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Summer News Update (1)
Members Update 04.08.16

Thursday, 4th August 2016

Dear Member,

We are acutely aware that, despite this being peak holiday time, the health service, and in particular nurses and midwives, continue to be under great pressure due to ever increasing demands for service and a continuing crisis with regard to the shortage of nurses and midwives.

Against this background I think it is appropriate that we would provide you with an update in relation to a number of important matters at this time.

1. Staff Shortages

As you may have seen, through the media last week, the INMO has just secured a public commitment, from the HSE, to offer all undergraduate students, completing their four year degree programme, next month, permanent posts in the Irish public health system. This should mean that 1,500 nurses/midwives (approximately), subject to successful completion of the honours degree programme, will be offered permanent posts in the coming months. In addition we continue to demand that all employers, at local level, fill all vacant posts in such areas as:

  • medical/surgical/specialist areas;
  • emergency departments;
  • theatre;
  • public health/community;
  • care of the older person; and
  • intellectual disability.

We are aware that some employers, at local level, continue to hesitate, to fill these essential frontline posts, despite commitments, at national level, from the HSE, to fill all frontline posts. Members are again requested to contact their local Industrial Relations Officer, through their local representative, and advise them, immediately, of any delay, by employers locally, in filling vacant posts.

2. Medical/Surgical Staffing Taskforce - Pilot Phase

2.1 As advised previously, in earlier newsletters and through the journal (World of Irish Nursing and Midwifery), the Taskforce on Nurse Staffing, in Medical/Surgical Wards, has now commenced piloting the recommendations contained in the interim report.

This means that a number of wards, in Beaumont Hospital, Our Lady of Lourdes Hospital Drogheda and St. Columcille’s Hospital in Dublin are currently preparing to implement the interim recommendations, on safe nurse staffing, to test their ability to improve patient outcomes and staff working environment. These pilot studies will run through, until October/November, with the results being then considered, by the National Taskforce, before a final report is issued around the end of the year.

Members will recall that this Taskforce was established as a direct result of the INMO’s safe staffing campaign in 2014/2015. The objective is that every Medical/Surgical Ward in the country (250 approx.) will, ultimately, have their staffing levels (complete with a skill mix of 80% Registered Nurse to 20% trained HCA) determined with reference to patient dependency and the professional judgement of the Clinical Nurse Manager 2 (CNM2). The CNM2 in all medical/surgical wards will be 100% supervisory and not hold a case load.

It is the view of the INMO, and indeed international experience, that the only way to establish, and maintain, safe staffing levels, leading to manageable workloads for staff, is to apply this kind of scientific approach and that is why the work of this Taskforce is so important. Members will be kept fully appraised of this initiative, in the coming months, as we continue to prioritise the critical issue of safe staffing levels, with acceptable manageable workloads for members, across our health service. In that regard it should be noted that, upon completion of this Phase 1 regarding Medical/Surgical Wards, the INMO will be demanding similar exercises in other areas i.e. specialist/care of the elderly/community and intellectual disability.

2.2 Local Disputes - Staff Shortages

Members should also be aware that in some locations the INMO has, or will be, commencing industrial action in protest at unacceptable staffing levels. In locations such as Our Lady of Lourdes in Drogheda and University Hospital Limerick members are currently engaged in a work to rule or will shortly ballot in protest at the current working environment. Our demand, in these and all such situations, is for the employer to either recruit additional nursing/midwifery staff and/or close beds to match the level of available staff. The INMO will always support members seeking to ensure they have manageable workloads which allow them to practice safely.

3. Emergency Departments

3.1 Overcrowding

As you also may have seen, in media reports last week, the INMO continues to demand the 24/7 implementation of the ED Agreement, from last February, to ease ED overcrowding and workloads on nurses in these departments. In order to ensure that the Agreement is implemented, in full, and without further delay, a special three person group has been established with representatives from 1. National Acute Hospital Division, 2. Assistant National Director HR HSE, and INMO (Ms. Phil Ni Sheaghdha the INMO Director of Industrial Relations is our nominee) and this group is undertaking visits, to a number of hospitals, over this two week period. In that regard the INMO will be demanding that all aspects of the Agreement are implemented including:

  • the appointment of seven CNM1s, through internal competition, where this has not taken place already;
  • the appointment of a CNM2, for admitted patients, in a number of Emergency Departments;
  • the appointment of an Assistant Nursing Director, based in the Emergency Department and specifically, and solely, responsible for patient flow in all 26 Emergency Departments;
  • The filling of all vacant posts as agreed in December 2015; and
  • The presence of senior clinical decision makers over the extended day.

