The health and safety of patients and staff in hospitals and long-stay units for the elderly is being put at risk on an ongoing basis by a failure to address dangerously- low staffing levels, nurses claimed yesterday.
In one unit in Leitrim there is just one nurse on duty between 5.30pm and 8.30am to care for 40 patients, the annual conference of the Irish Nurses Organisation in Killarney was told.
Marian Quinn, who works at Áras Carolan in Mohill, said this was despite the fact that some 28 of the 40 patients in the health board community nursing unit had high dependency needs.
"It's extremely difficult. You could have a patient dying and another in need of transfer to an acute hospital, and still you have full responsibility for all the other patients at the same time," she said.
While she said she would be helped by two care attendants on night shifts who were great workers, there should be two nurses on all shifts so that they could support each other if there was a major problem.
If anything went wrong she would be held accountable, even though she couldn't attend to all patients at the same time, she said.
"Over the last few months we had an episode of a gentleman trying to break in one night. He was in and only had to jump down off the window when he was noticed by a care attendant and he fled. This puts staff and patient safety at risk," she added.
Ms Quinn said the issue was raised with former minister for health Micheál Martin at last year's INO conference and he said such a high nurse-patient ratio was unacceptable, yet nothing has changed.
The matter had also been aired at the Labour Court which rejected an INO claim for an independent review.
The INO wrote to the Minister for Health Mary Harney about the matter on April 21st and has not yet received a reply.
The letter stated: "The HSE have taken the position that our staffing levels are satisfactory, in direct contrast with the position stated by minister Martin".
Ms Harney will be asked her view on the staffing levels when she attends the INO conference today.
Other nurses also gave examples of similarly high nurse-patient ratios. Ann Gallagher from Meath said she worked in a unit for the elderly where there was just one nurse looking after 37 patients at night.
Calling for minimum nurse-patient ratios to be set for all healthcare settings across the State, Gaye Griffin, a nurse in the east region, said a study by the University of Pennsylvania's School of Nursing in 2001 found that increasing the number of patients a nurse cares for from four to eight increases the risk of death by 31 per cent.
Furthermore, she said the Australian state of Victoria had introduced a system whereby there had to be one nurse for every four patients in city hospitals, and one nurse for every six patients in smaller hospitals.
This had drawn nearly 4,000 nurses back to the workforce and Victoria was now the only state in Australia with no nursing shortages. The move had also increased morale, decreased sick leave and staff turnover.
Meanwhile, nurses were urged yesterday not to be afraid to speak out about conditions which they felt endangered patients.
A male nurse in the UK who spoke out about inadequate staffing levels was fired some years ago, the conference heard.
But the INO is seeking statutory protection for nurses who "blow the whistle" on unsafe practices they find during the course of their work.
Yesterday it published a position paper on the protection of nurses and midwives upon disclosure of practices of concern in the workplace.