€5.75 Vol 23 No 10 December 2015 / January 2016

Latest course information from Journal of the Irish Nurses and the INMO PDC Midwives Organisation See centre pages

World of Irish Nursing & Midwifery

ED trolley figures continue to worsen page 6

INMO National Conference special report page 8

Importance of clinical handover in midwifery page 58

Beyond breaking point INMO serves strike notice over ED crisis CONTENTS 3

News & views 35 Recruitment and retention Albert Murphy highlights some activities 5 Editorial that may be of interest to members Liam Doran, INMO general secretary discusses ED overcrowding and the 49 Interview Merry Christmas possibility of a campaign of industrial M artin McNamara interviews inaugural action involving the withdrawal of labour professor for health systems in UCD, and happy new year in EDs Eilish McAuliffe 6 News 52 Refugees in Ireland to all members ED members set for strike action… St In part two of an article on the needs of Vincent’s work to rule suspended during migrants and refugees, PJ Boyle discusses from all talks… INMO called for Mater ED to go their care within the Irish health services off-call due to overcrowding…National conference special report: National 58 Midwifery focus at the INMO conference explores future funding Deirdre Munro discusses the importance of Irish health service and Update on of clinical handover in midwifery ongoing issues... Call for sex buyers Branch update law by Christmas... Executive Council 65 This month we focus on the INMO election 2016 – call to all candidates… Kilkenny Branch Phil Ní Sheaghdha, INMO director of industrial relations, reports on recent 68 Update ICTU negotiations and other national IR R ound up of healthcare news items issues… Workplace stress – does anyone care? Hospitals are ignoring safety-at- work legislation, writes Dave Hughes... Action averted at Limerick maternity Clinical hospital… HSA called in over Croom safety issues … Labour Court rules in 55 R esearch focus In the second instalment of a two-part favour of staff in Ard Aoibhinn services… series, CJ Coleman award winner Denise Plus: Section news, page 23 McGuinness provides insight into the world of bereaved mothers 28 International news El izabeth Adams discusses the ongoing role of the INMO in international Living projects 67 Book review 61 From the President Sonja Storm reviews Floor Play - You will 8 INMO president Claire Mahon rounds never look at your feet in the same way up news from the Executive Council and again by Isobel Guckian beyond Plus: Monthly crossword competition 63 Students & new graduates Dean Flanagan updates readers on news 71 Finance for students and new graduates Ivan Ahern offers some seasonal tips to ensure there’s money in your bank account after the Christmas spree Features Jobs & Training 26 Section focus This month we focus on the Student 37 Professional Development Section Eight-page pull-out section from the INMO PDC 30 Quality and safety This month Maureen Flynn looks at the 72 Diary Health Foundation, a UK charity that Listing of meetings and events nationally aims to bring about better healthcare and internationally Recruitment & Training 33 Questions and answers 73 WIN Bulletin board for industrial relations Latest job and training opportunities in 49 queries Ireland and overseas Vol 23 No 10 December 2015/January 2016

WIN – World of Irish Nursing & Midwifery is distributed by controlled circulation to over 32,000 members of the INMO. It is published monthly (10 issues a year) and is registered at the GPO as a periodical. Its contents in full are Copyright© of MedMedia Ltd. No articles may be reproduced either in full or in part without the prior, written permission of the publishers. The views expressed in this publication are not necessarily those of the INMO. Annual Subscription: e145 incl. postage paid. Editorial Statement: WIN is produced by professional medical journalists working closely with individual nurses, midwives and officers on behalf of the INMO. Acceptance of an advertisement or article does not imply endorsement by the publishers or the Organisation. EDITORIAL 5

Journal of the When enough really Irish Nurses and Midwives Organisation World of Irish Nursing & Midwifery is enough (ISSN: 2009-4264) Volume 23 Number 10 As I am preparing this editorial, the Organ- December 2015/January 2016 isation is continuing to prepare for the WIN, commencement of a campaign of indus- MedMedia Publications, trial action, involving the withdrawal of 17 Adelaide Street, labour, in emergency departments (EDs) Dun Laoghaire, up and down the country. This follows on Co Dublin. Website: www.medmedia.ie from our ED members voting by a margin of 92% in support of this campaign. The details of the action, including our when they are faced with adverse publicity four key goals, are detailed on page 6. and negative media attention. This cer- Our members made it clear, in the meet- tainly seems to generate corrective action ings surrounding the ballot, that they in contrast to the lack of action forthcom- Editor Alison Moore want strong forceful action, including ing when nursing staff, concerned about Email: [email protected] Tel: 01 2710216 strike action, as they do not believe health professional standards, raise misgivings employers fully understand the extent of only to have them fall on deaf ears. Production & news editor Tara Horan the crisis or will be willing to do what is However, on the back of the recent bal- Sub-editor Sinéad Makk necessary without such radical action. lot, our members have now said, and I am Designers Fiona Donohoe, Paula Quigley At the outset it should be said that absolutely certain they mean it, that they Advertising manager Leon Ellison it would be very hard to find a group of have had enough, they will suffer no longer Email: [email protected] workers, in the public or private sector and, in the interests of patients’ health Tel: 01 2710218 or in any type of employment, who have and their own wellbeing, they will take Publisher Geraldine Meagan shown more patience and fortitude than whatever action is necessary to secure an WIN – World of Irish Nursing & Midwifery our members in EDs over recent years. improved environment within our EDs. is published in conjunction with the Against the background of ever increas- It should be noted that this decision and Irish Nurses and Midwives Organisation by ing levels of overcrowding, recruitment this campaign of action recognises that MedMedia Group, Specialists in Healthcare bans, flawed hospital reorganisations ED overcrowding, and admitted patients Publishing & Design. and increasing levels of demand, they on trolleys, will remain a daily reality for have always strived to provide the best the Irish public health service. That is why possible care, to very ill patients, in intol- the demands being made as part of this erable environments. They have asked, on campaign, are all designed to improve the an ongoing basis through the INMO, for environment, for patient care, in EDs and remedial action but, in response, all they to provide sufficient staff to protect safe Editor-in-chief: Liam Doran received is broken promises and broken practice and, indeed, the personal health INMO editorial board: agreements. and wellbeing of our members working in Claire Mahon; Geraldine Talty; David O’Brien; While nursing numbers were being these departments. Moira Craig; Theresa Dixon; Martina Harkin-Kelly; reduced due to the recruitment embargo, As you would expect in such a situa- Eileen Kelly; Catherine Sheridan; Mary Leahy the numbers of doctors and allied health tion, efforts will undoubtedly be made to INMO editor: Ann Keating professionals were, correctly, being avoid strike action, with the assistance Email: [email protected] increased. However, the reality is you can- of the Workplace Relations Commission INMO editorial assistant: Freda Hughes not have a quality assured health service, (formally Labour Relations Commission). INMO photographer: Lisa Moyles you cannot have quality care for patients However, arising from the decision and INMO correspondence to: and you cannot have the best outcomes the strong mandate from our members, Irish Nurses and Midwives Organisation, for patients without the necessary number all parties, particularly government, the WIN Whitworth Building,

of registered nurses. The fact is our EDs are Minister for Health and the HSE, must Vol 23 No 10 December 2015/January 2016 North Brunswick Street, Dublin 7. grossly understaffed and, as a result, care realise token gestures and vague promises Tel: 01 664 0600 standards are consistently, and repeatedly, will not suffice on this occasion. What is Fax: 01 661 0466 compromised through no fault of the staff. required is a radical new approach to man- Email: [email protected] To add insult to injury, when ED nursing aging and staffing our EDs. Patients have Website: www.inmo.ie staff have raised concerns, like nursing and had enough, staff have had enough and midwifery staff in other areas, they have now government and management must www.facebook.com/ been told that they will have to ‘get on deliver or face the consequences. irishnursesandmidwivesorganisation with it’ or ‘make do’. Indeed our experience shows that management, at both local twitter.com/INMO_IRL and national level, only do what is right Liam Doran and required with regard to overcrowding, General Secretary, INMO 6 NEWS

ED members set for strike action Over 92% vote for action up to and including withdrawal of labour

INMO members working in emergency departments are set Enough of broken to begin strike action on Tues- promises: day, December 15, following an INMO President Claire overwhelming vote in favour of Mahon and general secretary Liam Doran a campaign of industrial action. announcing that 92% of This is due to the persistent and ED members had voted deepening levels of overcrowd- in favour of strike action due to the deepening ing, inadequate staffing levels levels of overcrowding and the ongoing compromising and understaffing in emergency departments of patient care in EDs through- throughout the country out the country. More than 92% of INMO members working in all the HSE in a formal notice. The overcrowding being at record consistent with best practice. country’s EDs voted in favour of action will involve all members levels despite all of the com- INMO general secretary taking industrial action, involv- with the exception of a standby mitments that it would be Liam Doran said: “This action, ing the withdrawal of labour, emergency response team, reduced. The latest figures, up which will involve strike saying they have simply had requiring the hospital, effec- to the end of November 2015 action, is being taken in rec- enough of broken promises. tively, to go off emergency call. (see Table), show that in the ognition that overcrowding The INMO has served formal The INMO is taking this cam- first 11 months of this year will continue requiring spe- notice on the HSE and all rele- paign of industrial action as almost 87,000 patients admit- cial, sustained, measures to vant health service employers, a last resort after 10 years of ted for care found themselves be introduced in our EDs, to that the campaign of industrial discussions and broken prom- on trolleys awaiting a bed. A safeguard patient care and the action, including strike action, ises. Members are particularly breakdown of these figures health and wellbeing of staff. will commence on December frustrated at the daily accept- show that in the month of “This campaign is also nec- 15, unless the government and ance by those in authority of November alone 7,407 admit- essary as a direct result of the hospital management address ED overcrowding and, in many ted patients waited on trolleys failure of government and specified issues. In keeping hospitals, ward overcrowding in EDs/overcrowded wards. health service management, with the agreed health service due to extra trolleys. November 2015 was the over many years, to recog- protocol, the INMO provided Against this background the 16th month in a row in which nise this overcrowding crisis three weeks’ notice and indi- campaign is seeking: overcrowding increased, and to allocate the necessary cated its availability to agree • Safe, adequate and consist- demonstrating that care is resources to properly address contingency measures. ent staffing levels (including being compromised on a it. Our members will no longer The INMO Executive Council recruitment and retention ini- long-term and ongoing basis. tolerate having to go to work, ratified a national campaign tiatives) for all EDs In addition, the situation is every day, to face constant involving all of the country’s • Additional, separate nursing getting worse not better. The overcrowding where both EDs, as follows: staff to look after admitted figures confirm that the meas- the care of patients, and the • Each hospital to establish a patients who are on trolleys, ures taken to date have failed health and wellbeing of staff, strike committee immediately thus ensuring the ED nursing to address the problem and is compromised without any- • Strike action will begin on staff can ensure safe practice in ensure that admitted patients one, in authority, seeming to Tuesday, December 15 and each ED can be cared for by adequate recognise the consequences. will initially involve action in • The designation of all EDs as numbers of nursing staff, in a “Members have had enough, a number of EDs on a simulta- specific places of employment, safe clinical environment, pro- patients have had enough, and neous/rolling basis under the Safety, Health and viding dignity and privacy. it is now up to government • Further days of strike action Welfare at Work Act, requiring During the consultation and management to address will take place, involving regular inspections to ensure process ahead of the bal- these issues, in dialogue with remaining EDs, again on a staff’s health and wellbeing lot for action, members also us, if this campaign of strike simultaneous/rolling basis, in • Proper, full and 24/7 imple- expressed their growing con- action is to be avoided.” the new year mentation of agreed cern about increasing delays At the time of going to • The campaign will ultimately escalation policies to minimise in patients being initially press, talks had commenced involve a nationwide strike overcrowding in EDs and on assessed (triaged). Mem- in the Workplace Relations involving all EDs. wards. bers confirmed that, due to Commission (WRC), formerly The exact location and tim- The INMO pointed out that the pressure in the whole ED, the LRC, in an effort to avert Vol 23 No 10 December 2015/January 2016 Vol ing of the strike action on the this campaign commenced members of the public are not the planned strike action on

WIN first day will be advised to the against the background of ED being seen, in a timely manner, December 15. WIN Vol 23 No 10 December 2015/January 2016 - - 2015 ED & ward ED & ward watch total 7 NEWS 2014 ED & ward ED & ward watch total y improved after after y improved 2013 in the hospital in general. in hospital the in eme concern at the situ ED & ward ED & ward watch total Following Following a meeting of the Management and the – Albert Murphy, INMO IRO Albert Murphy, – INMO with hospital manage INMO ED the in situation the ment, significantl INMO further talks to agreed shortages nursing regarding in the there hospital where nursing 100 currently are vacancies. discharge of discharge patients. extr the ED in particular, ation in and - - 35,337 48,394 36,811 37,606 45,927 55,004 days following the the following days the severe overcrowding in the overcrowding severe

The trolley watch figures figures watch The trolley ote for national industrial industrial national for ote n v recorded 29 patients on on 29 patients recorded on the trolleys morning of the 26. However, November INMO then learned that the was much figure higher with 45 admitted trol on patients leys. The INMO expressed I the INMO action in EDs, Hospi the Mater for called tal, to Dublin due call off go to department. emergency INMO called for Mater ED to go INMO called for Mater due to overcrowding off-call - IRO Philip McAnenly McAnenly Philip IRO 97 276 270 119 n/a n/a n/a n/a n/a 0 59 33 63 75 626 1,731 1,245 1,052 3,524 2,484 n/a n/a n/a n/a 121 922 621 1,640 1,800 3,212 n/a n/a n/a n/a n/a n/a n/a n/a n/a 58 n/a n/a n/a n/a n/a n/a n/a n/a 130 219 N/A N/A 434 554 1,183 1,062 1,461 1,977 1,979 2,303 755715 688 695 584 835 842 463 1,645 639 1,429 648 1,924 1,952 912 2,550 1,845 1,866 2,266 1,834 548 636 715 706 926 719 n/a n/a n/a 0 471349 768 268 759 302 1,073 578 416 832 1,350 930 688 732 886 765 964 786 948 1,068 461 271 395 272 329 1,753 527 731 1,434 1,959 162 90 166 365 1,780 3,004 2,242 2,729 3,499 4,046 780 931 252 359 375 398 276 333 0 122 199 88 141 143 25 n/a n/a n/a n/a 0 2006 2007 2008 2009 2010 2011 2012 2,754 712 1,306 1,759 2,312 3,719 882 1,339 1,157 1,299 1,698 1,235 1,503 2,274 3,431 3,359 3,346 5,104 5,543 6,835 1,563 2,253 3,225 3,157 3,854 6,181 3,960 3,533 4,891 6,012 3,279 2,638 2,660 3,415 3,151 7,009 6,371 3,070 5,642 7,280 1,398 1,208 1,370 1,173 1,696 1,800 1,715 2,387 2,006 2,063 2,169 1,283 1,066 1,271 1,657 598 1,400 1,043 1,631 1,736 2,865 1,229 349 361 429 554 491 1,129 2,696 2,708 1,102 456 724 301 602 647 541 669 886 1,322 3,669 3,438 4,115 4,118 6,335 6,202 3,980 3,846 3,201 4,363 2,731 2,608 1,988 1,812 2,973 4,379 2,457 1,911 447 867 4,907 3,642 5,233 5,575 6,400 4,642 1,809 3,680 3,500 4,541 4,026 5,594 5,252 4,990 5,764 5,986 4,374 2,746 2,115 4,681 1,926 929 2,265 2,256 1,254 1,483 1,217 1,611 1,949 2,512 1,245 703 958 2,339 1,957 2,006 2,102 1,130 n/a 0 3,002 1,161 2,009 3,517 3,032 4,237 1,942 1,740 2,612 3,072 3,925 4,721 5,504 4,581 5,105 3,560 4,014 2,730 3,211 4,468 2,270 2,569 2,493 2,484 3,102 4,075 3,677 5,533 4,785 4,855 4,017 5,730 7,509 8,097 7,649 6,831 5,915 6,465 5,930 7,731 27,824 21,804 23,222 25,190 25,318 25,049 31,223 33,839 34,263 32,820 25,050 25,635 24,102 31,860 53,142 46,853 54,445 59,029 69,600 81,214 61,861 63,241 70,029 86,864 “We believe that some some that believe “We INMO said: “The INMO approached said: “The INMO approached these talks with the aim of outcome, an agreed reaching environments the as working and the conditions under attempting are which nurses care of safe a level to provide continue. cannot arrived can be improvements the at through process set out the welcome we and LRC by regard”. this in assistance their industrial action for the dura the industrial for action tion of the talks. the of tion ease between 2014 and 2015: 24% Increase between 2011 and 2015: 7% Increase between 2008 and 2015: 60% between 2011 and 2015: 7% Increase between 2014 and 2015: 24% Increase ease Incr between 2013 and Increase 2015: 37% between 2010 between 2007 and and Increase 2015: 2015: 25% Increase 85% between 2012 and 2015: 40% Increase between 2006 and 2015: 64% between 2009 and 2015: 47% Increase Increase  - - the form form the al tot

al al

nagement agreed to, INMO INMO to, agreed nagement tion However, following a following a However, Wexford General Hospital General Wexford total Country University Hospital Waterford University Hospital Limerick University Hospital Galway St Luke’s Hospital, Kilkenny Hospital, Luke’s St Sligo Regional Hospital Sligo Regional Hospital General Tipperary South Roscommon County Hospital County Roscommon Our Lady’s Hospital, Navan Hospital, Our Lady’s Hospital Portiuncula Our Lady of Lourdes Hospital, Drogheda Our Lady of Hospital, Lourdes Nenagh General Hospital Nenagh General Monaghan General Hospital Monaghan General Midland Regional Hospital, Portlaoise Hospital, Midland Regional Tullamore Hospital, Midland Regional Midland Regional Hospital, Mullingar Hospital, Midland Regional Mid Western Regional Hospital, Ennis Hospital, Regional Western Mid Mercy University Hospital, Cork University Hospital, Mercy Mayo General Hospital Mayo General Louth County Hospital County Louth Letterkenny General Hospital General Letterkenny Kerry General Hospital General Kerry Cork University Hospital University Cork Cavan General Hospital General Cavan Bantry General Hospital Bantry General Eastern Tallaght Hospital Tallaght St Vincent’s University Hospital Vincent’s St St James’s Hospital James’s St St Colmcille’s Hospital Colmcille’s St Naas General Hospital Naas General Mater Misericordiae University Hospital Mater Misericordiae Connolly Hospital, Blanchardstown Hospital, Connolly Na Hospital Table 1. INMO trolley and ward watch analysis January-November 2006-2015 January-November watch analysis and ward INMO trolley 1. Table Comparison with total figure only: with total figure Comparison Beaumont Hospital Beaumont members agreed to suspend to suspend agreed members tal (SVUH), Dublin, engaged engaged Dublin, (SVUH), tal in industrial action in week a for to rule work of a to due October in intolerable working conditions and the inability to care safe provide their to patients. the to from LRC request con engage in intensive ciliation, which hospital ma

suspended during talks working in INMO members department of the emergency St Vincent’s University Hospi St Vincent’s work to rule Vincent’s St 8 National Conference SPECIAL REPORT

