Address by Honourable Damian E. Greaves at the Annual Nurses’ Awards Ceremony
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Address by Honourable Damian E. Greaves


Minister for Health, Human Services, Family Affairs & Gender Relations


at the Annual Nurses’ Awards Ceremony


Saturday, May 20th, 2006


Theme: Safe Staffing Saves Lives



As the curtains come down on activities commemorating nurses week, I believe that the theme chosen for this evenings culminating event is apt and merits reflection. I venture to submit further that introspection at this particular juncture is warranted at all levels of our health system, as quality and standards constantly pre-occupy the attention of those whom we serve. In this spirit therefore, the theme “safe staffing saves lives” is timely, on target and commendable.


I say this ladies and gentlemen because of the implications that inadequate staffing in whatever form it takes, has for the lives, safety and welfare of the patients who present themselves to health care workers. You know, and I know that when a patient who is ill comes to you, he places his/her life in your hands. He comes with a certain degree of confidence in what you and the health system can do for him. Neither he, nor his family bothers to think about your problems, your emotional state of mind, or how many workers are available. He has an immediate need for health care; thus all other issues are secondary. In fact, because of his pain and state of mind. It may be what the literature refers to as “an occasion for war”. and so, the issues of nurse migration and all its consequences, government’s macro economic policies, workplace environment, the quality of human resource management issues and the quality of training which you receive, must at all times be placed on the front burner for discussion and action. This is necessary, for all of the issues which I have articulated, all play a critical role in the performance of health care workers, positively or negatively, depending on our vantage point.


Given this is scenario, it is therefore pertinent that we develop programs and polices which are aimed at effective and efficient management and protection of the human resource capital at our disposal so vital is this role, that each and every health worker plays in the delivery of health services.


You will of course have noticed that from the onset, I made reference to health care workers, generally. I have done this because of the fact that I am acutely aware that all health care workers play a pivotal role in the delivery of health services.


As system’s theory posit, we are all part of the entire system and a weakness in any part of the system causes the entire system to breakdown or malfunction. This is not to suggest that there is no recognition on my part that this is your day. However, I really needed to draw attention to a larger issue. Hence forth you will feature prominently in the linkage between safe staffing levels and the saving of lives.


I want to begin by stating the obvious: nursing care is essential to providing health care in a wide range of settings. you nurses are the frontline staff in most health systems. You are the ones who really measure the pulse, that is, the efficiency of the health care system and therefore your contributions must be recognised as essential to delivering safe and effective care. Hence the issue of inadequate staffing levels in terms of numbers, must have negative implications on what you do. Simply put, overworked and tired nurses must make medical/clinical errors. High patient to nurse ratios not only have a negative impact on patient outcome, but also affect the nurses who are at a higher risk of emotional problems exhaustion, stress, job dissatisfaction and burn out, to name a few. Nurses who continuously work overtime because of low numbers, without adequate backup, are prone to greater absenteeism and poorer health, thus weakening the health system responses to the community’s health needs. Additionally, understaffing endangers patients lives, which results in longer hospital stays, increased health care costs and staff turnover. It is in fact a vicious cycle.


You of course must realize that the issue of safe staffing goes beyond numbers and include other variables that affect the provision of care. I want to therefore speak to the issue of workload, the work environment, the level of skill of nursing staff and the mix of nursing staff.

Without taking a journey into the intricate details of these complex issues tonight, is inappropriate, but we must nevertheless be aware of the impact of these variables on the mood of workers, the impact on the inability to give of their best, because of the friction and tension that some of the variables can impose on nurses. After all, they too are human and they too can be affected and are sometimes affected. The only difference there is, that when they became affected, it impacts negatively on what they do. Of course, while for most of us our object of work may be paper, theirs is a live human being with feelings of his/her own. In addition, the slightest error on their part may in fact contribute to the loss of a life.


