A chara, – As I look back on my career in hospital medicine over the past eight years, I can honestly say that the cases Ann Marie Hourihane describes (Weekend Review, April 27th) are unfortunately relatively common in our health service.
I have met the dedicated and often frustrated relatives she describes and oftentimes it was so frustrating for me to try to explain how little the service can offer them. But at the frontline of the service you are the person that people see and people blame for these issues even though you may have little or no control over them. You find yourself trying sometimes to defend these practices and your nursing colleagues because you know that the issue is not that the nurses or the doctors don’t care about the patient.
I have worked with some of the most dedicated staff and they are so frustrated at having to ration care on the wards. On a ward of 30-40 acutely ill patients, four to five nurses and a health care attendant are simply not enough to provide the level of care required. The wards are not staffed enough for someone to sit down and spend time feeding or cleaning the patients. This is sad but true.
Priority is given to the very acutely ill, to documentation and to the administration of treatment. Simple issues such as feeding and personal hygiene are often neglected in favour of these.
I have observed that the nursing staff over the years have seen their administrative load increase and the amount of documentation expected of them is ridiculous. I have witnessed nurses being reprimanded for not adequately completing documentation.
Oftentimes I have had to conduct ward rounds without the nurse present; I have had to do procedures without the assistance of a nurse and have had to have meetings with families without the patient’s nurse present. It’s not their fault – they just don’t have enough staff on the floor to do everything.
I feel sorry for the patients sometimes because they put up with so much. Some of the elderly patients, in particular, are so vulnerable. They deserve better.
It is professionally embarrassing for me, to stand in the emergency department at three in the morning and find myself trying to defend the service to the relative of an 80-year-old patient on a trolley for hours.
I would rather not be put in that position, but unfortunately, as resources are cut and hours are cut, and savings are made, someone has to pay and it’s the elderly, the infirm and the sick who are footing the bill. – Yours, etc,
Dr YVONNE RYAN,
Addison Park,
Glasnevin, Dublin 11.