Annual Report 2006

Irish Nurses Organisation Irish Nurses Organisation Annual Report 2006 Contents

Notice of Meeting 3 – Distance Learning Courses – National Report President’s Foreword 4 – Response to National Strategy – European Report – International Report Executive Council 2006/2008 6

Online and Information Technology 46 Introduction 7 – Library – Branch Officers/Section Officers/Nurse – Online and Information Technology Update Representatives – Nurse2Nurse (N2N) website – Organisational Developments – Information Office – Special Delegate Conference – Executive Council – Major Policy Issues National Section Reports 50 – Minister for Health and Children – Overview – Department of Health and Children – Accident and Emergency Section – Nurses and Midwives Legislation – Assistant Directors of Nursing/Public Health – Health Service Executive Nursing/Night Superintendents Section – Appointment of Director of Nursing and Midwifery – Care of the Older Person Section Services – Clinical Nurse/Midwife Manager Section – An Bord Altranais – Directors of Nursing/Midwifery/Public Health – National Council for the Professional Development Nursing Section of Nursing and Midwifery – Midwives Section – Irish Congress of Trade Unions (ICTU) – Nurse and Midwifery Education Section – International Nurses’ Day – Occupational Health Nurses Section – International Midwives’ Day – Operating Department Nurses Section – Staffing – Orthopaedic Nurses Section – Overseas Nurses Section – Practice Nurse Section Industrial Relations Review 14 – Public Health Nurse Section – Pay and Hours of Work Campaign – Rehabilitation Nurses Section – Accident and Emergency Overcrowding – Retired Nurses and Midwives Section – Health Service Reform – RNID Section – Non Implementation of Agreements – Student Nurses Section – Health Act 2004 - Repeal of Disciplinary Measures – Surgical and Medical Day Care Section – Other National Claims – Telephone Triage Nurses Section – Nurse Representative Training – Summary – A Campaigning Year – Regional Round Up – Industrial Relations Officers Press and Media 60

Affiliations 65 Organisation and Social Policy 34 – Social Policy Committee – Report on migrant women workers For the Record 66 – Intercultural and Interfaith Resources – Benevolent Fund – Recruitment and Retention of Foreign Nurses – Educational Loan Fund – Leadership Initiatives for Females in Trade Unions – Irish Nurses Rest Association (LIFT) – Publications – Women’s Health Strategy – Government Departments/Other Bodies – ICTU Strategic Implementation Committee for – Press and Media Equality Initiatives – Honorary Officers – Workplace Disclosure/Whistleblowing – INO Staff – Meeting with the Filipino Ambassador – Conferences – Fitness to Practice Appendices 68 I Branch Officers – Currently in Office II Section Officers – Currently in Office Professional Development Centre 37 III INO Secretariat – 2006 – Overview IV Salary Scales Applicable from 1 December 2006 – Workshops 2006 and Statistics V INO Private Nurses Fees – Conferences VI Subsistence Rates

2 Irish Nurses Organisation Annual Report 2006 Notice of Meeting

Notice is hereby given that the 88th Annual Delegate Conference of the Irish Nurses Organisation will be held on Wednesday,Thursday and Friday 9, 10 and 11 May 2007, in the Gleneagle/Brehon Hotel, Killarney, Co Kerry. Wednesday, 9 May: 4.00pm to 6.30pm (private session) 1 Registration 2 Ecumenical Service 3 Invocation 4 Branch Roll Call 5 Appointment of Tellers 6 Adoption of Standing Orders and Standing Orders Committee Report No. 1 7 Minutes of Annual Delegate Conference 2006 8 Minutes of Special Delegate Conference 2006 9 Adoption of Annual Report 2006, incorporating reports from the Deputy General Secretary and Directors 10 Adoption of Accounts for period 1 January 2006 to 31 December 2006 11 Adoption of Budget 1 January 2008 to 31 December 2008 (to be taken with Motion No. 1 - Organisational) 12 Appointment of Auditors 13 Adoption of Draft Rule Book 14 Debate on Motions Group 1 Organisational. Thursday, 10 May: 9.00am to 6.00pm 15 Roll Call 16 Adoption of Standing Orders Committee Report No. 2 17 Debate on Motions: Professional; Industrial; Social Policy; Educational 18 Address by Political Party Leaders/Spokespersons – Position of Political Parties on the INO’s Pay and Working Hours Campaign 19 Debate on motions continued 20 Presentation of Awards 21 Debate on motions continued. Friday, 11 May: 9.00am to 4.45pm 22 Debate on motions continued 23 Address by Minister for Health and Children, Mary Harney TD 24 Presidential Address by Madeline Spiers, RGN 25 Formal closure of Conference.

