Mr. James Geoghegan:

I thank the Chairman and committee for inviting us here today. I am a staff nurse on a medical ward. Since I qualified ten years ago, I have seen a gross deterioration, particularly in respect of staffing levels. I had a quick look at my ward yesterday as I was working. This time 12 months ago, we had a whole-time equivalent, WTE, of 23.5 for a 31-bed ward. We were told 12 months ago by our managers that this would be reduced to 22.5 and would affect all wards. Yesterday, our WTE was 19.8. This obviously has a compromising effect on our patients in respect of giving timely care and observing them. We have definitely seen an increase in falls in all the wards.

In response to Deputy Fitzpatrick's question, I will not bring up the graduate nurse and midwife programme, but I have worked in Australia with a different staff-patient ratio, and I did not encounter one fall in the five months I worked there. We see falls on a weekly basis in our hospital. I would certainly tell graduates to go to the sunny climes of Australia or to Canada.

When I was training, I had a nurse preceptor, a person who embodies nursing. When I see her coming to me in tears telling me that this is not nursing, that what she is doing is firefighting and that she goes to the chapel in the morning before she goes to work to pray that nobody dies on her shift, it is a sad state of affairs. We are feeling overwhelmed. I sent two risk forms down yesterday morning. One of my colleagues had to go down to the emergency department so I rang my assistant director of nursing to inform her that we were now short and looking for assistance. She had no nurse to give us and we were told to get on with it. We send our risk forms but feel we face a culture in which it is thought we should not be saying these things and in which one is marked out as a troublemaker if one does highlight these things. We are trying to show that a risk exists. I read the report on the Mid Staffordshire NHS Foundation Trust and my fear is that we are slipping slowly into this. We will look back in five or six years' time and ask why nobody said "Stop". Staff nurses are trying to say it through the risk forms and our disclaimers but feel we are on the floor and are not being heard.