Nurses call for increased patient-to-staff ratio, salary increases

The TT Registered Nurses’ Association (TTRNA) is calling on government to increase patient-to-staff ratios in all regional health authorities (RHAs). It is also calling for the implementation of several recommendations which have been made by commissions of enquiry and parliamentary committees.

TTRNA president Idi Stuart said the issue of patient-to-staff ratios is a bone of contention throughout all RHAs.

“We don’t have enough nurses to care for the amount of patients in our primary and secondary health care facilities, so you end up having numerous adverse events taking place in our hospitals and health care centres, such as incorrect medication, a number of falls, bedsores developing, longer patient stays, poor clinical outcomes, and the list is long.”

He said research proves there needs to be adequate staffing as nursing personnel comprises 30 per cent of all health care workers.

“Based on information received by the TTRNA via Freedom of Information request to all RHAs, we are short by almost 3,000 nursing personnel, and the government is not doing anything to resolve the issue so it’s getting worse.”

On Friday, the association protested in Port of Spain, beginning at the Port of Spain General Hospital and marching to the North West RHA’s (NWRHA) offices on Dundonald Street. Stuart said the NWRHA was short of at least 1,000 nursing personnel, and was not the only RHA that was understaffed.

“They have less staff, but more services are being offered at these institutions, leading to staff being stretched thing, burnout, and migration. We’re calling on government not only to implement patient to staff rations but also to begin implementing retention strategies to keep the nurses we have.”

He said a report had been prepared by the chief nursing officer with recommendations for implementing the patient-to-staff ratios, which had been presented to the Health Minister, Terrence Deyalsingh, almost six months ago.

“Unfortunately, she didn’t have the support of the technocrats at the ministry, and she tendered her resignation prematurely before her contract ended. We see this all the time where nursing staff are taken for granted, and their views are not incorporated, leading to faulty policy and cost implications for the country. Those making the policy are not working on the wards, these are specialist doctors who work for two hours and go to their private practice, but the word of the doctor is taken as gospel over the word of the nurse.”

Stuart said there were three recognised, registered, and accredited nursing schools operated by UWI, Costaatt, and the University of the Southern Caribbean. He said the association had recently been granted an injunction against the nursing school run by the Education Ministry to stop courses being offered there as it was not accredited.

“We urge potential nursing students to not go there as they will not be able to find jobs. There is room at the recognised schools to take in these students as they have the staff and the facilities. While there are sufficient students being trained at these schools to solve TT’s staffing shortage, the rest of the world is short of nursing personnel and the international nursing agencies are coming in as fast as we train, and recruiting nurses fresh out of school instead of requiring people to have experience. Also the 2023 salaries are chalk and cheese to what is being offered outside.”

He said the government is in the process of rectifying the issue of nurses being offered permanent contracts in most of the RHAs, which was an issue affecting retention of nurses.

Stuart said another issue contributing to the shortage of nurses was that the RHAs would take them off the ward to staff the authorities’ ambulances.

“We need government to make sure these ambulances are regulated properly, as far too often there are nursing personnel being injured. The vehicles are un-roadworthy. The RHAs use nurses to get away from hiring emergency medical personnel, which further contributes to understaffing on the ward.”

Stuart said once these two issues are resolved, the association will be bringing two more issues to the government. He said it was time that the population reaps the benefits of the money they put into the health care system.

In response to Stuart's concerns, Deyalsingh on Saturday said he was always willing to meet with Stuart as he has done in the past, once he writes asking for a meeting with the ministry's "technical and legal people." He said he would not conduct discussions in public.

Deyalsingh spoke to the media at the accreditation of the Mt Hope Women's Hospital as a baby-friendly hospital at the hospital's Colposcopy Centre.

He said Stuart's appeal for salary increases was not a decision for the ministry, but the Chief Personnel Officer (CPO) who negotiates with trade unions.

"It is for the union to meet with the CPO. Let the collective bargaining process work as it has in the past."