Mr. Liam Doran:

Yes, it is about to commence.

There is a fear of reporting. Registered nurses and midwives are reticent about coming forward and voicing their concerns. They are beaten up by the workloads they carry. We encourage our people to put in disclaimer forms where they believe that the system is such that they cannot provide the full range of services required by the patient if there are delays, for instance, in medication rounds, after-care procedure or post-operative mobilisation. If they are being compromised by shortages of staff, one has to document them. It does not happen as much as it should and that is because there is a sense among nurses that they will be put upon if they highlight such concerns.

The contradiction in all this, and it was mentioned by another member of the committee, is that documentation, which is the heart scald of nurses and midwives at the moment, is being received all the time, but the problem is that, when something goes wrong, the system looks only for the written word. If it is not written down, it did not happen. That is the bottom line of measurement of patient interaction. Everything that one now has to do might be subject to subsequent investigation. Therefore it has to be written down. HIQA insists on a strict regimen of forms and, because nurses are in the front line and are there 24/7, they are the profession that has to do it. However, no account of that is taken by those who would staff up the system to ensure that it was all done in a timely way.