National conference explores future funding of Irish health service A world class health ser- vice must be properly funded – this was the key message to emerge from the INMO’s national conference on Decem- ber 2. Debate centred on how Ireland should fund its health service, the level of funding needed and how to convince the political system of the need to invest in the service. Pictured at the INMO national conference in Croke Park were conference speakers (l-r): Tom Healy, director of Nevin Economic Research Arising directly from a Institute (NERI); Paul Goldrick-Kelly, NERI; Claire Mahon, INMO president; Geraldine Cunningham, associate director of culture change, motion adopted at ADC 2015, Barts Health NHS Trust; Liam Doran, INMO general secretary; Dr Peter Carter, former CEO/general secretary of the RCN; Edward Mathews, INMO director of regulation and social policy; and Prof Charles Normand, TCD professor of health policy and management the conference was convened to produce a policy document mand, professor of health funding system is, the less it Paul Goldrick-Kelly, also outlining the INMO’s position policy and management will cost to administer and the from the NERI, put the fund- on the future of the health at TCD. He asked whether more there will be available for ing of Ireland’s health system service. the Irish funding model has services and to pay frontline in context with other systems Opening the conference, adapted to the needs of the workers. in Europe. These can be bro- INMO president Claire Mahon population. The main objective “If it is cheap to manage, it ken down into two system said: “We are demanding a prop- in financing a health system won’t cost as much to collect,” types – the classic Beveridge erly-funded clinical environment is to use resources efficiently, he said, pointing to Univer- model, funded by general tax- where safe practice and safe with fairness and equity. He sal Social Charge as a fair and ation such as the NHS, or the care can always be maintained said you must contain costs equitable tax that is easy and Bismarck system, funded by within a working environment and ensure sustainability. cheap to collect. payroll, such as in Germany. that respects the health and Exploring the concept of “The current financing sys- Ireland has a complex dupli- welfare of nurses and midwives. universal healthcare, Prof Nor- tem of the health service isn’t cate system of public and Safe care can only be provided mand asked if Ireland wanted the problem; the problem is private provision. The question when you have a safe work- access to essential care to our unwillingness to devote is do we want to fund public ing environment within which depend on ability to pay, espe- more money to it,” he added. health by general tax revenue acceptable ratios must exist. cially as those with greatest Future funding requirements or via payroll contributions. “No one except nurses and need have the least resources. Speaking from the perspec- Mr Healy returned to the midwives can determine what There is little evidence that tive that health is a social essential question of how much care can be delivered safely user fees lead to less wasteful ‘good’ as well as a private health will cost in the future, and no one must be allowed use of services, he said. individual ‘good’, Tom Healy, answering succinctly by saying: to overrule this decision. Care “Universal coverage can be director of Nevin Economic “A lot more! How much more is being compromised by the organised so as to give appro- Research Institute (NERI), will depend on demographic decisions of those who never priate incentives to both users addressed the future funding changes in population, how see a patient and are only con- and providers of health. Partial requirements for health. long people live and morbidity.” cerned with budgets,” she said. coverage can lead to worse He was concerned at the He identified four possible INMO general secretary health and typically less effi- way health has become a com- ways forward: Liam Doran said: “The INMO cient use of services,” he said. modity and how its funding is • Reform the health service to is doing its part in bringing He pointed out that increased discussed in very narrow terms. be more cost effective forward a cohesive plan for prescription charges has led to “We are speaking on it as a • Invest in early intervention health. We only have over- people stopping some medi- current expenditure, rather and prevention to save spend- crowding in EDs because we cations and developing worse than a long-term investment. ing on health in the long run have not convinced the public health outcomes, which are Health funding is a shared • Make the service more equi- yet that this is wrong; the pub- more expensive to manage in responsibility between public, table – there is evidence that lic in turn must convince the the long-term. Whether funded private and voluntary sectors. societies that are more equal politicians that the health ser- directly or indirectly by gov- There is huge pressure on in terms of income and wealth vice must be properly funded.” ernment, all systems of health resources. The total public are healthier. At the moment Funding models finance come from the taxpayer health budget is about €13 government policies are mak- The various models of so, he said, the only question is billion – about 7% of GDP. We ing Ireland more inequitable Vol 23 No 10 December 2015/January 2016 Vol

N funding a health service were how affordable can we make it. are looking at a very large and • Involve employees – those I

W outlined by Prof Charles Nor- The more straightforward the complex system,” he said. working in the health service, WIN Vol 23 No 10 December 2015/January 2016

- - - - - e e O O W vice e ar need need e can O W e need to need to a Horan W W e ar know that know that T W e y W HN Section, said: said: Section, HN P eport b eahy, PHN and INM eahy, O R L – , followed the , followed presenta epartment of Health haveHealth of epartment e than good care. ’t put the money in, you you the money in, ’t put D eter Carter stressed that eter Carter that stressed ecutive Council member, Council ecutive member, P Mary INM Harkin-Kelly, Martina Geraldine Talty, INM Talty, Geraldine From the expert Ger panel, From The main message for gov for The main message he INM he conference in Croke Park on December 2 on December Park Croke in conference “Quality costs – if you don’t “Quality costs – don’t if you put the investment in, there is com little you that wonder you care. If of quality promise don can’t have simply a quality service.” health to focus on the focus staff to we have and how to them. retain aldine Cunningham responded: “ unacceptable.” the accept not policy of Marteinsson, tions. Patricia t keep them at home under the the under home at them keep said. she PHNs,” of care Council member, Executive said: the do, “The you more do. to asked It’s you’re more management. crisis to in place need a programme burnout.” stop ernment is that costs poor care mor “If there is any money saved money saved is any there “If to be efficiencies, it needs by into channelled particularly of the elderly. care Ex said: “Thepresident, HSE and the worth. our to recognise said: “Economics is a crucial crucial said: “Economics is a but nurses/midwives factor need to be of the informed spend so that we can influence spent.” are funds the where when you have an adequate adequate an have you when number of you have nurses, better outcomes.” patient constantly being talked about about talked being constantly question is how The cost. as a the and we get government can HSE to listen? officersthe national at and representatives eady f eady R section and or branch INMO change:

- - - - - the the this this direc e need O W GNs, R e not doing e not overcrowd orking in D W e ar W oblem but that with with that oblem but s. And on the other end, s. he He stressed: “The workload workload “The He stressed: A chaired debate by lively Mr Carter said the majority the majority Carter said Mr of older “The care people is He said that E Mr Carter reflected on the Carter on the Mr reflected verstressed and underpaid, and underpaid, verstressed D should be evenly distributed; should distributed; be evenly never should too much reliance be one on placed individual. to critical is Communication teamwork effective ensuring and leadership. INM Mathews, Edward social and regulation of tor will go a long way to address way will go a long older people justice. compassion can out be drained to need makers Policy you. of look this.” at and health service generally, highly is specifically, nursing The and stressful. pressurised to need other each support has greater.” been never Debate good community services, good community services, to will present people fewer E said that people can’t leave community nursing hospital if them. for there services aren’t was homes in nursing care of whom of HCAs, many done by untrained. were There enough. good not simply and factor is an affordability If HCAs are factor. a reality and prop trained educated, by supervised erly ing the deficits of in the care older people. sion? overworked, you “If are o they get specialist care.” specialist get they visible health the most was ing service pr the nursing care for them, for but the care nursing of the infantry we also need HCAs.” trained question of whether nurses they have their compas lost

- - - - - / O CN. R , the longer their D oblems. People have have oblems. People y for older for y people.” e W “The older last want we place “The workforce needs needs “The workforce It is essential to ensure that It that essential to ensure is He this said was complex a and midwives “Nurses that with chang He observed e living longer, many with with many e living longer, aining programmes to save to save aining programmes stay in hospital will be. Hos be. will hospital in stay for nearer their own home, in in home, own their nearer for they where community, their therefore and happier be will The longer a patient healthier. stays in the E people to be is in an acute hos to be is in an people shorter hospital stays when when shorter hospital stays long-term conditions such as as such conditions long-term disease, MS, motor neurone rheumatic conditions, type 2 or diabetes conditions. heart to address up to be geared changing health needs. these to sta help Specialist nurses bilise people with complex health pr general of the general secretary pitals are dangerous places, places, dangerous pitals are especiall challenges Human resources enough the health service has and nurses particularly staff, to midwives, meet demand, CE former said Carter, Peter He UK erred in cut said the on its nurse/midwife ting back tr the and is now paying money, other to ‘raid’ price and having in countries, including Ireland, to the order supply of needs NHS. the time in all health services and constantly searching we were solutions. new for often that things say when go they wrong, the ones are left the pieces. But it is to pick up of fault a the usually systems end the at nurse a with failure, the of system.” demographics, people ing ar to them want caredbe pital. pital. ------needs of the won’t do this this do won’t e W service delivery . This leads to hap This leads . So how do we get we get do So how educed costs. That is is That costs. educed n my return what I see I see what return n my is essential to a more more a to essential is demonstrated how smalldemonstrated O hen staff are clear about about clear hen staff are W Geraldine Cunningham, Cunningham, Geraldine According to According Ms Cunning “ After 17 years out working After years 17 She pating effectively when asked. effectively pating including nurses/midwives, nurses/midwives, including partici by can lead innovation associate director of culture of culture associate director change at Barts Health NHS on spoke how the deliv Trust, Models of efficient health service. health efficient changes in health provision can changes in health provision Nurses/ differences. big make by save can alone midwives to small attention paying more example inefficiencies, for by of rationalising procurement department. a in supplies of older of care ham, reform people their purpose, clear about their they team objectives, have mor – lower better results of lower lengths tality rates, stay and r when lenge poor behaviour they see it because people are clear about because people are what they feel to do, have and their roles supported in valued, opinions their and are They are chal to able count. by filling filling by a vacuum for a day then becomes somebody that later. week a problem else’s better at managing systems better at managing systems do what we that will need do? them to side the NHS, Ms Cunningham Cunningham the NHS, Ms side said: “ of inefficiencies in a lot is a lot the systems. I see people of man good at very who are poor at very crisis but aging a planning. population. ery of the health service must the health service must of ery meet the changing pier patients also,” she said. she also,” patients pier 10 National Conference SPECIAL REPORT

Update on major current issues A national meeting of • A possible joint initiative Industrial relations update Midwifery Workforce branch/section officers and with the Federation of Volun- Phil Ní Sheaghdha, direc- Planning Project nurse representatives followed tary Bodies aimed at a fuller tor of industrial relations, Director of professional the health policy debate at the understanding of the total provided the meeting with a development Elizabeth Adams INMO national conference on skill set held by the RNID comprehensive update on key advised the meeting of signifi- December 2. • Further engagement with the IR issues including the imple- cant remaining difficulties with Reports summarised the Department of Health, and mentation of the Lansdowne the final report emerging from Organisation’s activities in cur- specifically the Minister for Road Agreement and pay the HSE’s Midwifery Workforce rent critical areas including: Disability, on the issue of pol- restoration measures, which Planning Project. Campaign of Excellence – ID icies/funding for ID services. begin on January 1, 2016. In Despite strenuous efforts, sector Taskforce on Staffing and addition, Ms Ní Sheaghdha she said that the Organisation General secretary Liam Skill Mix in Nursing gave the current situation on: still has significant concerns Doran gave an update on this Mr Doran, who is a member • The transfer of four tasks about the work of the project, campaign, which is aimed at: of this Taskforce, updated the leading to the restoration of specifically about the meth- • Highlighting the damage meeting on the current status the time and one-sixth pay- odology applied which was done by budget and staffing of this important initiative. ment between 6pm and 8pm leading to recommendations cuts in recent years, and to He reminded the meeting • INMO demand for improve- of one midwife to 35 births in call for the proper funding for that the INMO commenced a ments in student nurse/ large and medium hospitals, services in the ID sector safe staffing campaign at ADC midwife pay and conditions, and a ratio ranging from one • Ensuring the full utilisation 2014, which led to then Min- and incremental credit for to 29 to one to 43 midwives to of the RNID, the unique ister for Health, James Reilly, graduating nurses/midwives births in smaller units. honours degree programme establishing a Taskforce on • Application for revised pay rate The INMO is demanding dedicated to optimising Staffing and Skill Mix in Sep- for group directors of nursing that any report published at potential and wellbeing of tember 2014, with phase one • Measurement of all hours this time must include a dis- the person with an intellec- of its activities focusing on actually worked by nurses/ senting comment from the tual disability, in all areas of medical/surgical wards/units. midwives. INMO, to indicate that the service delivery. The Taskforce has now These issues are covered in full Organisation felt that further To date, the campaign has produced an interim report, on page 14 of this issue and work was required to meet the involved: making a number of recom- ongoing on www.inmo.ie original terms of reference. • A very successful conference, mendations including: Ms Ní Sheaghdha also gave PDC and library update held by the Section in March, • CNM2 post to be 100% updates on a range of other Ms Adams also provided attended by over 200 RNID supervisory issues including: the meeting with an update members • Staffing levels to be deter- • The passage of the Workplace on recent developments and • Local protests about staffing mined by use of an agreed Relations Act 2015 and the growth, within the Profes- and standards with a number dependency tool (with nursing changes to industrial rela- sional Development Centre, of service providers hours per patient day as per in tions bodies and procedures which continues to expand its • A protest outside the Dáil New South Wales, Australia) • A range of collective claims, range of services, including: attended by over 100 repre- • Enhanced role for senior nurse from the INMO, in such areas • The PDC now provides over sentatives from across the management to establish, as: PHN training and trans- 120 different programmes country and maintain, safe and stable fer panel; general health • A calendar of events is now • Meetings with a number of levels at ward/unit level service transfer panel; record- available on the website with interested parties includ- • Initial 80/20 skill mix ing of sick leave; injury at work discounts for INMO members ing HIQA, the Federation of between nursing and health- schemes; regularisation of act- • Expansion of library services Voluntary Bodies and the care assistants. ing; fixed term appointments; • The continuing discussions Department of Health. The Minister for Health has higher post salaries (Labour between the INMO and UCD In addition, the Section has now confirmed his accept- Court hearing Dec 10); and on a partnership leading to produced a booklet summaris- ance of the interim report and agreement to review Dignity university credits for those ing the role of the RNID in all the exercise now moves into at Work policy following the undertaking INMO courses stages of life. a pilot phase. The immediate INMO survey on workplace • The ongoing popularity of The meeting was assured next step is to agree pilot sites. bullying and presenteeism in section meetings that the campaign will con- The pilot will commence, as the health service • T he ongoing development of tinue with a particular focus quickly as possible, with the • T he latest staffing figures the INMO professional web- on: outcome being referred back from the HSE (see page 14). site, dedicated to the PDC • Further engagement with to the national Taskforce for The director of IR now pub- • The ongoing INMO/UCD HIQA on the issues of the consideration, further amend- lishes a monthly bulletin on evaluation of missed care and person in charge (PIC) and ment where necessary, and, the website, updating mem- workforce planning in Irish Vol 23 No 10 December 2015/January 2016 Vol

N membership of inspection hopefully, publication of a final bers of general developments community nursing – to be I

W teams report in late 2016. in the IR area. published in February 2016. WIN Vol 23 No 10 December 2015/January 2016 ------MO gen delegate delegate that they they that N Author and Author and NEWS 13 NEWS nlightenment), said: nlightenment), said: E International (Survivors (Survivors International E port of male politicians and and politicians of male port “As a frontline organisation organisation a frontline “As of prostitu Survivors Survivor and campaigner Survivor and campaigner The majority of men are not not of men are The majority orward and strengthen this this and strengthen orward conference. All eligible conference. mem come to encouraged bers are f the within exercise democratic said I Organisation,” It manages the affairs of the It of the manages the affairs while also seek Organisation, to implement policies ing adopted at annual eral secretary Liam Doran. Liam secretary eral and independent law centre centre and independent law of sex victims which supports trafficking, we first-hand know which lies the human misery crimes. these of core the at Men must now stand up and be counted and tell politicians it to time is act.” “ Mia de Faoite concluded: concluded: Mia de Faoite sexual and “Prostitution exploitation can and will end humans all when only but come together to do it, which men”. includes course of willing to buy sexual access to buy sexual access willing to the bodies of vul socially stand up to the toxic minority and say ‘not who are of men see to glad am I name’. our in that evidenced the by pres activists at every step of this process.” campaigner Rachel Moran, of of Moran, campaigner Rachel SPAC of Call Prostitution-Abuse for ing women and girls and nerable it is so important the by and of men here ence sup tion welcomed the action at the action at welcomed tion Leinster House. - - - - xecutive Council is is Council xecutive targeted at source – – at source targeted E exploitative and abu exploitative your your form. nomination decriminalise women who women who decriminalise what they are via theseeking “The John Cunningham, chair of Cunningham, chair of John ber, about candidate each who ber, is, a critically important entity. a critically important entity. election, where they work etc. they etc. work election, where the to make helps This really member, every for election real, photo your so please submit graph and biographical data data and biographical graph with the Immigrant Council of Ire of Council Immigrant the a is “Prostitution said: land, brutal, are being prostituted, and and being prostituted, are buyers.” criminalise of men the small minority and brought who have who buy sex crime to every organised part country. our of behaviour for the better in in better the for behaviour to our order achieve goal of Better Men, for ‘Better Lives we All’, believe the Lives for a key laws represent proposed are We Ireland. for moment uniting to call on men to make demand by heard voices their which the law change in ing a will sive criminal enterprise which criminal enterprise which sive must be ------MO to MO to N eill, chief execu N to shoulder in soli O’ addition to completed addition to completed urses and midwives see see and midwives urses same time, the following: the time, same N ysical and sexual abuse in ysical and sexual abuse in lection manifesto. lection This will allow the I In “ “As the one national men’s the one national men’s “As Alan etwork said: “We welcome welcome etwork said: “We Photograph  E Pictured (l-r) outside Leinster House were: Alan O’Neill, the Men’s Development Network;Men’s the O’Neill, Alan were: Leinster House outside (l-r) Pictured general INMO Doran, and Liam Ireland; of Council the Irish Immigrant Cunningham, John sex buyersof bylaw introduction the demanding joint statement a who issued secretary, organisations the 73 from of page) top (pictured joined representatives They Christmas. recently the Dáil outside campaign Light Red the Off Turn the up make that provide details, to every details, to every mem provide application forms, forms, all candi application • • dates are asked to submit, at submit,to at asked are dates the member are included in a spe a in included are member cial the on notice opposite. page first-hand the caused harm first-hand by the associated and prostitution, We to exit desire prostitution. must criminalise demand and prosti who are those support tude to women and to stand to tude women to and stand shoulder N for us to this opportunity show women who our for support effects the worst have suffered atti abusive of some men’s prostitution. that consciously organisation our changing a lead in takes tuted and we must do so now.” so do must we and tuted tive of the Men’s Development of the tive Men’s those who darity with suffer ph ------xec E MO N to the I with survivors of of with survivors s May 2018, will com the Sexual Offences the Sexual Offences n

ate the demand for for pros ate the demand MO general secretary secretary MO general O, called on on called O, male pol omination forms must be must be forms omination

dship and hurt they visit visit they dship and hurt ctio eachtas. N M N e I The legislation, which will The will which legislation, Representatives from the the from Representatives efore Wednesday, February 10, February Wednesday, efore quality, Frances Fitzgerald. Frances quality, N El 2016. All details details All in 2016. to relation to be requirements an eligible

submitted to the general sec Executive Council election – call to all candidates Council Executive officer) on or retary (returning b

Men show solidarity with survivors ofsolidarity with survivors Men show Dáil outside prostitution Call for sex buyers law by Christmas buyers for sex Call utive Council for the period May for Council utive 2016 to mence early early mence the in year. new titution, must understand the the titution, must understand har on those who are prostituted, prostituted, are who those on it that they must realise and amounts to nothing than more exploitation. gross Liam Doran said: “Persons said: “Persons Liam Doran are prostituted who are vulnerable, overwhelmingly of sup need and in mistreated, who Men, port and protection. gener switch the focus of the focus law on switch the demand fuel who to sex buyers traf and sex prostitution for E ficking, is currently before the the ficking, before is currently Oir Bill, which has been introduced which has been introduced Bill, Justice and for the Minister by 73 organisations which make 73 organisations which make Off the Turn Light Red up the Campaign, including the I prostitution by calling for the the for calling prostitution by laws sex buyer of introduction Christmas. by representing all aspects aspects all Men representing at Lein gathered of Irish life to show ster House recently solidarity iticians from all parties to to parties all from iticians support 14 NEWS

Phil Ní Sheaghdha, INMO director of industrial relations, reports on recent ICTU negotiations and other national IR issues

