almost 2,800 unfilled nursing posts within the health service in Northern Ireland.
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This figure has doubled over the past few years and despite attempts to recruit nurses internationally, there is no sign of being able to fill this gap.
Our inability to recruit and retain nursing staff is the reason that we must take urgent action to ensure there are enough nurses to provide safe and effective care to the people of Northern Ireland.
This is why restoring pay parity with the rest of the UK is so important.
Nurses' pay here has fallen significantly behind England and Wales, and further again behind Scotland.
There is nothing to stop our highly-skilled nursing workforce leaving to work in other places where they will be paid more and, crucially, feel more valued.
In particular, we cannot afford to lose our newly-qualified nurses at this stage of their career.
These are the nurses of tomorrow that we need to nurture and encourage to stay.
Last year, the health service in Northern Ireland spent £52m on agency nurses to fill the gaps in the nursing workforce.
We currently cannot do without these nurses.
However far too much money is being spent in filling gaps rather than fixing the problem.
We realise that these are complex problems and solutions will not be found overnight.
However, we need to start somewhere.
Nurses deliver the majority of direct patient care and are well aware of the problems in our health service.
They are also well aware that there are not enough of them to deliver the care they would like to be giving.
The RCN's recent employment survey revealed that around half of nurses in Northern Ireland are considering leaving nursing because of low staffing levels and almost three-quarters feel undervalued.
This confirms everything that we have been talking about over the last number of months.
Our message is clear and simple. We have been given a mandate from our members that enough really is enough, and we believe that the people of Northern Ireland agree with us.
Pat Cullen is director of the Royal College of Nursing in Northern Ireland