Liam Doran General Secretary

Special events during Annual Delegate Conference 2007 • Address by political leaders regarding position of political parties on the INO’s pay and working hours campaign – Thursday, 10 May from 11.00am • Trade Exhibition on Thursday afternoon and Friday, 10 and 11 May • Presentation of awards – Thursday, 10 May, 3.30pm • Address by Mary Harney TD, Minister for Health and Children at 3.00pm on Friday, 11 May; followed by • Presidential Address by Madeline Spiers, RGN • Gala Dinner on Friday, 11 May at 7.30pm for 8.00pm

3 Irish Nurses Organisation Annual Report 2006 President’s Foreword

It gives me great pleasure to present The club culture of collegiality is not acceptable in a the Annual Report of the Irish Nurses health service where the patient is the focus of care. As Organisation for 2006. Another year I have stated before, the INO may often be the only has passed, as we continue to forge platform where nurses and midwives have an ahead with our call for recognition, opportunity to speak out on issues that concern them respect and reward. We stand and I am happy that you do so. The ongoing challenge together at this critical time in for us is to continue to ensure we recognise and support of our professions, our address your issues and concerns. patients and our public health I would like to thank Sheila Dickson, first Vice- service. This year has caused many President for her hard work and acknowledge the of us to reflect and question the Madeline Spiers commitment of Jo Tully our second Vice-President. ongoing direction of the health The Executive Council has also worked extremely hard service as it lurches from one during 2006, promoting the interests of scandal to another. Our central concern continues to nurses/midwives and patient care. I would like to be the patients we care for. They deserve a safe record my appreciation of their patience, leadership, environment and safe staffing, and we continue to conviction, and insight. The networking and local highlight the priorities required to give safe care and engagement that Executive members do, informs the safe practice. crucial decisions made at Council. This Council has However, dominating this past year is our fair and just worked hard with local representatives to lobby call for equality of pay and conditions with other effectively all local politicians about our legitimate therapeutic health grades. That long journey to bring claims. these claims to reality began over 26 years ago when The Irish Nurses Organisation continues to be greatly the Labour Court recommended that nurses and indebted to Liam Doran, our General Secretary, for his midwives should be the first to benefit from a leadership, insight and conviction. His political acuity reduction in the working week. In the intervening time and integrity informs our agenda, encouraging nurses we have exhausted every procedure to deliver these and midwives to step up to the plate and raise their much needed reforms, that values, rewards, and collective voices to acknowledge their real value in our respects our work. health service. I would like to put on record my It is, and continues to be, a struggle against the tide of appreciation of Dave Hughes, our Deputy General many vested interests. We can only depend on each Secretary, his knowledge and incisive approach to other as nurses and midwives, as we share a vision of industrial relations has our respect and confidence. He a valued and enabled workforce, highly skilled, highly makes us feel as intelligent, as he obviously is, on paid and highly motivated, each of us working to the matters relating to industrial issues. best of our potential in a safe and caring environment. Annette Kennedy, as Director of Professional To deliver that landscape we must have courage and Development and as President of the European belief in each other. We have, I believe, moved with Federation of Nurses has delivered an enhanced role confidence from silence to voice over the last year. for nurses and midwives both at national and There are very few politicians unaware of our claims, international level, across the legal, political, social and our intention to reflect that awareness of their and education spectrum, much of which will resonate position at the next election, is a clear and in health for years to come. Her report is unambiguous message. That is our strength. We know comprehensive and enclosed within this document. we can influence the outcome of the next government, This introduction cannot do justice to the full remit of as is our democratic right. the work of the professional development team. I wish to acknowledge the hard work and commitment of May I continue by thanking you all for your active Clare Treacy, Director of Organisation and Social support, dedication and conviction to our aspirations. Policy, who continues to deliver in the area of fitness It is rewarding and challenging to be President at this to practice. Furthermore, I would like to commend all time. Nursing and midwifery is moving rapidly into the industrial relations officers, and the entire new challenges and opportunities. The potential to Organisation’s staff, for their good humour, dedication, embrace new skills, such as drug prescribing, and commitment and hard work. create research opportunities, enhance our roles and forge new clinical pathways is to be welcomed and We have had the privilege of working with the PNA on encouraged. This year has exposed deep flaws in the this campaign. That strong professional relationship health system’s ability to monitor and truthfully has contributed to the strength and effectiveness of analyse outcomes for patient care. Reports such as our campaign and I would like to put on record my Leas Cross and the Lourdes Inquiry reaffirm our regard for the PNA leadership and support at this time. responsibility to really live up to the advocacy aspect The health service reforms have still not delivered the of our professional remit and challenge the current quality or quantum of service which we had hoped. organisational culture of silence. The rolling out of new structures, incorporating a new

