The Government's plan to allow nurses to prescribe medicines in certain circumstances is facing further delay, pending a detailed consultation process involving all interested parties.
The plan was announced by Minister for Health Mary Harney last October when she said it would be law by Christmas.
The consultation process is expected to be launched by the Department of Health in early summer. This means prescribing by nurses is unlikely to begin before the end of this year.
Yesterday, Tim O'Malley, Minister of State for Health, told delegates attending the annual Siptu nursing convention in Sligo that the Government introduced the necessary amendments to the Irish Medicines Board (Miscellaneous) Provisions Act before Christmas to enable Ms Harney to make regulations to allow for nurses prescribing. But he said these regulations could not be drawn up until a consultation process had been completed.
On a separate issue, Mr O'Malley appealed to nurses, particularly those in the mental health services, to speak up if they felt patients were being overly medicated. "Doctors are not always right," he said.
Delegates expressed concern about a new system for administering medication in the intellectual disability sector, whereby all medications to be given to an individual patient on a given day arrive from pharmacies in pre-prepared packs with the patient's name on them but with no details of what type of tablets are enclosed. Seán O'Toole, a nurse in Dublin, said this practice should be reviewed in the interests of patient safety. There could be tablets missing or too many enclosed and a nurse would be held responsible, he said.
"This is certainly an issue that raises a lot of concerns in the profession. We have gone along with it to date, but are we waiting for something to go wrong and then be asked why did we not complain about it?" he asked.
Jimmy Stenson, a nurse in Mullingar, said nurses needed to be able to clearly identify what drugs they were administering.
Helen Murphy, a nurse at Galway's University College Hospital (UCHG) said the problems in A&E units were a symptom of the crisis in the entire health service.
One issue rarely highlighted, she added, was the plight of patients whose operations were cancelled on a regular basis, even after they had already been admitted. Sometimes these patients would occupy beds for days, she said, because they would be told by their consultant to hang on until their operation was rescheduled - if they went home, there was no knowing when they would get a bed again.
"Nurses are regularly having to work short on the wards and continuously having to prioritise, knowing they should be delivering better care and taking time to reassure patients," she said.
Mary O'Keeffe, also a nurse at UCHG, said all the money paid on staff overtime would be better used employing extra staff.
Another delegate said healthcare facilities should not be built without staff having an input. He claimed a new mental health facility in Cashel, Co Tipperary, would have to be renovated before it opened as some walls and doors were in the wrong place. The Health Service Executive in the southeast insisted when contacted, however, staff were involved in building design.
Concerns were expressed by delegates in the mental health and intellectual disability sectors that they were expected to treat assaults as normal. Mr O'Malley said violent attacks on staff and patients were totally unacceptable. "More work needs to be done on prevention of violence and, in cases where incidents occur, in ensuring the proper support structures are in place for staff who suffer assault while carrying out their duties," he said.