Mother of brain injured boy a ‘prisoner’ due to nurse shortage

A mother is effectively a “prisoner” in her home because of a lack of nurses to provide home care for her severely disabled brain injured son, the President of the High Court has said.

The 17-year-old was granted an interim settlement in March 2017 of some €2.4 million in medical negligence proceedings to meet the costs of his care for two years, of which about €2 million was to meet nursing care costs.

However, there have been persistent difficulties getting nurses, Mr Justice Peter Kelly noted.

As the boy is a ward of court and issues concerning his care have to be approved by the court, the matter was before the judge on Monday.

A healthcare systems provider said in evidence that her firm provides healthcare assistance services to the boy but nursing care is separately provided. As a result of the boy’s complex care needs, he requires the assistance of an experienced nurse but there are constant difficulties providing that.

The provider said that older and retired nurses are reluctant to work on a “zero hours contract” basis and young nurses either go to hospitals, where they have guaranteed hours, to get experience or leave the country.

There is “a huge problem”, she said.

Full-time

When she said there is also a problem providing healthcare assistants because her firm cannot give them full time contract hours, the judge asked why not.

She replied that if the boy was taken to hospital for treatment, there was no work for assistants or nurses to do.

The judge said the boy did not appear to go to hospital too often and said, if care is provided three days a week, that is “constant work”.

The witness said the issue was nurses and she believed the only solution was to increase recruitment of nurses. She has been involved in providing care services for the boy for some two years and his mother provides nursing care when nurses cannot be provided, she said.

The mother sleeps on a chair outside her son’s room and provides him with “exceptional” care on a 24 hour basis. The mother is not a nurse but has accumulated considerable expertise and agency nurses often look to her for guidance, she added.

In his ruling, the judge noted, under the interim settlement, the mother had agreed to provide up to 20 hours of free care and some €2 million was allocated for 24 hour nursing care for two years to the end of February next.

Excess

There is supposed to be a nurse in regular attendance for the boy but nurses more often than not do not show up and the mother as a result is providing well in excess of 20 hours.

The boy’s mother had sought payment for the additional hours and the level of care provided by her has been commented on very favourably by doctors, he noted.

She also had set out detailed invoices noting the number of times a nurse was not available. The judge said he had no problem directing the mother be paid for the extra hours but the situation was “very unsatisfactory” as the settlement was agreed on the basis 24 hour nursing care would be provided.

It would be infinitely preferable if nurses were available as the mother is now “effectively a prisoner in her home”.

The judge said he had “no solution” to the problem but he expected it would feature in negotiations on the boy’s future care needs when the matter is reviewed next February.