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vision, remains a lost opportunity to change for the section meetings and communities. That invaluable better the healthcare landscape. However, the dialogue gives truth and reality to the lived experience appointment of Dr Siobhan O’Halloran was an of everyday life for nurses and midwives. Unless I see important achievement, though much more remains your place of work through your eyes, I cannot do you to be done. The structures are still in flux. The or your experience justice. So I appreciate your time continuing challenge to the INO is to create clear lines and consideration. This is your Organisation and it will of communication between those who do the work be sustained and focused by your support and vision. and those who administer the system. I wish to thank all branch officers, section officers, and The Health Service Executive has not effectively nurse representatives for their continued involvement managed the clearly identified problems in the health and hard work on behalf of their colleagues and system. So we continue to have too few acute hospital communities. If there is anything I have learned, it is to beds, inadequate community services, uncontrolled talk to each other, be knowledgeable, and stand nursing workloads, and high MRSA rates of infection, together. The INO is only as effective as the members which will only be reduced when we address the who actively get out there and support the issues. That endemic levels of overcrowding within our public determination, courage, and commitment is crucial to health service. this and any other campaign we wish to deliver on. Despite initiatives, we continue to experience severe Finally, may I extend my sympathies to the family and problems in A&E around the country. Poor workforce friends of members of the Organisation who died in planning and employing staff ceilings are blunt the past year. I would also like to extend my instruments to control costs which impact on front line sympathies to any staff and their families who may staff. However the Organisation welcomes the new have suffered bereavement during 2006. legislation to introduce nurse prescribing as a I now commend this annual report to you, which milestone to empowering a new departure for both the reflects another very challenging and busy year for the health service and the enhanced potential of nursing Irish Nurses Organisation. and midwifery practice. I must acknowledge the Minister for Health and Children in driving through this critical piece of enabling legislation, which we have worked towards for many years. This legislation will unlock real opportunities in areas such as diagnosis, prescribing and clinical autonomy and I am confident that further legislation in a new Nurses and Midwives Act, will be achieved in 2007. I would like to this opportunity to thank you all for taking the time to meet me in your hospitals, branches,

5 Irish Nurses Organisation Annual Report 2006 Executive Council 2006/2008

The Executive Council of the INO along with several staff members,from back left: Teresa Hayes; Clare Lynch; Mary Walsh; Eileen Mullane; Mary Forde; Joan McDermott; Raymond Boyle; Derek Reilly; Regina Durcan; Mary Connor; Marie Gilligan; Ann McGowan; Dorothy Mullarkey; Catherine Doyle; Collette Lynskey; Mary Cotter; and from front left to right: Alan O'Riordan; Edel Peoples; Liam Doran,Madeline Spiers; Sheila Dickson; Jo Tully; Ann Martin and Ethel Leonard.

