€5.75 Vol 24 No 2 March 2016
Student election to INMO Journal of the Irish Nurses and Executive Council Midwives Organisation See insert
World of Irish Nursing & Midwifery Image credits: Portico of General Post Office, May 17, 1916 by TJ Westropp. By permission of the Royal Irish Academy © RIA 1916 Proclamation, given to Kathleen Clarke (Ref: 17NO-1A66-01). Courtesy of Kilmainham Gaol Museum Launch of taskforce report critical for safe staffing page 6
First National Maternity Strategy Copyright welcomed Images page 17
Your questions answered on Transfer of Tasks process page 12-14
Interview with new NMBI president Essene Cassidy page 26
1916Special eight-page supplement CONTENTS 3
News & views 29 Media Watch Ann Keating reviews INMO activities 5 Editorial reported in the news As the country awaits news on who will lead the 32nd Dáil, the need has never 37 1916 special supplement been greater for national consensus Mark Loughrey examines the role played on how our health service should be by nurses and midwives in the events of structured, funded and accessed, writes Easter 1916 (pull-out supplement) Liam Doran, INMO general secretary 50 Branch update 6 News This month we focus on the INMO Athy/ Launch of taskforce report a critical step in Baltinglass Branch ensuring safe staffing on wards… Report’s €2m pilot scheme set to get underway… 55 Code Corner Pilot sites chosen for taskforce staffing Edward Mathews continues his initiative… INMO wins restoration of examination of the new Code of student pay… ED members accept revised Professional Conduct and Ethics 6 proposals… Exercise your vote in Seanad Midwifery matters elections… Transfer of tasks agreed under 58 F ocus on global call for action on LRA… INMO member elected NMBI preventable stillbirths president… INMO welcomes launch of Ireland’s first National Maternity 67 Update Strategy… Safe staffing agreed for Round up of healthcare news items Coombe delivery suite… Plus: ‘Cut-out-and-keep’ Q&A on Transfer of Tasks, page 13; Section news, page 19 Clinical 20 International news The largest international conference 51 CPD on violence in the health sector is set In our continuing professional education to take place in Ireland this year, writes series, Rebecca Pearsall and Gerry Elizabeth Adams Morrow examine jaundice in the newborn child 25 From the President INMO president Claire Mahon rounds up news from the Executive Council and beyond Living 61 Students & new graduates 65 Book review 26 Dean Flanagan updates readers on news R eflective Organizations: On the front for students and new graduates lines of QSEN & reflective practice implementation by Gwen D Sherwood Open letter 63 and Sara Horton-Deutsch. Reviewed by A reminder for members about their Lorna Peelo-Kilroe professional responsibilities when using Plus: Monthly crossword competition social media 71 Finance Features Mar c Evans offers tips on ensuring you have adequate home insurance cover Copyright 18 Section focus This month we focus on the Third Level Image Student Health Nurses Section Jobs & Training 22 Questions and answers 33 Professional Development Bulletin board for IR queries Eight -page pull-out section from the INMO PDC 24 Quality and safety This month Maureen Flynn looks at 72 Diary experience based co-design Listing of meetings and events nationally and internationally 26 Interview T ara Horan talks to new president of 73 Recruitment & Training Pull-out supplement the NMBI, Essene Cassidy, about the Latest job and training opportunities in Image by permission of the Royal Irish Academy © RIA Irish Academy permission of the Royal Image by challenges ahead for the board Ireland and overseas WIN WIN – World of Irish Nursing & Midwifery is distributed by controlled circulation to more than 32,000 members of the INMO. It is published monthly (10 issues a year) and is registered Vol 24 No 2 March 2016 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 One hundred years on Journal of the Irish Nurses and Midwives Organisation AS YOU are reading this editorial the World of Irish Nursing & Midwifery country will have voted, elected our TDs, and we may, or may not, have a govern- (ISSN: 2009-4264) Volume 24 Number 2 ment to lead the 32nd Dáil. I am writing March 2016 this on the eve of the election and it would WIN, appear, from opinion polls, that any new MedMedia Publications, government will involve a coalition of a 17 Adelaide Street, number of interests. Dun Laoghaire, In fairness to the recent election cam- Co Dublin. paign, whether you found it exciting or Website: www.medmedia.ie not, it did involve on this occasion, a sig- nificant degree of focus on our health health system. The public service must service, its current difficulties and how provide all services while the private sys- they might be resolved. It should also tem is heavily focused on elective/planned be noted that the INMO’s Trolley/Ward work. Acting Editor Tara Horan Watch is now used, on a daily basis, effec- However, at the same time, it has to Email: [email protected] tively as a barometer of the state of the be acknowledged that the latest CSO fig- Tel: 01 2710205 health service, as we count and make pub- ures, and the level of insight they provide Sub-editors Sinéad Makk, Anne Savage lic, the number of admitted patients on with regard to Irish expenditure on health, trolleys in inappropriate areas across our compared to our European neighbours, Designers Fiona Donohoe, Paula Quigley hospitals. provides information which cannot be Advertising manager Leon Ellison Indeed the INMO’s Trolley/Ward Watch ignored. Email: [email protected] is now an integral part of media coverage They certainly challenge everyone, who Tel: 01 2710218 of our health service, and I want to thank cares about our public health system, to Publisher Geraldine Meagan all of our members in emergency depart- redouble the effort to ensure we have a WIN – World of Irish Nursing & Midwifery ments and hospitals who supply us with universal healthcare service which is effi- is published in conjunction with the these figures on a daily basis. cient, effective and which treats everyone Irish Nurses and Midwives Organisation by Against this backdrop it is good to see equally, with access being determined by MedMedia Group, Specialists in Healthcare the increased attention given to health need. Publishing & Design. by political parties. Indeed, any consider- All of this reinforces the need for a ation of all the various health manifestos national debate, leading to a national con- would indicate an increased awareness of sensus, on how our health service should the severity of the current difficulties, but be structured, funded and accessed. The sadly no obvious agreement on how they INMO, based on experience and the cur- can be addressed. rent situation, is calling again for the It is not automatically clear, from all incoming government, of whatever com- Editor-in-chief: Liam Doran of the policy statements on health, what bination, to initiate this national debate. INMO editorial board: the medium and long-term commitment We must look beyond the normal five year Claire Mahon; Geraldine Talty; Martina Harkin-Kelly; Moira Craig; Theresa Dixon; towards funding of our public health ser- horizon, to determine how we want our Eileen Kelly; Catherine Sheridan; Mary Leahy vice will be. It would still appear that health service to serve us both now and INMO editor: Ann Keating the budget for health will continue to be for the next 25 years. Email: [email protected] determined on an annual basis. This is In this issue we are also commemo- INMO editorial assistant: Freda Hughes both disappointing and contrary to what rating the role of nurses/midwives in the is required. Easter Rising of 1916. I sincerely believe INMO photographer: Lisa Moyles The debate on healthcare and, in par- you will find the supplement, written by INMO correspondence to: Irish Nurses and Midwives Organisation, ticular, how we fund our public health our own Mark Loughrey, to be interesting Whitworth Building, service, is also taking place against the and insightful with regard to how nurses North Brunswick Street, backdrop of recent figures from the and midwives, and hospitals, played their Dublin 7. Central Statistics Office (CSO). These indi- part over those traumatic days. Tel: 01 664 0600 cated that in this country, we spend more One hundred years on from that rising, WIN Fax: 01 661 0466 than our European neighbours on health, we continue to have many challenges. Let
Email: [email protected] when you combine public/private expend- us hope that, in memory of those who Vol 24 No 2 March 2016 Website: www.inmo.ie iture including all charges and levies. In went before us, we now make the cor- bringing forward this information it is very rect decisions, particularly with regard to www.facebook.com/ important to remember that the combina- health, so that every citizen in this country irishnursesandmidwivesorganisation tion, of both public and private spend, is will always receive world class care. not readily comparable to the total public Liam Doran twitter.com/INMO_IRL spend that might arise in a single tiered General Secretary, INMO 6 NEWS Launch of taskforce report a critical step in ensuring safe staffing on wards
A radical new approach to The taskforce recommen- nurse staffing levels on med- dations, and its approach to ical and surgical wards was determining staffing levels, launched last month by Min- will avoid any repeat of recent ister for Health Leo Varadkar years when reductions took and Chief Nursing Officer place without any assessment Dr Siobhan O’Halloran, with of impact on patients, or on the publication of the interim the nursing staff and their report of the Taskforce on ability to provide safe care. Staffing and Skill Mix for The INMO has welcomed At the launch of the interim staffing report were (l-r): Dr Philippa Ryan Withero, deputy Nursing. the commitment to move chief nursing officer; Dr Siobhan O’Halloran, This taskforce was estab- to the next stage of the pro- chief nursing officer; Minister for Health Leo lished in response to the cess, in piloting the interim Varadkar; and Liam Doran, INMO general secretary INMO’s Safe Staffing Cam- recommendations in a num- manager 2 (ward sisters), prop- taken place in recent years, paign, which was launched in ber of medical and surgical erly empowered to maintain without any measure of the May 2014 in response to the wards nationwide. The INMO safe staffing levels, and nursing negative impact on patients dramatic reduction in nurse will ensure that the recom- practice on their wards. or staff as a result. staffing levels on inpatient mendations are applied and INMO general secretary, “The recent loss of nursing wards arising from the ban on any learning from their appli- and staffing taskforce mem- staff has, in turn, left us in recruitment. cation is reflected when the ber, Liam Doran said: “This is the current situation where In drawing up its interim pilot programme reports back a very positive day for nurs- we have inadequate num- report, the taskforce focused to the national taskforce. ing in Ireland. The taskforce bers of nurses to safely staff on the need to introduce For many years the INMO work, and its recommenda- wards. The taskforce rec- agreed measures, which will has sought that nurse staffing tions, offer the opportunity ommendations provide the determine patient acuity and on inpatient wards would be to move away from staffing opportunity to ensure that need, to ensure a consistent, determined by nursing staff, levels determined solely by all wards are safely and con- adequate and safe nursing following measurement of finances, to being consist- sistently staffed. This will aid workforce is available at all patient need and acuity. The ently determined by patient recruitment and retention of times. This is a step change taskforce recommendations need and acuity as applied by nursing staff because they will in determining nurse staff- bring members a significant nursing staff. That is the way have staffing levels allowing ing levels in the interests of step closer to this reality. This forward. It will, in future, pre- them to practise safely, which patients, their care and their will see nurse management, vent the dramatic reduction in is every nurse’s goal and return to wellbeing. particularly the clinical nurse nurse staffing levels which has objective.”
Report’s €2m pilot scheme set to get underway The framework drawn up by The ultimate goal is to sta- required to meet patient need to patient safety concerns the taskforce is now set to be bilise the nursing workforce, should be assessed to deter- in addition to their longer piloted in three acute hospitals raise care for patients, and mine the optimum skill mix term management across in general and specialist medi- make hospitals a healthier and number to provide safe, hospitals. The framework cal and surgical inpatient units. work environment for staff. effective and efficient care also recommends changes at €2 million has been allo- The framework identifies • Monitoring the ward and organisational level to ensure cated in funding to allow the four core assumptions to be organisational culture are continuous monitoring of project to be piloted this year. used in calculating the num- important indicators of staffing levels within hospitals The interim report sets out ber and type of nurses to be effective leadership that and across hospital groups. the framework for the pilot, deployed on any given ward: can influence the ward and A pilot implementation including a method to calcu- • Individual patient need should organisational climate group has been established, late a safe nurse staffing and be measured to identify the • The monitoring of patient with the INMO represented skill mix for acute hospitals. actual demand for nursing outcomes of quality and by President Claire Mahon, In particular, it recommends care, through acuity and safety, along with day to day to plan and co-ordinate the replacing the ‘one size fits dependency measurement measurement of safety trig- testing throughout 2016. On all’ approach with a range of • The skill mix within the gers such as nursing care left completion of the pilot, the Vol 24 No 2 March 2016 No 2 March 24 Vol factors when calculating safe nursing team as a whole in undone, to provide a mecha- taskforce will prepare a final
WIN nurse staffing and skill mix. addition to the nursing hours nism for immediate response report and recommendations. WIN Vol 24 No 2 March 2016 - - - - - w o H 7 NEWS which remains which remains ong could and not had to be addressed and and addressed be to had depleted to the in four past “This whole flows initiative “The Organisation will work will work Organisation “The “The INMO will continue “The INMO will continue eatly improve the staffing the staffing improve eatly oung nurses and midwives in in and midwives oung nurses from the INMO’s Safe Staffing Staffing Safe the from INMO’s Campaign. It is our continued belief that we must utilise evi rect a serious wrong done to rect a done to serious wrong y closely the with closely pilot sites to that ensure all of the resources fully necessary to utilise the to available are framework the three This locations. will that the environment, ensure both patients and staff, for arising improved is greatly consistent staffing levels from need.” patient on based levels on our medical and sur on levels years. five 2011/12. We also acknowledge also acknowledge We 2011/12. Ministers by recognition, the Brendan Lynch, Kathleen that this lin Varadkar, and Leo issue nurses/mid young that paying wives the than less minimum wage was wr continued. be to the outstanding pursue incremental of granting issue We graduates. to recent credit this that believe is necessary to in our continuing efforts grad young retain, and recruit, to our uate nurses/midwives health service, understaffed”. severely which have been wards, gical so dence based best practice to to dence based best practice gr - - - - - This will allow This scale (€29,497), scale (€29,497), angements also angements also the Irish healthcare system. healthcare Irish the INMO general secretary secretary INMO general INMO general secretary secretary INMO general etrospective incremental incremental etrospective wife will to the wife move second point of the which represents an increase an increase which represents over of €2,000 versee the pilot study. pilot the versee credit for the classes graduate for credit INMO The of 2011-2015. continue to will this pursue demand in the of interest these retaining and recruiting reg scarce, and valued, highly and midwives nurses istered to provide for a further review for a further provide review out the on discussions and of granting standing issue r The new arr
Liam Doran said: “The INMO said: “The Liam Doran INMO as restoration this welcomes it moves some way to cor • the ongoing roll out of the the ongoing out of the roll to all medical/ staffing method to be included wards, surgical for 2017. estimates the in said: “TheLiam Doran INMO the next step in welcomes implementing the taskforce work the three choosing by president INMO sites. pilot the on now Mahon is Claire national implementation group locally, our members and IRO, the relevant with together the local implemen on will be to each hospital in tation group o National Taskforce, which will which will Taskforce, National then complete its delibera in report final a issue and tions December 2016. ------ole for for ole 36 week clinical 36 week clinical aining on the task the nursing hours per per hours the nursing the improvements in in the improvements only further penalised further only penalised inbuilt complement of inbuilt complement of is expected that the pilot weeks after graduation the weeks after graduation he revised arrangements, arrangements, revised he ermanent the on staff ward It The findings of the pilot findings of the The pilot T 16 nurse/mid registered newly During the placement the pay of the year shall equal fourth 70% or scale, nurse staff the of hour an €9.48 P force framework (which framework (which force utilises patient day method) for staff staff for day method) patient and senior nurs ward the on ing staff within the hospital. the within staff ing Special tr the CNM2 on each on CNM2 ward the A 100% supervisory r An annual leave/other for 21% leave n addition, the government government the addition, n
to come into place from March March from come into place to for: provide 2016, 1, • studies, which will also be sub which studies, environment for patients and patients and for environment will run staff, third the until year. this of quarter studies will fed back to the be the graduating nurse/midwife. nurse/midwife. the graduating in was recognised This service fur a provided which UK, the ther emigration. for impetus withdrew granting of incre of granting withdrew • mental credit for this period, this for period, mental credit which • • • • them in a situation where they they where them in a situation min the than less getting were imum wage at €6.86 an hour. hour. an at €6.86 wage imum I ject to external research to to ject to external research confirm ------ospital, ospital, H ospital, Our ospital, Our H
e undertaking the ros e undertaking revised arrangements arrangements revised eplace staff nurses/mid will undertake an initial an initial will undertake
ectors of nursing in these of ectors nursing in these Beaumont The the govern In 2011/12 As As discus we to went press, ospital, Loughlinstown will ospital, Loughlinstown will educe the pay of fourth year year the educe fourth of pay esulting in the new graduate the new graduate esulting in three locations to put in place to put in place locations three to the necessary arrangements which commence the study, includes: sions were continuing sions with the were dir study using the framework on study on framework using the of its medical/surgical some wards. Taskforce on The Taskforce Staffing and cho has Nursing for Skill Mix Pilot sites chosen for taskforce staffing initiative staffing sites chosen for taskforce Pilot sen the three pilot hospitals that students, who are working full- working students, who are time on wards/units, leaving tered tered placement, during which they r roster. full the work and wives restoration the for provide also on of credit, grad incremental week period this 36 for uation, r the to moving second point of €2,000) over the scale (worth after weeks. 16 ment chose to unilaterally r
Incremental credit also restored for future nursing/midwifery graduates nursing/midwifery for future also restored credit Incremental other nursing The INMO and significant secured unions have of the pay of restoration stu INMO wins restoration of student pay wins restoration INMO when dent nurses/midwives they ar Lady of Lourdes of Lourdes Lady H the be the sites initial where the next six over pilot, running eight to takes months, place. Drogheda and St Columcille’s Drogheda and St Columcille’s Pictured with INMO student with INMO Pictured members midwife nurse and news of the welcoming of restoration significant last month were their pay Claire middle): row, (front INMO president; Mahon, Minister of Kathleen Lynch, at DepartmentState of Health with specialresponsibility for Health Mental Primary Care, and Disability; and Liam Doran, secretaryINMO general 8 NEWS
ED members accept revised proposals Implementation of all measures now key to addressing overcrowding
INMO members working in This acceptance, by 71% were not convinced they dations of the Emergency the country’s 26 emergency in favour to 29% against, would be implemented, on a Department Taskforce pub- departments have voted to followed the rejection of 24/7 basis, by health service lished in April 2015. accept revised proposals to previous proposals by ED management. The INMO pointed out that address ED overcrowding, members as they felt that The INMO is now mon- this Taskforce was accepted brought forward by the Work- they did not address the itoring to ensure that the by all stakeholders, across the place Relations Commission critical issues of confidence agreement now in place health service, including health (WRC). and clinical risk and they between the HSE and the service unions. The Organisa- Organisation is implemented, tion is looking forward to the INMO trolley and ward watch in full, on an ongoing basis in implementation of all changes January – February 16, 2016 the interests of patients and necessary to ensure the needs staff in EDs throughout the of the emergency department country. are central to all activity across Hospital 2015 2016 In particular the INMO the healthcare system. Beaumont Hospital 1,298 1,246 will now insist that all of the INMO general secre- Connolly Hospital, Blanchardstown 1,045 568 hospital and group level struc- tary Liam Doran said: “The tures, involving engagement acceptance of these pro- Mater Misericordiae University Hospital 782 789 between hospital manage- posals by our members Naas General Hospital 709 795 ment and INMO ED members, re-affirms their absolute St Colmcille’s Hospital n/a n/a continues, on a weekly basis. commitment to their patients St James’s Hospital 440 332 This is necessary to ensure and to ensuring that they St Vincent’s University Hospital 856 1,099 continuous implementation can deliver safe care to the Tallaght Hospital 732 675 of the, now agreed, System sick and vulnerable peo- Eastern 5,862 5,504 Wide Escalation Policy which ple presenting to them. Our Bantry General Hospital 97 118 places the pressures on EDs at members constantly stated, Cavan General Hospital 132 292 the centre of all health service in all of the information Cork University Hospital 682 1,055 activity. meetings held ahead of the Kerry General Hospital 165 308 In accepting these revised ballot, that this was never Letterkenny General Hospital 837 200 proposals, INMO members about pay and conditions but Louth County Hospital n/a n/a reaffirmed that this dispute it was all about ensuring the Mayo General Hospital 512 331 was always about patient unacceptable situation, in Mercy University Hospital, Cork 406 387 care and ensuring a safe work- emergency departments, was ing environment which must prioritised, by management.” Mid Western Regional Hospital, Ennis 9 144 minimise overcrowding and “We will continue, in the Midland Regional Hospital, Mullingar 755 785 maximise the ability of nurses interests of our members and Midland Regional Hospital, Portlaoise 383 456 to practise safely with man- the patients they care for, Midland Regional Hospital, Tullamore 436 521 ageable workloads. to lead the campaign, seek- Monaghan General Hospital n/a n/a The INMO has consistently ing the implementation of Nenagh General Hospital 15 55 said this was not a ‘tradi- this agreement, and also the Our Lady of Lourdes Hospital, Drogheda 1,306 1,015 tional’ dispute as it always need for additional beds, staff Our Lady’s Hospital, Navan 268 101 centred on the needs of and services right across the Portiuncula Hospital 369 73 patients and the requirement healthcare system”. Roscommon County Hospital n/a n/a of nursing staff to work in As we went to press, the Sligo Regional Hospital 333 440 an environment where they Workplace Relations Com- South Tipperary General Hospital 362 506 could deliver safe care and mission has convened the St Luke’s Hospital, Kilkenny 459 543 where management was con- first review of the agreement, University Hospital Galway 991 958 stantly working to ensure involving the INMO/HSE/ University Hospital Limerick 1,214 1,214 overcrowding was minimised. Department of Health for University Hospital Waterford 282 706 In addition to the specific Monday, March 14, 2016. requirements, now stipulated In order to prepare for this Wexford General Hospital 524 236 in the HSE/INMO agree- review, the INMO has con- Country total 10,537 10,444 ment, the Organisation will vened a further national National total 16,399 15,948 continue to work with all meeting of ED reps which Vol 24 No 2 March 2016 No 2 March 24 Vol Comparison with total figure only: Decrease between 2015 and 2016: –3% stakeholders to implement will take place on Wednesday
WIN the 80 plus recommen- March 9, in INMO HQ. 10 NEWS
Exercise your vote in Seanad elections NURSES and midwives who at any stage up to the end of surely that there would be through the ages. Ultimately, are graduates of NUI colleges February to be included on the some supervision of the activi- the Commission’s report was or TCD are among those priv- June register for that year. ties of the elected politicians in implemented following the ileged to have a second vote TCD academic grad- the Dáil. It can be argued that 1999 dispute and the first available to them for the elec- uates may verify their the outgoing group of senators degree status nurses emerged tion of six of the senators who inclusion on the register at gave great service by closely from the colleges in 2004. will serve in the new Seanad any time at the Seanad Elec- scrutinising all legislation and Based on a motion to the when it is formed. toral Office located in that the activities of Dáil Eireann. INMO annual delegate con- The people of Ireland voted academic registry or by con- Indeed, some of the best ference in 2015, the Executive to retain the Seanad as the tacting the office by email at: known senators to have occu- Council has called for nom- Upper House of the Oireach- [email protected] pied seats in the house are inations in respect of the tas, rejecting the political The NUI constituency com- those occupying the university university panel of the Seanad. parties’ efforts to abolish it. prises graduates from NUI seats, such as senators David Nurses and midwives are The Irish people have given Colleges in Dublin, Cork, Norris and John Crown. encouraged to support any graduates of the universities Galway and Maynooth. Addi- The right of nurses and mid- candidate selected and give concerned a special privilege, tionally, graduates of St wives to participate in such a a nurse or midwife a voice in which should be appreciated Angela’s College, Sligo are eli- privileged vote, which is not Seanad Eireann, speaking for and used constructively. The gible as a constituency. Copies available to the majority of Irish the public health service. It register of electors for the of the register are available citizens, was hard fought and would be a fitting achievement Seanad is published each June at the libraries of the various won in that it is directly related at this point to elect an INMO and the current register, which institutions and also at the to the achievement of degree member to such a position. will be used for the Seanad reception of the NUI offices, status for the professions. One way or another, grad- elections now in progress, was 49 Merrion Square, Dublin 2. That degree status came out uates with the entitlement to published in June 2015. As mentioned, Irish people of the implementation of the vote in the Seanad should use On graduation, each nurse have decreed that it is worth- Commission on Nursing recom- their vote and make the peo- or midwife is given the pre- while having an upper house, mendation of 1998 following ple’s decision to keep an upper scribed form to register for even if political parties felt it an industrial campaign led by house a democratic reality. Seanad elections. However, a was a superfluous institution. the INMO on a range of griev- – Dave Hughes, INMO graduate is entitled to register The intent of the people was ances held by the professions deputy general secretary Annual Delegate Conference 2016
