Public health nursing under strain, says union

The community and public health nursing system is under severe strain due to rising demand and falling staff numbers, a new report says.

Over half the nurses surveyed for the report said patients had missed out on care over the preceding week because of pressures on staff.

The Irish Nurses and Midwives Organisation (INMO), which commissioned the report, has called for the establishment of a commission to investigate the sector. It says the group should report back within a year on the role nurses should play in the primary care system and on the resourcing of their work.

The report found the main area of “missed care” was in health promotion, particularly in relation to older people and the management of chronic diseases. Nurses tended to prioritise clinical work such as injections or dressings or legislative obligations such as child protection at the expense of health promotion and disease prevention.

The care of older people on the risk register was identified as a particular challenge, with 70 per cent of nurses saying they had been unable to address this work in the preceding week.

Disadvantaged groups such as asylum seekers, the homeless, migrants and

Missed care

Travellers were most likely to miss out on care from a community nurse, the study by UCD’s school of nursing found.

Four out of five nurses reported not having the time to update case notes. And a lack of administrative support and inadequate staffing levels were identified as having a significant impact on the problem of missed care.

Co-author Dr Amanda Phelan said that while the population had increased and eligibility for public health nursing services was expanding with the rising allocation of medical cards, staff levels were falling. The INMO says there are 200 fewer community nurses compared to 2009.

"We're going off a cliff," said public health nurse Mary Leahy. "There has been a phenomenal loss of workforce, just as primary care is being sold as the panacea for everything in health."

INMO general secretary Liam Doran said it was "no coincidence" that attendances to hospital emergency departments were up 9 per cent this year, given the strain the community nursing sector was under.

One in six community nurses said they were dealing with a population of more than 10,000. The INMO says it was originally intended that each nurse would serve a population of just 2,500.