Office Bearers President: Madeline Spiers Senior Staff Nurse, Theatre, St Columcille’s Hospital, Loughlinstown 1st Vice-President: Sheila Dickson Staff Nurse, St Columbanus Home, Killarney 2nd Vice-President: Jo Tully Staff Nurse, St James’s Hospital, Dublin Clinical (16 seats) Raymond Boyle CNM2 (CPC) Cavan General Hospital Catherine Doyle CNM2 (CNS) St Vincent’s Centre, Lisnagry Regina Durcan CNS (Occupational Health) Mayo General Hospital Mary Forde CNM2 Cork University Hospital T eresa Hayes CNM2 Adelaide & Meath Hospital, Tallaght Joe Hoolan* Staff Nurse Midland Regional Hospital, Portlaoise Collet te Lynskey Staff Nurse University College Hospital, Galway Ann Martin CNM1 University College Hospital, Galway Anne McGowan CNS Sligo General Hospital Alan O’Riordan Staff Nurse (A&E) Adelaide & Meath Hospital, Tallaght Edel Peoples Acting CNM2 Letterkenny General Hospital Derek Reilly CMN2 Naas General Hospital Mary Walsh Staff Nurse Sligo General Hospital *Eileen Mullane Staff Nurse St Ita’s Hospital, Newcastlewest *Elected under rule following resignation of Joe Hoolan

Administration (3 seats) Marie Gilligan Nurse Practice Development Cregg House, Sligo Co-Ordinator (ADoN) Ethel Leonard CNM3 Portiuncula Hospital, Ballinasloe Joan McDermott Director of Nursing D’Alton Community Nursing Unit, Claremorris Education (2 seats) Mary Connor Nurse Tutor Centre for Nurse Education, Galway Mary Cotter Acting Principal Tutor/ Adelaide & Meath Hospital, Tallaght Specialist Co-Ordinator Student (1 reserved seat) Clare Lynch Student Nurse DCU Glasnevin

6 Irish Nurses Organisation Annual Report 2006 Introduction This is the 87th Annual Report for Organisational Developments the Irish Nurses Organisation, and it summarises the continuing activities, initiatives and successes, 87th Annual Delegate Conference of the Organisation, during 2006. The Organisation held its 87th Annual Delegate It was a year when the Irish Nurses Conference in the Slieve Russell Hotel, Ballyconnell, Organisation was, once again, the Co Cavan, on 3, 4 and 5 May 2006. most visible, and easily The Conference, which was attended by over 340 recognisable, trade union in this delegates and, on occasion, 100 observers, was again country due to our advocacy on packed with debate, and discussion, on the motions Liam Doran, behalf of patients and members General Secretary,INO submitted by our 41 branches and 24 sections. alike. In particular this year’s Annual Conference covered the This annual report, which will act as a historical record following: of the Organisation’s activities, readily chronicles the continuing efforts, commitment, professionalism and Address by Minister of State for Health and resolve of our members, activists and staff on a range Children of individual, group, regional and national issues. In the absence of the Minister for Health and Children, It is my pleasure to once again begin this report by Mary Harney TD, the Conference was addressed by the recording the continuing growth of the Organisation Minister of State for Health and Children, with special during 2006. At the end of the year it should be noted responsibility for children, Brian Lenihan TD. that our membership had reached almost 37,000 representing a 12% increase during the past 12 In his speech the Minister gave an unequivocal months. commitment that before the 2007 Annual Delegate Conference nurses and midwives would have the This is yet another historical high for the Organisation, power to prescribe drugs under legislation which and is absolute and conclusive proof that we are now would be passed shortly. His address also covered the voice of nurses and midwives, on all professional, such areas as acute hospital bed numbers, A&E educational, developmental and industrial relations overcrowding, nurse and midwifery education and he issues, in this country. touched on the issue of industrial relations and the This significant growth brings with it demand and Organisation’s priority claims. expectation which requires the Organisation to This was the first time, in over 30 years, that a serving continue to listen to members and develop services Minister for Health and Children had not attended the which meet their needs and requirements. INO Annual Delegate Conference. I implore you to always voice your views, directly to us, so that we can continue to develop, and evolve, Presidential Address services, energies and resources to the areas most Madeline Spiers, in her second address to Conference required by our members in their respective as the Organisation’s President, when replying to the workplaces. address from the Minister of State, gave a I now ask you to read and study this annual report, and comprehensive address touching on a range of issues to reflect upon the many and varied activities of your from A&E overcrowding, to patient advocacy, nurse Organisation. patient ratios and the industrial relations issues facing the Organisation. Branch Officers/Section Officers/ In particular Ms Spiers, as President, pointedly referred to the absence of the Minister for Health and Nurse Representatives Children stating that there was no point in the Minister It is only appropriate that I begin by recognising the blaming the Organisation for telling the truth about the continued loyalty, dedication and activity of our branch failings, and failures, of the health service to meet the and section officers, and nurse representatives, who needs of patients and staff. work, so tirelessly, on behalf of the entire She concluded by restating the Organisation’s Organisation. determination to continue as an advocate of patients On behalf of the Executive Council, and all of the staff, and its members. I want to place on record our deep and sincere appreciation for all of the invaluable and priceless Keynote Address work done by these key activists. Professor Allyson Pollock, from the School of Health in I salute your knowledge, professionalism and Social Sciences at the University of Edinburgh and the achievements and call upon you to remain active and School of Public Policy, University College London, committed as we go forward in 2007. gave a keynote address entitled Health Service