Public holiday payments over National competitiveness Christmas and New Year board unnecessary – ICTU The HSE has advised that Among the current areas of The Lansdowne Road the provisions with regard to concern being addressed by Agreement states at point public holiday premium pay- the Irish Congress of Trade 5.5 that: “The parties are ments for the Christmas and Unions is the recommendation agreed on the importance of New Year period 2015/2016 for a national competitiveness achieving sustainable public are as follows: board to be established. pay policy that will continue St Stephen’s Day The ICTU recently corre- of austerity measures imposed to support the ongoing eco- This year St Stephen’s sponded with Taoiseach Enda on the citizens of the Republic nomic recovery over the Day (December 26) will fall Kenny on the European Com- of Ireland required a National coming years as the financial on a Saturday and is a pub- mission’s recommendation on Competitiveness Council and emergency legislation comes lic holiday as provided for in the establishment of national therefore there is no need to be amended and repealed. the Organisation of Work- competitiveness boards within for a body performing similar “The government con- ing Time Act, 1997. Public the European area. functions. firms that it will engage with Holiday premium payments The concern of the ICTU and This is an issue of concern the representative bodies of should therefore be paid affiliated trade unions, includ- as the Lansdowne Road Agree- public servants during the to staff who work on that ing the INMO, is that such ment specifically states that lifetime of this agreement in day. The normal Saturday boards could infringe on the wage setting mechanisms are advance of it deciding on any premium payment will not autonomy of social partners in to be agreed between the gov- alternative pay determination apply. the collective bargaining and ernment and the public service structure.” In the case of staff who wage setting. trade unions. The trade unions Members will be notified work a Monday to Friday ICTU has drawn attention to had their first meeting on this of all further updates on this regime, the paid day off in the fact that the programme in mid-November 2015. issue. lieu of the public holiday will normally be granted on the following Monday (Decem- ber 28). Talks continue on transfer of tasks Staff who work a ‘5 over During the Lansdowne Road Beaumont, Tullamore and the can only transfer if the staffing 7’ roster talks, the INMO, SIPTU Nurs- Mater hospitals. levels within the nursing/mid- In summary, staff who ing and the IMO sought the With a view to moving wifery grades allow for nurses work a ‘5 over 7’ roster restoration of the premium this forward, as part of the /midwives to take on these should be granted premium payment time and one-sixth Lansdowne Road talks an inde- additional roles. payments for working over between 6pm and 8pm to all pendent process was sought to The trade unions’ position the Christmas and New Year nursing and midwifery grades. oversee the implementation of is also that time and one-sixth period as follows: They confirmed that sav- this particular issue with the would have to be restored to Christmas Day St Stephen’s ings could be found to restore understanding that the resto- all nursing grades who work Day New Year’s Day this payment if certain tasks ration of time and one-sixth between the hours of 6pm Friday December 25, 2015 were transferred from medical remained outstanding. and 8pm and that the role and Saturday, December 26, 2015 doctors to nursing/midwifery That process has com- function of nurses/midwives, if Friday, January 1, 2015 all staff. These tasks include: menced and is being led by changed in this manner, could public holiday premium. No • First dose antibiotics independent chairman, Sean not solely be their responsibil- public holiday premium pay- • IV medication McHugh, who has held a ity; medical staff would have ments are payable to staff • Nurse-led discharge number of meetings with the to have an involvement as who work on days other than • Out-of-hours phlebotomy, employer’s side, including otherwise they would become December 25 and 26, 2015 which is currently the respon- with the Department of Pub- deskilled. Therefore, a clear and January 1, 2016. sibility of NCHDs. lic Expenditure and Reform, local implementation process If you require further Since 2013, a number of the Department of Health, the would have to be in place in guidance please contact measurement exercises have HSE, together with the trade each acute hospital. the Employee Relations taken place. However, the unions involved – the INMO, These talks are ongoing and Advisory Services team, employer contested the esti- SIPTU Nursing and the IMO. members will be updated when a Tel: 01 6626966 or email: mated savings that the trade The trade unions’ position is final position is arrived at, which Vol 23 No 10 December 2015/January 2016 Vol [email protected] unions arrived at, following that the tasks, if transferred, the INMO Executive Council will

WIN surveys and work shadows in could result in savings but they then have to consider. NEWS 15

Phil Ní Sheaghdha, INMO director of industrial relations, reports on recent ICTU negotiations and other national IR issues Update on shorter working year scheme and sick pay/sick leave rules Shorter working year facilitate the implementation The HSE has announced of this scheme and to grant Latest nursing workforce figures a shorter working year applications for special leave The INMO and other public health service in Ire- scheme (governed by circular as far as possible. While due health sector unions meet land. Of those, nursing makes 023/2015, which is available consideration should be given health sector management up 34,852, consisting of: on www.HSE.ie). The circular to all applications, the needs bimonthly at the National • Nurse management – 8,205 confirms that all categories of of the service may require that Industrial Relations Joint • PHN – 1, 496 employees are encompassed in some cases an employee’s Council (NJC). This forum is • Staff nurses – 24,149 by this scheme and will be eli- application will be refused. chaired by the Labour Rela- • Other nursing – 1,002. gible to apply to avail of leave To be eligible to apply tions Commission. This represents a decrease in 2016. for unpaid special leave, an At the most recent NJC it of 111 staff nurse posts and The purpose of the shorter employee must have com- was confirmed that there were an increase of 75 in nurse working year scheme is pleted their probationary 102,245 (whole time equiva- management posts since “to permit HSE employ- period. lent, WTE) employees in the HSE figures for August 2015. ees to balance their working Staff must apply in writing arrangements with outside by November 30 in the year the recording of sick leave has sick leave but returns imme- commitments, including the prior to the year in which it is been resolved satisfactorily. diately following rest days, school holiday periods of their proposed to avail of the spe- The INMO had argued then the rest days cannot be children.” cial leave. While the period of constantly that the HSE recorded as sick leave. Under the terms of the special leave is unpaid, those was incorrectly applying the This has now been success- scheme, special leave is avail- participating in the scheme recording of sick leave. It is fully argued by the INMO and able as a period of two, four, may apply for special admin- now confirmed that the rules on November 2, 2015, the HSE six, eight, 10 or 13 weeks. istrative arrangements for the in respect of the recording of confirmed that these arrange- The leave may be taken as payment of part of basic salary sick leave are that sick leave is ments are backdated to March one continuous period or as a during the period of special recorded in days not in hours. 31, 2014, which is the date on maximum of three separate leave. The rules also state that if which the sick leave changes periods, each consisting of not See the HSE website for an employee is absent prior to were introduced in the public less than two weeks and not further details. The INMO rest days and absent immedi- service. Therefore due to this exceeding 13 weeks in total. information office can also ately following rest days, that change, members are urged The period of leave shall be provide advice on the scheme. the rest days will be counted to check with their HR depart- unpaid special leave. Recording of sick pay/leave as sick leave. ment that all sick leave taken The circular goes on to state The INMO is happy to con- However, if an employee is since March 31, 2014 has been that managers are required to firm that the issue relating to absent prior to rest days on recorded correctly.

Restoration of pension income for retired public servants R eTIRED public service of PSPR from 12% to 20% on • January 1, 2017 – return of • January 1, 2018 – return employees, including nurses the portion of any public ser- €500 to most PSPR-im- of €780 to most PSPR-im- and midwives, are set to vice pension amount in excess pacted pensioners pacted pensioners. receive an increase in their of €100,000. pensions over the next three The Financial Emergency Three-year cumulative annualised benefit of PSPR amendments Retired before Retired after WIN years. Measures in the Public Inter- Gross pension Mar 1, 2012 Mar 1, 2012 The Public Service Pension est Act 2013 also provided Vol 23 No 10 December 2015/January 2016 Reduction (PSPR), which came for additional PSPR reduction €14,000 €120 (0.9%) into effect on January 1, 2011, rates of 2-8% to be applied €16,000 €240 (1.5%) imposed reductions on annual to all annual public service €18,000 €360 (2.0%) public service pensions on pensions in excess of €32,500 €20,000 €480 (2.4%) payments over €12,000, using from July 1, 2013. €25,000 €810 (3.2%) a tiered set of bands and rates The restoration of pension €30,000 €1,260 (4.2%) with a top rate of 12% on any income will be phased in over €32,000 €1,440 (4.5%) public service pension amount three years as follows: €35,000 €1,680 (4.8%) €570 (1.6%) over €60,000. The legislation • January 1, 2016 – return €40,000 €1,680 (4.2%) €720 (1.8%) was amended from January 1, of €400 to most PSPR-im- 2012 to increase the top rate pacted pensioners €50,000 €1,680 (3.4%) €1,020 (2.0%) 16 NEWS

Workplace stress – does anyone care? Hospitals are ignoring safety-at-work legislation, writes Dave Hughes

It is a cruel irony indeed that health and safety risks in tive clothing and a safe code ity protocol or the placing of health workers, and nurses the health workplace, that pass. additional beds on all wards and midwives in particular, are employers and trade unions in With regard to workplace is resorted to as a first, rather ranked consistently as among the hospital sector throughout related-stress, European than a last measure. This those working in the most haz- Europe are currently engaged studies have identified unfa- makes entire hospitals into vir- ardous work environments. in a joint project to promote vourable organisation and tual powder kegs of stress with The top two most frequently occupational health and safety management in the workplace falling of standards of care and reported work-related health in healthcare environments as well as a poor social context concern for either patients or problems in Europe are mus- and to reduce the impact at work, including, but not lim- workers’ health and safety. culoskeletal disorders and of musculoskeletal injuries ited to: One of the key INMO work-related stress. and work-related stress. The • Excessively demanding work demands in the current ED A European Agency For INMO, as members of the and/or not enough time to dispute is for the effective Safety and Health at Work European Public Service Union complete tasks implementation of the Safety, study of 2000 suggests that (EPSU), are participants in this • Conflicting demands and Health and Welfare at Work 50-60% of all lost working dialogue. lack of clarity over a worker’s Act in all departments. days can be attributed to The extent of occupational roles In promoting this campaign work-related stress and psy- health risk in healthcare is • A mismatch between the throughout the coming year, chosocial risks. not a new phenomenon. Flor- demands of the job and the INMO will be drawing on The UK Health and Safety ence Nightingale, more than the worker’s competency – considerable research and Authority Survey 2009/10 150 years ago, was well aware underusing workers’ skills can expertise from across Europe estimated that in the region of the risk of musculoskele- be a source of stress just as and the Organisation will seek of 9.8 million working days tal injury involved in patient much as over stretching them to emulate those sectors of were lost during that year due care. She wrote that the space • A lack of involvement in deci- employment that have made to work-related stress and between beds should always sion making and a lack of most effective use of the exist- that employees with work-re- be sufficient to allow the influence over the way a job ing legislation. lated stress were absent for on nurse/midwife to reach any is done The European Commission average 22.6 days. The total part of their patient’s body • Working alone especially sponsored initiative by EPSU cost of mental health disor- without having to bend. when dealing with members and HOSPEEM (the Euro- ders in Europe is estimated at Dr Brendan Drumm, former of the public and clients and/ pean Hospital and Healthcare €240 billion per year, €136bn CEO of the Health Service or being subject to violence Employers’ Association) is of which is due to lost pro- Executive, described hospitals from a third party, including timely in focusing on the need ductivity including sick leave as “dangerous places”. Yet in verbal aggression, unwanted for greater implementation of absenteeism. The individual spite of the existence of health sexual attention or the threat the Directive in respect of the costs of unhealthy work envi- and safety legislation derived of or actual physical violence. hospital sector. ronments, which lead to either from a European Directive Many of these factors are Employers at European level musculoskeletal injuries or over 30 years ago, healthcare readily identifiable in the aver- seem to be prepared to take on psychosocial work-related is still practised in a high- age emergency department board the words of a former stress, are immeasurable in risk environment. This can be throughout this country. When EPSU president, Minke Wersäll terms of lost opportunity, pain contrasted with the dramatic the ED becomes overcrowded, of Sweden, when addressing and suffering. However, an EU and visible health and safety all rules are abandoned and the subject of occupational report from 2009 estimates improvements in areas such occupational stress levels go health and safety and work- that direct medical treatment as transport, communications, through the roof. place stress: “No carer should is costing €104bn. energy and construction. You This situation is replicated be hurt while providing care.” Such is the human and cannot, for example, enter a in many hospitals throughout – Dave Hughes, INMO business cost of occupational building site without protec- the country when full capac- deputy general secretary

• Annual leave Know your rights and entitlements • Sick leave • Maternity leave The INMO Information Office offers same-day responses to all questions • Parental leave • Pregnancy-related Contact Information Officers Catherine Hopkins and Karen McCann at sick leave Tel: 01 664 0610/19 • Pay and pensions Email: [email protected], [email protected] • Flexible working Mon to Thur 8.30am-5pm; Fri 8.30am-4.30pm • Public holidays • Career breaks • Injury at work • Agency workers • Incremental credit WIN Vol 23 No 10 December 2015/January 2016

- - - - - owever, owever, publicly publicly H E INMO IRO S SA to ensure SA to ensure H Limerick, back Limerick, back 19 NEWS H – Mary Fogarty, – Mary Fogarty, H to address the to the address E S imerick is the fifth fifth the is imerick H L H hospital only had a clin a had only hospital one midwife to 44 births. to 44 births. one midwife A two-hour work stop The INMO remains in con in The INMO remains Mary Fogarty, INMO INMO Mary Fogarty, UM 12, resulting in an unaccept an in resulting 12, or November 10 to bring bring to 10 November or that all safety concerns of that all concerns of safety as addressed, are members their by under law required employer. matters to a head. matters pending an deferred was this all of process implementation documented health and safety improvements. tact with the page had been scheduled page had been scheduled f ical midwife workforce of of ical workforce midwife 1 mately 5,000 births a year, year, 5,000 births a mately the able midwife to birth ratio ratio birth to midwife able of said: “It is regrettable IRO, the while that acknowledged that additional it required, were midwives to recruit agreeing delayed safe ensure and the midwives the maternity at standards hospital. International safe dictate midwifery standards of to birth ratio a midwife the INMO believes 1:29.5 and must be these standards that to in all maternity adhered of care hospitals to ensure safe and women, mothers pregnant babies.” The international midwifery midwifery international The standard is one to midwife was shortfall the so births 29.5 concern of cause a obviously frontline to midwives. for the for significant clinical midwifery UM deficits at the issue and January 2015 in has ever ongoing been since. in hospital maternity busiest With the country. approxi ------80%, to accept 80%, to accept ecommended additional ecommended additional additional work. Other additional work. Other additional appropriate appropriate additional welcome development development welcome This led to an independent to an independent This led The INMO raised the need need the raised INMO The elations Commission.” elations The INMO is calling on the HSE to HSE the on INMO is calling The to midwives immediately recruit at reinstated are safe standards ensure UniversityLimerick Hospital, Maternity ergonomic review that high review ergonomic major manual handling major manual handling been rec have improvements with comply to safe equipment standards the in workplace. CSSD The operatives. appoint of additional staff is ment a require the as it removes to undertake nurses for ment this ommended, including training and lighted significant deficits lighted significant deficits and r proposals. After proposals. lengthy dis a by was agreed, cussion, it majority of the proposals and to suspend suspend to and proposals the six of period a for action any at months, pending a review that time on implementation All of these issues progress. peri to review will be subject odically with the Workplace R ------ed ed evision evision 97.5 % of mid 97.5 workforce and and workforce ospital, Limerick ospital, Limerick SA) of the unsafe SA) of the unsafe ealth and Safety Safety ealth and at the University at the University H H H ( in respect of significant of significant in respect E frustration and concern by by concern and frustration The Organisation had to The Organisation had to Mary Fogarty, INMO IRO, IRO, INMO Fogarty, Mary Prior to this, The INMO has also secur The proposals put forward forward put proposals The S ospital. ecruited to work at the hos INMO has had to take take to The INMO has had to measures extraordinary engagement with the secure H which issues health and safety are impacting on the service and the physical wellbeing of depart nurses theatre the in Authority situation in the theatre situation theatre the in department. H the of take approach noti of the education and training education the of and training supports. on met said: “Our members November these discuss to 23 safety issues in over Croom called HSA the fying sion (WRC). (WRC). sion confirmed their wives levels of and midwives tional 30 nurses r will significantly this pital and stabilise the and preg mothers for services women nant attending. at required that are ports this hospital and a r Maternity following 27, November on of on a set reached agreement the by forward put proposals Commis Relations Workplace of a voting to favour work in rule, which would have seen from midwives withdraw all to roles administration clerical pregnant for care all prioritise babies. and mothers women, will see an addi WRC the at will that there be agreement sup of additional a review Action averted at Limerick Limerick at averted Action hospital maternity The INMO suspended indus trial to due action which was commence ment at Croom Orthopaedic ment Orthopaedic at Croom ------on on

E S in the the in E H S H ospital Limerick. ospital Limerick. concluded agree H members working working members ospital following a a following ospital H of patients. Industrial of patients. Industrial ersity ersity total of 24 beds will not will not beds of 24 total of premia pay. premia of ently 45 vacancies across vacancies across 45 ently ganisation also secured, ganisation also secured, favour of industrial action action industrial of favour – Lorraine Monaghan, IRO – Lorraine Regional update Regional Rights Commissioner has has Commissioner Rights – Mary Fogarty, INMO IRO INMO – Mary Fogarty, found in favour of an INMO of an INMO favour in found the Mid-West member in a for inhibited was who of almost 12 months period taking up a position from maximum attracted which The Rights payments. premia that found Commissioner unacceptable were there the delays by November November 2 about the open ment figure of figure ment the €3,000 for loss appointment of this nurse appointment of this nurse her a net settle and awarded A for all nurses working in this this in working nurses all for of specialist unit, payment val the location allowance open until the agreed staff the agreed open until ing of a new stroke unit at unit at of a new stroke ing Univ with manage It is agreed ment that the five remaining of a The secured. are levels ing Or annum. per €1,858 at ued action in the form of action a form work the in to rule will commence on During 2015. 16, December the work to rule all essential will patients by required care but provided be to continue non-essential/administrative done. be not will work the two directorates, which which the two directorates, severely is report members impinging on their ability to to a provide of care safe level strug they are patients and mont ballot of surgical the medical and in An overwhelm directorates. voted of members ing 99% in con to the highlight unsafe are There patients. for ditions curr gling to the reach basic care needs INMO has served notice served The INMO has Beau on action industrial of The INMO ment with the the ment with  • • • Annual Delegate Conference 2016

The INEC, Killarney Convention Centre Killarney, Co Kerry Wednesday to Friday, May 4-6, 2016

In accordance with Rules 5.9, 5.11 and 12.3.2, motions for debate at Annual Conference 2016 must be submitted to the General Secretary, no later than 12 weeks prior to Annual Delegate Conference (Wednesday, February 10, 2016 at 5pm)

BRANCH/SECTION GENERAL MEETINGS

Each Branch/Section should hold an Annual General d) Section to nominate TWO official delegates to attend the Meeting in order: Conference. Please note: Branch and Section delegate nominations must be a) To consider motions for submission to the Annual Delegate submitted to the INMO, on the appropriate form, no later than Conference 2016. Motions must be submitted to the General 5pm on Wednesday, February 10, 2016. Secretary, on the appropriate form; b) To consider any amendments or changes to the Rules of the Organisation, for submission to the Annual Delegate Conference 2016. Rule amendments/changes must be submitted to the General Secretary, on the appropriate form; Please note: Motions and changes/amendments to rules must be submitted to the INMO, on the appropriate form, no later than 5pm on Wednesday, February 10, 2016. c) Br anches to nominate delegates to attend the Annual Delegate Conference on the following basis:

Membership less than 50 - 1 delegate Membership of 50-100 - 2 delegates 101-200 - 3 delegates 201-300 - 4 delegates 301-400 - 5 delegates 401-500 - 6 delegates 501-700 - 7 delegates 701-900 - 8 delegates 901-1,000 - 9 delegates over 1,000 - 10 delegates For every 500 members, or part thereof over 1,000, each branch may have one further delegate

HOTEL RESERVATIONS FOR ANNUAL DELEGATE CONFERENCE 2016

This year the accommodation will be provided in The Gleneagle Hotel and The Brehon Hotel, Killarney, Co. Kerry. Three nights B&B accommodation will be reserved for all nominated delegates, from Wednesday, May 4, 2016 until Saturday, May 7, 2016, inclusive. Accommodation is available on a shared basis only. The INMO will not be responsible for any expenses incurred by delegates, other than the agreed package negotiated with the hotels. Delegates who wish to have a single room will be asked to pay the single person supplement. Delegates who are unable to arrive on the Wednesday evening, or who are departing earlier than the Saturday morning, May 7, 2016, must inform the hotel and Oona Sugrue. ADC Co-ordinator, as early as possible, but no later than Tuesday, May 3, 2016. Following your Branch/Section Annual General Meeting, when ADC delegates are nominated, Branch and Section Secretaries should reserve the required accommodation for their appointed delegates, clearly indicating the number of nights required by delegates, by sending the official INMO Booking form direct to: Central Reservations, The Glenagle Hotel, Muckross Road, Killarney, Co. Kerry prior to Thursday, March 31, 2016 All reservations for both The Gleneagle and The Brehon Hotels, Killarney will be made through the Central Reservations Team. All rooms will be allocated on a first-come, first-served basis. Confirmation of hotel bookings will be made direct to the Branch/Section Secretaries, by The Reservations Team in The Gleneagle Hotel.