The INEC, Killarney Convention Centre Killarney, Co Kerry Wednesday to Friday, May 4-6, 2016
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 Gleneagle 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 Vol 24 No 2 March 2016 No 2 March 24 Vol Branch/Section Secretaries, by The Reservations Team in The Gleneagle Hotel. WIN For all enquiries regarding Annual Delegate Conference, please contact Oona Sugrue, INMO HQ Tel: 01 664 0636 Email: [email protected] 12 NEWS Transfer of tasks agreed under LRA Premium pay to be fully restored for 6-8pm period
AS PART of the Lansdowne hospital setting nature of it Road Agreement, the INMO, • It is agreed and accepted • A meeting with the unions SIPTU Nursing and the IMO that these tasks cannot be will then take place as the sought that the role of the the sole responsibility of any timeframe has now been nurse would be expanded to one single grade and that altered, due to the delay in incorporate involvement by nursing/midwifery practice Department of Public Expend- nursing/midwifery grades in should expand to incorporate iture and Reform sign off undertaking four specified them • A request has been made tasks. These are: • The full restoration of nurs- to the directors of nursing/ • Intravenous cannulation ing/midwifery premium pay midwifery by the HSE direc- • Emergency phlebotomy; of time plus one sixth that tor of human resources for a
currently carried out by non was removed from nurses/ Phil Ní Sheaghdha, INMO director joint briefing with the INMO, consultant hospital doctors midwives under the HRA. This of industrial relations: which needs to take place • Intravenous drug administra- equates to a 2% increase in “Nurses and midwives are perfectly • Agreement on the independ- placed to deliver this significant tion – first dose salary and will be paid on July reform to the Irish health service ent chair of the national • Nurse/midwife led delegated 1, 2016 and backdated to Jan- which can only be to the benefit of the process discharge of patients. uary 1, 2016. patients for whom they provide care” • Set up of local hospital Agreement was dependent INMO director of industrial and midwives are perfectly implementation groups will on training being provided and relations Phil Ní Sheaghdha placed to deliver this signifi- only happen when all of the agreed staffing levels being said: “This agreement will pro- cant reform to the Irish health above steps are in place. in place in order for nurses/ vide an enhanced service to service which can only be to It is anticipated that this will midwives to take on these patients and allow for some the benefit of the patients for take at least three weeks, if tasks in a safe manner. The improvement in treatment whom they provide care.” not longer, and at that point, INMO, SIPTU Nursing and times, ultimately leading to With regard to time and one the INMO will notify mem- the IMO engaged in intensive greater efficiency and shorter sixth, which was removed from bers of the agreement to set discussions in October and treatment times for patients. nurses/midwives working the up local hospital groups on November, 2015. Included The agreement also provides period of 6pm to 8pm, Ms Ní this issue. The most important in this proposal was the res- an opportunity for nurses/ Sheaghdha said: “The INMO point for our members is that toration of premium pay of midwives to expand their role and other nursing unions have the premium pay which was time plus one sixth, which was to incorporate these specific been campaigning to have this removed will be restored ret- removed under the Hadding- tasks. restored since that time. This rospectively to January 2016 ton Road Agreement (HRA). “Nurses/midwives will not agreement provides for the res- on verification, and that the On February 10, the INMO, be the only grade responsi- toration of time and one sixth task can only be transferred in along with other nursing ble for these tasks, however, to the nurse/midwife which an orderly manner in accord- unions signed off this agree- they will have opportunities was removed under the HRA.” ance with the framework ment by the Department of to expand their practice in The next steps are: agreement. Public Expenditure and Reform these areas as staffing lev- • A circular letter will issue • See opposite for questions and and the Department of Health. els and appropriate training from the Department of answers on this LRA agree- This means: allows. Nurses and midwives Health to the HSE, instructing ment, which can be cut out • It is accepted that improving have been expanding their it to commence the process to keep and copied for your patient care is one of the cen- practice in these areas of care • The HSE will then issue a INMO colleagues. Local INMO tral aims of the proposal and in many countries and this circular letter to its own ser- IROs are also available to that there will be benefits to has resulted in benefits to vice providers advising them clarify any issues in relation to patients beyond the acute patient outcomes. Irish nurses of the agreement and the this agreement INMO member elected NMBI president INMO member Essene Cassidy members and staff of the with Ms Cassidy and her fellow The INMO also extended was elected president of the Organisation extended their board members, in the task of its congratulations to INMO Nursing and Midwifery Board congratulations to Ms Cassidy ensuring that nurses and mid- member Lorraine Clarke- of Ireland (NMBI) at a meeting on her election and send her wives have a strong regulatory Bishop, who was elected to of the board last month. best wishes for her term as body which best protects the the Education seat on the INMO president Claire NMBI president. public by ensuring that the NMBI board following the Vol 24 No 2 March 2016 No 2 March 24 Vol Mahon, the Executive Council, Mr Doran said the Organisa- professions can practise safely elections in November.
WIN general secretary Liam Doran, tion looked forward to working and to the highest standards. • See interview, page 26 LANSDOWNE ROAD AGREEMENT (LRA) Q&A on Transfer of Tasks
Q1. Has the ‘Transfer of Tasks’ process agreed under the HRA Q5. Does this mean four different tasks might apply outside and LRA concluded? of the acute hospital setting? A. Yes, a lengthy process of negotiation has resulted in an agree- A. No, the tasks remain the same. However, it may be some time ment that will enable an orderly transfer of the four identified before the service can be adapted and protocols developed to tasks, when staffing levels are agreed and training has taken place. allow nurses and midwives expand practice in locations outside the acute sector. The agreement is specific that if this is the case Q2. What are the four tasks? the requirement in the first instance is for engagement to discuss A. It is agreed between the parties that the following tasks, this process. including their intrinsic elements, will transfer in accordance with this Agreement from medical staff to nursing/midwifery: Q6. What training will be provided? 1. Intravenous cannulation, including in the appropriate setting: A. A detailed document setting out training requirements was • Peripheral cannulation in adults agreed as part of this process. It clearly sets out that staffing • Peripheral cannulation in children, which is subject to additional levels have to be in place to allow nurses/midwives expand prac- specific protocols and arrangements tice in these areas. It also sets out the standard requirements in Advanced treatments, some of which require specific medications respect of nursing practice in accordance with Nursing and Mid- and additional protocols and attendance of a doctor. wifery Board of Ireland scope of practice guidelines, which are 2. Phlebotomy available at www.nmbi.ie This is currently carried out by NCHDs as distinct from general routine phlebotomy, which is the responsibility of specifically Q7. Will this training be working time? trained and employed phlebotomy staff. This task includes, in the A. Yes, it will be agreed with the director of HR HSE that any appropriate setting: classroom training will be working time, and IT based training, • Venepuncture in adults which can be undertaken outside of the hospital, will be consid- • Venepuncture in children ered working time also. In a side letter between the chairperson 3. Intravenous drug administration – first dose; including in the and the INMO director of industrial relations, it states: appropriate setting: “I refer to the paragraph contained in the Transfer of Tasks • Medication management Agreement concluded on December 1, 2015, which reads as • Basic life support training follows: • Safe use of any medical devices and vascular access devices ‘The local management group as indicated above will put in (VADs) used in order to safely administer IV therapy place initial and ongoing support arrangements for the pro- • Theoretical knowledge of the medication prescribed in that clin- vision of training in the relevant tasks, including sufficient ical area (subject to local policy) appropriate training time’.The Agreement also states that an • Anaphylaxis treatment. agreed circular letter will issue to each location, outlining the 4. Nurse led delegated discharge of patients. requirement to prioritise this matter and ensure that the nec- essary actions are undertaken with immediate effect. I wish Q3. Will nurses/midwives be the only grades undertaking to confirm that the HSE will agree to include confirmation these tasks? that nurses undertaking relevant training in relation to such A. No, it is agreed and accepted that these tasks cannot be the tasks, as set out in Appendix 1 to the Agreement, will be facil- sole responsibility of any one grade but that nursing/midwifery itated with offsite personal training time of not less than two practice should expand to incorporate them. This should not days.” de-skill medical staff and it is important that they maintain some involvement in order to ensure this does not occur. The appropri- Q8. How will the process begin? ate measures required to ensure this occurs will be determined A. A national overseeing group will be set up immediately. The by the clinical director. Nothing in this Agreement diminishes the Department of Health, the HSE and trade unions will have a rep- responsibility of each qualified and trained health professional to resentation on this group and it will be independently chaired. The carry out such procedures, within their scope of practice, when INMO director of industrial relations will be the INMO represent- necessary for patient care or safety. ative. This group will be responsible for confirming the terms of this Agreement have been complied with. Q4. What happens in relation to sectors outside the acute Also, they will have the ability to meet individual hospitals if hospital? required if difficulties arise. The independent chair will have the A. It is agreed that in the context of the implementation of this final authority in respect of any dispute. Agreement in relation to sectors outside the acute hospital sec- tor that engagement will occur between the relevant parties with Q9. How will this be organised in the local hospital? regard to these tasks and appropriate measures to allow for their A. There will be a joint local implementation group made up of implementation in sectors outside the acute hospital settings. the chief operating officer, medical director and director of nurs- Immediate discussions between the HSE and nursing unions will ing, a representative of the INMO, SIPTU Nursing and the IMO. take place in order to agree appropriate arrangements and proto- There will be joint chairs agreed locally at the outset. In order to cols for change in the relevant sectors. ensure implementation within the agreed timescales.
Irish Nurses and Midwives Organisation LRA: Q&A on Transfer of Tasks
Q10. What if staffing levels are disputed? Q16. Is this payment for the transfer of these tasks? A. In accordance with the Agreement: A. No, the HRA is specific that time and one sixth could be • The local management group as indicated above will put in place restored to those who work the period 6pm to 8pm by savings initial and ongoing support arrangements for the provision of generated from changes to work practices including transferring training in the relevant tasks, including sufficient appropriate certain duties to nurses/midwives from medical staff. The value of training time the role of the nurse/midwife following the expansion of the role • The local management team will prepare a proposal for any in this way would then have to be examined as clearly the role additional requirements in relation to staffing, including skill- would have changed via this process. mix in line with nationally agreed ratios. This will be discussed at the local implementation group. In drawing up this proposal, Q17. Will this lead to a better service for patients? local managers will prioritise these requirements within pay bill A. Yes, the whole point is that interventions such as these can management and control processes and associated accountabil- be delivered earlier and in a more timely fashion when led by ity requirements. Consideration will also include overall benefits, nursing/midwifery staff. The benefits to patients of these devel- efficiencies and ongoing savings accruing from the changes as opments are well documented as: set out above • Earlier treatment and better outcomes for patients • Any dispute over this (or any other) aspect relating to imple- • Consistently delivering on safety targets mentation will be referred without delay to the National • Reduced levels of infection Implementation Group for determination • Enhances patient recovery which lessens patient stay in acute • The INMO, SIPTU Nursing and the IMO will ensure that, where hospitals appropriate, training is provided and adequate staffing levels are • Reduces bed occupancy by earlier discharge leading to better bed in place (subject to above), union members will co-operate fully utilisation, and improves patient flow throughout the hospital. with the transfer • Delegation of responsibility for relevant tasks to the appropriate Q18. What benefits would arise outside the acute hospital? grades in each location will be communicated in writing to the A. The benefits outside of the acute hospital are potentially very appropriate staff including an indication of the commencement important in changing the way health care is delivered. This can date. lead to a lesser dependency on the acute hospital and ultimately a greater degree of authority and autonomy for the nurses/mid- Q11. What if agreement on staffing cannot be reached at wives working in these sectors. local level? A. The parties would then refer the issues in dispute to the Q19. Why should nurses and midwives take on these tasks? national implementation group. The national group would then A. There are a number of benefits to the formal expansion of the either: role of nurse/midwife in this orderly way; a) Meet the local group at hospital level; or • The reality is that some of these tasks are being undertaken by b) Examine the issues raised in correspondence. nurses and midwives already. However, this is not governed by Either way the national group would endeavour to assist the a national agreement and therefore it is being rolled out in an parties at local level reach agreement. If this is not possible the ad hoc manner without definite agreement between nursing and independent chair of the national group can make a recommenda- medical staff in various locations tion which would be accepted by the parties. • Nurses and midwives scope of practice will incorporate these tasks and this will become part of the review of the emerging Q12. Will time and one sixth be restored as set out in the changed role of the nurse/midwife HRA if transfer of tasks occurs? • Once staffing levels allow and the nurse/midwife is educated A. Yes, the Agreement states that on verification of the training and deemed competent, they will have the authority to under- being provided, evidence of tasks transferring and no obstacles take these expanded roles within the workplace. This ultimately being created the payment which was in place prior to the HRA will increase the profile and general authority of the nursing/ for hours worked between 6pm and 8pm will be reinstated. midwifery grades and lead to a greater level of satisfaction in respect of the performance of the role in acute hospitals and in Q13. When will payment commence? services in long-term care/community settings A. As soon as the verification has been completed, which should • This orderly process, governed by agreed rules, will determine the be no later than July 1, 2016 and the payment at that stage will be pace and extent of the process. This is safer and fairer than the ad backdated to January 1, 2016. hoc transfer that is occurring in some locations now • The role and function of nurses and midwives by expanding and Q14. What if the evidence is not there that tasks have changing in this manner will need to be reviewed at the com- transferred but this is not due to staff refusal, but due to pletion of the process with a view to assessing the benefit and training or staffing not being provided? extent of this change A. The Agreement is specific that staff cannot be disadvantaged • The Haddington Road Agreement and the Lansdowne Road if circumstances outside their control prevent implementation of Agreement “Provided for the re-instalment of payment between the Agreement. 6pm and 8pm (time and one sixth). On transfer of these tasks, the Agreement now confirms that this will occur and be paid Q15. Is the payment of time and one sixth pensionable? to all nurses/midwives in all sectors, where it applied prior to A. Yes it is, as are all other premium payments made. July 2013.
Irish Nurses and Midwives Organisation WIN Vol 24 No 2 March 2016 ------aternity aternity M 17 NEWS unit at all times. s and senior mid s Joe Hoolan said: Joe Hoolan said: www.health.gov.ie O ational ur midwife members members ur midwife R I N CMM O and particularly the the and particularly
staff and enhances safe safe enhances and staff needs and preferences. and needs r members showed great great showed members r u ategy’s recommendations. recommendations. ategy’s Speaking on the issue, Speaking on the issue, “The of the recognition role The idwives Section, commits Section, commits idwives ow have the appropriate skill skill appropriate the have ow O “ INMO come. of midwives within the new the new within of midwives wel very care of is pathways their efforts and Through uni will their unit fied approach, n of mix to which allows support wives other mother on the and care infant suite”. delivery The collective goal must be to to goal must be collective The of excellent standards ensure cho care, in the environment on based the mother, sen by their this to embracing forward look these change and providing new models of care and choice women”. for can be 2016-2026 Strategy on: found leadership leadership and determina skill demanding safe tion in mix on this INMO M to itself work with con all deliver to cerned the upon str
------INMO ouncil C 2 group 2 group CMM orman said: “This G xecutive xecutive E
general secretary, secretary, general ary M 3 and orce planning, including planning, including orce at the centre of at the centre all services implementation of this implementation of this e, represents a step change change a step e, represents the matter. the matter. INMO was also reached Agreement INMO ovision of additional mid ovision aternity Strategy Steering Steering aternity Strategy roup, roup, iam Doran, said: “Theiam Doran, otation of senior midwives of senior midwives otation ior midwives in place before in place before ior midwives r acknowledges the dedicated work of the steering group, leading to the launch of this The forward-looking strategy. on the criteria to define the A midwife. senior a of role CMM strategy, which was formulated formulated which was strategy, after detailed discussion involv in our to approach pregnancy and childbirth. The recommen all members will require and of the team multidisciplinary to to existing alter approaches new facilitate care, of models totally the to sympathetic baby”. newborn and mother L take can place. examine if midwives would An meet this criteria. internal was also appeal mechanism could not if agreement agreed proce appeal This reached. be an of training analysis require ments the needed to ensure pr strategy. member and member of the M G in maternity ing all partners car the mother and dations place child final say the have would dure on sary measures, particularly on on particularly sary measures, workf wives required to facilitate the the facilitate to wives required full Department of Health, with of Department with Health, view to a the agreeing neces
------s sen INMO E ational ational reland. with the the with I N rganisation rganisation O nfants Health Health nfants I 2s, three senior 2s, three senior notes the inten notes fully endorses the endorses fully
, hospital manage C CMM INMO ame, all of the recom members would have have would members INMO y positive development y development positive requiring them to come them to come requiring n the short term the a positive transformation of of a transformation positive the WR the ants. During protracted negoti protracted During I The The ing the service to them rather than possible shortest the in ment timefr ations, over a number of days at addition in that accepted ment to two midwives must be on duty on a This means that the basis. 24/7 have must roster suite delivery WT of 16.5 a minimum for mothers and babies, bring mothers for and Women forward to drive Programme the implementation of the The strategy. with to working forward looks to imple this programme, in services maternity into a hospital for care and and care for into a hospital support. tion to establish a frame, which, in the view of frame, which, view of in the INMO led to an clinical envi unsafe ronment for mothers and and mothers for ronment inf natal care, which represents a a represents which care, natal hugel framework for delivering delivering for framework intended pathway, care the and mothers risk normal for babies care). (supported mendations itemised leading itemised leading mendations to will seek a meeting recommendations within the within the recommendations the development for strategy community midwifery of a service. This development will going see hospital midwives to out into the community, post and antenatal provide - - - - - om ater M inister inister M said its full full said its mission, the mission, the oombe W ational idwives Section idwives C N M eo Varadkar last last Varadkar eo om
INMO L C eland can improve improve can eland r I extensive ing extensive nego
w INMO and the
dwife members also wel also members dwife i strategy of their strategy role in the
eed safe skill mix levels in in skill mix levels eed safe ‘Creating a Better Future Future a Better ‘Creating the need to give pregnant pregnant to give the need
A dispute arose following A dispute following arose M
The elations elations or Health Health or n particular, they welcome they welcome n particular, reland’s first first reland’s INMO f proposals by management to to management by proposals of two-thirds senior redeploy delivery the of out midwives suite, over very a short time the delivery suite, which in in which suite, delivery the to of staff turn allows rotation hospital. the in recommence tiations at the Workplace tiations at Workplace the R Follo Safe staffing agreed for Coombe delivery suite for Coombe agreed Safe staffing the recognition of midwives of midwives the recognition leading care and delivering within the multidisciplinary come the recognition within come the within recognition the childbirth experience. natural I Hospital management en’s agr women appropriate and and women appropriate choices, supported informed by access to the correct level of care their and for support needs. individual ognition within the strategy, ognition within the strategy, of month, the month, now be implementation must top a priority. the launch of the launch of Welcoming I first National Maternity Strategy Maternity first National INMO welcomes launch of Ireland’s of launch welcomes INMO Ireland’s particularly the welcomes particularly rec nity Strategy by by Strategy nity care neonatal and maternity ahead, ensuring in the years standardised, safe, is it that a offers of high-quality and more and experience better choice to women families. and Together: National Maternity National Maternity Together: 2016-2026’ maps Strategy how out
Full implementation of recommendations now top priority of implementation recommendations Full
18 Section FOCUS
Spotlight on Section Officers
Third Level Chairperson Vice chairperson Secretary Student Health Nurses Section
Last year saw a continued focus and resurgence of the Third Level Student Health Nurses Section, which aims to consolidate and support nurses Alice Meagher Deirdre Adamson Laura Tully employed in third level educational institutions. [email protected] [email protected] [email protected] We aim to ensure the delivery of best practice to promote and advance student health. The section Education officer Treasurer promotes agreed professional standards of nursing practice in accordance with the guidelines set down by the Nursing and Midwifery Board of Ireland. We are a source of expertise on nursing practice in areas of student health and facilitate continuing education and professional development. This is an invaluable support network for those employed in the area of student health. Our educational officer liaised with members regularly throughout 2015, enabling members to keep up-to-date with Michelle Cresswell Orlagh Fleming recent developments and provided information relating to the michelle.cresswell@ orlagh.fleming@ Professional Development Centre at the INMO. Participation ittdublin.ie ittdublin.ie was encouraged in important online surveys. The education officer assisted with organisation and booking of expert speakers who provided education and professional updates on infectious diseases/skin conditions, oral contraceptives and mindfulness and meditation for holistic nursing.