7 Irish Nurses Organisation Annual Report 2006

Systems – Privatisation. In her address Professor INO/CJ Coleman Research Award Pollock argued that the INO should resist, with every initiative possible, the creeping privatisation of the This award was won jointly by Ann Flood and Ann Irish healthcare system. She argued the point using McHugh for their paper Research on Care in Rape and the experience of the United Kingdom, and other Sexual Assault. jurisdictions, where creeping inequity was a source of The award was presented jointly by Madeline Spiers, growing unrest and disempowerment to those who INO President, and Nancy Layton-Cook, from CJ could not afford to pay for the highest quality of Coleman and Company Limited, London. healthcare.

Motions Special Delegate Conference – The Conference also debated over 70 motions, 1 September 2006 submitted by branches/sections and the Executive The Organisation also held a Special Delegate Council, and these gave direction to the Organisation’s Conference, for the second year running, in Croke agenda for the remainder of 2006. Park, Dublin, on Friday, 1 September 2006. In particular the Conference debated an emergency The Conference reviewed progress on our pay and motion, with regard to the priority pay issues, and the working hours campaign in the light of the still awaited text, debate and processing to this motion is covered Labour Court recommendation and the pending ICTU extensively in the industrial relations review later in Special Delegate Conference to decide on the new this annual report. social partnership programme entitled Towards 2016. The Conference agenda also included presentation of The proceedings and decision of this Special Delegate the following awards: Conference are again recorded, at length, under the industrial relations review part of this annual report. Gobnait O’Connell Award for Outstanding Service Nora Donagh, from the Naas Branch, was the recipient Executive Council of the 6th Gobnait O’Connell Award which is presented The Executive Council of the Organisation, in annually, for outstanding service, by an activist to the compliance with rule, held 11 ordinary meetings Organisation. during 2006. The award, which is presented in memory of our deceased former industrial relations officer and Outgoing Executive Council ministerial advisor, Gobnait O’Connell, was given to The outgoing Executive Council, which governed the Nora in recognition of her years of commitment, Organisation for the period 2004 to 2006, met, for the interest and positive activity and success, on behalf of final time, on 4 May 2006, to finalise the proceedings the Organisation, for the Naas and other branches, in for the imminent Annual Delegate Conference. the Kildare region. On behalf of the staff of the Organisation, I would like to express my deep appreciation for all of the work and effort of the outgoing Executive Council whose term expired at the close of the Annual Delegate Conference in May 2006.

Incoming Executive Council Following the nationwide ballot, as provided for in rule, the following members were elected to the incoming Executive Council and will serve office for the period May 2006 to May 2008:

Clinical Category • Raymond Boyle, CNM2 (CPC), Practice Development Unit, Cavan General Hospital • Sheila Dickson, Staff Nurse, St. Columbanus Home, Killarney, Co Kerry • Catherine Doyle, CNM2 (CNS), Daughters of Charity, Gobnait O’Connell award winner Nora Donagh St Vincent’s Centre, Lisnagry, Limerick

8 Irish Nurses Organisation Annual Report 2006

• Regina Durcan, CNS (Occupational Health), Mayo General Hospital, Castlebar, Co Mayo

• M ary Forde, CNM2 (A&E), Cork University Hospital

• Teresa Hayes, CNM2, Adelaide & Meath Hospital, Tallaght, Dublin 24

• Joseph Hoolan, Staff Nurse (A&E), Midland Regional Hospital, Portlaoise, Co Laois