For all enquiries regarding Annual Delegate Conference, please contact Oona Sugrue, INMO HQ Tel: 01 664 0636 Email: [email protected] WIN Vol 23 No 10 December 2015/January 2016 ------ursing ursing N MO/SIPTU MO/SIPTU N 21 NEWS this Recommenda facilities. our members are paid paid are our members MO IRO Liz Curran said, said, Curran Liz MO IRO vertheless, having regard vertheless, regard having N “This should be welcomed welcomed “This should be Mr Doran concluded: “It concluded: “It Mr Doran I y its funding authority. The The authority. y its funding re entitled to be paid their to entitled be re their paid ecommend concession of the ecommend concession of the by all. We would now ask would now ask We all. by to proceed the government refurbishment capital its with shortest the in programme timeframe”. possible flawed and illogical at any flawed and illogical at any this particularly stage, but, at time, difficult unforgivable.” that is unfortunate considering is Ireland Homes this from legal action arising very welcome The initiative. and strategic investment, is overdue, is long approach, common sense approach a to the existing situation and, to of all, it seeks foremost the living environ improve publicthese people in for ment long-stay their owed monies as soon as owed monies as soon as their possible.” increments from 2011. We from increments 2011. We now to further look forward engagement with manage employer does not control its its control does not employer con it does neither and funding of its staff. levels the pay trol Ne the already alignment pay to no the court has to, referred option but to the acknowledge entitlement of the staff con cerned to increments and to r claim.” union the delighted that are “We has Recommendation court’s vindicated the I our that claim work members ing Aoibhinn Services Ard in a ment of the service with view a to having full, so tion implemented in that who findsan unsatisfac itself in largely tory situation influenced b - - - - - verall, further con verall, a would be fundamentally would be fundamentally public facil long term care current current situation. “The alternative, arising arising “The alternative, “The court has considerable “The court has considerable verdue. It is acknowledged It is acknowledged verdue. Liz Curran, INMO IRO: “Welook Curran, Liz with engagement to further forward with management a view to this having in full” implemented Recommendation ities is both welcome and long welcome and long ities is both o HIQA this plan requires that for to extend the timeframe to adherence infrastructural this is both log but standards, of view in and necessary ical the to a strict adherence from existing timeframes would be of the closure long-term beds in increases further to leading in emergency overcrowding num departments, increased discharges of delayed bers and, o of our traction health service. This Liam Doran said: “The gov said: Doran Liam decision to invest ernment’s in our this claim are aligned for pay pay aligned for are this claim The with HSE staff. purposes the that also agreed parties are staff this with associated claim increments afforded be should whom to HSE staffwith line in aligned. they are with the sympathy employer - - - not be ursing ursing N HI) ignore HI) ignore N eland ( “The parties are agreed “The agreed parties are MO general secretary secretary MO general eements. els of overcrowding in our in our els of overcrowding N I The reality is that, without without that, is reality The However, since 2011, the the 2011, since However, As the dispute could CR 21067), which stated which stated CR 21067), cerns expressed by by expressed cerns emergency departments and departments emergency and the elderly of number increase or delayed on trolleys people from acute in their discharge hospitals. the current situation and fail fail and situation current the to closing that acknowledge would be a existing public beds which serious error would only to an increased cause hardship elderly of number patients. and some this investment additional time to meet HIQA our health service standards, bed term long vital lose would This capacity. would, immedi ately, exacerbate the existing exacerbate the existing ately, lev Homes Ir vious union/management vious union/management agr that: that the staff associated with resolved at local level, or via a via a or level, at local resolved Labour Commission Relations in Conference Conciliation was matter the 2015, March to the Court. Labour referred was hearing Court Labour A The 2015. September, held in issued a Recommen Court service, which receives 90% 90% which receives service, of the funding from its HSE under Section the 39 of Health that it had 2004, advised Act from funding received reduced could the HSE and therefore increments. their staff pay not management has Aoibhinn Ard always accepted that the staff entitled to were be paid their that advised but increments, to afford not could service the fund receiving without do so the for ing from same HSE. 2015 October 27, on dation (L ------MO and MO and N O/SIPTU O/SIPTU M N ord to lose any to lose any ord verall verall health ser are offered to pre- offered are to persons with an with an to persons long-term care facil long-term care MO welcomes the MO welcomes the

N MO believes there is no is no there MO believes to high support needs. to high support needs. I N d Aoibhinn d Aoibhinn Services pro

timeframe for public nurs for timeframe rious standards. However, However, standards. rious This initiative requires the the requires This initiative Public The services’ staff have a a The services’ staff have In addition, there are a a are there In addition, Ar he T Health Information and Qual and Health Information government initiative to to government initiative in million €300 over commit capital funding to refurbish homes. nursing public ities remain an essential part part essential an remain ities of the o the health service vice, and cannot aff further bed capacity. The con further bed capacity. ing comply with fully homes to va the I to this alternative the given to maintain all avail pressure home stay/nursing long able beds. ity Authority (HIQA) to revise revise to (HIQA) Authority ity its SIPTU. sented by both the I both sented by long-established alignment pre to owing salaries, HSE to The service employs more more employs The service repre who are than 100 staff, number of community-based community-based of number residential offering units accom and residential respite modation for people with mild school children, adults and and adults children, school people. older intellectual disability Wex in ford town and county. Its day town day Its county. and ford services

in Ard Aoibhinn Aoibhinn services in Ard the An ongoing dispute over Aoibhinn Services Ard of failure increments pay to Wexford in has 2010 since staff their to Court the Labour in resulted the backing I Labour Court rules in favour ofin favour rules staff Court Labour vides residential and day day and vides residential services claim that staff of the service entitled to their are have incre

ments them. to paid INMO welcomes funding to refurbish nursing homes INMO welcomes funding to refurbish Benefits of INMO Rewards

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Offers are effective from 1st November 2015 and are subject to change. Only one discount can be used with each eligible proposal. You can only avail of a Rewards Programme once through Cornmarket. Discounts above must be requested at quotation stage and cannot be issued retrospectively. *Terms & conditions apply. You must apply to join the Scheme within 3 months of joining INMO Rewards to avail of this free offer. Savings based on an INMO member earning a salary of €35,000. The first 9 months means 9 consecutive months from the 1st of the month following the date that you are accepted as a member of the Scheme by the Insurance Company. This offer is not available to existing members of any Salary/Income Protection Scheme administered by Cornmarket. **Discount is only available to INMO Rewards members who are new Cornmarket customers taking out car insurance through Cornmarket’s Nurses & Midwives’ Car Insurance Scheme underwritten by Aviva Insurance Limited. €70 off is based on the minimum premium of €294.75, inclusive of Government levy. Actual discount is made up of €40 off plus an extra 10% off your premium. You must request a quote within 1 year of joining INMO Rewards. Entry criteria, terms & conditions apply. ***Discount is only available to INMO Rewards members who are new Cornmarket Home Insurance Customers taking out an Allianz home insurance policy through Cornmarket. €120 off is based on the minimum premium of €302.52, inclusive of Government levy. Actual discount is made up of €25 off plus an extra 25% off the premium. You must request a quote within 1 year of joining INMO Rewards. ****Lowest Pricematch offer is €13.13 for Mortgage Protection Plans and €15.15 on Level Term plans per month. 5% discount is subject to a minimum premium of €20 per month. †Tax return service is provided by Midas and is available one year after joining INMO Rewards. Midas is a tax-based service and not a regulated financial product. Cornmarket Retail Trading Ltd. is a wholly-owned subsidiary of Cornmarket Group Financial Services Ltd. Aviva Insurance Limited, trading as Aviva, and Aviva Life INMO Rewards are provided by & Pensions UK Limited, trading as Aviva Life & Pensions Ireland, are authorised by the Prudential Regulation Authority in the U.K. and are regulated by the Central Bank of Ireland for conduct of business rules. Allianz plc is regulated by the Central Bank of Ireland. Cornmarket Group Financial Services Ltd. is regulated by the Central Bank of Ireland. A member of the Irish Life Group plc. Irish Life Assurance plc. is regulated by the Central Bank of Ireland. Telephone calls may be recorded for quality control and training purposes. Section News 23

Clinical Placement Co-ordinator Section to meet three times per year The role of the CPC and the they have not already done so the INMO ADC 2016 was also activities could be dissemi- current challenges facing to ensure they are received. discussed during the meeting. nated amongst the Section. CPCs were among some of the Members also discussed and The current chair of CPC Sec- The INMO CPC Section is issues discussed at the second confirmed an agreed schedule tion, Shirley English, called happy to invite any member Clinical Placement Co-ordi- for further meetings and it on members of the Section currently employed in the nator Section meeting, which was decided that the Section to present proposed motions role of CPC to join the Sec- was held in October in INMO would hold meetings three at the January 2016 meeting tion, which endeavours to HQ. times per year to coincide with where a consensus would be act as a peer support group The group discussed issues the Student Allocations Liaison reached regarding motions for offering shared learning and pertaining to the role of the Officers Section meetings. This submission. experiences. CPC with emphasis on current would afford both Sections the The format of future meet- Simply email your contact challenging and developmen- opportunity to have their indi- ings was also discussed and it details to: membership@inmo. tal topics. Minutes from this vidual meetings overlap when was agreed to have protected ie. The next meeting will be meeting will be forwarded to essential and synergic sharing feedback time for members held on January 26, 2016 when all those who were present. of information and experience who have recently attended the Section looks forward to Section members are asked to could occur. a CPD activity so that knowl- meeting members both long- forward their email address if The proposed motion for edge acquired at these standing and new.

Radiology Nurses Section Third Level Student Health re-activated in November Nurses Section meets

XX

Pictured with the INMO general secretary Liam Doran and her colleagues, Jean Boland is presented with a small gift to thank her for her contribution to Pictured at the Radiology section meeting were (l-r): Claire Mahon, INMO the Section over the years (l-r were): Jenny Scott; Patricia Brady; Liam Doran; Jean president;Geraldine Gibson; Mary Nolan; Sharon O’ Connor; Vija Punneghade; Boland; Deirdre Adamson; Alison Meagher; Joan Broderick; Laura Tully; Orlagh Fleming; Vicky Sveydar; Sarah Higgins; Priscilla Alcos; and Susan Rutledge Elma Clancy; and Michelle Cresswell

The Radiology Nurses Section group and the various benefits The nurses working in uni- excellent. Members found was recently re-activated this would have. On behalf versities and ITs met recently it extremely beneficial for following a meeting in of the Section, she agreed to in head office to hold their themselves, but stressed that November where it was agreed review the possibility of this annual two-day workshop and it had also provided useful by all those in attendance that being brought forward. Section meeting. techniques that they could the Section was required. It was agreed by all present A number of significant use professionally in their During the meeting the that they would give a events took place over the two own practices for the wellbe- WIN

national Section officers were comprehensive list to Ms Ni days, one of which was the ing of the students. Vol 23 elected and it was decided that Sheaghdha as to their roles retirement of long standing Saturday’s schedule

meetings would be rotated and responsibilities and this member Jean Boland. included an update on contra- N around the country. will formulate the basis of any The Third Level Student ception by Dr Deirdre Lundy, o 10 December 2015/January 2016 INMO president Claire claim that may follow. Health Nurses Section also women’s health expert, and Mahon and director of The next Section meeting had a workshop on mind- also included their national industrial relations Phil will be held on January 16, fulness and meditation for Section meeting. All who Ni Sheaghdha were also 2016 in the INMO HQ and holistic nursing and mid- attended thoroughly enjoyed present at the meeting. Ms there will be teleconferencing wifery care. The Workshop the two days, both from a pro- Ni Sheaghdha discussed the facilities available for those proved hugely successful fessional CPD point of view, possibility of recognising who wish to attend but cannot and the group found Aparna, and also having the opportu- radiology nurses as a specialist travel. the facilitator, absolutely nity to network. Section News 25

INMO Christmas fair helps to raise money for ‘Sharing Fair’ initiative ‘Sharing Fair’ aims to help women living in difficult situations

More than 40 members have covered at future section of the Retired Nurses and events. Midwives Section met recently Christmas fair in the INMO head office for Another important part of their bi-annual conference. the day was the Christmas Guest speakers and talks fair which took place for the Topics that were covered duration of the morning and on the day included living during lunchtime. with arthritis; a two-part talk The ‘Sharing Fair’ Christmas delivered by Gráinne O’Leary, fairies came to INMO HQ, set The Sharing Fair team pictured at INMO HQ during the Retired Nurses and Midwives head of education and support up their stalls and contributed Section Christmas fair services with Arthritis Ireland. greatly both to the day and Age Action Ireland talked to creating a lovely Christmas to members about all of atmosphere. the services that Age Action With the Christmas music Ireland provide. This talk was and festivities people were given by Gerard Scully, senior treated to a little retail therapy information officer with Age while safe in the knowledge Action Ireland. that their support was going Siel Bleu gave a presentation directly to the Sharing Fair and a practical session on initiative which is run by the tailored exercise programmes Good Shepard Sisters. Pictured (l-r) during the Section bi-annual conference were: Gráinne O’Leary; for senior citizens. This session Sharing Fair works with Anna Winters; Mary O’Hara; and Deirdre Ronan was very well received. people in a number of Members evaluated the countries including Thailand, by women often living in very with fair financial benefits to day and gave feedback on the Kenya and El Salvador and difficult situations. All their the workers on the products topics that they would like to markets crafted items made projects are income generating that they produce.

Retired Nurses and Midwives Section travel to Krakow in Poland for annual autumn trip

The Retired Nurses and Mid- Cathedral, the Royal Tombs, wives Section has existed for Sigismund Bell and St Mary’s 10 years now and during this Basilica. The Bugle call – where time members of the Section every hour, a bugle is played have enjoyed many different from the top of St Mary’s activities from interesting lec- Basilica tower – is a unique tures and outings to spring and feature of Krakow, which dates WIN

autumn breaks. back more than 700 years. Vol 23 The destination of this year’s A trip to the Wielickza salt

autumn trip was Krakow in mines gave an insight in to N Poland. Members of the Sec- how miners carved solid salt o 10 December 2015/January 2016 tion had the opportunity to into ornamental chapels hun- Pictured on a recent trip to Krakow (l-r): Margaret McGuinness; Frances Byrne; Mary Galvin; and Deirdre Ronan, Retired Nurses Section chairperson learn all about the city of dreds of metres underground. Krakow through a range of dif- Next up was a trip to impression on everyone. an impressive range of crafts, ferent activities. the largest concentration Time was also spent in the amber, silver jewellery and First on the agenda was a camp of the Nazi regime, lively Rynek Glowny market souvenirs. walking tour of Krakow with Auschwitz-Birkenau, which square sampling local cuisine Krakow is an extraordinary a professional guide that is just a short journey from in the sunshine. The markets city to visit and was a memo- included entrances to Wawel Krakow. This trip left a haunting and the famous cloth hall have rable experience. 26 SECTION FOCUS

Spotlight on Section Officers Student Section Chairperson Vice chairperson The Student Section of the INMO represents approxi- mately 6,000 vibrant and hard-working student nurses and midwives nationally. We work closely with Dean Flanagan, student and new graduate officer of the INMO. Dean shares our understanding that in recent years our respective pro- fessions have been severely undermined and it is indeed new entrants into the professions who continuously incur Aoife Kiernan Stephen Woods mistreatment. The Student Section will focus on many of the main fac- tors affecting nursing and midwifery students, including incremental credit for 36-week placement, rate of pay during Treasurer Secretary the fourth-year work placement and pre-registration, post- qualification payment. We will also be addressing any concerns or issues that are raised by the class representatives nationwide, ensuring these are addressed in a prompt manner. The Student Section hopes that by the end of our term we will have represented our colleagues to their expectations and indeed hopefully surpass them. We encourage the nursing and midwifery students of Ireland to contact us with any queries they may have. Bose Allen Mary Escotho For any students who have yet to join the INMO, we urge you to do so and all are welcome to join us in our Student Section. To contact the Section, email the chairperson at: [email protected]

Affiliation Form for INMO Section Membership

Name: Tick ONE relevant Section you wish to affiliate with INMO membership No: Assistant Directors of National Rehabilitation Home Address: Nursing/Midwifery/Public Nurses Health Nursing/Night Nurse/Midwife Education Superintendents  Occupational Health Car e of the Older Person  Operating Department Tel (work):  Clinical Placement  Orthopaedic Tel (home/mobile): Co-ordinators  PHN  CNM/CMM Email: Radiology Nurses  CNS/CMS Place of employment:  Retir ed Nurses Community RGN Nurses Job title:  RNID Dir ectors of Nursing/  School Nurses Second section option (to obtain information Public Health Nursing Student Allocation Liaison only): Emergency Nurses Officers Network GP Practice Nurses  Student Section  Inter national Nurses T elephone Triage Nurses Vol 23 No 2 March 2015 23 No 2 March Vol Forward completed form to: Midwives Mary Cradden, membership services officer, Third Level Student Health WIN INMO, Whitworth Building, North Brunswick St, Dublin 7 National Children’s Nurses Nurses 28 INTERNATIONAL NEWS

INMO playing ongoing role in major international projects

ENS4Care project conclusion In 2013 the INMO, in collaboration with the European Federation of Nurses Associations (EFN) and 23 international partners (see Table on right), secured Euro- pean Commission funding for a two-year project entitled ENS4Care. ENS4Care is a thematic network and the main objec- tive is the development of evidence based guidelines for the implementation of possible without the commitment eHealth services in nursing and social care. and expertise of Dr Pamela Hus- In addition to building on existing good sey, lecturer in nursing and health practices among the participants of the informatics in the School of Nursing Network, sharing and transferring knowl- and Human Sciences, Dublin City edge across European regions is a core University and chair of the Health- element of the project. The initiative is care Informatics Society of Ireland’s part of the Competitiveness and Innova- Nursing and Midwifery group with tion Framework Programme (CIP), ICT Anne Spencer, educational technologist, Health Assembly (WHA) resolutions Policy Support Programme (PSP) funded PETAL (Partners in Education, Teaching which have culminated in 10 WHA res- by the European Commission. and Learning). olutions since 1948 that are specific to The ENS4Care guidelines on preven- Two final events in Brussels in Decem- nursing and midwifery. tion, clinical practice, advanced roles, ber brought this phase of the project to a The International Council of Nurses integrated care, and nurse ePrescribing conclusion: the Seventh European Innova- (ICN) has been a collaborating partner have recently been validated by an exter- tion Summit Conference ‘eHealth Services since establishment of WHO and the nal independent panel of experts and are and a Highly Qualified Nursing and Social INMO has been a member of ICN for the available at the ENS4Care website at: Care Workforce to Support the Health & past 90 years. www.ens4care.eu. Social Ecosystem’ and the final European The WHO is now in the process of Innovative, high quality, safe and Commission review meeting. developing and finalising its Strategic cost-effective national healthcare sys- Development of WHO Strategic Directions for Nursing and Midwifery tems are dependent upon policy-makers Directions for Nursing and Midwifery (SDNM) for the period 2016-2020. The and stakeholders developing and imple- 2016-2020 WHO draft consultation states that: “A menting high-quality eHealth services.1 Nursing and midwifery competent, well-supported and moti- ENS4Care has been designed as a historically have been vated nursing and midwifery workforce response to this need with an ultimate aim recognised within the can deliver quality, equitable health ser- of establishing a sustainable mechanism World Health Organ- vices and contribute to the well-being of to support nursing and social care research ization (WHO). The individuals, families and communities – a in the field of ICT enabled integrated care. professions have been basic human right”.2 Vol 23 No 10 December 2015/January 2016 Vol The development of the nurse ePre- central to decisions of gov- It provides a framework to implement

