Gabhaim buíochas leis an gCeann Comhairle as an deis seo a thabhairt dom labhairt ar an ábhar seo. Is cinnte go bhfuil díomá orm nach bhfuil an tAire Sláinte i láthair, ach leanfaidh mé ar aghaidh leis an Aire Stáit, an Teachta Catherine Byrne.
We all know the considerable work that goes on in our hospitals, for which the staff must be acknowledged. We know there are many difficulties with getting into the system because there is ample evidence of the waiting lists. There was always the feeling, however, that once one entered the Irish system, the treatment and care were excellent. While that continues to be the case, there are growing exceptions. Patients are in the system, but the understaffing and workload are so significant that it has a detrimental effect on the mental and physical health of both the staff and patients. The working environment, therefore, is not as it should be. Although I am speaking about the Mater Hospital, in particular, it applies to other hospitals also.
On St. Vincent's ward, which is an oncology and haemotology ward at the Mater Hospital, the patients are very unwell and they need extensive nursing and medical input. Consequently, the ratio of patient to nurse was historically 4:1. Nowadays, the standard is 6:1, but there are many days when there is one staff nurse for 12 patients, with a student nurse from 1st, 2nd or 3rd year on the ward also. It is difficult, therefore, to give the patients the care they need. For that ward to have the staff it needs to provide that care, there should be six staff nurses and two managers daily. In recent times, however, there have been four members of staff and one manager.
The patients on the ward are there for chemotherapy or complications relating thereto. They must experience a safe, effective delivery of chemotherapy and support with follow-up monitoring, which needs two nurses who are qualified and trained in safe chemotherapy administration practice on the ward at all times, according to the ward's policy and guidelines. In the past two weeks, it was lucky to have one qualified chemotherapy-trained nurse, leading to inexperienced nurses administering chemotherapy or vital chemotherapy being delayed. There has been some improvement in the numbers following meetings with the Workplace Relations Commission, the director of nursing and the union, but the issues leading to those problems are not being adequately addressed. Rather, there is high staff turnover because of the stress involved in working on a ward with very ill patients who do not receive the recommended care from qualified staff.
Experience counts for so much, which newly qualified and overseas nurses who do not have experience of Irish hospitals may lack. Newly qualified nurses need the guidance of qualified staff in order that they will become experienced staff in time. Nurses who are trained abroad are entering a system with which they are not familiar. I am not undermining or demeaning in any way the newly qualified or immigrant nurses, but they need to be guided by the experienced staff in Ireland in order that there is a mix of skills.
Nurses are under a great deal of stress. On a recent Sunday, three nurses were on sick leave, two of whom were trained in safe chemotherapy administration, which left on the ward two nurses who had been qualified less than two years previously and who were not qualified to administer chemotherapy. That is not acceptable for patients or nurses.
It is disturbing that the information I present today is in a context of excellent facilities and treatment for cancer. So many advances have been made and we know so much more about cancers and their treatment. It was disappointing and alarming, therefore, to hear about the staff issues. I know it is not confined to the Mater Hospital because I have information about other hospitals also.