Ms Claire Mahon:

Not necessarily. The INMO has been running a safe practice campaign around the country for the past 18 months at its own expense and which is free to members. The campaign is focusing on clinical risk and completion of clinical risk forms.

It is about the nurse protecting herself. Somebody commented that it is not about the staff but that the link between the nurse and patient outcomes is integral. One does not have good patient outcomes if one does not have the quality of staff. According to feedback we receive, although people fill in the clinical risk forms, staffing shortages are frequently not used as an excuse for something that has happened. The productive ward series, which is being brought out within our hospital level, aims to maximise the amount of time the nurse can have with the patient instead of carrying out other duties. Even through the small amount of data from the productive ward series, it is possible to correlate increases in falls with drops in staffing numbers. One frequently finds the same number of staff on duty in hospitals during the day as during the night, although the day workload is excessive. This is due to staff shortages. Patient outcomes and the burnout level among nurses are affected. Somebody spoke about the length of shifts. Nurses frequently tell us that once they have had their lunch break at 2 p.m., they work until 9 p.m. and may not get a cup of tea because there may be three nurses on duty dealing with 30 patients and a turnover of patients. That all leads to an increase in infection and we know we have a significant issue with infection across our hospitals. It also leads to an increase in falls and pneumonia. The significant factor is the mental exhaustion experienced by the nurses. They do report these issues but they do not see anything happening on the ground because people put their hands in the air and say they cannot do anything about it because of the budget. Nurses are faced with such decisions on a daily basis. They are facing the public on the front line and taking the criticisms but are powerless to do anything to make this better apart from refusing to take additional patients into their wards. It is coming to the stage where that will probably happen. We are there to protect the nurse but are also there to protect the patient.