WIN scribing guidelines would not be erning bodies and the adoption of World and evaluate nursing and midwifery INTERNATIONAL NEWS 29

developments by ensuring available, accessible, acceptable, quality and safe nursing and midwifery interventions at global, national, regional and country Table: ENS4CARE Thematic Network Partners levels. Enhancing leadership, strengthen- ing accountability and governance and • C3 Collaborating for Health (C3) – UK mobilising political will for nursing and • Danish Nurses’ Organisation (DNO) – Denmark midwifery workforce is essential. • Helsinki Metropolia University of Applied Sciences (HMUAS) There are four thematic areas: – Finland • Accessibility, acceptability of safe and • Irish Nurses and Midwives Organisation (INMO) – Ireland cost-effective nursing and midwifery care • European Platform for Patients Organisations, Science and Industry based on population needs, addressing uni- (EPPOSI) – Belgium versal health coverage and the attainment • European Nursing Research Foundation (ENRF) – Belgium of the Sustainable Development Goals • International Federation of Social Workers – Europe (IFSW-Europe) • Optimising leadership and governance – Germany accountability • Northern Health and Social Care Trust (NHSCT) – UK • Maximising capabilities and capacities of • Royal College of Nursing (RCN) – UK nurses and midwives at all levels through • Consociazione Nazionale delle Associazioni Infermiere – Infermieri collaborative intra and inter-professional (CNAI) – Italy partnerships • Ordem dos Enfermeiros (OE) – Portugal • Mobilising political will to invest in build- • Nieuwe Unie’91 (NU’91) – The Netherlands ing effective governance for nursing and • European Institute of Women´s Health (EIWH) – Ireland midwifery workforce actions founded on • Fundación Salud y Sociedad – Escuela de Ciencias de la Salud (FSS) evidence.3 – Spain The four thematic areas are • European Union of General Practitioners (UEMO) – Belgium underpinned by five guiding • European Association Working for Carers (Eurocarers) principles for implementa- – Luxembourg tion and include: ethical • Association of Patients with Cancer and friends (APOZ) – Bulgaria action, relevance, owner- • European Public Health Alliance (EPHA) – Belgium ship, partnership and quality. • Cittadinanzattiva Onlus (CA) – Italy The INMO on behalf of members has • 1.6&2.6 Million Club (1.6&2.6) – Sweden engaged fully in the consultation phase • The European Co-ordination Committee of Radiological, Electro- which closed at the end of November. medical and Healthcare IT industry (COCIR) – Belgium More information on the draft Strategy is • Continua Health Alliance (Continua) – Belgium available at: www.who.int/hrh/news/2015/ • Microsoft – Belgium midwifery_nurse_SDMN_consultation/en INMO to host the ICN Credentialing and Regulators Forum in 2017 • Advise ICN on developments and needs region with respect to the collaboration The ICN Credentialing and Regulators in the field of regulation, credentialing, • Information on impact of mobility within Forum was hosted by the Emir- and quality assurance. the region of both the Directive 2013/55/ ates Nursing Association In advance of the meeting, the INMO EU but also organisations working in November 2015. There submitted a national environmental scan in together on initiatives were more than 60 partici- partnership with the Nursing and Midwifery • Information on any planned future pants from various countries Board of Ireland, as did all other participat- initiatives. including: Australia, Bot- ing countries. The aim of the environmental All presentations and papers are avail- swana, Canada, Denmark, scan was to capture key trends and issues able on the ICN website at: www.icn.ch/ Jamaica, Japan, Jordan, Kenya, impacting upon the credentialing and reg- what-we-do/the-credentialing-forum.

Kuwait, New Zealand, Oman, Seychelles, ulation in each country, including national, The INMO is set to host the Forum WIN Singapore, South Africa, Taiwan, Uganda, regional and global issues. in 2017. Vol 23 No 10 December 2015/January 2016 UK, UAE, the US and, of course, Ireland. The major trends are captured across: Elizabeth Adams is INMO director of professional The Forum, on an annual basis, aims to: regulation; health/nursing; political/ development • Serve as a vehicle for countries with an government; society and technology. References interest in developing dynamic regulatory In addition, ICN had formally invited 1. Sheikh A, McLean S, Cresswell K. The impact of eHealth processes and credentialing programs to the INMO to present at the Forum on the quality and safety of healthcare. An updated sys- tematic overview and synthesis of the literature. Final communicate, consult, and collaborate incorporating: report for the NHS Connecting for Health Evaluation with one another on trends, problems, • An overview of regional nursing pro- Programme (NHS CFHEP 001) London. Imperial College London; 2011 solutions etc fessional, educational and regulatory 2.World Health Organization. Strategic Directions for • Promote and enable nursing’s role at the collaborations in Europe including in rela- Nursing and Midwifery Development 2016-2020 The Way forefront of healthcare and the develop- tion to the updated Directive 2013/55/EU Forward Zero Draft for Consultation. November 2015; p4 3. World Health Organization. Strategic Directions for ment of contemporary regulatory and • Information on what have been some Nursing and Midwifery Development 2016-2020 The Way credentialing systems challenges and also successes in the Forward Zero Draft for Consultation. November 2015; p6 30 QUALITY & SAFETY

A column by uality Maureen Flynn O&Safety The Health Foundation’s QI Resources

This month I want to draw attention to produce a framework for safety measure- The Health Foundation, an independent ment and monitoring (see figure right). Framework for measuring charity committed to bringing about bet- How can we get there and monitoring safety ter health and healthcare in the UK. The A follow-up report, Continuous Improve- Foundation’s website, www.health.org.uk, ment of Patient Safety, was published this Past Harm provides a treasure trove of resources for month which synthesises the lessons Has patient care been improving safety and quality. For example: from the Foundation’s work on improv- safe in the past? • Get ideas and inspiration from improve- ing patient safety over the past decade. ment projects. There is a categorised It advises that the journey begins with Integration Reliability and learning listing of hundreds of projects around the practical improvements based on what Are our clinical systems Are we responding and processes UK that are testing ways to improve the is known to work. The report presents a and improving Safety measurement reliable? quality of health services checklist for safety improvement, based and monitoring • Patient safety resource centre enables you to on experiences of supporting NHS teams access resources to suit all levels of practice, to improve safety. The checklist can be Anticipation and Sensitivity to from key research to national standards, used by frontline teams and healthcare preparedness operations

implementation guidelines and case studies providers when addressing their most Will care be safe Is care safe today? • Person-centred care resource centre pressing safety problems. in the future? designed to help healthcare professionals Improvements to safety on the ground support people to more effectively man- can only be successful with the support age and make informed decisions about of senior leaders. The report sets out the successful if they are not applied faith- their own health and care three vital steps that senior leaders can fully, just as national improvements in • Webinars cover topics on healthcare take to create an environment where safety won’t be achieved if they become improvement, improvement science and safety improvement can flourish: subverted into measures of accountabil- health policy, with a back catalogue of 1. Work with staff and patients to develop ity. These are the core lessons learned over recordings of previous webinars an organisational strategy for improving the past decade; the report draws on them • QualityWatch, a joint research programme patient safety to make the case for why and how future from the Health Foundation and Nuffield 2. Build an organisation-wide approach for improvements in safety can be realised. Trust, monitoring how the quality of health creating a positive safety culture Opportunity to get involved and social care is changing over time 3. Develop an approach for how safety When you are next looking for inspira- • QInitiative, led by the Health Foundation can be better measured and monitored tion for quality improvement, evidence or and supported and co-funded by NHS across the organisation. practical resources why not start by look- England, connecting people skilled in The practice and policy of safety ing at The Health Foundation website. improvement across the UK improvement are inextricably linked, Further information • Research scan, every month thousands of reflecting recognition that the design of You can access the two Health Foun- journals are scanned to select and sum- the wider system can support, and hinder, dation reports described in this column marise around 60 of the most interesting the efforts of front-line staff and senior at: www.health.org.uk/publication/ studies about healthcare improvement leaders. This report sets out the Health measurement-and-monitoring-safety • Communications toolkit for healthcare Foundation vision for an effective system and www.health.org.uk/publication/ professionals working in improvement for safety improvement: continuous-improvement-patient-safety

who want to understand and use com- • Measurement and monitoring Maureen Flynn is director of nursing and midwifery, munications to better plan, implement • Improvement and learning Quality Improvement Division, lead governance for quality and spread their work. • Engagement and culture and safety Measuring and monitoring safety • Strategy and accountability. Acknowledgement The Health Foundation published a sem- The report concludes that underpinning A special thanks to Helen Crisp for sharing information inal report in 2013, The Measurement and everything is the need to approach the on the work of The Health Foundation at the 5th National Patient Safety Conference held at the Aviva Stadium on Monitoring of Safety, drawing together aca- work with trust, sincerity and openness. November 12, 2015 and to The Health Foundation for demic evidence and practical experience to Local improvements in safety won’t be sharing resources freely on the web

Vol 23 No 10 December 2015/January 2016 Vol About the HSE Quality Improvement Division (QID): the division led by Dr. Philip Crowley was established in January 2015. The mission of the QID team is to provide leadership by working with patients, families

WIN and all who work in the health system to innovate and improve quality and safety of care by championing, educating, partnering and demonstrating quality improvement. Our vision is working in partnership to Quality Improvement Division create safe quality care. WIN Vol 23 No 10 December 2015/January 2016 33 ers w s n s & A n o i Quest Firstly, the appeal meets the criteria Firstly, facts based on the appropriate, considered therefore the appeal is and provided criteria apart the of meets all the person secondly, or, that they fact have the not from been two in the for post they this second instance, 2012. In December 31, by years 17/2013, circular with should be appointed in accordance term contract on basis, to the fixed a temporary post and that the appeal to the and thirdly, salary of that post, or, the within fall might not circumstances the particular may be the argument as of acting process regularisation the job itself needs changed and/or the job has that made exercise evaluation job is an agreed There evaluated. to be perceived on individual’s this purpose and appeals based for to will be redirected grade current their duties being above that will be appeals there Finally, evaluation process. the job and facts the validate to order full hearing in a will require also clarify that the matters are from not clear applicants submission/application form. to notify all will be in a position that he Mr Doherty hopes made an appeal as soon as possible and also who have those the for necessary schedule dates hearings. of this If you get correspondence nature, please contact us and to be interest your advise us if a hearing is scheduled. It is in that hearing. official at an INMO by represented are that it is recorded in days not in hours. The rules also state not in hours. days in that it is recorded are days and absent to rest is absent prior employee that if an days, that the days will following rest rest immediately be is absent prior employee an if However, counted as sick leave. rest following immediately but returns on sick leave days to rest as sick leave. cannot be recorded days the rest then days, the INMO and by argued This has now been successfully these that confirmed the HSE 2, 2015, on November on date the 2014, 31, to March backdated are arrangements the public in introduced were changes the sick leave which sick leave your of should seek a review you Therefore, service. days that your rest to ensure have employer your from record need you If categorised as sick leave. not been incorrectly INMO industrial your contact this please with assistance any you. assist will advise and they and officer relations With of director INMO industrial Sheaghdha Ní Phil relations Bulletin Bulletin Board

from from member from from member

QA

Having acted up for two years prior to December 2012, I am prior years two for Having acted up to a permanent of being appointed confirmation waiting the agreement under qualify that I post. I am advised I yet Agreement, the Haddington Road of as part brokered to date. have employer from confirmation my not received that a submission has been notified us The INMO have Can you made to please an advise on the current arbitrator. status of this process? You have previously notified us that progress had been had that progress notified us previously have You sick of the recording of the INMO in respect made by of my days as part rest my recorded employer My leave. that sick fact I despite the leave, had to work returned confirm Can you days. following my if immediately rest agreed current, the what is concluded and has this process method? recording correct

Query Query

The outcome of this may result in a number of scenarios: in a number this may result of outcome The Reply the correct, you Haddington ofare Road Regularisation Yes, The health of arbitration. the subject is now process Posts Acting John Doherty be appointed that unions agreed trade service excess in Mr Doherty has received this arbitration. conduct to the Mr Doherty has advised the process. of 800 appeals under he isthat as an initial step, employers the unions and trade obtain an to both of all appeals top review desk undertaking a of overview all the appeals and validity to confirm their secondly as per the established criteria. do they In other words, meet the the agreement. out in as set regularisation for criteria

Yes, you are correct, the correct, you INMO are has contested the manner Yes, in on a roster. who are those for sick leave the HSE recorded which of sick leave the recording of the rules in respect know, you As Reply WIN Vol 23 No 10 December 2015/January 2016 - INMO training rep course in Sligo: (l-r):row Front Philips;Deepa Tina Ward; Breda Henry; Dolores Tiernan; and Hamilton Grainne (l-r): Row Back Murphy;Albert Heffernan; Cormac Hughes’ David O’Hara; Grainne Cullen Patricia Kiloran;Keane; Rita Lyons; and Trevor Lynam Deirdre FOCUS 35 FOCUS has an ‘Update Your Details’ Details’ Your has an ‘Update O ffice and these are useful for for useful these are ffice and contact details. contact O The INM rganisation may not have received their their received may not have rganisation Maria O’Regan, Temple Street, Maria Temple was O’Regan, the lucky INMO Loyalty the of of €1,000 as part winner The Cornmarket. by which is sponsored Scheme their to thank for INMO this draw members ran presentation the continued support. (l-r)at Pictured O’Regan; president;INMO Mahon, Claire Maria were: consultant, insurance general Fennessy, Ronan secretary general INMO Doran, Liam and Cornmarket; O updated the Mem from which is available form ensuring that details we the correct have each for member including their email and details. contact organiser officer/ relations is INMO industrial Albert Murphy Email: [email protected] bership bership - nurse/midwives nurse/midwives O rganisation. Mapping rganisation. O lbert Murphy at email: email: at lbert Murphy A or from employments where where employments from RO

lbert details. Murphy for reps training course was held in was held in course training reps A A ound and the ound and on the new sick pay scheme. scheme.pay sick new the on s reported last month, a training training a last month, s reported eedback Due to the of high turnover staff it is F A If you are interested in running these these in running interested are you If is a process whereby the representatives the representatives whereby is a process out carry at workplace effectively level workplace in the in of members an audit are our members where to highlight order each in workplace. from to transfer for nurses commonplace to one employment another and the talks courses, please training representatives contact organised Mapping – getting on the members links between ing strong the gr course was held in Sligo for reps which which reps for Sligo was held in course successful – see photo very to be proved . above interested are you If in November. Cork the INM in attending mapping has out carried been that signify establish for exercise positive very is a it courses courses workplace, in your please contact local I your [email protected]. INMO training rep

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Did you know that the INM the that know you Did To date, the date, the majority of new To members In addition, the INM the addition, In New members who join the join who New members ctober. The scheme aims to produce produce to The scheme aims ctober. irector of regulation and social policy. We We policy. social and regulation of irector or the INM the or so they can sees members being awarded a awarded being sees members INMO briefings you can you avail of encouraging a for gift card to them the join have opted to have avail of these benefits. Now than ever it more makes sense to join the INM new recruiting for worth €20 card gift to be a success. proved has also members, do your new work colleagues So therefore, INM the join to them ask and favour a O noted, this scheme was launched in was launched in this scheme noted, to new members for substantial benefits the INM ise the Tools for Safe Practice course or course Safe Practice for Tools the ise was delivered by Edward Mathews, INM Edward by delivered was will shortly launch a briefing on statement launch a briefing will shortly the details will circulate in due We writing. course and would be delighted to organise course a workplace. your in recently organised a very successful ses successful very a organised recently in Ennis than 30 members more for sion on the d to carry out short presentations on a range on a range out short presentations carry to or time at lunch members for of subjects Mary times? suitable other ucts, including free income protection for for protection income free including ucts, nine are invited to sign up for this scheme and this scheme and for to sign up invited are subse Cornmarket contacted by will be their application being approved to quent f INMO Loyalty Scheme INMO Loyalty the INM for good so So far scheme!

retention & retention Recruitment Recruitment up round FOCUS 49 Driving change in

healthcare Martin McNamara and Eilish McAuliffe pictured recently at UCD’s Belfield campus