We need to all agree, that safe staffing is critical for nurses because it impacts on their ability to carry out care. Not only is there a link between safe staffing and care, but liability for nurses and the entire health system increases, when there is inappropriate infrastructure and staffing. We need to consider the fact that globalization and instantaneous information via satellite has enabled the saint lucian public to become wiser, and more knowledgeable. The public which we serve is more acutely aware of its rights and consequently, people will be asking more questions and make more demands on the system – and they are already doing so. In addition, they will be making use of litigation more often. This is therefore an additional reason, why this issue is so critical.


We now come to the issue of the quality of the environment in which nurses work and its implications. A varying, and often poor quality environment in which nurses produce is widely recognized as not only contributing to mood and productivity, but it is also one of the factors contributing to the global challenge of attracting new recruits to the profession and retaining existing ones.


Factors such as inflexible scheduling, heavy workloads, ineffective management and weak leadership, inadequate incentives and poor career development opportunities also impact on the quality of care that nurses can provide in the health care system.


I firmly believe that nurses will be attracted to and be retained at their place of employment when opportunities exist that allow them to advance professionally and to gain autonomy and participate in the decision making process, while being fairly compensated.


Having articulated some of the challenges regarding safe staffing levels and the link with the lives of those under your care, I thought it would be useful to speak to the future; my prescription for change.


My point of departure will be the strategic plan of the ministry of health, human services, family affairs and gender relations. for years, this ministry has been without such a plan. I now feel comforted by the fact that this plan has been completed and it does offer some prescriptions on some of the issues that I have highlighted. It provides details on staffing levels, training, planning and other issues. Our ministry intends to implement this plan fully. We are aware however, that it will take some time to do so.


Migration of nurses to the United States of America and other countries is an inescapable fact. in addition, we must take cognisance of the fact that:

  1. We will not be in a position to prevent nurses from migrating (since they have a right to do so).

  2. We may not be able to compete with the united states as far as salaries are concerned; but we have began discussions with Sir Arthur Lewis Community College on increasing its intake of nurses. These discussions are ongoing. Once we have completed the discussions, and the plan is implemented, it is our hope that we will always have a steady supply of young nurses in the system.


I pause here to reflect on the dearth of nurses from the south western and western coasts. that needs to be looked into.


However, as far as losing experienced nurses are concerned, we will put measures in place to minimize the push factors, recognising that we can do little about the pull factors.


Our strategic plan speaks eloquently about how we will deal with human resource planning, promoting autonomy in the workplace and promoting positive practice environments. In fact, the leadership for change is one programme which we encourage nurse leaders to follow, because we believe that positive change must and will come. This is an escapable fact. Over the last five years, management at agency level has had an open door policy with regard to dealing with management and policy issues. This door has been and will continue to be open to nurses. we have included nurses whenever possible on our various policy committees in order to enrich the quality of our policy decisions and we will continue to do so.


We have gone even further ladies and gentlemen. Recognizing the role of effective human resource management systems wide in the delivery of nursing services, we have made provisions for the appointment of a chief nursing officer to advise on human resource management issues. This position will soon be filled once we have complied with the various administrative processes.


We also recognize that this is a changing environment, and nurses must become increasingly more competent both generally and in the specialty areas.


Consequent upon the above, and within the available scarce resources, we will continue to seek opportunities for the training of nurses. in addition, Saint Lucia is working with the University of the West Indies to provide a distant learning programme towards the bachelor’s degree in nursing for practicing registered nurses.


At the level of the UHC, we are going to insist on new legislation dealing with the registration and licensing of nurses. One of the components we will insist on is continuing education for nurses as a prerequisite for licensing.


Ladies and gentlemen, our objective is, and has been to make a positive impact on the health care system. We are acutely aware and you are to, that everything cannot be dealt with all at once. While we have had a few successes, there is still so much more to be done. The only promise that I can make to you therefore is that while I am still the minister for health, and even when I have left the position, I will work valiantly and assiduously towards the improvement of health care generally and the improvement of the nursing profession, specifically in this country.


May I offer congratulations to all the awardees, organizers and you here present in general.


I want to thank you nurses for your commitment, dedication and selflessness; all this in less than favourable conditions.

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