• C ollette Lynskey, Staff Nurse, University College Hospital, Galway

• Ann Martin, CMM1, University College Hospital, Galway

• Ann McGowan, CNS (Cardiac Rehabilitation), Sligo Following their election at the INO ADC were: INO president,Madeline Spiers General Hospital (centre),with first vice-president,Sheila Dickson (left) and second vice-president, Jo Tully • Alan O’Riordan, Staff Nurse (A&E), Adelaide & Meath Hospital, Tallaght, Dublin 24 President • Edel Peoples, Acting CNM2, Letterkenny General Madeleine Spiers, Staff Nurse, Theatre, St Columcille’s Hospital, Co Donegal Hospital, Loughlinstown, was re-elected as President • Derek Reilly, CNM2, Naas General Hospital, Co of the Organisation for the period 2006 to 2008. Kildare First Vice-President/Treasurer • Madeline Spiers, Staff Nurse (Theatre), St Sheila Dickson, Staff Nurse, St Columbanus Home, Columcille’s Hospital, Loughlinstown, Co Dublin Killarney, Co Kerry, was elected to the office of first • Jo Tully, Staff Nurse (Theatre), St James’s Hospital, Vice-President/Treasurer. Dublin 8 Second Vice-President • Mary Walsh, Staff Nurse (Theatre), Sligo General Josephine Tully, Staff Nurse, St James’s Hospital, Hospital Dublin 8, was elected to the office of second Vice- Administration Category President. • Marie Gilligan, Nurse Practice Development Co- Finance and General Purposes Committee Ordinator, Cregg House, Sligo This committee, which is required under rule, was • Ethel Leonard, CNM3, Portiuncula Hospital, Co chaired by the President, Madeline Spiers, and met on Galway 11 occasions. It has six other members including the two Vice-Presidents. • Joan McDermott, Director of Nursing, D’Alton Community Nursing, Claremorris, Co Mayo Industrial Committee Education Category The outgoing industrial committee was chaired by Margo Flavin. Following the election of a new • Mary Connor, Centre for Nurse Education, Galway Executive Council, this committee was chaired by • Mary Cotter, Acting Principal Teacher/Specialist Co- Sheila Dickson, 1st Vice-President, and worked under Ordinator, School of Nursing, Adelaide & Meath the guidance of David Hughes, INO Deputy General Hospital, Tallaght, Dublin 24 Secretary. During the year this committee constantly monitored Student Reserve Seat and discussed strategy with regard to the following: • Clare Lynch, Student Nurse, Dublin City University, • The pay and working hours campaign Glasnevin, Dublin 9 • A&E overcrowding Election of Officers • Motions forwarded to it by Annual Conference Following a ballot of delegates at the 2006 Annual • Monitoring, assessing and determining the Delegate Conference the following officers were Organisation’s stance on all other IR issues including elected: various grading and other claims.

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• The need for corporate level involvement, of senior nursing/midwifery management, in the form of a directorate • The reporting relationship of the director of nursing/ midwifery • The future role and configuration of the nursing and midwifery planning and development units.