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/Midwives 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 Forward completed form to: T elephone Triage Nurses Midwives Mary Cradden, membership services officer, Third Level Student Health INMO, Whitworth Building, North Brunswick St, Dublin 7 National Children’s Nurses Nurses Section News 19
Section roundup Call for ODNs to enter Telephone Triage Section The next Telephone Triage annual poster competition meeting, which will be held on April 12 in the Heritage As the ODN Section confer- awarded to multiple winners, meet with the judges. Hotel, Portlaoise, will include ence approaches, submissions depending on the entries. Members are encouraged a session on preparing for are now welcome for the Posters must be original to submit a poster as this is HIQA. Booking is essen- Section’s annual poster compe- work and an abstracts on a great opportunity to share tial and the session will be tition (see page 66). the posters will be included your work with your perioper- accredited. Log on to www. This year’s conference, the in the printed conference ative colleagues. inmoprofessional.ie to book theme of which is ‘periopera- proceedings. There is a reduced confer- your place or contact the tive nurses – the vital link for The closing dates for poster ence fee of 50% for members INMO at Tel: 01 664 0600 excellence in patient care’, will entries is Friday, March 25 and who enter the poster competi- be held on April 15 and 16 in entrants are required to have tion (one reduction per poster School Nurses Section the Clarion Hotel, Liffey Valley, their poster erected prior to entered). A session on medication Dublin. the opening of the conference For full criteria and management in the school The poster competition is on Friday, April 15. guidelines email: helen.ocon- setting will be held at the sponsored by Tekno Surgi- Entrants must also be avail- [email protected] or log onto next School Nurses Section cal and has a total prize fund able at peak viewing times www.inmo.ie for further meeting on April 16. of €1,000, which may be throughout the conference to details. Members of the Section are invited to attend this informative event which will be held in the Heritage Hotel, ED nurses urged to get involved in Section Portlaoise. If you are working THE Emergency Department sharing and support. for Monday, March 7, 2016 from in a school setting and have Nurses Section, which is in Members can connect with 12pm to 2pm in INMO HQ. colleagues also working in the process of being re-estab- fellow nurses and midwives During this meeting, a com- this setting, please ensure lished, is set to give members through the INMO national mittee will be elected to run that they are aligned to their the opportunity to link up with section network, where the section and set out goals national section by con- colleagues from across the there are currently 25 active for the coming year. tacting the INMO at email: country for ongoing special- sections. All ED nurses are welcome to [email protected] ised networking, information A meeting has been organised attend this meeting.
Rep Training Are you interested in representing the INMO?
A training course will be held in INMO HQ over two WI N days as follows: Vol 24 No 2 March 2016
• Thursday, April 14 to Friday, April 15, 2016 Places available For all enquiries email: [email protected] 20 INTERNATIONAL NEWS Violence in the health sector – a broader view The Fifth International Conference on Violence in the Health Sector is being hosted by Ireland this autumn, writes Elizabeth Adams
The largest worldwide conference of the International Council of Nurses for dedicated to workplace aggression and more than a decade in delivering this inter- violence within the health and social ser- national conference. This conference is vices sector is set to take place in Ireland supported by over 40 national and interna- this year, when the Fifth International tional agencies including the International Conference on Violence in the Health Sec- Council of Nurses, International Labour tor comes to Dublin from October 26-28, Organization, Public Services International, 2016. This follows four successful interna- World Medical Association, International tional conferences on Violence in the Health Hospital Federation, American Nurses Sector in Amsterdam (2008 and 2010), Association, Sigma Theta Tau International violence in healthcare Vancouver (2012), and Miami, US (2014). and the International Alliance of Patient • Gender aspects and implications of vio- The theme of this year’s conference Organisations. The INMO is active in the lence in healthcare is ‘Broadening our view – responding local planning committee to support the • Legal and/or ethical aspects and implica- together’. The Dublin venue (the Crowne hosting of the 2016 conference. tions for employers and employees Plaza Hotel and Conference Centre, Considerable advancement in address- • Policies and strategies on workplace Santry) marks a homecoming for Irish ing the problem of aggression and violence including local, national, and nurse, Dr Kevin McKenna, lecturer with violence in health and social care have international and global guidelines, Dundalk Institute of Technology. Dr been achieved from educational, research, standards, reporting, prediction, risk McKenna is a founding member and has practice, service and organisational per- assessment, prevention, management, co-chaired both the organisation and sci- spectives nationally and internationally. after care and rehabilitation entific committees of the International In addition to raising awareness, the 2016 • Scientific, methodological, operational Conference on Violence in the Health conference will provide a platform to aspects and instruments regarding work- Sector since its inception in 2008. In share these international developments, place violence partnership with Bord Fáilte, the Dublin with a particular emphasis on best prac- • Social and psychological theoretical per- Convention Bureau, and Dundalk Institute tice research and initiatives to effectively spectives on workplace violence of Technology, Dr McKenna has led the ini- respond to the problem. The specific aims • Staff training and education issues tiative to have Dublin selected as the host of this year’s conference are: regarding workplace violence venue for the 2016 conference. • To sensitise stakeholders to the issue of • Violence towards patients and horizontal Work related aggression and violence workplace violence in health/social care violence. within the health and social services sec- • To offer multiple perspectives of violence In addition to receiving a book of pro- tor is a major problem that diminishes – including biological, spiritual, experien- ceedings which includes abstracts and/or the quality of working life for staff, com- tial, legal, political and societal – so as to full papers by all presenters, all delegates promises organisational effectiveness enhance our understanding of the topic attending will also receive a certificate of and ultimately impacts negatively on • To exchange experiences and strategies International Continuing Nursing Educa- the provision and quality of care. These to effectively respond to the problem of tion Credits (ICNECs) from the ICN which problems pervade both service settings workplace violence in order to encourage is internationally accepted as continuing and occupational groups. Dr McKenna collaborative responses. professional development. completed his doctorate in this subject The conference provides a unique oppor- Irish nurses and midwives are invited to area with the RCSI, Dublin, and has led a tunity for nurses and midwives to network submit an abstract for consideration as a number of national and international pro- with a diverse community of colleagues conference workshop, an oral presentation jects, including formulation of the Linking engaged in this important area of work. or as a poster presentation. To submit an Service and Safety strategy for managing Apart from the geographical diversity of abstract or for further information on the work-related aggression in Irish healthcare delegates, there is also a multiplicity of conference see: www.oudconsultancy.nl/ in which the INMO played a key role. perspectives including clinical/service, dublin_5_ICWV/index.html Together with Prof Ian Needham (chair) organisational, educational, research and and Nico Oud (organiser), Dr McKenna has regulatory. The conference sub-themes Elizabeth Adams, INMO director of professional
Vol 24 No 2 March 2016 No 2 March 24 Vol development, was actively involved with this conference worked collaboratively with many national cover many concepts including: during her tenure as consultant for nursing and health
WIN nursing associations under the umbrella • E conomical aspects and implications of policy with the International Council of Nurses in Geneva 22 Questions & Answers
Bulletin Board With INMO director of industrial QA relations Phil Ní Sheaghdha
this time. Annual leave that is accrued during unpaid mater- Query from member nity leave can be taken at a time that is agreed between the employee and the employer and any public holidays I am currently on a period of unpaid maternity leave. Will that accrue will be added to the end of the period of unpaid I lose all my annual leave entitlements during this period maternity leave. of time? While on parental leave, the same rules apply, you accrue your annual leave and any public holidays that may fall dur- Reply ing this time. Thank you for query. While on unpaid maternity leave, you are While on either unpaid maternity leave or parental leave, regarded as being in employment and should retain all employ- you are entitled to continue to receive your increments and ment rights, such as annual leave. your incremental date should not change. During your 16 weeks of unpaid maternity leave, you can However, as this period of time is unpaid, you do not con- accrue annual leave and you should not lose any annual tribute to the HSE superannuation scheme, so this period is leave. You also accrue any public holidays that occur during not reckonable for pension purposes.
be placed on INMO members regarding roles currently under- Query from member taken by other grades within the health services. I work in the intellectual disability sector and have been The Organisation has written to HSE management requesting asked to attend training on the ‘Safeguarding Vulnerable that no implementation or training be requested of any INMO Persons at Risk of Abuse’ policy. Has this policy been member until full consultation has taken place with the INMO agreed nationally? I am worried about the impact that and other unions at national level. this policy will have on my already overburdened day-to- day duties. You should advise your manager of these facts if requested to partake in training or if other changes to your current role are suggested. Reply We will advise members when this consultation meeting is Thank you for your question. I can understand your concerns scheduled and update all members following the meeting. regarding the roll-out of this policy. In 2015, INMO members Should you have any further queries or questions, please con- objected to this policy based on the lack of consultation with tact your regional industrial relations officer who will be able to them and also the additional responsibilities it appears would assist you further.
• 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 • Flexible working Email: [email protected], [email protected] • Public holidays Mon to Thur 8.30am-5pm; Fri 8.30am-4.30pm • Career breaks • Injury at work • Agency workers • Incremental credit 24 QUALITY & SAFETY
A column by Ouality Maureen Flynn &Safety All in this together – experience based co-design
EXPERIENCE based co-design (EBCD) is • Sustained co-design work in small groups Experience based co-design an approach to improve healthcare services formed around those priorities six stage process combining participatory and user experi- • A celebration and review event.3 ence (EB) and design tools and processes Why use EBCD in practice? (CD) to bring about quality improvements. EBCD acknowledges emotions and Staff, patients and carers use a co-design experiences rather than attitudes and process to reflect on their experiences assumptions. These ‘touch points’ are of a service, work together to identify catalysts for driving improvements. improvement priorities, and to devise and EBCD blends the aesthetics of what it implement changes. Jointly staff, service feels like, with performance (function- users and carers reflect and celebrate their ality) and engineering (safety) to design achievements.1 The EBCD approach how- improvements. The engagement of staff ever, incorporates experiences of service with service users/carers as partners with users/carers and staff via user-centric design shared purpose improves communication methods to develop practical solutions that and services, acknowledging we are all in could positively impact on service users’ this together to improve our healthcare. experiences of healthcare. Overall the process includes: Where did EBCD come from? • Gathering experience information, obser- • What is the focus of the project (area, A decade ago an EBCD approach to vations, interviews department and/or speciality)? improve patient experience was first • Prioritise and agree key issues (touch • What is the strategy for leading it? piloted in a head and neck cancer service points, critical points, good and bad, • To whom and how will the project be at Luton and Dunstable NHS hospital. To moments of truth, emotional hotspots) reported and who is accountable? date there are over 80 reported EBCD pro- • Patients/staff co-design solutions together. • What measurement strategy will be used jects in seven different countries.2 International examples where EBCD has to measure impact and sustainability of There were four overlapping strands of been used to improve experiences of giv- changes on experience and processes? thought which contributed to the devel- ing and receiving care include: • Is there an evaluation planned? opment of the EBCD approach: • The productive operating theatre (TPOT, • Ethical considerations must be observed in • Participatory action research Ireland) – in progress EBCD Quality Improvement (QI) projects • User-centred design – focus on the user’s • Community mental health (Ireland) and ethical approval should be sought for direct input in design • Emergency departments (Australia) EBCD research activity. • Learning theory – learning in different ways • Carers of chemotherapy (UK) Experience based co-design can link • Narrative-based approaches to change – • Accelerated EBCD in lung cancer services experience based practice to evidence telling the story.1 and ICUs (UK) based practices. When managed carefully What is involved? • Mental health settings (international). EBCD brings groups together to work The EBCD cycle is divided into six stages Get involved effectively towards common goals. It pro- (see Figure): At your next ward, unit or team meeting vides a mechanism to communicate and • Setting up the project why not talk about how you engage with strengthen relationships/teams.
• Gathering staff experiences through patients and families in designing care. If Maureen Flynn is the director of nursing and midwifery, observational fieldwork and in-depth you would like to consider an EBCD pro- Quality Improvement Division lead, governance and staff interviews ject, supports are available through quality engagement for quality for quality • Gathering patient and carer experiences improvement teams locally and nationally. Acknowledgements A particular thanks to Deirdre Munro and Lorraine Mur- through observation and 12-15 filmed Project management principles strengthen phy for sharing their experience of EBCD and assistance in preparing this column. Special thanks also to Prof narrative-based interviews the approach. Questions to consider: Glenn Robert, Kings College London for openly sharing • Bringing staff, patients and carers together • Is the EBCD project a standalone initia- publications and workshop material (2015/2016)
in a first co-design event to share, tive or integrated with other initiatives? References on request. Resources available on http:// prompted by a short edited ‘trigger’ film • Will the project focus on experience, www.kingsfund.org.uk/projects/ebcd Contact: Deirdre Munro, QID HSE Email: deirdre.munro@ of patient narratives, their experiences of efficiency, safety or wider improvement hse.ie and Lorraine Murphy, QI Advisor Email: lorrainew. a service and identify priorities for change issues? [email protected]
Vol 24 No 2 March 2016 No 2 March 24 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. FROM THE PRESIDENT 25
On the ground with the president
Strategy and initiative on nursing and ED dispute resolved midwifery values SINCE my last column, our ED members Chief nursing officer, voted to accept the revised proposals in Dr Siobhan O’Halloran, the ED dispute. The emphasis is now on joined by the Minister implementation of the agreement in full, in for Health, Leo Varadkar, the country’s 26 EDs and the Organisation launched her Office’s will continue to monitor this. The INMO Strategy for 2015-2017 will continue to seek additional beds, staff along with an initiative and services across the health service. on nursing and mid- wifery values, which I attended. At the launch of the Strategy and initiative on nursing and midwifery values National Maternity The Strategy is to were (l-r): Liam Doran, INMO general secretary; Dr Philippa Ryan Withero, deputy chief nursing officer; Claire Mahon, INMO president; Leo Varadkar, Strategy 2016-2026 ensure a broad under- Minister for Health; Dr Siobhan O’Halloran, chief nursing officer; Dr Anne-Marie Wa e w rmly welcomed the launch by the standing of the role of the Ryan, deputy chief nursing officer; and Susan Kent, deputy chief nursing officer Minister for Health of the first National CNO’s Office across gov- Maternity Strategy 2016-2026 – Creating a ernment and its role in developing health policy. It sets out the vision, mission and values Better Future Together. for the Office. It also highlights the Office’s strategic objectives until the end of 2017. The Midwives Section, in particular, In addition, a communication and consultation initiative to affirm the values that welcomes the recognition, within the underpin nursing and midwifery practice has been developed. The goal is to ensure strategy, of the need to give pregnant that the values of care, compassion and competence are re-inforced in nursing and women appropriate and informed choices, midwifery practice and culture across all settings. The initiative will involve extensive supported by access to the correct level of consultation with stakeholders and will develop a repository of good practice. This will care and support for their individual needs. help the nursing and midwifery professions contribute to a culture of safe patient care.
Interim report on nurse staffing/skill mix Branch meetings I ALSO attended the recent launch of the Interim Report on Staffing and Skill Mix I WAS out and about over the last few for Nursing, by the Minister for Health, Leo Varadkar and the chief nursing officer, weeks meeting members on the ground at Siobhan O’Halloran. This report was welcomed by the INMO. It was a positive day information, branch and section meetings. for nursing and a critical step in ensuring safe staffing levels on medical and surgical These gatherings are very informative and wards. important events in our calendar. My key priority as president was to seek the establishment of safe minimum nurse Many branches put forward members and midwifery staffing levels. The Taskforce on Staffing and Skill Mix for Nursing was for election to the Executive Council and established in response to the INMO’s ‘Safe Staffing Campaign’, launched in May I would like to thank those members for 2014, due to the reduction in nurse staffing levels, on inpatient wards, arising from their interest in working on behalf of the the ban on nurse recruitment. Organisation. I am delighted at the development of this framework for safe nurse staffing As you can see there have been a num- and skill mix in general and specialist medical and surgical care settings in adult ber of positive developments within the hospitals in Ireland and the commitment to move, immediately, to pilot the interim nursing and midwifery professions over recommendations. It offers the opportunity to move from staffing levels controlled the last month. I am pleased to have WIN been able to bring you some good news by finances, to staffing levels governed by patient need and acuity as determined and Vol 24 No 2 March 2016 applied by nursing staff. for change.