Martin McNamara talks to Eilish McAuliffe about the benefits of health systems research and education to healthcare professionals Following her appointment as the E: Health systems research is seen as remember is waking up on the floor with inaugural professor for health systems increasingly important in unifying the a circle of rather bemused white-coated in UCD, Martin McNamara talks to Eilish worlds of research and decision-mak- junior doctors peering at me. I had fainted McAuliffe about her new role and why ing; it connects the various approaches (due to an overheated ward) and had to health systems training and education is an to research that generate knowledge to ask myself whether I was really cut out important part of nursing and midwifery. inform and strengthen health systems. for this work. The second moment was at M: Eilish, congratulations on your recent It is an area that is receiving increasing a regular morning meeting in a residential appointment as the inaugural professor of attention internationally and the WHO unit for disturbed adolescents. Part of the health systems at UCD. I want to start by acknowledges that the evolving field of therapeutic regime was to have staff and asking how do you define health systems? health policy and systems research is sen- residents sit in a circle every morning and E: Health systems is an umbrella term sitive and responsive to the knowledge address whatever issues people chose to that encompasses all the elements that needs of decision-makers, health prac- bring up. Sitting in one of these morning form part of a country’s healthcare deliv- titioners, citizens and members of civil meetings listening to the discussion, I ery: the institutions, the workforce, the society. realised that the staff probably had more products and medicines, the information, M: Health systems has only recently ‘problems’ than the adolescents; was it the financing and governance structures emerged as an academic field. I’m inter- time to abscond? and the services. These are what the WHO ested in the career trajectory that has led to You can decide which of these expe- defines as the building blocks of a health your current position. riences prompted me to undertake an system. E: I completed a BSc in psychology with MBA and get involved in healthcare M: What distinguishes health systems as a minor in pharmacology in UCD with the management, developing expertise in an academic endeavour? specific intention of becoming a clinical organisational psychology and change E: In the academic context, health psychologist. I went on to do my clinical management! My next career move was systems is about taking a more holis- training at the Institute of Psychiatry in to the University of Malawi in east Africa, tic perspective on all that contributes to London and spent my early career working a move that my fellow graduates from achieving a healthy population; eg. see- primarily in child and adolescent psychol- the MBA programme at Strathclyde Uni- WIN

ing the population as part of the system ogy in the NHS. versity found difficult to reconcile with Vol 23 No 10 December 2015/January 2016 and as having a role to play in improving There were two ‘aha’ moments that their typical MBA graduate expectations health rather than as mere recipients of led me to move away from my clinical of being able to command high salaries. health services. It is about researching the role. The first was when I was assigned The personal benefits and the learning inter-relationships between various parts to a paediatric ward in an acute hospital that ensued from my time in Africa more of the system and understanding how in Dumfries and Galloway while work- than compensated for any loss of sal- change or improvement in one domain ing in the psychology department at the ary. Anyone who has spent time working may positively or negatively influence Crichton Royal Hospital. There were great in a low-income country will attest to another domain. expectations of this long-awaited child the richness and formative nature of the M: What do you see as the distinctive psychologist; I arrived on the ward and experience. contribution of health systems research to was instructed to join a ward round that On returning to Ireland I continued my healthcare delivery? was already underway. The next thing I connection with Africa. In 2004, I estab- 50 FOCUS

lished the Centre for Global Health in my international collaborations are with move away from narrowly defined career Trinity College and remained as its director schools of public health. I also work with progression pathways and expose peo- until 2014. The Centre’s research activ- colleagues in business schools and within ple to flexible learning experiences that ity was focused on strengthening health the social sciences. As long as my school give health professionals the scope to systems in Africa through multi-country enables me to achieve my goals, I am discover where they can make the best interdisciplinary research. I balanced this happy. contribution. with my research in the Irish health sys- As a general observation, I would say Not all health professionals make good tem, completing a PhD in health strategy that medical schools are less embracing leaders, not all want to be leaders. Some during my time in TCD and supervising and of change, there tends to be a strong drive may be more effective in purely clinical supporting middle and senior managers to retain the status quo. Of course, that roles, others may be good mentors, have and health professionals as they under- could also be said of many institutions a passion for quality improvement and so took masters level research on a broad with a long history! on. With this in mind, what we are doing range of management and organisational M: What impact do you think health sys- here in UCD is creating a flexible modular issues. tems research and education can have on structure that provides several masters M: Why should a health systems health professional education? level pathways for healthcare profession- programme be located in a school of nursing E: In my opinion, health professionals als. All of our health systems programmes and midwifery and what are the potential in this country receive excellent technical will be interdisciplinary, as it makes no synergies between nursing, midwifery and training. Against this they receive insuffi- sense to train people for systems roles in health systems in terms of research and cient education about the health system disciplinary silos. education? and how to work within this system to M: Again, I strongly agree. For me, the E: Health Systems research tends to maximise their impact on patient care. purpose of academic nursing and mid- be problem driven and therefore bene- It is not enough to be a good nurse, you wifery is to strengthen the disciplines so fits from ‘embeddedness’. Nurses and must also understand other professionals’ that they can make a distinctive contribu- midwives are the most embedded pro- roles and contributions, you must be able tion in diverse interdisciplinary contexts. fessionals in the healthcare system, to work as part of a team, see beyond the What about the potential impact of health comprising the majority of the healthcare boundaries of your specialty, ward or hos- systems research on health professionals’ workforce and having more direct con- pital, question how things are done and education and wider formation? tact with patients than any other health strive to find better ways of delivering care E: Health systems research by its nature professional. and improving health. must be interdisciplinary. One thing I have Placing health systems research with Placing well-intentioned people in a learnt from my experience in the Centre nursing and midwifery provides a deeper dysfunctional system will not improve for Global Health over the past 10 years understanding of problems that research that system and it may even do harm. We is that interdisciplinary research is fraught can help to resolve, as well as creating must give health professionals the evi- with difficulties. It takes time to under- greater potential to accelerate the speed dence and expertise to create functioning stand and appreciate the contributions of at which research evidence can be made systems that are efficient and effective. other disciplines, to traverse the language available to decision-makers and imple- If we don’t do this, we will constantly be differences, to bring together the differ- mented to improve healthcare. restructuring, reconfiguring and reforming ent bodies of literature and then there Real and lasting improvement in our to little effect. Teaching health profes- is the thorny issue of where to publish: health system will only happen if we man- sionals how to understand, analyse and single-discipline journals or more inter- age to embed research in every aspect of improve the systems they work in is where disciplinary ones. Now that the latter are healthcare practice and health services health systems academics can make a real climbing up the impact-factor scale this is delivery. Nurses and midwives are very contribution. less of an issue. well placed to make this happen. It also M: I totally agree. System blindness char- On the plus side, this type of research helps that many of the current senior acterised by a lack of understanding and is richer for the variety of perspectives leaders in healthcare come from a nurs- appreciation of others’ roles in the system is it brings to bear on problems and it is ing background. This helps instil a belief a major issue that needs to be addressed. As intensely rewarding, as there are always amongst more junior nurses and midwives educators, where might we begin? new challenges that bring new learning. that they can really be the drivers of sys- E: We should start at the undergraduate Health systems research can be diffi- tem improvement. level with introductory courses in systems cult to explain. One misperception is that The College structure in UCD helps to thinking and the healthcare environment. research needs to be about the whole sys- promote interdisciplinarity and there is In UCD we are developing an elective that tem for it to be considered health systems great potential to develop programmes of aims to do just that and it will be offered research but, of course, it would be impos- research and teaching across the schools to students from across the university. sible to orchestrate a research project in our College and beyond. At the postgraduate level, it is about that accounts for every aspect of a health M: You were formerly based in a medical giving people the knowledge and tools system. school. Do you notice any changes when to challenge how things are done, to test M: What might be a more useful charac- compared to your current location? different ways of organising and leading terisation of health systems research? E: I am a strong believer in interdiscipli- healthcare teams and services and to be E: A more accurate reflection is one nary research and teaching and everything bold and innovative, using the best evi- where the research question emerges from Vol 23 No 10 December/January 2015 Vol I do speaks to this. Because of this I don’t dence available to them and building new a systems problem and the researcher

WIN feel defined by the school I am in. Many of bodies of evidence as they go. We need to focuses in on one or two leverage points to FOCUS 51

explore and understand that problem. person; rather, it involves the relational tive team performance. It is essentially M: Can you give a specific example from process of an entire team, group, or about addressing the practical problem your own research? organisation. In contrast to traditional of improving patient safety, but doing E: A project I am about to start work- approaches that focus on the development so within a rigorous research framework ing on; ‘Co-Lead: Collective Leadership of the individual as a leader, the approach that allows us to test a new model of and Safety Cultures’ is a five-year project in this programme will be on developing leadership. This reflects another distinc- that starts from the problem of healthcare the team as a dynamic leadership entity. tive feature of health system research: errors and risks to patient safety. Recent Rather than starting from a top-down, active engagement with the system not concerns about quality and patient safety competency framework-driven curricu- only to inform the research question but have raised issues about leadership, gov- lum targeted at the individual as a leader, also to pave the pathway for implemen- ernance, poor working relationships in development will be informed through a tation and scale-up or dissemination of teams and lack of clarity in accountability bottom-up, service needs-driven, co-de- the findings. So in Co-Lead, for exam- and reporting relationships. One major signed curriculum targeted at team ple, the Ireland East Hospital Group and contributory factor is failure to invest in members as co-leaders. This represents the HSE are partners in the research. leadership development and the lack of a radical shift from current practice and The King’s Fund in the UK is another an evidence base to support a consistent an entirely necessary one if the hospital important partner as they are doing com- approach to the training and development groups are to function effectively as net- plementary research in the NHS and it of leaders and teams. This research pro- worked structures. The programme will provides a good opportunity to share gramme will draw on emerging theories of implement leadership development inter- learning across both systems. collective leadership. ventions for groups of leaders at different M: Thank you Eilish. You provide a com- M: How do you define collective leader- levels within the hospital groups and test pelling case for health systems education ship in this context? the impact of these interventions on staff and research and their contribution in E: Collective leadership is not the role performance and patient safety. supporting healthcare professionals to of a formal leader but refers to the inter- The overall aim is to support quality strengthen health systems. action of team members to lead the team and safety cultures through the devel- Martin McNamara is the dean of nursing and head of by sharing leadership responsibilities. It opment of a new model of healthcare school at the UCD School of Nursing, Midwifery and is not a characteristic of an individual leadership that is associated with effec- Health Systems, UCD

Rep Training Are you interested in representing the INMO?

A training course will be held in the Limerick Office, Unit 4B, Courtfields, Raheen over two days as follows: • Tuesday, January 12 to Wednesday, January 13, 2016 Commencing at 2pm on Tuesday and continuing for a full day on Wednesday

For all enquiries email: [email protected] WIN Vol 23 No 10 December 2015/January 2016 assessment and any results. Pending out a idency at the centre and clients are given process. confidential andseparate to the asylum community mental health nurse. positions of aprimary care social worker and on site. of acuteand chronic conditions for residents GP service for the referral andmanagement T S chology psychologists from the therapy. school education, parent supportandplay two P ical doctor (area medical officer), a visiting assessment), two nurse-midwives, amed specialist (CN vices. City) primary care and social inclusion ser team works as part of on-site to more than 320 residents. socialsupport care frommedical centre the health scr gee Reception Centre inDublin, the refugee needs led.NowlocatedatBalseskinRefu transitory and the serviceis demand and Consequently the populationremains including ers/refugees andprogramme refugees, newl untary healthassessmentis offered to all of direct provision accommodation, vol As the refugees, In part two of an article on responding to the needs of migrants and 52 FOCUS eekers who are basedin the medical centre. he team also works closely with the visiting works closelywiththe visiting also he team personalised hand-held record of their H H T N and clerical staff. Inaddition, there are he interdisciplinary healthscreening ealth assessmentsare privateand HS y-arrived residents – asylum seek T he team ismadeup of a clinical nurse T E receptionis thephase centrefirst T he S

T childcare staff who provide pre- he team works in partnership with partnershipin with he team works eening team provides healthand ervice for Refugees and Asylum hey are undertaken during res victims of human trafficking.victims of HSE S alsorecently approved the –asylumseekers health PJ Boyle HSE HSE (

S Dublin North pecialist Psy discusses ------ulation isnotahomogeneousgroup. public healthassessment psy erally healthy – both physically and gen aremajoritycountry of origin, the health issues pre-departure from their and asylum seekers mayhave specific wellbeing needs of people on arrival. evaluation of the immediate health and assessment andabroader psychosocial opment. and culturalnursing competencedevel health, transcultural migrant experience on seekers, the team hasamassedspecialist s nificantly. Byresponding to the healthand over the past 15 years it has evolved sig screening, suchas a focuswith on communicable disease ‘Public health’ in context of migrant health studies taken a number of work-based research residents since its inception and hasunder assessment tothousandsofscreening public health. maternity, paediatrics,infectious diseases, are arranged ifnecessary, for example nursing support and interventions. have a serious illness requiring different refugee experience, somepeople mayalso screening. health orcommunicablediseasepublic not cosm of global health. Our experience is presenting healthissues reflect amicro assessment healthand disclosures duringthe comes ocial care needs of refugees and asylum Although some newly arrived refugees was establishedservice Although the chologically. Likewise the refugee pop limited to the provisionlimited tothe of voluntary to date. their care within the Irish health services H H , referrals to specialistservices ealth screening comprises owever, in addition to their T 1,2,3 he team has provided health T B, hepatitisand , vulnerability prepared? T H refugees heir needs of needs of IV, ------– are we Pr nity integration and primary healthcare. including childr wifery practice hassupportedmany people, ma vices andprofessionals inacutehospitals, involves close liaison with healthcare ser serious mentalhealthproblems. palliativelife-limitingand care conditions, or partnershipswith community-based ing asylum seekers and refugees is form and others with clients Engaging system. currentthe fragmented provemoreand cost effective valuable than the organisation and relevant agencies, may implement migrant healthservices,across interdisciplinary unitin the and populationhealth. and cial resourcing, including staffing, education require significant commitment and finan accordanceguidelines in will with these gees andmigrants. for improvement inhealthservices for refu ie. p fessional interdisciplinary andinter-agency prooffersbest an opportunity to deliver on screening inIreland from the required.accessing equitable care when refugees and the barriers associated with f vices. Many of these servicesmay not be care andpsychiatric/mental healthser of care, such as communication/language such of care, amiliar with the living circumstances ofwith the amiliar ractice in public health – see acticalities may impact on the provision ganisations with expertise in commu with expertise ganisations A keywithworking componentof A T Over the years our nursing and mid Overand theyearsnursing our H ternity services, community/primaryternity he newguidelines for migrant health training inprimary care, publichealth Health owever, gapsremain and there isroom en with chronic illness,with chronicen T he delivery of practice E stablishing a single stablishing asingle HSE www.hpsc. to planand HSE T his work / H P S C ------FOCUS 53

HSE refugee clinic Balseskin 2014 barriers, cultural differences in understand- Total number of asylum seekers accommodated (2014) 1,358 ing causes of ill-health and treatments, and health-seeking behaviour, lack of resources Total invited for health screening assessment (2014) 1,217 such as interpreters/mediators. We work Total number attended health screening assessment (2014) 981 (81%) from a specialist knowledge base of trans- Reviews/recalls/emergencies (2014) 2,141 cultural nursing and cultural competence, including application of explanatory health Total No (multidisciplinary) (2014) 2,711 models. We can share this information with Grand total of attendances (2014) 5,833 other services, agencies and professionals. Using this community development Health screening Jan-April 2015 639/786 approach enables a richer engagement and Reviews/recalls Jan-April 2015 804 ownership by service users to finding their Top eight countries of origin of asylum seekers in 2014: own solutions to their needs. Balseskin Pakistan, Nigeria, Bangladesh, DRC, Zimbabwe, Albania, Algeria, Malawi clinic staff liaises with many such ser- Cohorts accommodated: asylum seekers, convention refugees, programme refugees, permanent vices, such as the Community Mothers medical resettlement cases (UNHCR evacuees), victims of human trafficking, pending deportees Programme, HIV Ireland, the Cross Care Staff at HSE : Staff at HSE Medical Centre, Balseskin: PJ Boyle, CNS; Dr Maureen Brennan, AMO; Kay Migrant Project and Jesuit Refugee Service. Murphy, nurse/midwife; Liliana Moralés, psychologist; Ann Maria O’Brien, nurse/midwife; Elaine Upton Our vision of nursing extends beyond nar- and Lorraine O’ Connor, medical secretaries row definitions of public health to include other important social determinants rele- vant to the migrant health context. In addition, professional education is a key component of our work. We contribute to formal multidisciplinary undergraduate and postgraduate programmes in nursing, medicine and psychology, including partic- ism and social justice. In March this year T ranscultural Nurses Association www. ipation in many international conferences the University of Limerick hosted the europeantranculturalnurses.eu, the Irish and symposia on migration and health. RESTORE Migrant Health Conference Transcultural Nurses Network www.tnn.ie Future of migrant health work addressing issues beyond language and and the Partnership for Health Equity web- Despite examples of effective migrant cultural barriers, including the promotion site www.healthequity.ie health programmes across Europe, there of professional migrant health education Help in times of need remains cause for concern. There seems to for healthcare staff. Ireland has partici- As Ireland prepares a response to the be a number of contradictions to Europe’s pated in a number of international studies European refugee crisis, where do you posi- approach to migrant health. Health- and conferences investigating such issues. tion yourself and how prepared do you feel? care organisations and professionals are In Ireland the HSE National Intercultural It is important for us not to lose sight of the becoming increasingly compromised pro- Health Strategy 2007-2012 (under review) value of helping each other in times of need. fessionally and ethically in their practice. has contributed significantly to the migrant As a nurse who has worked exclusively with In some EU states healthcare staff must health sector. Although not all its recom- asylum seekers and refugees, I continue to consider the ‘migrant status’ of people mendations have been implemented, work ask myself – is it not simply the case that before determining their level of access to is ongoing in several areas, including health we are all individual human beings deserving care and treatment. This is an unfair and screening, language and communication. of respect and dignity when we need care? challenging position for any healthcare The HSE National Intercultural Governance We need to ask ourselves if the assigning of professional. Such expectations may be Committee works with other HSE direc- a political, social or administrative label to a interpreted as a collusion by healthcare torates, statutory bodies and NGOs, to person negatively affects us and the quality professionals with stringent and damaging advance the recommendations. of care and relationship between the nurse migration policies that can deny people The nursing profession contributes sig- and the patient, and, if so, why? their fundamental human rights. For fur- nificantly to this organisational process PJ Boyle, who holds a doctorate of professional studies ther information on such developments and to the wider HSE organisation on (Health), is a clinical nurse specialist (asylum seekers see www.eupha.org and www.ecre.org issues of migrant and intercultural health, health assessment) at the HSE Medical Unit, Balseskin WIN Refugee Reception Centre, Dublin, Email: [email protected]

In an effort to address such issues, in including policy development and educa- Vol 23 No 10 December 2015/January 2016 April 2014 at the European Association of tion. Nursing scientific literature provides This article is published with the support of the INMO Public Health Conference on Migrant and many useful resources, including specialist Executive Council and the Regulation and Social Policy Department of the INMO. Ethnic Minority Health in Granada, Spain, texts in transcultural nursing and cultural participants drafted the ‘Granada Decla- competence. References 1. Brennan M et al. Health of asylum seekers – are we ration’ to highlight concerns of healthcare The International Council of Nurses doing enough? Forum JICGP 2013; 30(1) professionals to the Council of Europe (see position statement on the treatment of 2. O’Brien A et al. Improving health care for a culturally diverse population by bridging the gap for pregnant www.epha.org/a/6023). migrants, refugees and displaced peo- women. In: Markey K et al. Lets Learn Together, Lets Although clinical knowledge and ple outlines the professional and ethical Work Together: Challenges and Solutions for Transcul- project management are important, fun- obligations of nurses internationally in tural Health and Social Care 2012; Cambridge Scholars Publishing damental in responding to migrant and responding to the needs of migrants 3. Boyle PJ et al. The Complex Health Needs of Asylum refugee health needs is humanitarian- and refugees. See also the European Seekers. Forum JICGP 2008; 25(1) FOCUS 55

A shortened experience of motherhood In the second article in a two-part series, Denise McGuinness provides insight into the world of bereaved mothers

