'Not enough nurses in the community'

An inadequate community health care system would make it very difficult for convalescing patients to be taken care of at home, according to the president of the Malta Union of Midwives and Nurses.

"We do not have enough nurses in the community to take care of patients," Paul Pace said.

Earlier this month Parliamentary Secretary Joe Cassar called on relatives to take care of patients at home in a bid to vacate badly needed hospital beds.

The Medical Association of Malta has supported this view, saying the failure of families to do their utmost to take care of elderly relatives discharged from hospital was contributing to an acute shortage of beds. Some 80 beds are constantly blocked by patients who do not require care in hospital.

However, employers have expressed concern that this might increase the number of workers taking time off to take care of their sick relatives.

Yesterday Mr Pace said community nurses were already badly overstretched, with each nurse having to visit many patients every morning.

"We are bewildered by Dr Cassar's call since there is already a lack of community nursing services to take care of these patients," he said.

Mr Pace said having relatives take care of patients could be dangerous unless the adequate community care systems were in place. "We are encouraging the government to start discussions with the union on the set-up of new primary health services," he said, adding that Dr Cassar's appeal would have been much more appropriate if these services were already in place.

A former surgical nurse, who preferred not to be named, said relatives need to know exactly what they had to do in case of complications when they take a relative home.

"If a patient is discharged when he still has stitches, anyone taking care of him needs to be aware of the importance of hygienic measures so that the wound does not get infected," she said, adding she was concerned patients would start being discharged too early.

The nurse has reason to be concerned. Last year her 17-year-old daughter haemorrhaged three times after an operation to remove her tonsils. She said the teenager was asleep when she started haemorrhaging and later entered her parents' bedroom covered in blood.

"Even though I am experienced in the field, seeing her covered in blood stunned me and I was barely able to function. Let alone someone who is not experienced," she said. The nurse echoed Mr Pace's calls for community nurses which could help patients discharged from hospital.

Answering questions by The Times, Dr Cassar's office said nobody would be discharged from hospital until a clinician determined it was safe to do so.