Get in touch Y ou 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] 26 INTERVIEW Breaking new ground
New president of the NMBI, Essene Cassidy, talks to Tara Horan about the challenges ahead in her term of office
Essene Cassidy is no stranger to break- represent whichever sphere I’m in at a “I think it is important in this second ing new ground in her nursing career. She given time.” term of the board that there is continu- has moved seamlessly along an unworn Ms Cassidy is a registered children’s, ity between the old board and the new path from children’s nursing, through general and public health nurse with more one, and I feel that I have the experience general nurse training and on to public than 25 years experience since she gradu- and the knowledge of what we’ve been health nursing, the latter as one of the first ated from Temple St Children’s Hospital, through.” non-midwives to be permitted to enter with which she still feels great affinity. The 2011 Act enhances the protection that field as a postgraduate. She is currently an assistant director of of the public in its dealings with the pro- Now, since her election as president of public health nursing attached to the Early fessions of nursing and midwifery, while the Nursing and Midwifery Board of Ire- Years Inspectorate, Tusla, to which she ensuring the integrity of the practice of land (NMBI), Ms Cassidy is approaching was appointed in October 2014. Tusla is the professions. The board comprises 23 her new role with a refreshing confidence also breaking new ground since its incep- members with a lay majority of 12. Of the and zeal. She was elected to the board tion in January 2014, when it became remaining 11 members, eight are regis- of the newly-structured NMBI in Octo- the dedicated State agency responsible tered nurses and midwives elected by the ber 2012, as the representative for public for improving wellbeing and outcomes professions. health nursing. This was the first board for children. This was the most compre- “I acknowledge that the general percep- convened under the Nurses and Midwives hensive reform of child protection, early tion of the NMBI is about the retention fee Act 2011, which significantly reformed the intervention and family support services and fitness to practise issues. However, regulation of nurses and midwives and ever undertaken in Ireland. the board does so much other good work meant a large body of work was on the A member of the INMO throughout that hasn’t been marketed to date. cards to oversee the reforms. her career, Ms Cassidy became involved “I want us to be transparent, to be rele- “We began with a new board structure in the Waterford Branch and served as a vant and visible to registrants. I want us to and a new Act. The CEO, Dr Maura Pidg- workplace representative for Waterford be seen as a good thing, not something to eon, was also new just before we came Community Services in 2011, under the be afraid of. The key to this is for the NMBI in and she led us through this period of guidance of INMO IRO Liz Curran. She also to go out on roadshows so people can put significant progress for nursing and mid- became involved in the INMO PHN Sec- a face to who we are and hear about the wifery,” said Ms Cassidy. tion, which perhaps was the impetus for other work we do. We have to work more Ms Cassidy is keen to promote all the her running as the PHN representative on in partnership with our key stakeholders essential work that the NMBI does, both the new NMBI board. who are the staff organisations, the regis- in protecting the public and for the profes- Ms Cassidy said she hopes to bring her trants and the Department of Health. We sions of nursing and midwifery. nursing experience gained across all of are all on the one journey, we are all here “As the inaugural board, we did a lot of these roles and grades to her appoint- to do the same things, which is to protect hard work in starting to address the issues ment. “I look forward to continuing, with the public and promote the professions.” of most relevance to the registrants and my colleagues on the board, the reform The NMBI has just relaunched its web- also to maintain public protection. and progress at the NMBI, and continuing site, www.nmbi.ie, which it hopes will “I understood the distinct roles of public the work that has taken place since the keep registrants more up to date on devel- protection and promotion of the profes- enactment of the 2011 Act.” opments in the future. sion very quickly, and can wear different She succeeds Paul Gallagher as presi- While on the first board, Ms Cassidy’s Vol 24 No 2 March 2016 No 2 March 24 Vol hats on different days. Although I am a dent, who finished his three-year term of work focused on two main areas – ethics
WIN nurse and a union member, I am able to office in December 2015. and fitness to practise. As chair of the INTERVIEW 27 The NMBI’s core functions NMBI ethics committee from 2012-15, she • Maintaining the Register of Nurses Being cognisant of the pressures on our supported the revision and development and Midwives registrants, we are also looking at flexible of the updated Codes of Professional • E valuating applications from Irish payment arrangements, to make it easier Conduct and Ethics for Nurses and and overseas applicants who want for them to maintain their registration.” Midwives and the Scope of Practice to practise as nurses and midwives Professional development Framework for Nurses and Midwives, and in Ireland The NMBI plays a pivotal role in nurs- the ongoing revision of the Medication • Suppor ting nurses and midwives ing and midwifery education in Ireland. Management Guidelines. to provide care by developing Undergraduate and postgraduate pro- Ms Cassidy was recently invited by Chief standards and guidance that they grammes in nursing and midwifery in the Nursing Officer, Dr Siobhan O’Halloran, can use in their day-to-day practice country’s 14 higher level institutions must to represent the NMBI on her Office’s comply with the standards and require- • Setting requirements for nursing three-year ‘Strategy and Initiative on ments set down by the NMBI. The NMBI and midwifery educational Nursing and Midwifery Values’, which was programmes in higher level also approves continuing professional launched last month. institutions development (CPD) courses, includ- “This is a fantastic honour for me to be ing those run by the INMO Professional • Investigating complaints made by working in partnership with the Chief Nurse Development Centre. patients, their families, healthcare in the Department of Health, and with Part 11 of the 2011 Act provides, for professionals, employers and Mary Wynne, nursing and midwifery ser- including Fitness to Practise the first time, a statutory basis for main- vices director in the HSE. It’s a really good inquiries tenance of continuing competence of opportunity for the NMBI to move forward registered nurses and midwives. When this and proactively market what it does.” prima facia case. “The PPC is doing sterling part of the Act is commenced by the Min- Fitness to practise work; it’s our filter before full inquiry.” ister for Health, the NMBI will have a one There are currently two separate fitness Ms Cassidy said the new Fitness to Prac- year period to develop, establish and oper- to practise processes running in parallel. tise Committee worked hard on setting ate one or more schemes to monitor the One committee deals with older cases still up a structure for the 2011 Act. A panel maintenance of professional competence being dealt with under the 1985 Act, with of inquiry is convened for each com- by registered nurses and midwives. its recommendations just coming to the plaint, made up of five people, with a lay The NMBI recognises and supports board at final approval stage. majority. the importance of CPD to nurses and All complaints received on or after While there was some controversy ini- midwives throughout their professional October 2, 2012 fall under the 2011 Act tially about the amount of publicity given careers. “As my own career shows, you and these are dealt with by the new Fit- about an upcoming inquiry, the current don’t stop learning as a nurse. You have ness to Practise Committee, on which procedure is that a notice is put on the to always think of the post you are in Ms Cassidy sat as vice chair, with Noel NMBI website and sent to the media, giv- and what you can do to supplement your Giblin as the chair. ing the date that an inquiry is to be held role. Often that means stepping outside In a new departure under the 2011 Act, and no further details. of nursing and perhaps doing a multidis- fitness to practise inquiries are now gen- Retention fee ciplinary course to give you a different erally held in public. However, ahead of The biggest area of contention faced by perspective. Diversity encourages healthy this, the new Act provided for the creation the NMBI in the past year must have been debate and gives us a wider view of what is of a Preliminary Proceedings Committee the campaign against its attempt to raise required,” said Ms Cassidy. (PPC), separate from the Fitness to Prac- the annual registration retention fee paid “We are going through a period of tise Committee. This committee screens by all nurses and midwives. transition. We have significant organisa- complaints received against registrants “The retention fee issue was extremely tional change to implement and achieve. and only refers those with a prima facia divisive. We acknowledge that and what’s As a board, we’ve learned a lot since our case to the Fitness to Practise Committee done is done. However, the decision to inception under the new Act. We are mov- for inquiry. increase it was reversed and it is now ing forward – it is an exciting time. Once Ms Cassidy sees this as a great improve- capped at €100 under the Lansdowne we get through this period of transition, I ment on the 1985 Act structure. Road Agreement,” said Ms Cassidy. want to see at the end of my tenure that “Under the 2011 Act we are trying to “The increase was sought on the basis we have delivered on the organisational keep a forward momentum going. The of the information that the board was change and we have an organisation that complaint goes to the PPC first, which provided with in relation to the imple- is future-proofed, fit for purpose and considers the complaint and the regis- mentation of the 2011 Act. While the relevant to the registrants and our key trant’s response, and decides whether board is aware of the significant financial stakeholders.” there is a prima facia case.” constraints that registrants are under, this A native of Waterford City, Ms Cas- WIN To date under the 2011 Act, less than has to be married with the fact that the sidy moved to Dublin, with her husband
20% of complaints go forward to the Fit- NMBI is self-funding and our only source and four children, last year, following Vol 24 No 2 March 2016 ness to Practise Committee as prima facia of funding is from our registrants. So when her appointment to Tusla. Educated to cases. The board members receive copies we want to work on developments and Masters level at UCD in child health, Ms of all the documentation on what was want to roll out on initiatives, we have to Cassidy also has a Higher Diploma in reha- considered and the registrant’s response figure out how we are going to fund them. bilitation management from UCD, a HDip to the complaint. In the majority of cases “The financing of the NMBI is something in public health nursing from UCC, and a the board will agree that there was no that the board is actively working on. Bachelor of nursing studies from TCD. MEDIA WATCH 29
New plans to ease trolley crisis
Progress in the ED crisis and the much welcomed Nurse Staffing/ Skill Mix report hit the headlines this month, Ann Keating reports
ED crisis discussions as part of the Lansdowne Road levels consistently being determined by The Irish Independent (February 6) ran Agreement, during October and Novem- patient need and acuity as determined a headline – Nurses back plan aimed ber of last year, to agree the expansion of and applied, by nursing staff. That is the at easing trolleys crisis as 71pc vote nursing and midwifery practice and restore way forward. It will, in future, prevent the in favour. “The threat of hospital strike premium pay of time plus one-sixth which dramatic reduction in nurse staffing lev- action by nurses has been lifted – but was removed from nurses and midwives els which has taken place in recent years their union has warned that there can under the Haddington Road Agreement. without any measure of the negative be no slide in agreed measures to reduce The four tasks, previously carried out by impact upon patients or staff as a result.” emergency department overcrowding. doctors, are: Intravenous cannulation, The story was also covered in the Irish The return of industrial peace came after emergency phlebotomy that is currently Examiner (February 2) with the head- the Irish Nurses and Midwives Organisa- carried out by non-consultant hospital line New nursing plan for wards. “A new tion accepted, by a margin of 71%to 29%, doctors, intravenous drug administration model of nursing care where wards are the revised proposals to trigger a series – first dose and nurse or midwife-led del- staffed according to how sick patients are of measures aimed at easing the trolley egated discharge of patients…The deal rather than ward size or cost will shortly crisis when overcrowding reaches a cer- is dependent on training being provided be trialled in three hospitals under a €2 tain level. The proposals were agreed by and agreed staffing levels being in place in million pilot scheme. If it proves viable fol- the Workplace Relations Commission last order for nurses and midwives to take on lowing testing throughout 2016, it will be month and involve a range of actions, these tasks in a safe manner. It was also rolled out nationally, ending the current including cancellation of operations, doc- agreed that these tasks cannot be the sole ‘one size fits all approach’ to calculating tors doing more ward rounds to discharge responsibility of any one single grade but ward staffing levels.” patients and ultimately placing patients that nursing/midwifery practice should Maternity Strategy on trolleys in wards in order to make expand to incorporate them…Phil Ni The Irish Examiner (January 28) gave space in the emergency department.” Sheaghdha said the deal would allow for space to the launch of the Maternity Strat- Liam Doran said: “There is also the ongo- an enhanced service to patients.” egy – Focus finally put on the mother ing problem of insufficient hospital beds Nurse Staffing/Skill Mix – Overhaul of maternity services. “It is and additional beds are essential if there is The Evening Echo (February 4) reported not before its time that women are to be to be a significant dent in the trolley fig- that Nursing Group welcome report. offered as natural a birth as possible, in a ures.” He said: “Our members constantly “The Irish Nurses and Midwives Organ- safe environment, under the new National stated, in all of the information meet- isation welcomed an Interim Report on Maternity Strategy…The plan promises ings held recently, that this was never Nurse Staffing/Skill Mix and a govern- to put women and families at the cen- about pay and conditions. It was all about ment commitment to move to pilot its tre of all services and to treat them with ensuring the unacceptable situation in recommendations. The Taskforce rec- dignity and compassion. The new strategy emergency departments was prioritised by ommendations, and its approach to will involve the establishment of a new management.” determining staffing levels, will, when community midwifery service which is Transfer of tasks rolled out nationally, avoid any repeat of designed to facilitate better continuity of Nurses to get €20 weekly rise in the recent years when there was no floor, care and more choice in birth, with better ‘win-win’ deal was a headline in the Irish to nurse staffing levels, and reductions information and communication through- Examiner (February 11). “Nurses are set to took place without any assessment of out the different stages of pregnancy and WIN receive a pay boost of an average of €20 impact upon patients or upon the nurs- birth. The announcement of the strategy per week following an agreement that ing staff and their ability to provide safe yesterday has, understandably, been given Vol 24 No 2 March 2016 will see them taking on four tasks usually care. INMO general secretary, Liam Doran a broad welcome by the medical profes- carried out by doctors. The deal essen- said: “This is a very positive day for nurs- sion, in particular the Irish Nurses and tially sees the restoration of the ‘unsocial ing in Ireland. The Taskforce work, and its Midwives Organisation, a group that is hours’ payment which nurses received for recommendations, offer the opportunity never slow to criticise health services.” working in the evenings. The Irish Nurses to move away from staffing levels deter- Ann Keating is the INMO media relations officer, and Midwives Organisation…took part in mined, solely by finances, to staffing email: [email protected] Irish Nurses and Midwives Organisation Commemorative Publication March 2016
Copyright Nurses and Image Midwives 1916in the 1916 Easter Rising
Copyright Image
Image credits: O’Connell Bridge (Kelly’s Corner, D.B.C. & Eden Quay) and Portico of General Post Office. Both pictures by TJ Westropp, May 17, 1916 By permission of the Royal Irish Academy © RIA
Pull Out WIN Vol 24 No 2 March 2016 na Cásca 1916 in Éiríamach Mná Cabhrach Altraí agus of matron and asked if the position England to fill the nursein trained (I wives Organisation further. Minister did not pursue the matter any the advertisement and it seems that the no objectiontohad Hence, the Union icz’s letter point up the hostility to the deportation and imprisonment ofand the deportation leadersexecution ofthe of the ing against upris yearwitnessed the that Easter failed 1916, theplace five yearsin took earlier T at thetime.Ireland in rule thatexisted was alarger range of training hospitals. whereEngland, theremerelyin trained governors sought anIrishnurse who had could shedany light on the matter. H governorsMeathgested that the of the information shehadreceived which sug Markievicz was seemingly concerned at to the present day Irish the Irish C in the newDáilÉireann, the republican, In Oct place in Dublin at Easter 1916 in the events midwivesthat took the role played by nurses and Mark Loughrey examines 1916 Markievicz andindicated repliedmade enquiries,the toUnion ing hat hostility increasedwith events thathostility hat ountess Markievicz ospital, Dublin, were advertising for a T he sentiments expressed inMarkiev o b N e r 1921, the Minister for Labour urses’ Union, the precursor B ritish rule. , wrote aletter to N N T MO). that the Meath he subsequent u N rses and Mid urses’ Union R C ising and ising ountess B 1 Hav- ritish - - - - 2
the I the 80 yearsafter some women some ofthese by taking partinaremembrance proces lishment of the Irish Free State. dered outrage among the Irishpublic. engen part, rebelswho took many ofthe their lives in it. lostin theconflictor partook wounded, midwives,who tendedtothe and nurses the many hospitalstaff, particularly the overlooked. Among thoseoverlookedare the events of Easter week 1916have been enquiry, many others who played arole in have been the subject of muchhistorical rise of led to the Warment Independence, the of resultant heightening of nationalist senti B sioned with Ireland’s statusaspart of the Volunteers, becameincreasingly disillu sion through Dublin in 1935. against was intent on holding an armed uprising unteers, the Irish 1914, a aged amore independent Ireland. In who envisplacate those insufficient to receive amodicum of independence, was ritish Empire. A sub-group within the vol While the T Home h N is article aims to shine a light on MO first commemorated theevent Sinn Féin and, ultimately,Féinand, theestab Sinn dissident group knownas the Irish B R ritish ruleand other national ule, under which Ireland would R ising’sprotagonists central R epublican 3 B
rotherhood, I Copyright mage T he ------A 2,614further were wounded. 16 policemen;64rebels; and254 civilians. Easter became inevitable. the rebels aftersix days of bloody conflict soldiers arrived inDublinandsurrender by the conflict progressed, more andmore P among themthe Generalimportance, gic strate sites of number of a took control of Dublin, proclaimed anIrish as itapproached insurr regardingproposedsages date thefor the awry. Volunteers received mixed mes public park and the Four April 24, 1916, these rebels agreedMonday, to co-operate.Easter On the women’s auxiliary, to aid gether –andaboat carrying German arms total. nounced dead on arrival and43 died in Infirmary,Street, Jervis Of the 700 peopleseenat the str ist groups, the Irish ost Office (GPO), St Stephen’sSt (GPO), Greenost Office Some 450people were killed during the F T Located beside the rebel-occupied ain on the city’s hospitals and staff.and ain onthecity’shospitals rom the outset, the rebels’ plans wentplans rebels’rom the theoutset, he casualty toll placed an enormousplaced he casualtytoll 7 ection –some were stood down alto
R the rebel assault was intercepted ising: 116members of the military; T r alee Image by TJ Westropp, General Post Office, C itizens’ Army and C C B umann nam flag staffatcorner, May 17[1916]. ourts. ay, 6 38 were pro 4 R gathered in C epu Royal Irish Academy ©RIA 5 o K C haritable blic and erry. As By permission of the permission By B an, - - - -
WIN Vol 24 No 2 March 2016 - - 27 ational Mater ational were scarce and scarce were N offins C
25 Courtesy of Kilmainham Gaol Museum 26 ross flag in order that it be spared that it be spared order flag in ross Intent on avoiding the risk of injury injury of risk the avoiding on Intent C y by day [the ambulances] ran the the ambulances] ran [the day y by 24 For some staff who ventured beyond beyond ventured who some staff For Due to the closure of funeral funeral of homes, Due to the closure many ed some of those who died were merely those of some died who were sewnmerely interment.to prior sheets into ply. their hospital walls, danger was ever pres of the dead were buried where they fell of the dead fell – they were buried where including in gardens. from nearby gunfire, the gunfire, nearby from a displayed Street, nity Hospital, Holles R hostilities. the bullet-sweptof gauntlet streets, frequently struck by whilst on their shots journeys on journey a single we cannot recall … wewhich did not get a bullet through somewhere”. ent and ambulance personnel recounted: recounted: ent and ambulance personnel “Da 1916 Proclamation, given to Kathleen Clarke (Ref: 17NO-1A66-01) (Ref: Kathleen to Clarke given 1916 Proclamation, - - - ty ty i C Here, Here, 20 yal yal Lying-in Lying-in o he intense R onetheless, onetheless, T
N 21
23 otunda R
ggot Street. ggot 22 a B
the South Dublin Union, now Union, now South Dublin the 19 e func vital with their persisted mage Copyright Copyright I and mattresses, which they used as as used they which mattresses, and e to interruptions electricity in the sup Across the city at the Across Patients, Patients, and those who tended amsden, described the ‘terrible rebellion’ in which two bullets entered Ward 7 and 7 and Ward entered two bullets which in necessitated the evacuation of patients to the of the rear institution. Hospital, the lady superintendent, Miss Miss superintendent, lady the Hospital, R stray bullets entered the operating theatre theatre the operating stray bullets entered and the dining nurses’ room. to them, were not entirely safe to them, were safe not entirely than 200 More hospitals. the inside the at treated wounded were Hospital, Dublin of makeshift barricades. makeshift staff ther tion of maternity care, albeit in darkness du limb amputation was reportedly was reportedly limb amputation underway. the site of the Hos James’s modern day St cover behind patients to take forced pital, beds combat at
------11 - 14 16 - - - of Sur yal Victo- yal o R
15 ollege
C 17 Yet the number of Yet 18 Dr Steevens’ Hos Steevens’ Dr yal 12 Dublin’s Dublin’s o 9 R Street). sing. A number of doctors A doctors of number sing. i haritable Infirmary, Jervis haritable Jervis Infirmary, R of improvised hospitals were were hospitals of improvised C onnell iscuit Factory, the Adelaide Hos Adelaide the iscuit Factory,
