Sir, - Padraig O'Morain's article in your edition of October 14th, while raising some pertinent issues regarding the problems facing midwifery, misrepresents public health nursing as a career. The notion that public health nursing is poaching midwives from a service that is already under pressure from staff shortages fails to acknowledge the problems facing all branches of nursing as they struggle to provide a service to individuals, families and communities.
The perception that public health nursing is a less stressful area of nursing is largely unfounded. It is facing the same staffing problems nationally with specific shortages in urban areas where housing costs are high. The job itself is stressful due to a lack of both human and material resources. The continual challenges of trying to provide a quality service is very taxing . Allied to this is the ongoing failure by policy-makers to acknowledge the pivotal role of public health nurses in the interface between people and their health services.
What is required in general terms is a new "joined up" approach that uses the knowledge and skills of all health service personnel in the community. It is essential that health policy acknowledges that individuals live in a family or community and not in a hospital. There is an opportunity to do this in the proposed new health strategy.
Integration of services across disciplines must be put at the centre of the strategy so that a seamless approach to health-care provision is ensured. This may require legislative changes such as a revision of the Health Act 1970.
Mr O'Morain highlights the critical issue of pay and incentives to make it possible for nurses and midwives to live in high-cost areas. However, he introduces a divisive argument that seems to imply that public health nurses are getting paid more to do a less important job. This detracts from the real issue - nursing and midwife shortages. - Yours, etc.,
Sylvia McShane, Lecturer, Public Health Nursing, University College Dublin, Dublin 2.