The term "de-nursing" has been heard of late in the Legislative Council chamber, as councillors expressed concern over a trend in the public medical service.
"De-nursing" is the "dis-assimilation" and dismantling of nursing activities by administrative methods. In the name of levelling its financial burdens, the Hospital Authority has deployed untrained and unprofessional health care assistants and technicians (assistant workers) to substitute professionally trained nurses.
To my dismay, the authority, in the name of speeding up renal dialysis waiting times, has trained these assistant workers to perform clinically complex tasks. These tasks involve medical procedures, in which professional nursing knowledge is a basic requirement. There is no doubt the assistant workers do not meet these basic requirements. They have had only a few months' training and I am concerned about the safety of patients.
This case illustrates the downside of the de-nursing process and I am concerned it will now be accelerated, with more unprofessionally trained workers taking over jobs that should be done by professionals. This could lead to a reduction in nursing quality and an increase in clinical mistakes and will have an adverse effect on patients' health.
This de-nursing phenomenon has been brought about, because of the lack of a comprehensive nursing manpower blueprint. The "nurse to nursing target ratio" has not been observed. The administration should be working on a well-defined nursing manpower ratio. However, despite the fact that many countries have legislated the ratio within 1:4 and 1:6, the administration has said Hong Kong will not follow suit. A clearly defined ratio is a concrete manpower guideline and the benchmark for measuring patients' safety.
The government must restructure the current nursing manpower policy, formulate nursing service indicators and a manpower ratio and mitigate de-nursing problems in order to maintain the quality of the nursing service in Hong Kong.