C B during the conflict.the during 10 attended to 100 injured and a and a to 100 injured attended h 40 cases with cases 40 wounds, gunshot not be boiled for the purpose, the for boiled be not was also at the centre of events. was also events. of at the centre T 13 8 ating theatre illuminated only by ating theatre only illuminated by cy-missions’ became a defining fea defining cy-missions’ became a urses in training to become Jubilee to urses in training Jubilee become he casualty toll also resulted in the N T Many of the Many wounded were not phys A nursing nun from Dublin’s Mater Mater Dublin’s from nun A nursing A depot used to store medical supplies medical supplies to store depot used A ational Maternity Hospital, Holles Hospital, Holles ational Maternity eing close to St Stephen’s Green and Green and eing close to St Stephen’s verstretched. In an effort to relieve the the In to verstretched. an effort relieve here, five people were brought in dead dead in brought were people five here, and gas rendered sterilisation of oper of sterilisation and gas rendered and Lady Dudley nurses, precursors to to precursors nurses, Dudley Lady and also provided public health nurses, today’s on the street. first-aid Street, being converted into a tempo into a converted being Street, N ically able to make it to hospital and to hospital and it to make able ically ‘mer pital pital Hospital gave a vivid account of the the of vivid account a Hospital gave of that events Easter week, recounting in the absence of electricity the sur the embattled the B 12 of whom died. hospitals and mercy missions were insuf were missions mercy and hospitals ficient to cope with the workload and ficient to cope with the workload and a number further 130 cases of gunshot wounds further 130 cases of gunshot wounds Hospital. at Mercer’s treated were ria Eye and Ear Hospital also found itself itself found Ear Hospital also and ria Eye o established, including in private houses. private in including established, into transformed was Square at Merrion hours; three just in hospital temporary a 5pm commenced at 2pm and by work some 15 patients had been admitted and a ture of the the of ture risty. risty. water as impossible instruments ating could that no patients she recounted yet infections. post-operative to succumbed e nun the said electricity of lack candles sourced in the hospital’s sac the hospital’s in candles sourced burden on burden surrounding institutions, that empty 30 its offered matron hospital’s beds to the wounded. Some 50 injured whom had of some soon arrived, soldiers neighbouring in accommodated be to homes. Jacob’s Jacob’s T of four wounded, in brought were and 70 whom later died. rary emergency department and treating department emergency rary and treating some geon on duty worked day geon on duty worked and night, his oper geons, Mercer’s was the scene of 20 20 of scene the was Mercer’s geons, deaths from the from Street, converted a grocer’s van into an into an van grocer’s a converted Street, to aid first ambulance and administered the on wounded Sackville Street nearby O’ (now mage Copyright Copyright I WIN Vol 24 No 2 March 2016 tal, tion. injuredthe fromstreetinstitu the to the stretchersas whichwith to carry bed quilts ing a balcony at the the hospitaland anumber mond’sarea overwhelmed catchment tution’swerepatients transferred to neutrality. hospital’srespectrequested the thatthey dissuaded from doing soby a doctor who in the conflict. left part to takethey accommodation and prayed for them as providednuns who them with foodand ‘enthusiastic reception’ from the resident rebel outpost after volunteers received an the St John’sing. Education and Events utilising the buildingasastate of the art 1916 purchased the former featured in the In 2013 conflict. the I The Richmond ‘the aprons‘the of slaughterhouse workers’. their uniforms reportedly soon resembled referencebrutality oftheconflict, tothe a vividin but, wounded in tendingtothe ‘complete disregard safety’for theirown to a bed. home, onthe floor,and evensofas two on to accommodatepatientsinitsnurses’ nearby Sir Patrick Dun’s Hospital intense fighting. of sites especially Mount Street in bedlamat events that it witnessed duringthe it events that gates belies the dramatic andpoignant serenity that liesbeyond the T B T N At one point, rebels considered point, occupyAt one he sheernumber of casualties resulted he 300 or so casualties in the uildings now owned by the I N orthumberland R 29 ichmond, was usedasa temporary orth
T here, doctors and nurseshere, exhibited and doctors I Copyright 31
33 B
runswick Street with a view to mage Sir Patrick Dun’s, which had C on vent, located besidelocated vent, R oad andits R ichmond but were C R e ichmond Hospi B N ntre. ridge, were the urses fromthe of the insti R T ichmond’s N o environs, MO also day, the 28 32 N R used
ich R MO 30 is ------civilian theof One and volunteers. soldiers ians, Siding with the rebels with the Siding turally impressive building. were pronounced dead on arrival at thearrival pronounced were deadon accommodate the injured. Fifteen people space toin order Dublin toup Union free outl R pioned fresh airandlight. nod to Florencenod to and airy with a window for each bed – a in nursedwereso, they onthe floor and, ble the large windows left patients vulnera f scarecrow character of a man”. protruded through his uniform, making a on him.Pieces of hisundergarments, wool, very dead. They hadplayed a machine-gun little volunteer. Ilooked at him.He was Tommie forget besidehim. I’llnever that a deadLane, Moore corner of at the lying pomegranate. wasA volunteer a like open wall with a hishead white bundle; was slit bullets. Dublin. plans foundsomehow,way toits their an extensiontothe as 189 permitted staff to signal to rebels thesignal to staff to permitted hospital but he died en route. R refuge of Father Mathew Hall–near the his mother wheeled himinhispram to the two-year-old boy was shotin the headas that attended the loss of life. the actualsuffering and circumstances wounded and dead, belie while staggering, number of dead were lying around: civil around: lying number ofdead were illuminating. One manrecounted: “A eature had two consequences. Firstly,had twoconsequences. eature ichmond. ichmond. A priest took the boy to thepriest tookthe ichmond. A T T order to avoid being wounded by stray he testimony of eye-witnesses is also is he testimony of eye-witnesses he 7,was designedit goes that story the ying facilities in the nearby R 39 37 casualties squatting against awas ichmond Hospital is an architec
Secondly, hospital’sthe vantage T Eden Quay, May 17[1916]. of the permission By he hospital’she wards werelarge 34 Image by TJ Westropp, Kelly’s Corner, DBC& erences to the scoreserences of tothe R ef N i ghtingalewho cham Royal Irish Academy ©RIA T aj C 38 onstructed in 35
36 Mahal but,Mahal T T
r
his design his agically, a N orth - - - - b permitting themtoevadecapturedresses mortuary tothe cured the key leading from the hospital’s those tion colluded with the rebels by sending again inaccounts itly assistedrebels are repeated time and day in the week to look at them”look . to in the week day every rebellion a therethink would was “you him evade capture. he hadbeen discharged in order to help searching for one rebel, asurgeon lied that the volunteers. Indeed, when police came suggests concealed by wardrobes and bed screens. emerging inaholeat the hospital that was terminated at the andreportswent further thatthetunnel needed to. if they their escape goodmakethrough which theycould the GPO bored a tunnel to Henry Street, further still. rebel to surreptitiouslyled the freedom. staff ure which seemingly irritated the hospital close observation by a detective, ameas U at the GPO.wounds bullet cumbed to suc he after a consignmentofcabbage rebel was smuggled to that institution in nun at the MaterHospitalrecalled that a the letin orderinvestigator to forming’ the a mother. nuns at the hospital. the suddenincr ingly notin on the ruse, was perplexed by C their ate in a bed in the sick-nuns’ ward. Here positions of approaching soldiers. requests by investigating authorities by ignoring voluntary hospitalsreportedly frustrated of gunshot wounds tothem, gunshot of pr lets only to discover a baby in his arms, awoke afteran operation to remove bul reportedlyvolunteerevidence. One the – effectivelyinstitution destroyingat the rebels’ boots and uniforms on their arrival the rebels is a matter of conjecture. with sided hospitals which these extent to the pantryhaving dinner, anurse pro y visiting detectives. One doctor,seem haritable Infirmary,wentStreet, haritable Jervis pon his arrival, he was placed under esumably inan effort to passhim off as It was said of the staffat the hospital: A short distance away the staffat the Furthermore, nurses reputedly burned Ultimately,inwhile thedetectivewas It is suggested that staff at that institu Suggestions that hospital staff tac hospital Suggestions that volunteer make his escape. , some of whom considered ‘chlorowhom consideredsome of , faces were concealed innuns’head who were badly injured to recuper that the hospital staff sided with 45
B ritish forces to report cases T ease in the number of sick he rebels who occupied street and quickly andand quicklystreet of the 41 C
44 h
aritable Infirmary – R ising. A nursing 42 47
T 46 but the here arehere Dublin 40
T his 43 ------
WIN Vol 24 No 2 March 2016 - - itish itish ritish ritish r B B cause? ritish Forces, ritish Forces, rue too rue, T B , that T historians 61 ritish soldier had epublican – not also have – not also have 60 B – and the surprise the surprise – and R 62 63 ritish army) after she after she ritish army)
B 59 ising assert that the that ising assert avell, just months earlier, earlier, just months avell, R C ommander of the C An ritish authorities were well aware of of aware well were authorities ritish B he T In 2015 it was suggested that Kehoe’s that Kehoe’s was suggested In 2015 it In 1932, a piece in the republican news republican the in piece a 1932, In “A Volunteer fell wounded outside [the] [the] outside wounded fell Volunteer “A elgium during World War I. Yet, would would Yet, War I. elgium during World by his own admission, described soldiers described soldiers own admission, his by ease edgy and ill at as shot a nurse in uniform. shot a nurse shooting amounted to ‘cold-blooded ‘cold-blooded to amounted shooting had been the nurse that and murder’ of fear ‘airbrushed’ from it history for that a becoming known paper rankled and injured the injured and rankled hospital door. Immediately a nurse rushed a nurse rushed Immediately door. hospital as she Just man. the fallen attend to out could reach she and ere door the reached wounded– wounded man she herself fell the [sic] British bullets… by down Keogh struck which could be plainly was in full uniform visible to the A true British… Irishwoman she was”. certainly line: similar a adopted Phoblacht er-up’ certain atrocities. er-up’ authorities were authorities were to trying of guilty ‘cov of the Easter of the the the that the shooting effect galvanising all after – exert could nurse a of caused and martyr-status assumed had (and sentiment anti-German in surge a the to enlistment for German authorities by executed was from Allied aiding of escape soldiers the in B in even a rebel, by of a nurse the killing by mentioned is that possibility a – error one historian at least attack made by volunteers on the soldiers the soldiers on volunteers attack made by it is asserted, shot who subsequently, nurse Edith nurse - - - - heir heir urse urse T With With N When When 53 54 aulfield, aulfield, C hey fired on her and on her and fired hey eportedly remarked remarked eportedly
T 55 aulfield foregoes explic aulfield foregoes C
eannt r
57 56 Elizabeth O’Farrell and her grave at Glasnevin Cemetery Image courtesy of Kilmainham and her grave and Glasnevin Cemetery Museum Elizabeth O’Farrell mage C 58 er that she hoped there would be would be there that she hoped er Copyright Copyright I here are many accounts of accounts many are here se’s death to one any Moly se’s party, T Although Following Kehoe’s death, rebel leader leader death, rebel Kehoe’s Following Similarly, the injured rebel to whom the to whom injured rebel Similarly, ritish private” only to die “in agony” ritish to die private” only “in agony” Kehoe’s death. According to According death. Kehoe’s cessa brief a at thankful was nurse the she reached the bottom of the stairs she she the stairs of bottom the she reached was which her body dead – after was shot asked who soldiers by table a on placed Sinn any there “Are colleague: grieving her upstairs?” Feiners Eamonn that the nurse had “died for Ireland just just Ireland for had “died the nurse that Volunteer the worn had she if as surely as uniform”. Kehoe is often cited Kehoe as en being to route that attend, testified Union soldiers at the shots he and surprise” by by “taken were their and “lost fired had another rebel in a moment “because a nurse for heads” full opened the door uniform and came the stairs. down her”. killed B thereafter. neux and Kelly are less circumspect. circumspect. less are neux and Kelly a “terrified was shot by do so she to case account notes that Kehoe assumed that that assumed that Kehoe account notes a momentary lull in hostilities signified a which ceasefire, permitted to her to tend As the wounded. she descended the stair ‘no bloodshed’ at the institution. ‘no bloodshed’ at tion in the conflict and remarked to a to a remarked and conflict the in tion co-work that, she heard gunshots – “the patients, gunshots – “the that, patients, she heard downstairs ran and cried the patients” she advice. colleague’s against her itly attributing responsibility for the the for attributing responsibility itly nur
- - - - - 51 52
48 49 hari C he assis T
ing located located ing ommander 50 e C B ising to have ‘grown ‘grown to have ising R mage Copyright Copyright I embellished over the years. the over embellished itish Forces in Ireland, issued a a issued Ireland, in Forces itish r B y cost her own”, said colleague. a cost y own”, her Nurse Margaret Kehoe. Image courtesy Bateson of Ray Kehoe. Margaret Nurse General General Maxwell, the Jeffery notes a tendency for some some for tendency notes a Jeffery What appears more certain is that that certain is more What appears One nurse whose sacrifice warrants whose One warrants sacrifice nurse urse Kehoe worked at the infirmary of of the infirmary at worked Kehoe urse urse Kehoe lost her life. life. her lost Kehoe urse astle, in a case of extreme presenteeism, ritish military headquarters. ritish military headquarters. oting that the hospital’s nurses’ home home nurses’ hospital’s the that oting he Union became the site of intense gun of intense the site Union became he he South Dublin Union. Union. Dublin South he of the the of accounts of the 1916 of accounts in the telling’ and readers should make up up make should telling’ readers and the in nurses’ of own minds if accounts their the activities in hospitals such as been or have accurate table Infirmary are somewhat fire and it was amid this that 43-year-old 43-year-old that this amid was it and fire T N was taken over by rebels with sleeping with sleeping rebels by over taken was out’. to ‘clear forced and awoken nurses B tant matron recalled events at the Union Union the at events recalled matron tant n N t on a sprawling 20-acre site, the Union Union the site, 20-acre on a sprawling importance militarily of strategic was because it was the to in close proximity eral lives by her unselfishness, but it very very it but unselfishness, her by lives eral nearl C to appendicitis but refused developed sev saved her post: “She probably leave nurses nurses made the great to ensure sacrifices One tended to. wounded nurse were sta the military hospital at Dublin tioned at Margaret Kehoe Margaret Kehoe. especial mention is Margaret statement following the rebellion in which in rebellion the following statement “gallantry the particular’‘in praised he shown those who exposed by nurses to in attending fire to a heavy themselves the and wounded”. removing WIN Vol 24 No 2 March 2016 w bulletlinbridge, Coof died Carlow, who memory of NurseMargaret J Kehoe, Leigh erenced this: rebel at the South Dublin Union. conceded by William tentional andaccidental. Kehoe suggest that her shooting was unin 1916 its current whereabouts are unknown. the plaque subsequently disappeared and the hospitalstaff. inspiration”“sourceand pride to of constant noted that the plaque would serve asa T rificed herlife for herpatients’ wellbeing. matron remarking that the nurse had sac nursesforhospital’s everywhere, with the Kehoe’san exampleas was cited death now pital (formerly the South Dublin Union and erected inhermemoryat St Kevin’s Hos of filling hernursing duties B conjecture, what appears more certain, as manner forming herProfessional Dutiesin a heroic he hospital’s medical superintendent ateson points out, is that she died ful is that points out, ateson ounds received in this hospital while per “ As the plaque was beingunveiled While the truth about thecircumstances While thetruth N This plaque has been erected to the urse Kehoe’surse remain opento death St James’s Hospital) in April 1965 ref on EasterMonday, 1916”. I Copyright mage 68 In spite oftheeulogies In T
C osgr 65 T andaplaque his much was ave, himselfa 64 66
N 69 urse boots which canboots Pearse seenbehind be ontheright-hand sideof 67 - - - - - (Ref: 17PC-1B14-19). O’Farrell Elizabeth isvisiblebymainly her - -
Pearse surrenders to BrigadierGeneral Lowe, 29, April 1916 her days spreadingher dayswordimpend of the while the br nan remarked: were “We theonlywho two Grennan, in the rain. Years later, Gren had madeher way, with her friend Julia she was stationedat the GPO, where she nursedwounded. the various nition, food andmessagesbetween the conflict, the 32-year-old ferried ammu m – aprerequisite when joining nur ievicz. O’Farrellwas first exposed to trained in arms use by and Inghinidhe na hÉireann and was She was amember of the Gaelic League schooling took ajobatprintinghouse. was born in Dublin and following her some years later, becameamidwife. She Easter Elizabeth O’Farrell O’Farrell retreated to a house on Moore r ing insurrection in the provinces before eturning to Dublin to partake. During thepartake. Dublin to eturning to ought umbrellas to the Rising” . umbrellas tothe ought B From the second day of the insurrectionFromsecond dayof the the 1916in the Another central character As the GPO came under increasing under fire,As the GPO came O’Farrell was anardent an. sing duties during her aidtrainingfirstsing dutiesduring the image. Museum Gaol ofKilmainham Courtesy 70 R ising was Elizabeth ising was O’Farrell who, rebel outposts in the city andin thecity rebel outposts R ising was beingplanned, spent C R ountess epublican and, C 71 umann na
Mark - - - -
who transported him to the nearby Sir PatnearbySir him tothe who transported shot andshe was obliged to alertlocals just feet fromwalking O’Farrellman was a at Grand bridge crossingthe Street where shehelpednurse the injured. “enemy press”. as thein ordersaw to she frustratewhat own admissionsheadopted this stance camera largely behindPearse. in which O’Farrell stoodback from the iconic photograph ( the official surrender took place.Here an Pearsemeet the to O’Farrell accompanied rebel leader Pádraic surrender.and decidedto rebellion of the T attended ing in 1930 reveals a ‘Miss O’Farrell’ who Organisation’s 10th Annual at thean examinationofthedelegates city garrisons throughoutrebel thesage to mes surrenderwith delivering hand, the wasn’t”. Pearse was the important figure –Elizabeth remarked: “It was an editorial decision … In brushing her from the historical record. a] faireducation”. matron described heras“a fair nurse, [with in her final examinations. 1921 where sheachieved almost70% Maternity Hospital,Holles Street, in early long training as a midwife at the my hands several times”. primary clue that she was there at all. at was thereshe primary clue that photograph – with hershoesproviding the visiblein onlythe kneesfrom down the a rudimentary editing procedure, O’Far is noteworthy. Using what appears to be c ency and she was spared a lengthy spell in the surrender messagegarnered her clem tional surrender”. Head-Quartershave agreed uncondito an of the Provisional Government present at membershopelessly outnumbered, the and the lives of our followers now surrounded and in Dublin citizens, the hope of saving slaughter offurther preventorder the to wives’ ran for election tothe Organisation’sMid I rick Dun’s Hospital. the rell was removed from some versions of N ustody. She commenced her six-month- here, the volunteersrealised the futility O’Farrell was charged, white inflag T O’Farrell’sin delivering co-operation Pearse’s letter of surrender noted:“In An examination of ballot papers in thepapers ballot An examinationof MO’s archives suggests that O’Farrell relation tothis,onecommentator h . She recalled: “Ihad to take my life in photograph entirely, effectivelyair e subsequent treatmentimagee of the C 73 ommittee in1925.
to represent Dublin midwives. 72 Hence, O’Farrell islargely 74 77
76 B
ritish Generalwhere ) was takensee left) 75 78 T In fact, whileIn fact, C Furthermore, he hospital’s C ouncil Meet anal Street,anal N B ational y her 79
------WIN Vol 24 No 2 March 2016 - - - of of he he rit
T B
ollege
C
mage I Copyright Copyright at the Elizabeth O’Farrell to Tribute By permission of the Royal Irish Academy © RIA Academy Irish By permissionof the Royal National Maternity Hospital, Holles St, Dublin Holles St, MaternityNational Hospital, War of Independence and the subse of Independence and War mid the heady nationalist atmos nationalist heady the mid he nurse’s letter was prophetic. was prophetic. letter he nurse’s T A phere Irish nurses shunned the shunned Irish nurses phere execution and imprisonment of rebels rebels of imprisonment and execution the public, heightened anti- shocked quent granting of Free State status. State Free of granting quent ish sentiment in Ireland and gave rise to to rise and gave ish sentiment in Ireland the Image by T J Westropp, Hotel Metropole, Sackville St, May 17 [1916]. 17 [1916]. May SackvilleSt, Metropole, Hotel Westropp, T J Image by - - - mage I being shot, shot, being ritish ritish of Journal B 82 the nursing profession the nursing profession metery, Dublin. Her grave Her Dublin. metery, went, under orders, the foe to to the foe went,orders, under e C “In Dublin “Nurses are mostly strong loyal strong mostly are “Nurses ising and alludes to the fact that, ising that, and fact the to alludes R he verse on O’Farrell’s gravestone is is gravestone O’Farrell’s on verse he T the insurrec followed that days the In O’Farrell died in 1957 and is buried in in died in 1957 and is buried O’Farrell ers blotted out in penal servitude out in penal servitude and others blotted to the English difficult it is so for life… for understand the Irish, and to their realise real . and convictions” feelings a reference to the events that followed followed that to the events a reference the the riots over sorrow deep in is naturally and terrible loss of and those of life, who us ruins blackened the on look Dublin love time buildings can be erected, grief – in with life… to brought be cannot dead the but that to know wrung heart is woman’s every in our midst young men are meet bearing sadly, unfearingly, proudly, proudly, meet bearing sadly, unfearingly, ”.defeat not but surrender of flag the lost, been had battle rebels’ the although a war of sorts was ongoing and about to intensify. Nursing: but: ists” tion to the a wrote nurse Park where a plaque in her memory reads: reads: memory her in plaque a where Park “Her was dedicated to the life cause of Irish . Freedom” Glasnevin “When duty stone reads: called on the field of battle she
- - - - 80 is R ), found sig found ), e Foundation Foundation e h O ational Mater T hat hospital also N N of which Meehan T
O collaborated in the collaborated O the in 81 N Copyright Copyright ommittee ising, Ena Meehan, long time time ising, long Ena Meehan, C ear of the of 50th anniversary to “prevent further bloodshed” to “prevent R ity Quay, where O’Farrell was was O’Farrell where ity Quay, C hese include a bronze memorial, memorial, hese include a bronze T ection. hat year the year hat I rses Organisation (I Organisation rses A number of memorials to O’Farrell A number of O’Farrell memorials to T While O’Farrell’s role in the Easter the in role O’Farrell’s While u nity Hospital (see right). erected in 1966, at the at in 1966, erected exist. awards a medal in O’Farrell’s honour each each honour O’Farrell’s in medal a awards to year excel who midwives academically. Dublin’s O’Farrell of Elizabeth the location born, is nificance in O’Farrell’s actions during the nificance O’Farrell’s in insurr aimed to fund nursing and midwifery and midwifery nursing fund to aimed education and post-graduate research and of was symbolic the to importance to “committed is which profession nursing life”. of service the ing may be interpreted in many ways, in in ways, many in interpreted be may ing 1966, the y called of the then general secretary Irish N establishment of the O’Farrell Elizabeth Foundation secretary. honorary was the Easter Commemoration and, in a letter to the Irish Independent, to and, in a letter co-oper Meehan O’Farrell’s noted that the surrender of word ation in spreading had helped Mater Hospital, Dublin. Bureau of Military History 1913- Archives online resource: Statement by Witness. Dan N ursing, the English nurse repre- 1921. [cited 2015 September 7]. Available from: http://www. MacCarthy, 1, Malahide Road, Clontarf, Dublin. Bureau of sentative association which bureauofmilitaryhistory.ie/reels/bmh/BMH.WS0463.pdf; See Military History 1913-1921. [cited 2015 September 7]. Avail- also Nolan E. Caring for the Nation: A History of the Mater able from: http://www.bureauofmilitaryhistory.ie/reels/ also traded in Ireland at the Misericordiae University Hospital. Dublin: Gill and Macmil- bmh/BMH.WS0722.pdf (p. 6). For further accounts of and time.83 Instead, in 1919 they lan; 2013 (p. 80-81) references to Kehoe’s shooting see; O’Brien P. Uncommon 17. O’Brien E. The Charitable Infirmary Jervis Street: 1718- Valour (p. 45-46); Personal testimony of Wardmaster Patrick were given the option of 1987, A Farewell Tribute. Dublin: The Anniversary Press; 1987 (p. 37) Smyth of the South Dublin Union: Statement by Witness. joining a new representa- 18. Prendergast E, Sheridan H. Jubilee Nurse: Voluntary Dis- Mr Patrick Smyth, 175 James’ Street, Dublin. Bureau of Mili- trict Nursing in Ireland, 1890-1974. Dublin: Wolfhound Press; tary History 1913-1921. [cited 2015 September 8]. Available tive association for nurses 2012 (p. 15) from: http://www.bureauofmilitaryhistory.ie/reels/bmh/ and midwives which, in 19. 1916 Rebellion Handbook (p. 232) BMH.WS0305.pdf#page=1 (p. 1); Personal testimony of the 20. Coakley D. Baggot Street: A Short History of the Royal Assistant Matron of the South Dublin Union, Annie Mann- keeping with nationalist sen- City of Dublin Hospital. Dublin: Royal City of Dublin Hospital; ion: Statement by Witness. Miss Annie Mannion, St. Kevin’s timent, featured a shamrock on 1995 (p. 53) Institution, 1 James’ Street, Dublin. Bureau of Military History 21. McEwen Y. “It’s a long Way to Tipperary”, British and Irish 1913-1921. [cited 2015 September 8]. Available from: http:// its badge (see left). That associa- Nurses in the Great War. Dunfermline: Cualann Press; 2006 www.bureauofmilitaryhistory.ie/reels/bmh/BMH.WS0297. tion, known then as the Irish Nurses Union (p. 126-127) pdf#page=1 (p. 3) 22. O’Brien P. Uncommon Valour: 1916 and the Battle for the 58. Evening Herald. 1965 April 19 (p. 3) and now as the Irish Nurses and Midwives South Dublin Union. Cork: Mercier Press; 2010 (p. 47) 59. An Phoblacht. 1932 June 25 (p. 2) Organisation, grew to become the State’s 23. Miss Ramsden’s Report is reproduced in the British Jour- 60. See Campos A. Forgotten First Victim of the Rising Margaret nal of Nursing. 1916 May 27; LVI (1469) (p. 472) Keogh Honoured. Irish Mirror [Internet]. 2015 April 13 [cited 2015 largest trade union for nurses and midwives. 24. 