The Workplace Relations Commission (WRC) is due to undertake its fifth review, of this Agreement, on Friday, 2nd September 2016, and a further update will issue after this meeting. In addition to this the Emergency Department Taskforce, is due to meet, later this month, with the Minister in attendance. At this meeting the INMO will again be demanding that all aspects of the Agreement, including special initiatives to aid the recruitment of staff, are implemented without further delay.

3.2 ED Taskforce on Nurse Staffing - Expert Group

The ED Expert Group on Nurse Staffing, established as part of the ED Agreement, continues its work and is expected to issue its report within the next four weeks.
This four person group (the INMO is represented by Ms. Bernie Stenson, CNM2 in the Emergency Department in St. Vincent’s Hospital and Executive Council member) is charged with the task of:

  • examining international evidence with regard to how best to determine ED staffing levels and to make recommendations on same; and
  • recommend immediate initiatives to address current staffing difficulties.

A full report, detailing the recommendations of the group, will issue, to all Emergency Department members, the moment same is available.

4. Nursing/Medical Interface

As previously notified, the restoration of time and one-sixth and the nursing medical interface verification process is underway and due to conclude this week.

This process, as agreed, involved site visits, by the national verification team, to each of the hospital groups and reports from each hospital to the national verification team. This national verification team has representatives from the Department of Health, HSE, SIPTU Nursing, the IMO, and the INMO (Ms. Phil Ni Sheaghdha, INMO Director of Industrial Relations, is our nominee).

The hospital site visits are all completed and the required written confirmation from the local implementation group of each hospital have now all been received.

The independent chairman of this process has convened the parties to finalise the process of verification on Friday, 4th August 2016. This should result in sanction of restoration of payment of time and one-sixth for hours worked between 6.00 p.m. and 8.00 p.m. and retrospection of this payment, as per the agreement, to January 2016.

A separate update will issue after this meeting.

5. Richmond Education and Event Centre

I am pleased to advise all members that the refurbishment works, on the Richmond building, to develop the INMO’s Education and Event Centre, has now commenced and is expected to be completed in early January 2017. This work will see the Richmond Building becoming a dynamic centre, for all of the professional development work done by the Organisation, as we prepare for mandatory competency assurance, for all registered nurses and midwives, in the next two/three years. In addition the refurbished building will allow the Organisation offer the facility, to other bodies, thus delivering a new and additional funding stream for the Organisation. Periodic updates, on the refurbishment work, will appear on the INMO website (www.inmo.ie) and it is hoped that the building will formally be open in early spring 2017.

6. Executive Council Appointments

As you will recall the new Executive Council took up office last May immediately following this year’s Annual Delegate Conference. Due to the pressure of work it was necessary for our colleague Ms. Kate Finnamore to resign from Council as it was simply not possible for her to commit in relation to the time and work requirements. Against this background, and recognising there was already one vacant seat following the recent elections, I am pleased to announce the following members will now sit on Council until the end of its term in May 2018:

  • Ms. Marie O’Brien, Clinical Nurse Manager 1, Ennis General Hospital; and
  • Mr. Tommy Caulfield, Staff Nurse, Portiuncula Hospital, Ballinasloe.

On behalf of our President, Martina Harkin-Kelly, Officers, fellow members of Council and staff we welcome Marie and Tommy, to Council, and look forward to working with them, through our challenging agenda, over the next 18 months.


Notwithstanding the many ongoing severe difficulties, facing nurses and midwives and the health service, I hope, in this summertime, that you have had the opportunity to take some leave with your family and friends. Indeed I hope that leave allows you the opportunity for some rest and relaxation away from the pressure of work. I also hope the above update is of interest to you, at this time, and please watch out for further updates, either through the website/Facebook or journal, in the coming weeks. Thank you for your attention to this note. Please bring its contents to the attention of all nurses/midwives in your workplace.

With kind regards.

Yours sincerely,

Liam Doran
General Secretary


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