The development of maternal-foe- just blame yourself for small things, maybe time she had with her baby. tal attachment from an early stage in I should have gotten to the hospital earlier.” The couple received counselling from pregnancy has been described in the lit- (Ash 22+1/40 P3) the bereavement midwives. The com- erature.1,2,3 Psychoanalyst, Daniel Stern State of being munity midwives provided support and describes how the baby has a long prena- Shock, numbness and helplessness midwifery care during the pregnancy, birth tal history as the baby grows and develops are common feelings following a sudden and following the birth. Helen attended in the mother’s uterus; subsequently, the death. Amelia described this feeling of her GP during the pregnancy and found baby undergoes a parallel development in helplessness, being unable to make any her to be a great support. Helen also the mother’s mind.4 Birth is the meeting decisions. She felt broken. The hospital appreciated the honest communication place for the baby that is in her arms and care she felt was very good as they pro- with one of their doctors at the hospital. in her mind. vided direction with what to do next: “We found out at 20 weeks and after In a study5 exploring the experiences “Obviously you’re broken and you’re not that we met with the bereavement mid- of mothers as they suppress lactation capable of… you don’t know what to do, wives over the weeks and months leading following late miscarriage, stillbirth or you know what you’re supposed to be doing up to Tom’s birth. The doctor, he was always neonatal death, mothers were attached and the hospital was really good at guiding very honest with us, he always told how it to and grieved the loss of their babies. you as to what the next step was.” (Amelia was and you know if things had changed.” They valued their pregnancy, holding their 38/40 P3) (Helen 42/40 P1) baby and bonding with their baby. The Anne described a restless hyperactivity During the pregnancy Helen and her care bereaved mothers receive during this following the loss of her baby and then husband had time to prepare for their time can be as lasting and important as following the funeral everything became baby’s funeral and they wanted it to be any other memory of the pregnancy or the more real: a special occasion with family and close baby’s brief life.6 “You are still kind of in business mode. friends: Mothers and grief You have been doing so much stuff and it’s “It was something we could do for Tom Normal grief is associated with common not until after that everything hits you.” (pseudonym).” experiences of shock, anger, sadness, anx- (Anna 24+6/40 P2) Family bonding WIN 7 iety, guilt and numbness. Mothers in the Unviable baby Some mothers had other young children Vol 23 No 10 December 2015/January 2016 study described these feelings and behav- Helen discovered at her routine 20- to consider. It was a painful experience for iours. Perinatal loss is considered to be one week scan that her pregnancy was mothers to first cope with the loss of their of the hardest losses to come to terms unviable. She explained that she knew baby and then to prepare and support with. In the study, two mothers described for more time in her pregnancy, than not, their other children with their loss. these feelings and also self-directed blame that her baby would not survive following Cora prepared for the situation; she following the loss of their baby. birth. Pregnancy changes a mother’s body asked the midwife to take her baby out of Prior to her interview, Amelia said: “He in many ways; physically, emotionally and the room before the children arrived. She was given to me to look after,” “I made bad spiritually, this experience is a very chal- then had an opportunity to talk with her decisions,” she felt responsible for the loss lenging time for mothers with an unviable children, comfort them and prepare them of her baby. pregnancy. Helen made a decision to leave to meet their new baby brother. The chil- Another interviewee, Ash stated: “You work and committed to enjoying the short dren subsequently held their brother. Cora 56 FOCUS

recalled how she prepared the children: to you and then it really hit home that this al16 offer the opinion that parental choice “I let them see me, we hugged and I made was the little baby and I got upset. I wept not to see their baby or uncertainty should sure that they were okay, once they were and I agreed then to have the blessing at be continuously revisited in the hours comfortable I asked them did they want to that point… yes please I do want to have her after birth as the opportunity for contact see him and then I brought him back in and blessed. I was very grateful for that. I was is fleeting and final. they got to hold him and they were very, really appreciative of that.” (Sinead 23/40 Newer grief theories guided the under- very good.” (Cora 27+4/40 P3) P2) standing of memory making following the Sarah spent a few hours with her baby With support from the bereavement loss of a baby. These new models place after she died. Her husband wanted their midwives and chaplain Sinead looked at emphasis on holding on to and develop- toddler to see her new sister also. Sarah and touched her baby: ing continuing bonds with the deceased. described: “I would definitely encourage any mum Parenting and caring for the baby that “My husband wanted my little girl to see who was going to go through this to see has died is recognised to produce posi- Amy even though at that time she would their baby, definitely, it’s the only chance tive memories by supporting the grieving have only been 13 or 14 months because you will ever get to see that child and if process; it provides an opportunity to we wanted to have a photo. But practically you don’t I think you will regret it. You will bond with the baby and forms a sense of that was hard work because my toddler was always wonder what did they look like and I identity for the baby.18 Mementoes are running riot, she was running everywhere.” should have held her. It was the right thing a tangible reminder of a baby’s short life (Sarah 26+6/40 P2) to do.” (Sinead 23/40 P2) and mothering. The literature describes Some mothers brought their baby home Cora’s baby lived for approximately 30 the importance of mementoes to fami- for a night before the funeral. This journey minutes: lies19,20,21,22 by creating a bond and sense home for the family with the baby was “I still can’t and I’d love to be able to of identity of the baby18 that may aid the managed in different ways. Amy reported: remember holding Ronan (pseudonym) grieving process. Radestad et al23 describe “He slept in the bed between us. We took because seemingly I held him while he was the significance of creating memories in him ourselves to Glasnevin and a friend of alive.” (Cora 27+4/40 P3) the form of photographs, baby clothes and my husband had written a poem just after From the accounts of the experiences of moulds of the baby’s hands and feet. he found out that Tom was born and that the bereaved mothers in this study, hold- Bereavement theory guided the under- was read at the funeral.” (Helen, 42/40 P1) ing their babies did not appear to cause standing of a mother’s grief in the short Cora and her family went shopping and unnecessary distress or harm but rather time period following the loss of a baby. bought their baby an outfit that he could was viewed as a positive experience during The bereaved mothers strongly empha- wear going home from the hospital. This a very difficult time. sised feeling traumatised in the early ritual involved the children and created Discussion days following the loss of their baby, with family memories as they moved forward: The psychological transition to the feelings of helplessness described. Grief “Myself, John (husband’s pseudonym) role of a mother and motherhood begins symptoms of shock, anger, emptiness, and the two girls went shopping. We bought during pregnancy.8 The development of helplessness and loneliness are described Ronan (pseudonym) an outfit and we brought maternal-foetal attachment from an early in the grief literature.24,7,25 Perinatal grief is it up to the hospital for him, the midwives were stage in pregnancy has been described in a unique grief; it is a prospective mourn- going to dress him.” (Cora 27+4 P3) the literature.1,2,3 The theory of attach- ing, relinquishing hopes, dreams and Consideration of the impact of the ment guided the study, namely Bowlby’s fantasies about the child that never was. baby’s death on their other children was influential work on attachment9,10 and The findings of this study have provided prioritised by mothers. For some mothers Ainsworth’s11 description of attachment a useful insight for professionals involved bringing the baby home was a very impor- as a specific emotional bond between an in the care of bereaved mothers following tant event in the family’s life. infant and caregiver. the loss of a baby. Holding a baby that has died It was important for mothers in this It is important for bereaved mothers to The discourse on whether a mother study5,12 to have their motherhood val- have their motherhood acknowledged and should hold her baby following late mis- idated by holding their baby. While an validated and to receive compassionate carriage, stillbirth or neonatal death is earlier study by Hughes13 suggested that and empathic care from nurses and mid- ongoing in the literature and in clinical it may be harmful for a mother to hold her wives. The support of health professionals practice. In more recent years mothers are stillborn baby, more recently, it is recog- is paramount at the time of a baby’s death encouraged to hold and spend time with nised that it may be important for mothers as this may influence how a bereaved their baby that has died. It is suggested to hold their baby, providing love, warmth mother copes with the baby’s death and that touching the baby’s hands and feet and time with their baby. The literature has the memories surrounding the birth and can help the mother realise that her baby identified that mothers value and benefit death years later.6,26,27,28

is now separate from her and this may from contact with their baby, particularly Denise McGuinness is a clinical midwife specialist help the grieving process. Sinead described when they are supported to do so.14,15,16 (lactation) at the National Maternity Hospital, Dublin and the transition from being in labour to see- Current clinical guidelines suggest that a clinical tutor in midwifery at the School of Nursing and Midwifery, Trinity College Dublin ing her baby. Being face-to-face with her decision making around holding a baby baby made the whole experience very real that has died should be a parental decision Special thanks to Dr Barbara Coughlan, lecturer, UCD School of Nursing, Midwifery and Health Systems who 17 and she became upset: made with an experienced practitioner. provided supervision with the research study and subse- “When you’re going through the labour The role of healthcare professionals in quent papers. Vol 23 No 10 December 2015/January 2016 Vol pains it’s all about you at that time but encouraging parents to see and hold their References on request from [email protected]

WIN suddenly they bring this tiny little baby up stillborn baby is paramount. Kingdon et (Quote McGuinness D, WIN 2015; 23(10): 55-56 WIN Vol 23 No 10 December 2015/January 2016 Clinical handover: Deirdre Munro discusses the importance of handover in midwifery Clear communication protects all published ‘C ical Effectiveness Committee (NCEC) of tions inpractice andimprove the quality improve health outcomes, reduce varia guidelinesImplementation can of clinical define models approachesunderpin ordence-based to for implementation provide robust evi guidelines recommended by the NCEC assur tee; its role is to prioritise and quality Situation services in Ireland. involved in clinical handovers inmaternity intended for useby allhealthcare staff Clinical over) inMaternity Services’, National rary or permanent basis. personprofessional or groupa tempo on a patient aspects ofcare all forability some or for professional responsibility and account Clinical Identify 58 MIDWIFERY FOCUS Support Group to act on the recommenda Support act onthe Group to established the National Implementation identified asa contributory factor, the HSE poor communication wasin which 2012, inUniversityHospital Galway College Background The NCECisaministerial commit In November 2014, the National Clin Following a tragic maternal death at clinical decisions. e national clinical guidelines. These handover refershandover tothetransfer of Guideline No.5. This guidelineis , or group of patients, to another ommunication (ClinicalHand of care asappropriate. 1

------consultations; suchas tions of apatientincluding:professional Guideline No. 5 include all communication Recommendations with patients or relatives. leveland communicating of carehigher a escalation toshift, at changeof as care; patient’sand transition ofa condition of professionalanother,one to deterioration handover,on clinical thr base guidelineforvided theevidence the team of researchers at UCD. The team pro was supportedb sub-groupguidelines, the ing theclinical by Celinemanaged Conroy.developIn was munication (clinicalhandover). This group recommendations oncom with guideline national clinical a established todevelop and guideline development group was also tion inmaternityservicesIreland. and informafocused communication of timely, accurate, complete, unambiguous describes the essential elements for Assessment in Ireland. handover practices in maternity services an examination ofcurrent clinicaland relates to both urgent and routine condi and the reports ofthecoroner,tions ofthe HIQA The recommendations contained in National Clinical Guideline No.5National Clinical Guideline ough asystematicreview of literature chaired by Eilish Croke andproject HSE. A communication sub-groupHSE. A communication 3 y Prof Gerard Fealy anda 2 expertconsultation team-to-team and 1 It It - - - - - r preferencesing their meeting thewhile • Organisational handover.rating elements of clinical risk and to organisational, conductcontent risk for patients. Recommendations relate minimising variability, therebyreducing the promoting standardisation of practice and structureda communication tool,using staff in maternity services to be conducted (clinical handover) between healthcare • • • • clinical handover process, consider Conduct • • • • •

equirements of confidentiality. Audit vant quality and safetyand committee vant quality C in emergencies risk activity R P R clinical handover accurate, up-to-date information during Ensur between professionals. policy forhandover the clinical Pr ongoing staff in-service education Mandatory Pr guideline national clinical Dev ance with stakeholdersance with The patientshouldbeinvolved in the articipation should takearticipation priority except ecognise clinical handover as a clinicalhandoveras ecognise clinical eview existing clinical handover guid handover eview existing clinical onsider electronic patient recordsandonsider patient electronic ovide staff and with ovidetraining education omote a culture of mutual respectmutual of culture a omote elop a local policy in compliance with e all staff have access to relevant,access to have staff all e clinical handover practice byrelehandoverpractice clinical for staff orientation andorientation staff for

- - - MIDWIFERY FOCUS 59

diagnostic data as a solution to provide • The ISBAR tool should be used when mentation of this important guideline. The relevant accurate up-to-date information communicating information in relation to HSE and all healthcare organisations are • Implement multidisciplinary clinical a critically ill or deteriorating patient responsible for disseminating and imple- handover where possible, include junior Risk rating menting the guideline, including education and senior staff • The safety pause should be utilised dur- using the recommended communication • Shift handover should include a discussion ing shift clinical handover to provide an tools. of operational issues, including identifica- opportunity to clarify and discuss any The service user is at the centre of tion of factors that may impact clinical care aspect of a patient’s care healthcare. Clinical handover is every • ALL patients should be discussed at shift • Radiology QA guidelines should be imple- healthcare organisation’s responsibility. clinical handover mented in all locations for the management All healthcare staff are accountable and • Clinical handover should be conducted in an of critical, urgent, clinically significant and responsible within their professional scope area with minimal distractions/ interruptions unexpected radiological findings of practice for adhering to Guideline No. • The organisation should ensure manda- • Laboratories should have policies and 5 and for maintaining competence when tory protected time be designated for assurance processes in place for clinical communicating through clinical handover.

shift clinical handovers handover of critical results. Deirdre Munro was midwife researcher on the national • Clinical handovers should specify staff Read-back communication project UCD. Currently INMO Executive attendance, roles and responsibilities at • Read-back is by the recipient of clin- Council member. Project co-ordinator QID, Corporate HSE clinical handover ical handover to confirm and clarify Special thanks to Prof Gerard Fealy and the UCD team, Eilish Croke and Celine Conroy, Communication (Clinical • Clinical handover should be conducted clinical handover information is received Handover) sub-group, GDG HSE verbally, face-to-face, supported with rel- and confirms responsibility References evant documentation Summary 1. Communication (Clinical Handover) in Maternity Ser- vices. National Clinical Guideline no 5. Department of • Taped handover must NOT be used in any The National Clinical Guideline No. 5 Health/ NCEC/ Patient Safety First. Nov 2014. http://health. circumstance. recommends that higher education insti- gov.ie/wp-content/uploads/2014/11/National-Clini- Content tutions providing preparatory professional cal-Guideline-No.-5-Clinical-Handover-Nov20141.pdf 2. Fealy GM and Riordan F (2014) Communication and • Clinical Handover should be conducted education and continuing education and Clinical Handover Practices: A Systematic Review (System- using ISBAR₃ communication tool (Iden- professional development should incor- atic review conducted on behalf of the National Clinical Effectiveness Committee), Dublin: HSE/UCD tify, Situation, Background, Assessment, porate clinical handover within curricula. 3. Fealy GM, Munro D, Riordan F, McNamara M (2014) Clin- Recommendation, Read-back, Risk) The Guideline also recommends the estab- ical Handover Practices in Maternity Services in Ireland (National review of clinical handover practices conducted • ISBAR₃ may be available in written for- lishment of a national communication on behalf of the National Clinical Effectiveness Commit- mat but preferably electronically (clinical handover) group to support imple- tee), Dublin: HSE/UCD Operating Department Nurses Section Conference 2016

Call for Abstracts The INMO ODN Section conference planning committee welcomes submissions from members on current Irish perioperative research, to form part of the conference WIN programme. Vol 23 No 10 December 2015/January 2016

Abstracts (between 250-300 words) to be WIN submitted to [email protected] Vol 23 No 7 September 2015 Closing date for abstracts: January 8, 2016 Vol 23 No 9 October 2015 23 No 9 Vol For all enquiries email: jean.carroll @ inmo.ie,Tel: 01 664 0648 WIN Website: www.inmoprofessional.ie FROM THE PRESIDENT 61

On the ground with the president

All Ireland Chief Nursing Officers conference Happy Christmas ON BEHALF of the Organisation, I attended the All Ireland Chief Nursing Officers con- IT IS hard to believe that Christmas ference in the Titanic Centre in Belfast. The theme of the conference was ‘leading and is upon us and 2016 is just around shaping the nursing and midwifery agenda — an all-Ireland approach’. The conference the corner. I would like to take this was hosted by Dr Siobhan O’Halloran, chief nursing officer (CNO) at the Department opportunity to extend my warmest of Health and Charlotte McArdle, CNO for Northern Ireland. wishes for the festive season. Many Leo Varadkar addressed the conference and thanked nurses and midwives for their of you will be working, providing contribution to the health service. He also acknowledged the challenge in recruit- excellent care on the frontline to ing nurses and midwives, but advised that progress was being made. He stressed his our loved ones, but I do hope that you will ongoing support for the work of the ‘Taskforce on Staffing’ and ‘Skill mix for Nursing’, get to take some time out for yourselves chaired by Dr O’Halloran, in developing a framework to determine the safe staffing to be with your families and loved ones. I and skill mix requirements for the nursing workforce in general and specialist medical thank all INMO reps, committees, Branch and surgical care settings. He also announced that he had approved the taskforce’s and Section officers who work on a volun- interim report on the framework. An extensive pilot is to be funded and run next year. tary basis on behalf of the organisation. I want to mention the CNOs’ award for ‘Excellence in Cross Border Nursing’ which This work is greatly appreciated, as is your was presented to Anne Gallen and Alan Cory Finn for establishing the Cross Border commitment to the INMO. I look forward Senior Nurses and Midwives Forum. This award recognises innovation and excellence to meeting you at your AGMs in the new in patient care within the border region or on an all-island basis. year. Happy Christmas and new year.

European Federation of Nursing Assembly (EFN) Social policy ELIZABETH Adams, INMO director of professional development, Dean Flanagan, AS YOU are aware we have been in INMO student and new graduate officer, and I attended the European Federation of involved in a number of campaigns in Nursing Assembly in the Royal College of Nursing in London. At the general assembly relation to violence against women. A we discussed key political issues related to the three main political institutions: number of initiatives have been launched European Commission, Council and European Parliament, including a discussion on in November to end violence against the sustainability of the European Nursing Research Foundation, developed when EFN women. Man-up launched a video in con- started co-ordinating the EU thematic network ‘ENS4Care’. junction with Cathal Pendred UFC fighter I sit on the EFN workforce committee. During our meeting we evaluated the EU strat- which can be found at www.manup.ie egy on ‘EU workforce for health’ and agreed on two position statements on ‘recruitment Our general secretary Liam Doran was and retention’, and ‘dementia and the workforce needed in the community to cope with one of the guest speakers at White Ribbon the challenges of chronic diseases’. Furthermore, the entire general assembly, represent- ambassadors’ reception event recently. ing 34 member States, adopted the EFN Position Paper on ‘Principles Underpinning the I am immensely proud of our Organisa- Development of Health Care Assistants’, providing clear guidance for the EU in its polit- tion’s involvement in these important ical discussions surrounding ‘mutual recognition’ and ‘workforce for health’. It is time issues on social change and gender equal- ity. I would encourage you to participate researchers and policy-makers start acknowledging the EFN’s concerns and solutions. WIN in events in your local area. We continue to be involved in the Turn Vol 2016 23 No 10 December 2015/January Branch and section meetings off the Red Light Campaign and hope I RECENTLY attended a number of branch and section meetings. It is great to see so to see the government introduce the much activity and to see new sections being established and old ones re-energised. criminalisation of the purchase of sexual These are important events and I would encourage you all to look at upcoming events services into the Sexual Offences Bill in and participate. Details of meetings can be found on page 72. the coming weeks.