1916 Rebellion Handbook (p. 243) September 8]. Available from: http://www.irishmirror.ie/news/ Its history, however, is a story for another 25. Ibid. (p. 241) irish-news/forgotten-first-victim-rising-margaret-5507195 26. Testimony of ambulance staff in Foy M, Barton B. The 61. Foy M, Barton B. The Easter Rising (p. 191). For a more day. Easter Rising (p. 197) nuanced reading; see Townshend C. Easter 1916: The Irish 27. Anon. A Nurse in Dublin Castle. In: McHugh R, editor. Dub- Rebellion. London: Penguin; 2006 (p. 290-299) Mark Loughrey is a registered general nurse specialising 1916lin 1916: An Illustrated Anthology. London: Arlington Books; 62. O’Farrell P. Who’s Who in the Irish War of Independence, in intensive care nursing. In 2011 he was awarded a PhD 1976 (p. 107) 1916-1921. Cork: Mercier Press; 1980 (p. 82) cited by Jeffery K. scholarship by the INMO, the first of its kind ever awarded 28. Now a residential/day-care facility located near Grand Nationalisms and Gender. by the Organisation, and commenced doctoral studies Canal Dock. 63. Foy M, Barton B. The Easter Rising (p. 189) at the School of Nursing, Midwifery and Health Systems, 29. 1916 Rebellion Handbook (p. 241) 64. Testimony of Liam T Cosgrave in his Bureau of Military University College Dublin. He completed his thesis entitled 30. Molyneux D, Kelly D. When the Clock Struck in 1916: History Witness Statement: Statement by Witness. Mr Liam ‘A History of the Irish Nurses Organisation, 1919-1999’ Close-Quarter Combat in the Easter Rising. Cork: The Collins T. Cosgrave, Beechpark, Templeogue, Co. Dublin. Bureau of Press; 2015 (p. 67-68) in 2015. Mark is currently completing a history of the Military History 1913-1921. [cited 2015 September 8]. Availa- 31. Foy M, Barton B. The Easter Rising (p. 185) ble from: http://www.bureauofmilitaryhistory.ie/reels/bmh/ Irish Nurses and Midwives Organisation in advance of the 32. Ibid. (p. 112, 115, 206) BMH.WS0268.pdf#page=24 (p. 6b) Organisation’s centenary in 2019. 33. Ibid. (p. 114) 65. Bateson R. They Died by Pearse’s Side. Dublin: Irish Graves 34. Ibid. (p. 205) Publications; 2010 (p. 271) Acknowledgements 35. Molyneux D, Kelly D. When the Clock Struck in 1916 (p. 170) 66. I would like to thank Ray Bateson for kindly sourcing 36. Testimony in Foy M, Barton B. The Easter Rising (p. 157) Ruth Taillon, John Kepple, Noel Nelson, Prof Eoin O’Brien, the wording of the plaque. Since 2009, a plaque to Kehoe’s 37. O’Brien E, Browne L, O’Malley K, editors. A Closing Memoir: Paul O’Brien, Frank Miller and The Irish Times, Pádraig Óg memory is also located at the GAA clubhouse in her native The Richmond, Whitworth and Hardwicke Hospitals. Dublin: Leighlinbridge, Co. Carlow. Bateson’s exhaustive account Ó Ruairc, Ray Bateson, Lar Joye at the National Museum The Anniversary Press; 1988 (p. 15) of memorials of the Easter Rising contains a picture of that of Ireland, Prof Keith Jeffery, Eamon de Valera and The 38. For a more comprehensive analysis of Nightingale’s plaque which reads: ‘To the memory of nurse Margaret Irish Press, the National Photographic Archive, Sophie contribution to hospital design; see Bostridge M. Florence Kehoe, Orchard, Leighlinbridge. Who lost her life on Easter Evans and the Royal Irish Academy, the National Library Nightingale, The Woman and Her Legend. London: Viking; Monday 1916 at the South Dublin Union while attending to of Ireland, UCD Library, Luke Portess and Aoife Torpey at 2008 (p. 335-339) wounded volunteer Dan McCarthy who was later to become Kilmainham Gaol and Glasnevin Museum, Prof Gerard 39. 1916 Rebellion Handbook (p. 243) President of the GAA 1921-1924. Unveiled by Mr Christy 40. Foy M, Barton B. The Easter Rising (p. 206) Fealy at UCD and Albert Murphy, Edward Mathews, Phil Ní Cooney, President GAA 22nd August 2009. Erected by Leigh- 41. Ibid. Sheaghdha and the staff at the Irish Nurses and Midwives linbridge GAA Club’; see Bateson R. Memorials of the Easter 42. See: Statement by Witness. A Member of the Community Organisation Rising. Dublin: Irish Graves Publications; 2013 (p. 33) of the Sisters of Mercy, Mater Hospital, Dublin. Bureau of Mil- 67. Irish Times. 1965 April 20 (p. 11) itary History 1913-1921. [cited 2015 September 7]. Available References from: http://www.bureauofmilitaryhistory.ie/reels/bmh/ 68. Evening Herald. 1965 April 19 (p. 3) 1. Letter from Constance de Markievicz to the Secretary of the BMH.WS0463.pdf (p. 3) 69. Taillon asserts that a plaque to Kehoe’s memory exists Irish Nurses’ Union dated 24th October 1921 (INMO Archives, 43. O’Brien E. The Charitable Infirmary Jervis Street (p. 38) in Baggot Street Hospital, Dublin. Inquiries with the Health Dublin) 44. Ibid. Service Executive and staff at the institution have failed to 2. Letter from the Secretary of the Irish Nurses’ Union to 45. Ibid. produce any leads as to its whereabouts; see Taillon R. When Constance de Markievicz dated 26th October 1921 (INMO 46. Ibid. History Was Made... The Women of 1916. Belfast: Beyond The Archives, Dublin) 47. Meenan FOC. St. Vincent’s Hospital, 1834-1994: An Histori- Pale Publications; 1996 (p. 60) 3. For an account of the commemoration see Irish Press. 1935 cal and Social Portrait. Dublin: Gill and Macmillan; 1995 (p. 89) 70. Irish Independent. 1966 July 1 (p. 11) April 22 (p. 2) 48. Jeffery K. Nationalisms and Gender: Ireland in the Time of 71. Ibid. 4. Throughout this article the terms rebel and volunteer are the Great War 1914-1918. In: 19th International Congress of 72. Ó Ruairc P. Revolution: A Photographic History of Revolu- used interchangeably to denote the men and women who Historical Sciences; 2000 August 8; Oslo, Norway. tionary Ireland, 1913-1923. Cork: Mercier Press; 2011 (p. 66) fought in pursuit of an Irish Republic during the Rising. The 49. Anon. A Nurse in Dublin Castle (p. 121) 73. O’Farrell’s role in the Rising and the iconic surrender terms soldier and military are used to denote the British (and 50. Freeman’s Journal. 1916 May 8 (p. 2) photograph is well examined in Episode 4 of the RTÉ docu- Irish) military forces and personnel who opposed them. 51. Sometimes referred to as Margaretta/Margaret Keogh. mentary Réabhlóid. Available from: https://www.youtube. 5. Foy M, Barton B. The Easter Rising. Stroud: Sutton Publish- 52. The testimony of the Assistant Matron, Annie Mannion, com/watch?v=DvHxSdyH8Pk ing; 1999 (p. 210-211) can be sourced at: Statement by Witness. Miss Annie Mann- 74. The surrender letter is reproduced in Hegarty and 6. Colloquially known as Jervis Street Hospital and now the ion, St. Kevin’s Institution, 1 James’ Street, Dublin. Bureau of O’Toole’s engaging account of the Rising; see Hegarty S, site of Jervis Shopping Centre. O’Toole F. The Irish Times Book of the 1916 Rising. Dublin: Gill 7. 1916 Rebellion Handbook. Belfast: Mourne River Press; Military History 1913-1921. [cited 2015 September 7]. Availa- and Macmillan; 2006 (p. 135) 1998 (p. 242) ble from: http://www.bureauofmilitaryhistory.ie/reels/bmh/ 8. Now office accommodation. BMH.WS0297.pdf#page=1 (p. 2). In the wake of the Rising, 75. O’Farrell E. The Surrender. In: McHugh R, editor. Dublin 9. Mitchell D. A ‘Peculiar Place’: The Adelaide Hospital, Dublin. the nurses’ home was looted by those seeking souvenirs of 1916: An Illustrated Anthology. London: Arlington Books; Its Times, Places and Personalities, 1839-1989. Blackwater the conflict. Many of the items taken transpired to be the 1976 (p. 213) Press: Dublin; 1989 (p. 153) nurses’ own belongings for which they were compensated 76. Ibid. 10. Crookes G. Dublin’s Eye and Ear: The Making of a Mon- afterwards: Statement by Witness. Miss Annie Mannion, St. 77. Farmar T. Holles Street (p. 72) ument. Dublin: Town House and Country House; 1993 (p. Kevin’s Institution, 1 James’ Street, Dublin. Bureau of Military 78. Ballot paper for election of officers and executive commit- 104-105) History 1913-1921. [cited 2015 September 8]. Available from: tees of the Irish Nurses’ Union for the year 1925 (INMO Archives, 11. Farmar T. Holles Street, 1894-1994: The National Mater- http://www.bureauofmilitaryhistory.ie/reels/bmh/BMH. Dublin); Irish Nurses’ Union Gazette. 1925 May (13) (p. 3) nity Hospital - A Centenary History. Dublin: A. & A. Farmar; WS0297.pdf#page=1 (p. 5). For those interested in further 79. Irish Nurses’ Union Gazette. 1930 June (31) (p. 1) 1994 (p. 47) oral history testimonies related to the 1916 Easter Rising; see 80. Irish Independent. 1966 June 14 (p. 5); Irish Press. 1966 12. 1916 Rebellion Handbook (p. 241-242) McGarry F. Rebels: Voices from the Easter Rising. Dublin: Pen- June 14 (p. 7); Irish Independent. 1966 June 24 (p. 11); Irish 13. Now home to the Health Service Executive. guin Ireland; 2011. Independent. 1966 October 21 (p. 12) 14. 1916 Rebellion Handbook (p. 242). The former Mercer’s 53. Caulfield M. The Easter Rebellion. 2nd ed. Dublin: Gill and 81. Irish Independent. 1966 October 26 (p. 2) Hospital is now a primary care clinic near St Stephen’s Green. Macmillan; 1995 (p. 93) 82. British Journal of Nursing. 1916 May 13; LVI (1467) (p. 429) 15. Foy M, Barton B. The Easter Rising (p. 60) 54. Ibid. 83. Now known as the Royal College of Nursing (RCN). See
Vol 24 No 2 March 2016 No 2 March 24 Vol 16. The unnamed nun’s testimony can be sourced at the Mil- 55. Ibid. McGann S, Crowther A, Dougall R. A History of the Royal Col- itary Archive’s excellent online resource. See Statement by 56. Molyneux D, Kelly D. When the Clock Struck in 1916 (p. 127) lege of Nursing, 1916-1990: A Voice for Nurses. Manchester: Witness. A Member of the Community of the Sisters of Mercy, Manchester University Press; 2009 (p. 27) WIN 57. Testimony of Dan MacCarthy available at Military 50 BRANCH FOCUS
Branch Officers Athy/ Chairperson Vice chairperson IRO Baltinglass branch INMO Athy/Baltinglass email: [email protected] Eileen Lawrence Sharon Blanchfield-Farrell Derek Reilly [email protected] [email protected] [email protected]
Branch workplaces and Education officer Secretary Treasurer areas covered • Kildare/Wicklow community care services • St Vincent’s Hospital, Athy • Baltinglass Community Nursing Unit • Private nursing homes Sinéad Wall Eilish Horgan Clodagh Cardiff • Practice nurses [email protected] [email protected] clodaghmcardiff @gmail.com
Latest news Industrial relations update Unlike some other INMO branches, the Athy/Baltinglass Derek Reilly is the IRO for the Athy/Baltinglass Branch. Branch generally has a very good St Vincent’s Hospital, Athy attendance at meetings. • The INMO has a proactive group of members who meet regularly to address At the recent AGM, delegates areas of concern within the hospital. Of primary concern is maintaining safe and motions were put forward for staffing levels and ensuring that all vacant posts are replaced. Within the past the upcoming ADC which is being year there have been negotiations in relation to developing future services and held in Killarney on Wednesday, roster changes, ensuring those in acting positions are remunerated correctly. St May 4 to Friday, May 6. Vincent’s is a progressive centre with plans for further development in the future. The AGM heard members’ concerns about future staffing Baltinglass Community Nursing Unit levels. There was also concern • The main area of concern in Baltinglass is poor staffing levels. CNM1 posts lost due to the fact that our care of through the moratorium have yet to be replaced. This is high on the agenda for the elderly services are recruiting 2016. National talks are currently in process in relation to care of the elderly staffing. temporary nurses and therefore will not be able to compete with Community: the acute sector which is offering • The issues within the community include redeployment and the large workload permanent posts. This issue is being that PHNs and CRGNs have in the area. A number of members were involved in actively pursued by the INMO. the recent agreement pertaining to the national PHN transfer panel.
You are not alone Counselling, legal advice, domestic assistance and bodily injury cover WIN
Free helplines provided by DAS, 365 days a year, 24/7 Vol 22 No 7 September 2014 Tel: 1850 670 407 for counselling or 1850 670 707 for other services See www.inmo.ie for further details WIN Vol 24 No 2 March 2016 ------reland reland I 51 CPD A study in 1
2 encephalopathy of 0.9 per of 0.9 per encephalopathy is treated. treated. is
el at which bilirubin is likely to to which bilirubin is likely el at e (opisthotonus), high-pitched cry, cry, e (opisthotonus), high-pitched ematurity, the rate of serum biliru the rate ematurity, owever, the chemical subgroup of the chemical of subgroup owever, oblems that include lethargy, irritabil that include lethargy, oblems – encephalopathy bilirubin hronic a – occurs – occurs cute bilirubin encephalopathy – describes the clinical fea ernicterus clinical the describes – Complications in newborn children children in newborn Complications Breastmilk jaundice, in a baby who is is who jaundice, in a baby Breastmilk jaundice with babies for prognosis The H The lev A number of terms are used to describe mia. Children with this condition have with this condition Children mia. have pr tures of either tures acute or chronic bilirubin apnoea and eventually seizures and coma and seizures eventually apnoea and C which includes term problem longer developmental seizures, palsy, cerebral vision and difficulties, learning delay, hearing problems, dysplasia dental and K ity, poor suck, abnormal muscle tone and poor suck, abnormal muscle ity, postur A hyperbilirubinae is severe there when n 2010 found n that found 2.5% 2010 of infants had Complications sur A prospective rare. with jaundice are UK incidence a found study veillance of bilirubin otherwise well, is benign and self-limiting. and benign is well, otherwise due to an on condition depends underlying example, cause. the of causes surgical For jaundice (such as obstruction due to bil • • bilirubin, which is called ‘unconjugated called ‘unconjugated which is bilirubin, the blood- to penetrate is able bilirubin’, the between the membrane barrier, brain This chemical can brain be and the blood. the tissue of the to toxic brain and spinal biliru as known condition a causing cord, bin encephalopathy. encephalopathy. bin cause brain and spinal cord damage is damage is cord and spinal cause brain a num by variable and may be affected which degree the include factors, of ber of pr co-existing illnesses in a and bin increase, newborn. of consequences raised the neurological (hyperbiliru the blood stream bilirubin in these binaemia), are: • 100,000 live births. 100,000 live iary atresia) are likely to resolve once the the once to resolve likely are iary atresia) condition phototherapy and that none had that none had and phototherapy complications. i ------after ventouse deliv after ventouse with pathological jaun oblems with dark urine dark urine with oblems – includes malformations – includes malformations age at weeks birth under 38 . This causes red blood cor blood causes red This . and Pearsall Rebecca –rare problems which include which include problems –rare age over 25 over age diabetes mellitus – includes sepsis includes – – includes rare conditions, Gil conditions, – includes rare ome children e are also other more rare causes of of causes rare more other also e are sibling with jaundice requiring first 24 or their of hours day after life, first 24 ective ome newborns are at higher risk of of at higher risk ome newborns are eastfed babies eastfed – occurs group incompatibility lood – occurs uropean, Asian or Native American Asian uropean, or American Native – in this situation large areas of of areas this situation large – in rauma Newborn babies S most babies, jaundice is not an For ent ABO or rhesus blood group from from or rhesus blood group ABO ent the mother bert’s syndrome and Crigler-Najjar Crigler-Najjar and syndrome bert’s syndr puscles to break down (haemolysis). puscles to down break (haemolysis). Ther example ciated with for birth trauma cephalhaematoma can ery) cause also jaundice. Metabolic galactosaemia and hypothyroidism Inf differ has a the newborn baby when haemolysis T be asso can as (such child the bruising in Anatomical of the liver and biliary tree, where bile bile where tree, biliary and the liver of obstructed becomes the in liver Br Male Maternal Maternal E ethnicity. Genetic B Gestational treatment A esolves two of weeks by esolves age. • • • • • ological jaundice is generally harmless and ological jaundice is generally r • • • Prognosis disease. Physi of an underlying indication six of the child’s life. These babies also life. six of the child’s to poor can lead (which to be unwell tend irritability and unusual sleepi feeding, obvious and widespread ness), with more jaundice, and pr stools. pale and Risk factors include: factors These jaundice. developing • • • There is a long list of these problems these problems of long list is a There following the into can be grouped which categories: • dice will often develop the problem the within develop problem often dice will the • Jaundice in in Jaundice newborns - - - - - levels are higher in newborn newborn in higher are levels
of age, peaks at seven to 10 days of of days to 10 of age, peaks at seven breastfed and formula fed babies. fed formula and breastfed last for up to 12 weeks. 12 to up for last ofessional education series, ofessional
athological jaundice is less common common athological jaundice is less n both these situations the newborn the newborn these situations n both P I Jaundice Jaundice is the condition common most born babies of 60% Approximately Physiological jaundice, the commonest of is a subtype jaundice Breastmilk is caused by a a caused by is jaundice Pathological is a type of physio type jaundice is a Breastmilk For most babies, jaundice is completely completely is jaundice babies, most For Jaundice is a yellow colouration of Jaundice is of colouration a yellow Bilirubin n the n clinical second update continuing this in mally, and have normal urine and stools. and urine normal have and mally, but important to recognise in order order in to recognise but important to treat potential causes. underlying age, and can persist for up to 12 weeks. 12 to up for persist can and age, will be well, will baby gain weight nor logical jaundice in breastfed babies, which which babies, logical jaundice in breastfed can medical that requires the newborn baby of attention. at term will develop jaundice first in the While week of their approximately lives. age (gestation term before babies of 80% jaundice in develop will weeks) under 38 their of week first the lives. of newborn jaundice Causes cause of jaundice of the newborn, usually of age, peaks between days two at appears days of five to age, three and decreases by of days 10 age. in breast apparent jaundice physiological four to two at appears usually – babies fed days range of illnesses in the newborn baby. baby. newborn the in illnesses of range harmless. This is called ‘physiological jaun called ‘physiological This is harmless. occur in can jaundice Physiological dice’. both children. This is because newborn babies babies newborn is because This children. blood of red concentration a higher have corpuscles also have These corpuscles. down more and break a shorter lifespan children. young quickly very in Terminology
month’s article focuses on the issue issue the on focuses article This month’s child. newborn the in jaundice of eyes) the of (whites the skin and sclerae caused the by build-up of a chemical called bilirubin. Bilirubin is a bile pigment the break from produced which is mainly of down red cells. blood CPD module CPD examine Gerry Morrow jaundice the in child newborn I pr 52 CPD
encephalopathy and the pathological (including glucose-6-phosphate-dehy- • If transcutaneous bilirubin measure- findings of deep yellow staining in the drogenase deficiency). Ask whether any ments are unavailable in primary care, brain. siblings or close family members have refer to a neonatal or paediatric unit Diagnosis required hospital treatment such as pho- for measurement of a serum bilirubin In order to make a diagnosis of jaundice totherapy or exchange blood transfusion level within six hours. Do not rely on in the newborn, you should make a clinical for neonatal jaundice. visual assessment of jaundice to guide observation at every contact, particularly You should also offer parents and carers management. within the first 72 hours. If the baby has information on: If admission is not necessary, reassure one or more risk factors for developing • How to check the baby for jaundice parents and carers that: significant hyperbilirubinaemia, ensure • What to do if they suspect jaundice • Neonatal jaundice is common and is usu- they are re-examined during the first 48 • The importance of recognising jaundice ally temporary and harmless hours. Record your findings in the clinical in the first 24 hours • Breastfeeding can usually continue. notes: • Observing for signs of adequate Treatments • Examine the baby in bright, preferably hydration The choice of treatment in secondary natural light, for example in daylight by • The importance of checking the baby’s care will depend on a number of factors, a window nappies for dark urine or pale stools. including the underlying cause of the jaun- • Look at the skin of the whole body and Management dice. Treatment options include: blanch to assess for jaundice (for exam- Arrange emergency admission (via 999 • No treatment – this may be appropriate ple gently pressing on the nose) ambulance) if there is jaundice with fea- for well newborn children with phys- • Also examine the whites of the eyes tures of bilirubin encephalopathy (for iological or breastmilk jaundice and (sclerae), gums and palate example atypical sleepiness, poor feeding a bilirubin level below the treatment • Check for any signs of illness or fever or irritability). threshold • Assess weight gain Arrange urgent admission to a neona- • Treatment of any underlying illness (such • Evidence of bruising. tal or paediatric unit (depending on local as infection), with as follows: Assess how widespread the jaundice has arrangements) within two hours if jaun- – Phototherapy, absorption of light become. Jaundice spreads from the head dice first appears at less than 24 hours of through the skin converts unconju- downwards in the newborn. Widespread age. gated bilirubin into products that are jaundice may indicate a more severe prob- Arrange urgent admission to a neona - more easily excreted in the stool and lem, but cannot be relied on in isolation to tal or paediatric unit (depending on local urine assess severity. arrangements) as soon as possible and – Exchange transfusion, indicated if the If there is doubt about the diagnosis, to be seen within six hours (using clinical baby has signs of bilirubin encepha- consider referral to a neonatologist or judgement regarding more urgent referral lopathy and considered if the risk of paediatrician for further assessment. or admission) if: kernicterus is high or jaundice is not You should ask the baby’s mother • Jaundice first appears at more than seven responding to phototherapy about: days of age – Early surgical treatment, required for • Obstetric history (including the mother’s • The neonate is unwell (for example leth- conditions such as biliary atresia. rhesus status and blood group if known) argy, fever, vomiting or irritability) and the baby’s gestational age at birth • Gestational age of less than 35 weeks Dr Rebecca Pearsall is a clinical author at Clarity Informatics and Dr Gerry Morrow is editor and medical • Age at onset and duration of jaundice • Prolonged jaundice is suspected – that is director at Clarity Informatics. Clarity Informatics is • Feeding history (type of feeding and a gestational age of less than 37 weeks contracted by the National Institute for Health Care whether there have been any problems with more than 21 days of jaundice; or a Excellence (NICE) to provide clinical content for the Clinical Knowledge Summaries service available through with adequate intake) gestational age of 37 weeks or more with the Clarity Informatics Prodigy website at: • Number of wet or dirty nappies in a day more than 14 days of jaundice http://prodigy.clarity.co.uk (to assess the state of hydration) • Poor feeding and/or concerns about References 1. Manning D, Todd P, Maxwell M, Platt MJ. Prospective • Also specifically ask about the presence weight, particularly in breastfed infants surveillance study of severe hyperbilirubinaemia in the of dark urine and/or pale stools • Pale stools and dark urine. newborn in the UK and Ireland. Arch Dis Child Fetal Neo- • Signs of illness (for example lethargy, For all other jaundiced neonates: natal Ed. 2007 Sep; 92(5): F342-F346 2. Walsh SA, Murphy JF. Neonatal jaundice – are we fever, vomiting, significant weight loss, • If transcutaneous bilirubin measure- over-treating? Ir Med J. 2010 Jan; 103(1): 28-29 irritability) ments are available in primary care, 3. National Institute for Health and Care Excellence. Jaun- • Family history of relevant conditions record the level within six hours and dice in newborn babies under 28 days NICE Guidelines [CG98] Published May 2010. Available from: https://www. – for example significant haemolysis manage according to local protocols nice.org.uk/guidance/cg98 [Accessed January 28, 2016] Book Online Safe Secure Online Booking System for All INMO Education Programmes and Conferences www.inmoprofessional.ie
