General healthcare rules indicate that a nurse should have an average of 4-5 patients to look after but with the manpower situation being as it is, this has become closer to 12. The situation gets worse at the ITU where nurses who are supposedly concentrating on one patient often have to deal with as much as 3 or 4 patients. Putting it simply, government has extended health services without essential manpower which clogs the whole system.
Although we have seen an active international campaign to recruit nurses from foreign countries, the huge shortage of around 700 nurses which are needed to run our healthcare system more efficiently will not be addressed anytime soon . Attempts to employ around 30 nurses from Pakistan have been mired in visa problems. The stark fact is that this recruitment intake will not even make for the 100 or so nurses lost to retirement this year..
We all remember that before EU accession, former Health Minister Louis Deguara had told the Prime Minister that there were sufficient nurses in the Maltese Health care system. This resulted in a numerus clausus on nursing courses at university of just 50 with their stipends slashed from the highest level of stipends to the lowest in the entire university.
The situation at Mater Dei continues to take a turn from the worse due to the lack of planning where all support roles are being dumped onto nursing staff. Transferring of medicines from the pharmacy to the wards, clerical work, data input, transporting patients and running errands are just a few of the roles that nurses are expected to fulfill alongside their jobs. This is a situation which clearly cannot go on as nurses are certainly not trained for this kind of work.
To add insult to injury, nurses are being removed from the wards where they work in and placed in other areas, taking them out of the environment they are used to and putting further pressure on the nurses left who are trying to cope with the added workload.
Overcrowding is another common problem. A maximum of 26 patients are often taken into a 20-bed ward. At night, the staff send these extra patients away, finding them a bed wherever possible in the health system. However, during the day, if a patient needs to lie down, they have to fight for a bed – truly humiliating when one is already demoralized by illness.
The long-term plan of better community service, making available health care professionals to the homes of people who may be bed-ridden but do not require hospital facilities has to be implemented without delay. Apart from increasing the well-being of the patient, this will also remove pressure from hospitals, leaving nurses to tend to those patients that really require hospital care.
We need to move away from the polyclinic attitude to primary health care, where patients are required to attend a clinic for services. This is a 1970s attitude that the rest of Europe has moved away from in order to provide more patient-based services. But how can this happen without adequate staffing levels of midwives and nurses is the question the government should be asking? The reply is definitely pie in the sky for now.