Get in touch You can contact me at the INMO headquarters at Tel: 01 6640 600, through the president’s corner on www.inmo.ie or by email to: [email protected] STUDENT & NEW GRADUATE FOCUS 63 Placement advice and tips

Dean Flanagan discusses the details of the new Student Section meeting and offers first year students tips for their first placement

New Student Section meeting The new INMO Student Section (see page 26), which represents approximately 6,000 student nurses and midwives across the country, held its inaugural meeting in Dublin recently. The meeting was held in November and coincided with the class rep meeting, which took place on the same day. During the meeting, which was attended by more than 40 people, nursing and midwifery students from across most of Ire- land’s third-level institutes put their names forward for election onto the new Section. The Student Section is a great oppor- Pictured at INMO HQ attending the first meeting of the new INMO Student Section were (l-r): Claire Minton; tunity for students to decide what they Eddie Flynn; Mary Escoto, secretary, Student Section; Bose Allen, treasurer, Student Section; Dean Flanagan, student and new graduate officer; Aoife Kiernan, chairperson, Student Section; Tara Collins; Cliodhna Beirne; Fiona Conlon want on the agenda for the coming year. Dunne; Alicia Wallace; and Darren Ó Cearúill, student representative, Executive Council I work very closely with the Section and look forward to collaborating with the new [email protected] as places will be • Look after yourself: It seems really simple chairperson Aoife Kiernan who studies at limited. To view the full programme visit: but how can you care for others if you are NUIG. It is also fantastic that the head of www.aeic.ca/english/conferences/ not looking after yourself? Eat regular department in NUIG, Catherine Comiskey national meals and drink plenty of water because has pledged to support Aoife in any way Placement time has arrived being well hydrated aids concentration. possible in light of the ongoing difficulties I want to wish all the first years the best Establish a good sleep pattern and try to facing student nurses and midwives. of luck in undertaking their first place- exercise The other Section officers elected were ments and I really hope you enjoy them • Talk to family and friends: ‘Second-year as follows: Stephen Woods, vice chair- as much I did. blues’ may actually arrive in your first or person; Bose Allan, treasurer; and Mary Here are just some tips to make note of third year and they come without warn- Escotho, secretary. as you begin your placements: ing. It’s that time in your course when Workshop with Canadian nursing and • Get organised: Being organised can help you wonder whether you can really do midwifery students make your student years a success. To this? The answer is yes, you are already The Canadian Nursing Students’ Asso- save time, make folders for your assign- doing it. I got through these doubts by ciation hosts their national conference in ment briefs, timetables and documents. talking to my family and friends, seeking

January every year and they have invited On placement, maximise every learning the advice of my tutor and taking some Vol

Irish students to join them virtually as opportunity by organising your time to time for myself 23 No 10 December2015/January 2016 ‘global guests’ for their keynote speak- include all the experiences open to you • Plan your time: This sounds so simple but ers presentations on January 28, 2016. • Access support and ensure you maintain can mean the difference between 3am This will be the first webcam conference regular contact with your CPCs and men- panic writing and actually enjoying the organised for students to interact with tors: They are there to help. They are assignments. I used to try to keep assign- each other from across the world. experienced nurses and can answer ques- ment dates in my diary and then work The 2016 conference will focus on tions you’re unsure about or just offer to out how many words per day I needed transformation and the changing listen. Access support sooner rather than to do to complete the assignment by the landscape of the nursing and midwifery later, don’t let something small become deadline. professions. If you are interested in this major (this was the biggest fear I had on Dean Flanagan is student and new graduate officer at please contact me by email to: dean. placement) the INMO BRANCH FOCUS 65

BranchBranch Officers Officers Chairperson Treasurer Secretary KilkXXenny Chairperson Vice chairperson branch INMO KilkennyXX Branch email: [email protected] Tel: 061308999 Jenny Moloney Margaret Murphy Sheila Swain [email protected] Margaret.Brennan [email protected] Branch workplaces and areas covered [email protected] • XX Secretary/Executive Council IRO Branch workplaces and areas covered Vice Chairperson IRO • St Luke’s General Hospital • Kilcreene Regional Orthopaedic Hospital • St Colomba’s Hospital • Castlecomer District Hospital • St Patrick’s Centre • Aut Even Hospital • Public health nurses and community RGNs XX Fran Hayes LizXX Curran [email protected]

Latest news Latest news IndustrialIndustrial relations relations update update The Kilkenny Branch of the INMO • XX meetsXX twice or three times per Liz Curran is the IRO for the Kilkenny Branch. year. The venue for these meet- Local issues ings has been rotating between Kilcreene Regional Orthopaedic St Luke’s Hospital, Kilkenny Hospital and St Luke’s General • A number of services are planned to move into the new building in the Hospital to allow for flexibility coming weeks, including the accident and emergency department, MAU, of attendance. Local reps and oncology services, endoscopy and hepatology services. Additional nurse our IRO are meeting regularly to staffing levels for services in the new building have been agreed, however, discuss issues pertaining to their discussions with the INMO continue regarding the proposed revised opening own areas. hours of the MAU in the new building. In the maternity department, shift The main issues of concern relate leaders have been appointed and additional midwives have been appointed to staffing levels and ongoing over- to the department. crowding and lack of recognition on the appeals process for Acting St Patrick’s Centre, Kilkenny Category 3 status. • Ongoing uncertainty prevails in this service regarding the future St Luke’s Hospital has undergone management of the service further to various HIQA reports. Discussions are major capital project development ongoing with regard to same and discussions have commenced regarding the on a new ED, day services facility, implementation of the report on moving on from congregated settings. A oncology unit, hepatology and number of industrial relations claims have been served to management and

MAU which will be operational WIN are awaiting a response. over a phased period between Vol 23 No 10 December 2015/January 2016 November 2015 and February Aut Even Hospital 2016. There is in-house enthusi- • The INMO has sought discussions with management regarding nurse staffing asm to ensure adequate staffing levels and nurse management posts in this service. is agreed and adhered too. INMO members have attended Kilcreene Hospital safe practice workshops with our • INMO compensation for loss of earnings claim has now been resolved and all IRO on industrial relations mat- members eligible for increased payments have received their due monies. ters and have been active at local and national demonstrations on Castlecomer District Hospital issues of concern in support of • Claims for payments of location allowance to members in this hospital are our colleagues. ongoing. REVIEW 67

Make the new year all about your feet THE first book launched in Europe on Ms Guckian also includes a lot of small foot health for the general audience since ‘did you know’ boxes along the way. Once 1845, Isobel Guckian’s Floor Play – You again, these are entertaining and highlight will never look at your feet in the same way some facts that you may not have been again is the product of many years’ clinical aware of. experience. As for specific foot problems, having The author trained as a general nurse at recently suffered from a double Morton’s the Mater Hospital Dublin, later obtaining neuroma (which incidentally the author a degree in podiatry from the University would prefer to call Durlacher’s neuritis) of Cardiff. She is a council member of the in my left foot – due in my case to high- Society of Chiropodists and Podiatrists in impact sports rather than wearing high Ireland. heels – I was already aware that I should Her book aims to serve as a practical take better care of my feet. However, guide to the most common foot being aware of it and acting on it are two complaints and focuses on problems different things. With the simple advice at such as dry skin, cracked heels, verrucae, the start of this book, I will make a greater ingrowing toenails, fallen arches and effort this time, and it is now part of my Achilles tendon complications. It also new year’s resolution. looks at broader issues such as children’s The book could certainly act as a great feet, sports injuries and foot health in resource for those studying foot-focused diabetes, among others. neglect our feet – regarding general foot specialties, but it is mainly aimed at the However, as is suggested by the cover, health as well as a potential ‘erotic organ’ general audience to promote greater Ms Guckian starts the book on a less as Ms Guckian describes it. appreciation of the importance of foot serious note with a description of an However, this is by no means a book care. evening get-together between friends, of ‘fifty shades of toe-sucking’, rather it The book can be purchased online at which ends up with foot massage and draws attention to our feet and how we www.bodyrightphysio.ie – perhaps to the reader’s surprise – an should probably think of them a lot more – Sonja Storm

episode of toe sucking. This description than we do. Floor play – You will never look at your feet the same way will certainly catch the reader’s attention, Along with the rather unusual again, is published by Barrett Business Communications and is aimed to highlight how much we introduction to a book on a health topic, ISBN 978-1-908417-68-8 ! Crossword Competition

1 2 3 4 5 6 Across Down Solutions to November crossword 1 Tend to your mental health when the 1 Blend (3) 7 788 ceiling is set low! (4,4,4) 2 The ‘N’ of ENT (4) Across: 1. Son 3. Transcribed 7 Painting, sculpture etc (3) 3 Christmas (4) 8. Gander 9. Sympathy 10. Inter 9 10 9 Hatchets (4) 4 Male relative (5) 11. Deals 13. Brain 15. Consort 11 10 Get some jewellery from a Celt? OK (6) 5 Pays attention to (5) 16. Example 20. Satyr 21. Triad 11 Dam (4) 6 Fruit found in the calendar (4) 23. Clash 24. Pakistan 25. Figaro 12 13 14 14 Fewest or smallest (5) 8 The confused Yank hated rum as 26. Approximate 27. Tit 15 16 17 15 The ‘two’ in a deck of cards (5) traditional Christmas fare (6,3,3)

16 Stand here at darts and dispel the echo (4) 9 Naval caddies are upset to find an Down 18 19 20 18 Blood-vessels (5) abundance of riches here (8,4) 1. Significant 2. Nineteen 3. Their 21 Bar of precious metal (5) 12 A mushroom, for example (6) 21 22 4. Nosegay 5. Roped 6. Betray 22 Shinbone (5) 13 The Royal County (5) 7. DIY 12. Strep throat 13. Birds 23 23 It’s hell being a shade different (5) 14 Extremely angry (5) 14. Nixer 17. Pheasant 24 Part of the window my father wore? (4) 17 Spider’s creation (6) 24 25 18. Sternum 19. Link up 22. Disco 25 Avarice (5) 19 Publish, bring forth (5) 23. Crime 24. Pea 26 27 28 26 Ingrained dirt (5) 20 On which to perform a show (5) 29 Points a weapon at its target (4) 27 You might lose her in this major 30 31 32 29 33 It has a diameter and circumference (6) European river (5) 33 34 35 34 Damage (4) 28 Tropical bird (5) 36 Snakelike fish (3) 30 Grain used in brewing (4) 36 37 Would Confucius, Plato and Aristotle 31 Vegetables that grow in pods (4) The winner of the 37 exemplify the Magi? (5,4,3) 32 One’s pal is much confused (4) November 35 Sprint (3) crossword is: Colette Gibbons Name: The prize will go to the first correct entry opened. Louisburgh Address: Closing date: Tuesday, January 19, 2016 Post your entry to: Crossword Competition, WIN, MedMedia Publications, Co Mayo 17 Adelaide Street, Dun Laoghaire, Co Dublin 68 UPDATE

First 1,000 days’ nutrition has lifelong influence The first 1,000 days of life – from cognitive development of offspring. conception to two years of age – has “Our research shows that moderate fish been identified as a unique ‘window of consumption during pregnancy showed opportunity’ for nutrition, which can have no detrimental effects on the offspring a major long-term impact on health. and can actually benefit their language Speaking at a medical seminar on this and visual motor skills in the early years of topic in Dublin, Dr Emily Oken of Harvard life,” she explained. Medical School in the US, who is an expert Also speaking at the seminar, Prof in this field, said that studies show that Michael Turner, the national lead for the nutrition in early life ‘has a lifelong influ- HSE clinical programme in obstetrics maternal and foetal complications and ence on the health of an individual’. Her and gynaecology, pointed out that the the need for obstetric intervention, all of research has pinpointed the first trimester increasing rate of obesity in Ireland was which increase the cost,” he explained. during pregnancy as the most sensitive having a severe impact on contemporary Dr Oken and Prof Turner made their period of development. At this stage, the obstetrics. comments at the annual First 1,000 Days baby is most sensitive to environmental “We now know that a woman’s seminar, in association with the Irish exposures, such as poor nutrient intake pre-pregnancy weight is far more influen- Nutrition and Dietetic Institute. It is part and excess weight gain by the mother. tial than weight gained during pregnancy of a programme aimed at encouraging “The nutrition a baby receives in the on her offspring and contributes to her behavioural change in the way nutrition is womb during the first trimester in particu- chance of gestational diabetes, incidents approached in Ireland. lar, has a lasting effect on their cognitive of which have increased in Ireland three- Attendees at the seminar, which took development and risk of obesity, type 2 fold in the last six years. place in Dublin’s Convention Centre, were diabetes, heart disease and stroke in later “This is largely due to the fact that told that while the impact of good nutri- life,” she said. one in six women in Ireland are obese tion on children’s physical and cognitive Dr Oken is currently involved in an before they conceive and there is better health is well acknowledged, expectant ongoing study into the benefits of screening compliance among obstetricians parents and new parents need more maternal oily fish consumption on the and GPs. Gestational diabetes results in advice and support.

Dealing with Study finds midwife-led maternity care is domestic violence safe and offers value for money A video, made by White Ribbon A recent study has found that mid- low-risk women cared for in the HSE Ireland and the INMO, highlights the wife-led maternity care is €182 cheaper Dublin North-East region between 2004 issue of domestic violence in Ireland per woman than consultant-led care and 2009, looked at the mean difference through the experiences of nurses and is as safe an option for expectant in clinician salaries, cost of care based on dealing with victims of domestic mothers. manager’s data, known costs of postnatal violence. The video was launched The study, which was carried out by the bed days and costs of key interventions. at the White Ribbon annual event School of Nursing and Midwifery and the Findings from the study will have on November 25 in the Rotunda Hospital School of Medicine in Trinity College, found significant implications for future policy and was followed by ‘16 days of action that the average cost of caring for a woman makers and funders of maternity care and against violence against women’. in midwife-led units was €2,598 compared highlights the need to incorporate more INMO general secretary Liam Doran to €2,780 in consultant-led units. midwife-led units into maternity care in represented the INMO on the day and The research, which involved 1,635 Ireland. White Ribbon Ireland thanked him as well as Claire Mahon and Naomi O’Donovan Masters of care: Pictured for their excellent contributions. (l-r) are Joanne Doyle, The video is testament to the psycho- Sinéad Moran, Eilín Ní logical and physical toll that violence Mhurchu and Cathy Keighery, four nurses from against women has on the victim, survi- the Irish charity Jack and vors, our communities and our country as Jill Foundation who have received their masters a whole. It aims to highlight how endemic degree in children and the problem is in Irish society and how young people’s palliative healthcare professionals, including nurses, care and complex care. This brings to five the have an undeniable voice in this as they total number of Jack and have a unique view from the frontline. Jill specialist children’s It is hoped that this video will reinforce liaison nurses at masters level. The core group of a zero-tolerance approach to violence children’s liaison nurses Vol 23 No 10 December 2015/January 2016 Vol against women in our society. at Jack and Jill manage 1,000 nurses and carers

WIN See www.inmo.ie for more details. UPDATE 69

Nursing home upgrades delayed until 2021 ALONE unhappy with government decision to delay closures and upgrades

ALONE, a charity that works with older of 2021 when we will have 240,000 addi- the private sector for the care of our most people who are homeless, socially iso- tional over 65s compared with when the vulnerable people.” lated or living in deprivation, has recently problems were first identified in 2009.” “Enda Kenny previously stated that he expressed their frustration over the “It took the Fair Deal review three wanted to make Ireland a great country to government’s decision to push out the years to be published, another 18 months grow old in, so far he has failed to invest deadline for nursing homes closures and for a plan to be developed and now the in this notion. We need to plan for the upgrades to 2021. implementation of the upgrades is being future and invest in alternatives. Of late, According to CEO of Alone, Sean pushed out to 2021, 12 years later. This we have been hearing from vulnerable Moynihan: “This government has largely investment needs to be fast-tracked as a older persons that it is virtually impos- ignored the warnings and failed to matter of urgency,” said Mr Moynihan. sible to get home help at the moment. adequately invest in our public nurs- Mr Moynihan continued: “ALONE is This is not good enough, home help hours ing homes. In September, there was an also concerned about the over reliance are vital to keep people active in their announcement of €450 million in the gov- on private nursing homes. Our public communities for a fraction of the cost of ernment capital spend in nursing homes, nursing homes are a cornerstone of our nursing home care. Investment in primary however now it is being reported as €300 health system. There is a danger that we health care is desperately needed to stop million. Even with this investment, it are moving to a more and more privatised the current problem from running out of won’t be enough to tackle the challenges system. We cannot be wholly reliant on control,” added Mr Moynihan.

2015 IARN annual MedMedia – 20 years of publishing WIN 2015 saw the 20th anniversary of relationship with the INMO as publishers conference held in MedMedia publishing WIN – World of Irish of WIN, which is such an integral part Nursing and Midwifery. of the Organisation’s communication Galway WIN publisher Geraldine Meagan said: strategy. We are looking forward to The annual conference of the Irish “We are delighted to have been part working together for many more years to Association of Radiology Nurses (IARN) of such a longstanding and successful come.” was held in Galway on October 10. This year’s event was hosted by Galway University Hospital. The conference was INMO member receives prestigious very well organised and informative and the Irish Association of Radiology Nurses UCD Alumni Award would like to give a special thanks to Sarah Higgins and all those in Galway for their University College Dublin hard work. celebrated its outstanding alumni at the UCD Foundation Day Informative presentations were given Alumni Awards 2015 recently. by Prof Peter McCarthy, consultant President of UCD, Prof Andrew radiologist University Hospital Galway J Deeks presented awards to 15 notable alumni who have (UHG); Smitha Sukumaran, RGN, achieved excellence in their St Vincent’s Hospital, Dublin; Dr Jeeban field and whose professional Das, SpR,UHG; Stephen McNulty, achievements are a source of inspiration to students. radiographer, UHG; Dr Patrick Navin, SpR, INMO member Virginia Pye, UHG; and Dr Gerry O’Sullivan, consultant director of public health nursing for HSE Longford/Westmeath, radiologist, UHG. was presented with the Nursing, WIN The conference provided members Midwifery & Health Systems award. A spokesperson for UCD with a fantastic opportunity to update Vol 23 No 10 December 2015/January 2016 said: “Ms Pye is an innovative themselves on current and emerging leader in the area of child welfare interventional radiology practices as and health services. One of her well as to discuss issues arising out of an greatest achievements was in 2014 when the HSE launched the Child increased demand for services in tandem and Family Needs Assessment with little or no resource improvement. Framework for Public Health for public health nurses working in the Next year’s meeting will be hosted by the Midlands”. Mater Hospital in Dublin. Further details Virginia Pye is pictured above will be published in WIN in due course. with Martin McNamara, dean of nursing and head of school at For further information, or to join IARN, the UCD School of Nursing and please contact Sharon O’Connor by email Midwifery and Health Systems at: [email protected] 72 DIARY

Thursday 28 December Retired Nurses and Midwives Library Opening Hours Section AGM. 11am. INMO HQ. Wednesday 16 Contact [email protected] or Tel: Closed December 23 to January 4 RNID Section. 11am-1pm. INMO 01 6640648 for further details HQ. Contact [email protected] or Tel: 01 6640648 for further details December For further information on the library February Monday-Thursday: and its services, please contact: 8.30am-5pm January Tel: 01-6640-625/614 Friday 5 Friday: Fax: 01-01 661 0466 Saturday 9 Nurse/Midwife Education Section 8.30am-4.30pm PHN Section. 11-1pm. INMO HQ. AGM. 11.30am. INMO HQ. Contact Email: [email protected] Contact [email protected] or Tel: [email protected] or Tel: 01 6640648 for further details 01 6640648 for further details Tuesday 12 Care of the Older Person Section. 11am. INMO HQ. Contact jean. March [email protected] or Tel: 01 6640648 Tuesday 1 INMO Membership Fees 2015 for further details Care of the Older Person Section Saturday 16 annual conference. Clayton A Registered nurse €299 Radiology Nurses Section. Hotel, Galway. Log onto www. (Including temporary nurses in prolonged employment) 12pm-2pm. INMO HQ. Contact inmoprofessional.ie to book your B Short-time/Relief €228 place. Contact [email protected] [email protected] or Tel: This fee applies only to nurses who provide very short term 01 6640648 for further details or Tel: 01 6640648 for further details relief duties (ie. holiday or sick duty relief) Wednesday 20 Saturday 5 Telephone Triage Nurses Section INMO International Nurses C Private nursing homes €228 AGM. 11am. INMO HQ. Contact Section Conference and Culturefest. D Affiliate members €116 [email protected] or Tel: INMO HQ, Dublin. Registration Working (employed in universities & IT institutes) 01 6640648 for further details at 8.30am. Contact jean.carroll@ inmo.ie or Tel: 01 6640648 for E Associate members €75 Saturday 23 Not working Operating Department Nurses further details Section AGM. 11.30am. Tallaght F Retired associate members €25 Hospital. Contact jean.carroll@ G Student nurse members No Fee inmo.ie or Tel: 01 6640648 for further details Saturday 23 GP Practice Nurses Section AGM. Obituary 11am. INMO HQ. Contact jean. Notice for Sections [email protected] or Tel: 01 6640648 v It was with great sadness that the INMO community learned of the for further details v  ll Sections must ensure that A sudden death of their colleague Jacqui Ellis. Jacqui worked as a clinical they have organised their Saturday 23 nurse specialist/team leader in children’s palliative care with the Laura AGMs by February 13, 2016. CNM/CMM Section AGM. Lynn Children’s Outreach Service and previously worked as a clinical Contact [email protected] 11am-1pm. INMO HQ. Contact nurse specialist with the Louth/Meath palliative care team based in Our or Tel: 01 6640648 [email protected] or Tel: Lady of Lourdes Hospital, Drogheda. 01 6640648 for further details She was a member of the INMO since May 2002 and was extremely Tuesday 26 active in the Drogheda Branch, holding the position of treasurer for four Student Allocation Liaison officers Condolence years. She attended Branch meetings and always made a calm, rational group. 12pm-3pm. INMO HQ. and intelligent contribution. Contact [email protected] or Tel: v The INMO extends its deepest 01 6640648 for further details sympathy to the family and Jacqui was an exceptional person, who devoted herself to her patients; she was the essence of care and understanding. The INMO Drogheda Tuesday 26 work colleagues of the late Kevina O’Callaghan who was Branch, her friends and colleagues extend their deepest sympathies to Clinical Placement Co-ordinators Jacqui’s partner Dave, her mum Agnes, brother Geoff and his partner Section. 11am-1pm. INMO HQ. a valued member of staff at Ennis General Hospital. May Mandy, all her extended family, friends and work colleagues on their Contact [email protected] or Tel: enormous loss. 01 6640648 for further details she rest in peace.