If you require any assistance with booking online please contact the Professional Development Centre on 01 664 0641/01 664 0618 WIN Vol 24 No 2 March 2016 Answers: Question 1=A,B,C Question 2=A,C, 3=A,B,C,D Question 5=A,B,C,D 4=A,C,DQuestion Question 53 CPD sisted for longer longer for sisted developed within within developed en with jaundice should be with en child is less than 35 weeks of The gestation The jaundice has life of hours 24 first the The jaundice has per than one than week Childr referred to a specialist if: to a specialist referred Answers for the CPD the multiple choice for Answers After reading this article you may wish may you this article After reading 5. B) unwell is child The C) D) learned, have you what on to reflect this how might own be your to applied your this in of a note to make work and portfolio. on jaundice in newborns appear in quiz below. box inverted the and resources: further information For www.clarity.co.uk A) A) - ysiological jaundice in the new the jaundice in ysiological tarts child when old days two is esolves when the child esolves is 10 days esolves the child when esolves is 10 weeks s less common in breastfed children breastfed common in s less S Ph born usually: R old I R old omplications of jaundice in the troke athological jaundice in the newborn: athological jaundice in s less common than physiological s less common than physiological rritability I I newborn the in jaundice S newborn include: C P 2. 2. A) C) C) B) D) D) 3. A) breastfeeding by caused be Can B) birth of hours 24 within starts Often C) Can causes D) treatable to due be 4. A) sucking Poor B) C) Vomiting D) e common than pathological e common common e in the under mothers Mor of 25 age jaundice Mor C) Less common in pre-term children C)common in pre-term Less D) 1. Physiological jaundice in newborns is: jaundice in newborns is:1. Physiological harmless and temporary Usually A) B) There may be more than one correct There may be one correct than more the to answer questions choice multiple (given answers correct The listed here. box) inverted the those are in below the authors by deemed most appropriate CPD this of context the in article. WIN Vol 23 No 2 March 2015 ------wife behaves in a manner in a manner behaves wife 55 CORNER CODE essary, and other more general general and other more essary, ts responsibly in the disclosure the disclosure in ts responsibly king a decision to share information, information, king share to a decision While the Code does not make any does not make any the Code While This will not be a surprising value for for not be will a surprisingThis value of conduct standards associ The ne could not be seen to be in breach be in breach not be seen to ne could e seen as not only injuring the patient, e seen as not only injuring the patient, areful to exercise professional judgment judgment professional exercise to areful O necessary is it when to determining in a nurse/ example, For information. share a in caring for be involved may midwife that strengthens the public trust and and the public trust strengthens that and con in the professions, confidence also Code The but also the professions. will midwives and nurses expects that expectation their that uphold a patient’s private, will remain personal information an that the same time recognise but at part of their inherent of the provision infor share to is the requirement care each nurse or mid that requires the Code and sharing of information. sharing the distinctions between explicit con among colleagues of information distinction the information, of sharing of the Code. is implicit in the provisions the sharing of infor where of the Code sequently any breach of privacy could of privacy breach could any sequently b When fashion. in an appropriate mation ma judgement, professional exercises wife and ac where of a patient with the care cerned this is nec but one must be is necessary, mation c ated with this value require that a a that require with this value ated nurse or mid patient, and in addition, reminds us that us that reminds and in addition, patient, expect a right to their that have patients private. remains personal information important but it is midwife, nurse or any the privileged arising that from recall to hold, nurses/midwives position that of privacybreaches carry with them a particular injury a patient. for ------t of a multidisciplinary team. If t of a multidisciplinary team. t vexed area, in terms of what of what in terms area, t vexed ot N t of a nurse or midwife, who is oper t of a nurse or midwife, tients, based on best evidence or best or best based on best evidence tients, The next value under this principle under this principle nextThe value The standard also requires impartiality requires also standard The This takes us into the domain of shar takesThis us into a nurse or midwife was working for a a working was for midwife or nurse a est available evidence. est available commercial entity and was employed entity employed and was commercial extol the virtuesto of a particular prod characteristics of a working environment is a nurse or midwife or personal life, the of act to in the best interest required ofthese withstanding any which is hon advice give and to patient, relationships Trusting honestyand confidentiality that requires relationship the basis of a trusting form their and midwife or nurse the between ment which might be available, or indeed or indeed be available, which might ment if uct. the on based and balanced truthful, est, b it is intended to withhold any information information withhold any to it is intended this must not be taken a patient, from and nurses and midwives light-heartedly, to pursuant their obligations must recall for including the requirement the Code, also and dignity respectperson, the of for which patient, the of bestinterests the the heart should be at of everything a does. nurse or midwife Impartiality and integrity on the part nurse or of any who is dealing with a patient. midwife personal beliefs arise where may This conflict with a particular of treat course patients have a right to know, what they they what know, a right to have patients is in their best and what know, need to the exer requires This know. to interest on the judgement cise of professional par available practice standards. available which is a with patients, ing information somewha ating as an independent practitioner, but but practitioner, independent an as ating also as par pa - - - - -
tients and colleagues. and colleagues. tients wives, this month, we focus on the on the focus we this month, wives,
y are required to show honesty, integ honesty, show to required y are In this regard we can see that the prin the that can see we this regard In Each principle in the Code underpins underpins principleEach in the Code purpose of this principle overall The xtends beyond the relationship between between relationship the xtends beyond ciple relating to trust and confidentiality and confidentiality trust to ciple relating e rity and trustworthiness in all dealings ritytrustworthinessand dealings all in with pa discusses the fourth principle, Trust Confidentiality and Trust fourth principle, the discusses Mathews Edward of Profes of the Code In our exploration and Trust fourth – principle of the Code Confidentiality. associated and set of ethicala values ethical values The of conduct. standards primarythe state of obligations and goals the standards and nurses and midwives, practice flow of conduct and professional the show also They values. these from members that behaviours and attitudes expect the right to of the public have It importantis midwives. and nurses from consider to all nurses and midwives for of the Code, the totality of the contents ethical reflectand to on the principles, to how deciding in standards and values practise nursing and midwifery. purpose Overall The honesty. and confidentiality is trust, and nurses that requires value ethical first is a core trust that recognise midwives of their principle the centre at professional and colleagues. with patients relationship of standards associated the of terms In nurses that requires the Code conduct, must try rela and midwives develop to In a series examining the new Code of Professional Conduct and Ethics, and Conduct Professional of Code new the examining series a In Understanding the Code the Understanding nurses and registered sional Conduct for mid In addition, with patients. tionships of trust the a nurse and midwife and their patient, and and their patient, a nurse and midwife we that relationship the also extendsto in the workplace. with colleagues have each that as a standard, requires, Code The truth honest, gives nurse and midwife ful, balanced information and advice to to and advice information balanced ful, 56 CODE CORNER
patient who is undergoing a specific pro- which requires the exercise of profes- Record management cedure and, in the course of preparing for sional judgement and responsibility by Finally, and quite appropriately in times the procedure, a patient may share with each nurse and midwife in circumstances of developing IT infrastructures in hos- a nurse or midwife a very specific detail where such information must be shared. pitals, the Code explicitly recognises the about their private life. In those circum- Where a nurse or midwife has to make role of nurses/midwives in safe guarding stances, a nurse/midwife would have the difficult decision to share otherwise confidentiality which extends to all forms to exercise particular care not to share confidential information, outside the of record management, not only paper information which is not relevant to the immediate care team, then the patient records but also the appropriate use of patient’s particular condition, and only should be told that this is to occur, unless information technology and social media. communicate that which is relevant. to do so would cause the patient seri- As mentioned there is a requirement to In addition, within the clinical team, ous harm. This is required to respect the maintain confidentiality in the context of nurses and midwives need to be careful dignity and autonomy of the individual, using social media, that requires nurses/ only to disclose information to those who while at the same time allowing each midwives to exercise vigilance and caution must of necessity receive that informa- nurse or midwife to exercise their profes- in ensuring that information contained in tion. Examples have come to light where sional judgement in the interest of others paper records and other IT systems is con- nurses and midwives have shared too to whom they should have regard. fidentially maintained. The relevance of widely within the clinical team or among Careful professional judgement this standard to maintaining patient clini- their colleagues, information which Circumstances can also arise where a cal files as confidential will be immediately patients would expect not to be shared person may be regarded as lacking the apparent, and each nurse and midwife will unnecessarily, and which can put a regis- ability to give consent, or have dimin- understand the necessity to ensure that no trant in breach of the Code. ished capacity, and a nurse or midwife is unauthorised access occurs to a patient’s In addition, nurses and midwives often in a difficult situation in knowing file, and that they themselves only access must exhibit extreme care in the use of whether, absent of the consent of the the file as necessary. social media, it can never be appropriate individual concerned, they can release However, the requirement to maintain to share any information relating to a information to those who are close to the this level of confidentiality also extends patient, or information that could poten- patient. The Code requires that if a patient for instance to summary sheets used at tially identify a patient or a particular is considered to be incapable of giving handover in many care environments, clinical area in which a patient is being or withholding consent to the disclosure and nurses and midwives must exercise cared for, using social media or other sim- of confidential information about them, care to ensure that these are placed in an ilar communication media. that each nurse or midwife should con- appropriate disposal facility, within the Difficult situations sider whether disclosing the information hospital, prior to leaving the clinical area. The Code does recognise that difficult to those close to the patient is what the Additionally, nurses and midwives may situations can arise for nurses and mid- patient would want or if it is in their best be provided with usernames and pass- wives, which are regarded as exceptional interest. This again requires the exercise words to IT databases, and it is important circumstances, which might require a of careful professional judgment. that these remain confidential to the nurse or midwife to share otherwise Circumstances often arise where nurses nurse or midwife in question and that confidential information with people and midwives are telephoned by those no unauthorised access to the system is outside the clinical team. Circumstances close to the patient and, in circumstances permitted. Nurses and midwives should might arise where one is required by where the patient themselves cannot be vigilant not to access information via law to release information to a court or inform you as to whether they wish infor- IT systems which is unnecessary for them other statutory body, or one may decide mation disclosed to a particular person, to care for the patient in question, in par- when exercising careful professional then care must be taken in deciding ticular nurses and midwives should be judgement, that it is necessary to share whether to disclose that information. The vigilant not to access the records or test confidential information to protect the Code does provide, as indicated, con- results of others to whom they are not patient themselves, to protect the inter- siderations such as the best interests of providing care, as this would be a breach ests of society, or to protect the interests the patient, and what the patient might of the patient’s right to confidentiality. of other people. It is imperative that wish if they were able to give consent, Overall, it is important that nurses and nurses/midwives exercise the most care- but ultimately each nurse/midwife must midwives respect the trust and confidence ful professional judgement in deciding to make a judgement call. If a nurse makes invested in them by individual patients, release information in these exceptional a judgement call to release or withhold and also to remain vigilant as to the trust circumstances, though at the same time, information, based on relevant consider- and confidence invested in the profes- they must be conscious of the interests of ation, it is important to record what has sions generally, and this principle of the the patient, of society, and of other peo- occurred, and also to set out one’s ration- Code points us to a conclusion that such ple. Where having exercised that careful ale for making the decision in question. If trust and confidence is best maintained judgement, the nurse or midwife comes a nurse or midwife were to make a good by being honest with patients, showing to a decision that they must breach the faith decision, based on relevant consider- integrity in one’s relationships, building confidence of the patient, they must ations, which later came to be questioned, trustworthiness, respecting confidential- only disclose the minimum amount of then an accurate record of what they did, ity and acting in the best interests of the information necessary, and only to an and why, would be important in showing patient and society as a whole. Vol 23 No 2 March 2015 23 No 2 March Vol appropriate person. This forms part of that they exercised careful professional Edward Mathews is INMO director of social policy and
WIN a core ethical value under the principle judgement in reaching their final decision. regulation WIN Vol 24 No 2 March 2016 58 MIDWIFERY MATTERS ilies andnations. This burden of stillbirth and economic coston fampsychosocial improving child development. and newborn deaths andstillbirths, on investment, by preventing maternal such inputsresult ina quadruple return cost benefitanalysis and discovered 2016 conductedeconomicseries Lancet healthcare. and equityof of quality The four papers is presented below. research.synopsis ofthe contents of the A stillbirtharea of in the global experts series able stillbirths’ on January 19,2016. This its secondseries entitled ‘Endingprevent silence, the address this sustainable development goals. To help documents, suchas the United Nations not feature strongly inglobalstrategy do not record stillbirth rates and it does constitutes stillbirth.Many countries univ den. There isglobal disagreement on a who die, stillbirth statistics remain hid Ending pr tum care. w natally. Many stillbirthsare preventable ante90% of deaths occurringeventwith stillbirth occurring during labour is a rare complications. In high income countries and obstetric non-communicable diseases (most ditions suchasmaternal infections labour and birth. all stillbirths(1.3million) occurring during these number ofhigh dle-income countries. A which 98% occur in low-income and mid stillbirths annually across the globe, of birth. There are an estimated 2.6million around thetimeoftheirstill die babies DESPITE advances in maternity care, with action working onthiscall global forher experience shares Alliance, Scientificmember ofthe MargaretMurphy, a Stillbirth Advisory International Committee ofthe preventable stillbirths Global calltoactionon ith high quality antenatal and intrapar Stillbirth creates aheavy burden of The stillbirthrate is asensitive marker numbersbabiesspite of the of In Most result from preventable con ersal definition of what gestationersalwhat definitionof deaths are preventable, with half of of four key papers brings together commonly syphilisandmalaria), eventable stillbirths Lancet launched ------various psy munities andsocieties.Parents experience a for 2030, have includedstillbirths. Data laid outumbrella,with targets (EWEC) within the Every Woman Every Child such as tunities be steadily grasped. Initiatives recommendauthors that theseoppor childr stillbirths withinwomen’sgrating and stillbirth impedeand thiscan stillbirth rence of preventbe done to the occur nothing can socially ostracised. A fatalism existsthat womentraumamany for families,with and taboocan further exacerbatestigma with apr ally are living with depression associated bereavement care. respectful maternityservices,including of these symptoms could belessenedby protracted grief. Research suggestssome baby, includinganxiety, depression and after thedeathoftheir long persist often ffectswomen, families, caregivers, com There are however chances of inte An estimated 4.2million women glob en’s health programmes. The Lancet the ‘Every Newborn Action Plan’, evious stillbirth.Insome cultures prevention. chological symptoms that - - - - -
and r laboration in the prevention of stillbirth • • • • stillbirths, including: actions necessary to achieve areduction in Series recommendations opportunities. in the limitation of research and funding of stillbirthremain restricted. This results Yet inmany relevant policiesmentions for tracking stillbirth rates have increased. – www.thelancet.com/series/ending-preventable-stillbirths – www.thelancet.com/series/ending-preventable-stillbirths – Global Village Midwives Twitter @Globalvillagemw Resources included insuchaglobalpaper is thefirsttimethatIrishstillbirthstatistics have been recalltoactioninhigh-incomecountries’. This ‘Stillbirths: statistics totheLancetseriespaper4byFlenady etal, investigator group,MargaretcontributedIrish stillbirth member ofTheLancetstillbirthsinhigh-income countries Committee oftheInternationalStillbirthAlliance. Asa College CorkandamemberoftheScientificAdvisory Margaret Murphyis a lecturerinmidwifery at University recommendations toendpreventablestillbirths. of GlobalVillageMidwives,whichsupportspriority Deirdre Munro and MargaretMurphyaremembers and isproject co-ordinator QID, Corporate HSE Deirdre Munro is a member of the INMOExecutive Council series. action fromthe moting collabor ity collaborative research, inparticular to high qual and disseminationof in conduct be donethrough facilitating collaboration will outcomes. This psychosocial including will work to enhance international col work toenhance will MargaretScientific AdvisoryCommittee, Summary • • T ventions with proportionate investment An increasedvoice, especially forAn women biggest challenge policy makers, which isidentifiedas the Intentional gaps. In Indicator and tions and especially to monitorprogress The Through herinvolvement with the ISA he implementation of integrated inter vestigation into crucial knowledge elated adverse pregnancy outcomes, quality of care Lancet ate with globalpartners inpro s to measureinterven effects to of Deirdre Munro series hasidentifiedpriority leadership,especially from Lancet’ s stillbirth - - - - - WIN Vol 24 No 2 March 2016 - sessments ecognise when you’re out ofecognise when you’re s social media guidelines Cornmarket. The student member who who The student member Cornmarket. will the winning nominates also preceptor din the awards to with a guest, be invited, officer graduate and new Dean Flanagan is INMO student ner and will also receive a prize. a receive also will and ner ts that you think could be interpreted as an attemptts that you think could be interpreted e that how you act outside of your placement, in your in your e that how you act outside of your placement, eferring to the patient case studies in your coursework, or eferring to the patient case studies in your coursework, guidelines UCD students with Dean Flanagan, INMO student and new graduate new INMO student and graduate with DeanUCD students Flanagan, participating as part in a video workshop of the right), officer(centre, 2016 Students Association Conference Nursing National Canadian et your preceptor/clinical placement co-ordinator know if placement co-ordinator et your preceptor/clinical you ry to co-operate with members ofry to co-operate their and respect your team Be awar ability to practise on your perceived also impacts time, spare It may be useful to view NMBI’ Do not accept gif treatment to gain preferential L someone at risk ofbelieve you or someone else is putting harm Do not plagiarise coursework or clinical as When r to change the be sure anything that may identify an individual, A patient eg. them anonymous, names or make Ask for help when you need it and r not going to look bad ifyour depth; it’s you admit that you need guidance more T individual contributions to your education
– – Make care your first concern your care Make – dignity Respect – others with Work – – ofHigh standard care – Be open and honest – ofUphold the reputation your profession – 61 FOCUS GRADUATE & NEW STUDENT in practice The preceptor The preceptor .inmo.ie/Preceptor Table 1: Extracts from NMBI scope of from practice 1: Extracts Table ork with others to protect www Provide a high standard of a high standard Provide at all times and care practice act with Be open and honest, integrity and uphold the ofreputation your profession Make the care of the care Make people your them treating first concern, as individuals and respecting their dignity W and the health and promote wellbeing of those in your care, andtheir families and carers the wider community nate their preceptor before April 8, 2016 8, 2016 April before their preceptor nate at of the year will be invited, with a guest, to to with a guest, will be invited, year the of the annual awards at their award receive will also They on May 5. ADC the dinner at by sponsored cash prize a €1,000 receive ------Professionalism Professionalism et regular et regular G ‘Visioning a ‘Visioning a CD participated in a in a CD participated U g and Midwifery Board of of Board g and Midwifery ses and midwives can nomi ses and midwives sin dents in sing or midwifery student, and I student, and I or midwifery sing esented at the International Congress Congress the International esented at Students need to be familiar with the NMBI’s professional guidelines professional NMBI’s the with familiar be to need Students Due to the growing popularity of the Due to the growing popularity of the As Canadian Stu of the part Nursing The NMBI guidelines are the foundation foundation the The NMBI guidelines are perfectly learning,still it’s so You’re eceptor of the Year award Year eceptor of the eland (NMBI) sets the standards of pro the standards eland (NMBI) sets to ensure good nursing and midwifery practice, writes Dean Flanagan practice, midwifery and nursing good ensure to Ir INMO ‘Preceptor of the Year’ award, this this award, Year’ INMO of the ‘Preceptor will The award event. is now an annual who has to an INMO member be given or mid nursing and motivated a inspired ing students. ing Pr full potential. their to reach student wifery Student nur of Nurses Student Assembly 2016. The The 2016. Assembly Student of Nurses Irish for opportunity great a was workshop the on views their to issues students share the them well as giving as nursing facing nurs Canadian with interact to opportunity global future: what are the most pressing the most pressing are what global future: global health difficultiesand nursing facing this findings from The work currently?’ dents’ Association National Conference dents’ Association National Conference 2016, stu video conference workshop The recently. theme of the workshop was January which was shop, 29, will on held be pr feedback from preceptors to build on your from preceptors feedback weaknesses. your address and strengths workshop Video conference fessionalism that you’re expected to expected meet you’re that fessionalism as a nur and practice and midwifery of good nursing of wellbeing the health and tool in a key are the to the to public. adhere ofscope Failing or nurse to a registered lead may practice register, the from removed being midwife of to gain a good understanding vital so it’s 1). Table (see you from expected what’s acceptable to ask questions. Preceptors to support students. there are would to with the you familiar urge become you will help which of practice, NMBI scope as a responsibilities your with to grips get midwife. or nurse a as and professional The Nur Open letter 63
Social media – An open letter to members
Dear Member, views of members, both when they are In this context social media offers a As an organisation the INMO constantly satisfied, and when they are not, with our powerful medium to communicate the strives to promote and protect the welfare work. We fully encourage and respect the message of our Organisation, and to of members, in all matters related to their rights of our members to freely express receive the full views of our members, and employment, pay and working conditions, their opinions and the facts upon which we welcome members communicating while also promoting the objectives of they are based, relating to the work of the with us through social media. However, justice, equity and equality. Organisation. social media and other communication To further these aims, it is necessary However, it is also the policy of the fora, must not be used in a manner which that constant contact is maintained with Organisation that all nurses and mid- is abusive to members, or to the employ- our membership through meetings in local wives, and the staff of the Organisation, ees of the Organisation. workplaces, our branch/section structure, must be treated with respect at all times, The INMO will continue to do and also our annual delegate conference. in all communications. While recognis- everything, within its collective power, It is through these structures that the true ing, and fundamentally respecting, both to promote and protect the welfare of democracy of the INMO is reflected and the right and duty of members to tell us members in all matters relating to their this in turn shapes and influences all our their opinions, it is not acceptable that employment, pay and working conditions. work and activity. In addition, we commu- any member, or staff of the Organisa- We will continue to communicate with, nicate with members through email, text tion, would be subject to abuse, in any and listen to our members, using what- messaging, posted circulars, WIN – World form, including online via social media. ever media our members choose. of Irish Nursing & Midwifery journal and Constructive, open debate is always In doing so we commit to be respect- through social media to further facilitate worthwhile. However, personal abuse ful of the rights of each individual we focused professional debate on matters of serves no good and is only destructive communicate with, in accordance with mutual interest. while also being unprofessional. the ethos of our Organisation, and the Maintaining this contact is extremely It must also be remembered that, as requirements of the Code of Professional important and we always welcome an Organisation made up of registered Conduct and Ethics for Registered Nurses the views of members in relation to professionals, all are bound by the NMBI and Midwives. In return we ask and expect all matters relevant to the work of the Code of Professional Conduct and Ethics that all members will do likewise, showing Organisation. It is only through members for Registered Nurses and Midwives. This respect to fellow members and employees talking with us that we can continue to code requires that all registrants should of the INMO, when expressing their views work to protect, defend and advance the be aware of their professional responsi- about the work of the Organisation. pay and working conditions of nurses and bilities when using social media, which is Yours sincerely, midwives, and assist with ongoing profes- further supported by the NMBI guidance Claire Mahon, President sional development. to nurses and midwives on social media Geraldine Talty, First Vice President It is therefore essential that we hear the and networking. Martina Harkin-Kelly, Second Vice President WI N Vol 24 N o 2 March 2016 REVIEW 65 Take time to reflect THE authors of Reflective Organizations examples of how proposed strategies have a distinguished record in nursing and approaches can be implemented. education, quality and safety in health The thread throughout is reflection and education, transforming organisations and its benefit to learning and development. compassionate and creative approaches Summary sections at the end of each to education and learning. There are a chapter are very useful as are the thought number of contributing authors which provoking questions scattered throughout. reduces a purely academic focus to one The book focuses primarily on the that presents real examples of change and US health and education systems and, development in a variety of practice and although providing excellent examples of teaching settings. ideas and strategies, the translation may Framed by the authors’ rationale for be a slight challenge to our systems. transforming healthcare professionals In summary, this was a much easier and to respond rapidly and reflectively to more enjoyable read than the cover and increasing demands, they present a num- size might denote, being well presented ber of interesting arguments, supported and laid out. It has relevance for any by numerous examples of proposals to both reflective leaders and learning envi- individual or groups considering ways to support future-orientated healthcare. ronments is well argued, including risk enhance care outcomes, learning oppor- Starting with transforming education in taking and facing challenges. The book tunities, teaching content and styles, and both content and teaching style, a clear builds on themes such as the development personal and professional development, line of reasoning is presented for the con- of collaborative teams with useful exam- with an overall theme of reflection and sideration of new approaches that can ples, with the emphasis on quality and collaboration at its core. equip healthcare professionals to be more safety and the positive outcomes that can – Lorna Peelo-Kilroe, Strategic Project reflective learners and educators. be achieved for service users and health- Officer at HSE Office of Nursing & A number of fresh techniques intended care professionals alike. Midwifery Services Director to stimulate learning through creative What makes this book readable is the teaching strategies are presented with way it speaks to education providers and Reflective Organizations: On the front lines of QSEN & reflective practice implementation by Gwen D Sherwood clear examples of how they were incor- professionals in practice and avoids cre- and Sara Horton-Deutsch; published by Sigma Theta Tau porated into practice. The importance of ating a theory/practice gap by presenting International: Indianapolis, USA ! Crossword Competition
1 2 3 4 5 6 7 Across Down Solutions to February crossword: 1. Donkey or fool (3) 1. Some nights, Sonia can be amazing! Across: 3. That’s some volatile rut – it’s off the (11) 1. Scrivener’s palsy 6. Item 8 9 spectrum! (11) 2. Obstinate (8) 10. Colon 11. Double bed 8. Sign of the zodiac, the bull (6) 3. Customary (5) 12. Amassed 15. Corgi 17. Etna 9. Unwelcome type of reaction, perhaps 4. But it’s not the highways that pay it, 18. Hide 19. Rebel 21. Crossed 10 11 12 shown with ill grace (8) it’s the motorists! (4,3) 24. Cave 25. Poor 26. Inner 10 & 23d. Pile bronze up to achieve 5. Perfect (5) 28. Talking 33. Treasurer 34. Let in 13 14 Scandinavian recognition (5,5) 6. Ancient tale or myth (6) 35. Reel 36. Englishman 11. Showing signs of age or worry (5) 7. Spasmodic movement (3) 13. Peruses (5) 12. Unravel England’s tie from this (11) Down 15 16 17 15 & 16. How I assessed henna to identify 13. Learn about what concerns the 1. Sick 2. Role model 3. Venus leprosy (7,7) kidneys (5) 4. Nudge 5. Rout 7. Tuber 18 20. Depart (5) 14. Glow, radiate (5) 8. Midfielder 9. Placard 13. Suir 19 20 21. Subvention (5) 17. Ingredient also called pimento (8) 14. Dessert 16. Shoplifter 23. Spaghetti, for example (5) 18. Dashing, brave (7) 20. Brain stem 21. Cypress 21 22 23 24. Cross associated with Nazis (8) 19. Spiced sausage (6) 22. Earl 27. Niece 29. Aural 25. Scandinavian marauder (6) 22. Name of a book, film etc (5) 30. Kells 31. Wren 32. Anon 26. Hymn about the whitebeam I’d 23. See 10 across 24 25 chopped (5,4,2) 24. Ocean. (3) 27. The first woman in the Bible. (3) The winner of the 26 27 February crossword is: Mary O’Malley Name: The prize will go to the first all correct entry opened. Address: Headford Closing date: Monday, March 21 Galway Post your entry to: Crossword Competition, WIN, MedMedia Publications, 17 Adelaide Street, Dun Laoghaire, Co Dublin UPDATE 67 Zika virus: nurses are first point of care Education and community resilience key in prevention and intervention of virus XXXX As the largest group of health professionals early detection and intervention,” said Dr in the world, nurses play a vital role in Hughes. educating patients on risk and prevention of In May 2015, the first infections of the Zika virus, as well as providing care to Zika virus were confirmed in Brazil and those affected by the virus. since then the virus has spread to over The International Council of Nurses 13 countries in the Americas and in Cape (ICN) has issued a recommendation that Verde, Africa, with cases now confirmed in nurses in infected countries advise patients the US and Europe. to protect themselves against mosquito While the virus is transmitted to people bites through the use of insect repellents, primarily through the bite of an infected bed nets, window and door screens, and by primary healthcare in most countries, it is Aedes species, it can also be spread through covering exposed areas of skin. In addition, important they are aware of the risks of the blood transfusion and sexual contact. any containers, such as flower pots or virus, the ways to prevent its spread, and Unfortunately, there are many cases buckets, that many contain water where when testing and treatment are needed,” in Brazil and other countries in South mosquitoes can breed, should be emptied said Dr Frances Hughes, CEO of the ICN. America, in which a pregnant mother has and removed. “To reduce fear and anxiety, it is passed the virus on to her unborn child. In non-affected countries, the ICN important for communities to have access Al Jazeera reported that the Brazilian advises nurses and midwives to ask to up-to-date and accurate information, Minister of Health has announced that whether their pregnant patients have and nurses are the key vehicle of delivery there are more than 4,000 suspected and recently travelled to infected countries of this information. Nurses are also well 400 confirmed cases of microcephaly and to advise them against travel to those placed to educate and offer psychosocial among newborn babies with many areas. support to reassure the public and build strongly suspected of being caused by the “With nurses providing the majority of community resilience, as well as ensure Zika virus. New education standards to support Mental health nursing and midwifery care research network A research network that aims to The Nursing and Midwifery Board of Ire- enhance the mental health and wellbeing land (NMBI) has launched new standards of people throughout their lifetime has and requirements to support the educa- been launched by Kathleen Lynch, Minis- tion of nurses and midwives in Ireland ter of State at the Department of Health. to help them provide the safest, most ENGAGE (Interdisciplinary Clinical effective care possible to patients. Mental Health Research Network) gen- The two documents, Midwife Reg- erates and disseminates high-quality istration Programme Standards and collaborative research about mental Requirements and Nurse Registration health and is based on principles of Programmes Standards and Requirements, inclusivity, valuing diversity and partner- outline the undergraduate programmes ship across communities and services. that students must complete in order to Speaking at the network launch, Dr become a nurse or midwife in Ireland. the public in its dealings with nurses and Aine Horgan, chair of ENGAGE, said: “The aim of these revised standards and midwives, and to protect the integrity of “The network will provide a mechanism requirements is to support the continuous nursing and midwifery practice through for the accelerated transfer of research enhancement of professional undergrad- high standards of professional education, evidence into practice and a forum uate education programmes in Ireland, training, practice and professional conduct. to influence national research policy. thereby ensuring that new registrants They also incorporate the legislative The initiative is all about collaboration are equipped to meet the challenges to requirements of the Nurses and Midwives WIN and inclusivity and we look forward to provide responsive, high-quality, com- Act 2011, the EU Directive 2013/55/EU
working with service users, commu- passionate and safe patient care,” NMBI concerning the recognition of professional Vol 24 No 2 March 2016 nity bodies and the general public in president Essene Cassidy said. qualifications, as well as building on the addressing how research can be gener- The new standards, which have been recommendations contained in the Report ated, discussed and applied to address developed following a comprehensive of the Review of Undergraduate Nursing the key challenges in society related to review of undergraduate nursing and mid- and Midwifery Degree Programmes and mental health and wellbeing.” wifery education in Ireland, are in keeping other reports into the provision of health- with the NMBI’s responsibilities to protect care in Ireland. UPDATE 69
HPV DNA testing in cervical cancer could Diabetes toolkit improve efficacy of screening process launched for nurses
The Health Information and Quality of the screening process. Authority (HIQA) is to conduct research to HIQA director of health technology determine the optimal primary screening assessment, Dr Máirín Ryan said: “By test for the prevention of cervical cancer examining international evidence on the in Ireland. clinical and cost-effectiveness of HPV At the request of the National Screen- testing and by modelling these benefits, Elaine Newell, community diabetes nurse specialist, is ing Service, HIQA will undertake a health along with the budget impact of switching presented with the Diabetes Toolkit for Practice Nurses by Abina O’Flynn and Gary Hannify from MSD technology assessment to independently to HPV DNA testing for the Irish health- evaluate the clinical, financial, ethical care system, we will be in a position to A new diabetes toolkit resource to and organisational implications of estab- provide independent advice on the opti- support nurses working with patients lishing human papillomavirus (HPV) mal screening strategy for preventing with diabetes is to be presented to every testing as the primary screening test for cervical cancer in Ireland.” practice nurse in Galway. preventing cervical cancer. At present, liq- HPV is a common virus usually spread This toolkit will support practice nurses uid-based cytology is used as the primary by skin-to-skin contact during sexual by providing the vital resources needed screening tool by the National Cervical contact. Most people will have HPV at to monitor high-risk diabetes patients, Screening Programme (CervicalCheck). some point in their lives and in most support their treatment and help them If low grade abnormalities are detected, cases it causes no symptoms and is to effectively manage the condition. It the same sample is tested for HPV DNA cleared by the body’s immune system. contains educational material about to determine if the woman should be However, persistent infection with a diabetes symptoms, treatment and referred for colposcopy or back to routine number of HPV virus types can lead to management of the condition, as well screening. Changing the order of these cervical cancer. as support tools that patients can use tests, that is, using HPV DNA testing as The final results of the health tech- themselves. The toolkit was developed the primary test followed by liquid-based nology assessment are expected at the by community diabetes nurse specialist, cytology, has the potential to improve the end of the year and will be submitted Elaine Newell, in partnership with MSD, detection of cancerous and pre-cancerous to the National Screening Service for Saolta University Health Care Group and cell changes and to increase the efficiency consideration. Galway University Hospitals.
Win a luxurious two-night midweek break away in The Lodge at Ashford Castle
Situated on the outskirts of the charming village of Cong, and just 40 minutes’ from Galway, The Lodge at Ashford Castle is the ideal destination for those seeking a cosy hideaway retreat which is still close to the heart of everything that the region has to explore.
With thanks to The Lodge at Ashford Castle you could win a luxurious two-night midweek break, including accommodation for two people in one of the luxurious rooms at The Lodge with breakfast each morning and dinner one evening in Wilde’s, where Chef Jonathan Keane has a reputation for showcasing the very finest local produce.
For further information on fantastic midweek rates visit www.thelodgeac.com or phone 094 9545400
Terms and Conditions: Prize available to take from Sunday-Thursday only. Prize is subject to availability and non-transferable.
The winner of the February giveaway to the Castleknock Hotel & Country Club is: Helen Gordon, Walkinstown, Dublin 12
To enter send this form to: The Lodge at Ashford Castle, MedMedia Ltd, 17 Adelaide St, Dun Laoghaire, Co Dublin. Closing Date: March 21, 2016. Winner will be announced in next issue. Name: Phone no: Address: € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € €€ € € € € € € € € € € € € € € € FINANCE 71 € € € € € € € € € € € € € € € € € € € N € € €M € E€Y €Is €your€ €home€ € € € € € € € € € € € € € covered?€ € € € € € € € € € € € € € € € € € € € € € € € € € € € € € € Marc Evans offers some tips on how to ensure € €MATTERS€ € € you€ have adequate€ cover€ for your€ home € € € € € € € € €
FOR most people their home is their most Checklist of benefits valuable asset. Therefore it is important 3 Accidental damage 3 Alarm discount 3 Contents in transit to ensure you have the right home insur- 3 Loss of oil 3 Smoke alarm discount 3 Public liability ance cover. When you are looking for 3 Home Rescue 3 Christmas gifts 3 Unoccupancy period home insurance you should always discuss 3 Freezer contents 3 Wedding gifts 3 Unspecified all risks cover the level of cover and the benefits of the 3 Fire brigade cover 3 Alternative accommodation 3 Policy excess policy. The following tips will help you to 3 Door locks 3 Personal money 3 Satellite aerials ask the right questions and get the best value when shopping around for home under home insurance it is important to How can I get the best price? insurance. make sure you have a checklist of bene- When deciding on home insurance you How much should I insure my home for? fits that you should look for on any home should ensure: When it comes to insuring your home insurance policy (see Table). • The amount your buildings are insured for it’s important to know what the word Check for extra services is correct and not over or under insured ‘home’ refers to. The home includes Some insurance policies offer extra • Your contents are insured for the right domestic outbuildings, garages, green- services. For example, Cornmarket home amount houses, sanitary fixtures, swimming pools, insurance policies include Home Rescue,* • That valuable items such as engagement tennis courts, patios, terraces, driveways, which provides an emergency repair ser- rings are covered footpaths, walls, gates, hedges, fences, vice to secure your home and prevent • That you ask about the excess amount, aerials, satellite dishes and their fittings further loss or damage occurring following it’s important to know if you do claim and masts, including landlord’s fixtures an emergency, as a result of the following: how much you have to pay and fittings, all on the same site. This may • Damage to piping, leaks from sanitary • That you tell the insurance company seem complicated but you need to think fixtures/fittings and fixed water installa- if you have been claims free for more of more than just the house itself. tions within your home than three years as this may reduce your It is also important to remember it is • Failure of the electrical supply within premium. not the selling value you should insure your home as a result of a fault or dam- Marc Evans, Director, Cornmarket Group Financial your home for. It is the value it would cost age to the internal electrical installations Services Ltd to rebuild it should the need arise. To get • Your home being made insecure or if an up-to-date valuation on the rebuild- entry is impeded, due to loss/theft of Cornmarket currently has an offer where you can avail of three months’ free** when you buy a new home ing costs of your property, there is an keys or damage to locks, as a result of insurance policy (subject to a minimum premium of easy to use calculator to guide you on the theft or any other accidental cause, or in €334.52). This offer runs until March 31, 2016. For more Chartered Surveyors of Ireland website at the event that a child may have locked information, Tel: 01 408 6202 www.scsi.ie themselves in a room *Cover provided by Mapfre Assistance. Mapfre Asistencia Compania de Seguros y Reaseguros SA trading as Mapfre How much should I insure contents for? • Storm damage or any other accidental Assistance Agency Ireland and Mapfre Warranty is When it comes to insuring the contents damage to the roof that renders your regulated by the Direccion General de Seguros y Fondos de of your home, valuations can vary, as home insecure Pensiones del Ministerio de Economia y Hacienda, Spain, and is subject to the Central Bank of Ireland’s conduct everyone is different. Contents are defined • Breakage of glazing to external win- of business rules. Mapfre Assistance Agency Ireland is as all property including business equip- dows or doors that renders your home registered in Republic of Ireland. Reg No 903874 ment, valuables, clothing, personal effects unsecured. **Three months’ free insurance in year one is based on a 25% discount off the normal year one Allianz premium and and money in your home or its domes- This benefit allows you to get to the is only available to new customers taking out a new home WIN tic outbuildings, garages or greenhouses source of the problem quickly any time, insurance policy through Cornmarket and underwritten by
owned by any member of your household day or night. As this service is an added Allianz. Any applicable discounts are applied at quotation Vol 24 No 2 March 2016 or for which they are responsible. An easy benefit, it won’t register as a claim against stage, we are unable to issue discounts retrospectively. Allianz Plc is regulated by the Central Bank of Ireland way to look at it is all items which you your home insurance policy. Cornmarket Group Financial Services Ltd. is regulated would take from your home if you were to What if I need to make a claim? by the Central Bank of Ireland. Cornmarket is part of move house. If you need to make a claim you can do the Great-West Lifeco group of companies, one of the world’s leading life assurance organisations. Telephone What are the essential benefits? so by calling the claims number found in calls may be recorded for quality control and training With so many different levels of cover your insurance underwriter policy booklet. purposes 72 DIARY
Thursday 21 March Retired Nurses and Midwives Library Opening Hours Section meeting. INMO HQ. Saturday 5 From 11am. Contact jean.carroll@ INMO International Nurses inmo.ie or Tel: 01 6640648 for Section Conference and Culturefest. further details INMO HQ, Dublin. Registration March For further information on the library at 8.30am. Contact jean.carroll@ Saturday 23 Monday-Thursday: and its services, please contact: GP Practice Section meeting. INMO inmo.ie or Tel: 01 6640648 for 8.30am-5pm HQ. From 11am. Fitness to practise Tel: 01-6640-625/614 further details Friday: session. Contact jean.carroll@ Fax: 01-01 661 0466 8.30am-4.30pm Monday 7 inmo.ie or Tel: 01 6640648 for Email: [email protected] Emergency Department further details Section meeting. All interested members welcome to attend this meeting. INMO HQ. 12pm-2pm. May Contact [email protected] or Tel: 01 6640648 for further details Wednesday 11 OHN Annual conference. INMO Membership Fees 2015 Maryborough Hotel, Douglas, Cork. April Contact [email protected] or A Registered nurse €299 Tel: 01 6640648 for further details (Including temporary nurses in prolonged Monday 4 employment) National Children’s Nurses Notice B Short-time/Relief €228 Section meeting. INMO HQ. 11am. This fee applies only to nurses who provide Contact [email protected] or v Annette Halton is calling Tel: 01 6640648 for further details on all former staff of very short term Mercer’s Hospital to form a relief duties (ie. holiday or sick duty relief) Saturday 9 committee so as to make a PHN Section meeting. INMO HQ. reunion a success. C Private nursing homes €228 11am-1pm. Contact jean.carroll@ D Affiliate members €116 inmo.ie or Tel: 01 6640648 for v Contact Ms Halton Doyle further details at Tel: 087 8137402 or Working (employed in universities & IT email: annettehalton@ institutes) Saturday 9 eircom.net or Margaret CRGN Section meeting. INMO HQ. Hynes nee Lowery, Tel: E Associate members €75 11am-1pm. Contact jean.carroll@ 087 2055742, email: Not working inmo.ie or Tel: 01 6640648 for [email protected] F Retired associate members €25 further details G Student nurse members No Fee Saturday 9 Clinical Nurse/Midwife Managers EORNA 2017 Section meeting. INMO HQ. From v The eight Congress of the 10am. Contact jean.carroll@ Events and conferences European Operating Room inmo.ie or Tel: 01 6640648 for Nurses Association (EORNA) v Irish Nurses and Midwives Golf society annual outing. Mullingar Golf further details will be held in Rhodes Island, Club. €50. Coffee/tea on arrival, golf and dinner. Booking from March Greece from May 4-7, 2017. 28 on BRS at mullingargolfclub.com. Booking will only be confirmed Tuesday 12 on receipt of payment within five days, to Kay Browne, treasurer at Telephone Triage Section meeting. v Submissions for abstracts is Mullingar Golf Club, Belvedere Mullingar. For queries, contact Kay Heritage Hotel, Portlaoise. now open online. The theme Browne at Tel: 086 826932 Preparing for HIQA inspections. for the Congress is ‘The v T he eighth Child and Family Nursing Conference will be held on From 11am. Contact jean.carroll@ Colossus of Perioperative Tuesday, April 12, 2016 in Cork University Hospital. Email: Bebhinn. inmo.ie or Tel: 01 6640648 for Nursing’ further details [email protected] for more information v A bstracts that address v T he eighth Sonas APC International Dementia Conference will be Thursday 14 the latest clinical practice, held in the Citywest Hotel, Dublin on March 16 and 17, 2016. Contact Assistant Directors Section education and innovation, [email protected] meeting. INMO HQ. 11am-1pm. research/evidence based Contact [email protected] or practice, leadership and Tel: 01 6640648 for further details management, informatics, healthy workplaces, risk Condolences Friday 15 and Saturday 16 management and service v T he INMO Limerick Branch extends their deepest sympathies to ODN Section Conference. Clarion development issues or any Ailish Bredin, senior staff nurse at Brothers of Charity Brawnmore, Hotel, Liffey Valley, Dublin. Please other latest trends and on the recent death of her mother Margaret Roche. RIP log on to www.inmoprofessional. developments relevant to ie to book your place or contact perioperative nursing are v Sinc ere condolences to Eileen Selby, from all her INMO colleagues, [email protected] or Tel: welcome for education on the recent death of her sister Rita Flynn. May she rest in peace 01 6640648 for further details session proposal or for poster v T he ODN Section offer their deepest sympathies to their former presentation. colleague Mona Guickian-Fisher on the recent loss of her husband, Saturday 16 v Useful information on abstract Phil Fisher. RIP School Nurses Section meeting. submission, registration, v Portlaoise Heritage Hotel. From The INMO Retired Nurses Section would like to extend their as well as accommodation 11am. Contact jean.carroll@ condolences to Louise Mahon, whose son Jamie who lived in Vol 24 No 2 March 2016 No 2 March 24 Vol options is now available on inmo.ie or Tel: 01 6640648 for Melbourne, Australia with his wife and sons, passed away on www.eornacongress.eu January 17, 2016. May he rest in peace
WIN further details