European Working Time Directive The Executive also heard monthly reports on the progress of initiatives, in the nine pilot sites (detailed in the 2005 annual report) where work to secure At the ADC 2006 Madeline Spiers,president,INO greets Brian Lenihan,Minister of compliance with the European Working Time Directive State at the Department of Health.Also pictured is Dave Hughes,deputy general was underway. secretary,INO In particular the Council focused its attention on ensuring that any, and all, initiatives agreed in the Nursing and Midwifery Education and relevant fora, had the potential to enhance and expand Practice Committee the role of all nurses and midwives thus allowing non- consultant hospital doctors (NCHDs) comply with the Chaired initially by Ann Martin, first Vice-President, 48 hour rule. and latterly by Jo Tully, working under the guidance of Annette Kennedy, Director of Professional Development, the work of the nursing and midwifery Midwifery and Children’s Nursing – education and practice committee, is detailed in full Undergraduate Degree Programme within the report from Annette Kennedy later in this The Executive Council, throughout 2006, also report. However, in summary, the committee had a monitored the discussions, involving the Organisation, very heavy workload with a particular focus upon the leading to the commencement of undergraduate pending legislation on drug prescribing, for nurses degree programmes in midwifery and children’s/ and midwives, changes in nurse/midwifery education general nursing which finally commenced in and the integration of trained healthcare assistants. September 2006. Social Policy Committee At its meeting in September 2006 the Executive Council warmly welcomed these two initiatives which Co-chaired initially by Sheila Dickson and Raymond effectively now provide for undergraduate degree Boyle, and under the guidance of Clare Treacy, Director entry into all disciplines of nursing and the profession of Organisation and Social Policy, the work of the of midwifery in this country. social policy committee is detailed elsewhere in this report. A&E Overcrowding – Enough is Enough The committee again focused on wider social and Campaign socio-economic issues, outside of the direct world of nursing and midwifery, on which, in the view of the The Executive Council continued to devote much time Executive Council, there was a need to adopt policies, and effort to the Enough is Enough campaign aimed at make submissions and/or engage with other parties. highlighting the continuing pressures on patients, and staff, in many of the country’s overcrowded A&E departments. Major Policy Issues In particular the Executive Council found it necessary In addition to the work of the committees the to highlight, in April 2006, the fact that almost 500 Executive Council, reflecting upon the decisions of patients were on trolleys, nationwide, in the second Annual Conference and developments nationally, was week of that month. also very actively involved in the following: In response the Minister for Health and Children declared A&E overcrowding a ‘national emergency’ Health Service Reform and appointed a dedicated task force to address the issues. The Executive Council devoted a period, at each of its monthly meetings, to address the continuing issue of The Organisation jointly chaired, through its Deputy the health service reform and the role of nursing and General Secretary Dave Hughes, an A&E Forum with midwifery, at senior management level, within the the Health Service Executive, which met on a monthly Health Service Executive. In particular the Council basis to monitor the situation. In the final quarter of focused upon: 2006 the level of overcrowding began to reduce but

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the situation, at the end of the year, continued to be monitored closely by the Executive Council.

Minister for Health and Children Mary Harney TD, continued as Minister for Health and Children, during 2006. The Organisation noted, with great disappointment, her decision not to attend our Annual Delegate Conference in May, and her absence is referred to earlier in this report. However Ms Harney continued to meet on other occasions with the Organisation, both formally and informally, during the year with much attention focusing on: Pictured were (l-r): Liam Doran,general secretary INO; Martin McDonald,national • The required legislation to provide for drug director of HR,HSE; Madeline Spiers,president,INO; and Prof Brendan Drumm,HSE prescribing for nurses and midwives chief

• The continuing difficulties created by A&E Statutory Instrument, which then must be sent to overcrowding Brussels for three months, was being finalised and it • The development in nurse and midwifery education. did incorporate the majority of the requirements sought by the Organisation. Pending finalisation of the necessary legislation it is Department of Health and agreed that an implementation committee will be Children established on which the Organisation will be represented. This committee will be charged with the During 2006 the Organisation continued to have task of agreeing the education, service and other regular, and ongoing, contact with many officials, and initiatives which will be required to ensure that drug divisions, of the Department of Health and Children. prescribing becomes a reality, before the end of 2007, Arising from the reform programme a significant for an initial cohort of registered nurses and midwives. number of changes were taking place, with regard to the role of the nursing and midwifery policy units, in the department, and these were still being worked Health Service Executive through throughout the year under review. During 2006, the Organisation continued to develop, During 2006 the Organisation had particular contact and strengthen, its links with senior management in with the department with regard to the legislation to the new Health Service Executive. provide for drug prescribing for nurses and midwives. During the year Professor Brendan Drumm met with the Executive Council on two separate occasions, in order to have an open and frank exchange of views Nurses and Midwives with regard to the reform agenda and how it was being Legislation rolled out across the system. The Organisation was again very disappointed to see During these exchanges the Organisation pointed out that the government, during 2006, did not publish a its growing frustration with the lack of progress on real new Nurses and Midwives Bill despite many reform, at the point where the service meets the commitments to do so. This legislation, which was patient or client, and the continuing disempowerment originally recommended by the Commission on of nurses and midwives arising from the increased Nursing in 1998, remains pending as we enter 2007, layers of bureaucracy being created within the HSE. and the government has not given a firm date for the In reply Professor Drumm argued that there was a publication of this bill. major transformation programme and that the bureaucratic reform was the first phase, which was Drug Prescribing almost complete at the end of 2006 and they were now moving on to reform the role of health professionals at On a much more positive note the Organisation the point where they engage with the patient or client. wishes to record its appreciation for all of the work done, during 2006, with regard to the formulation of The Organisation also repeatedly expressed its the necessary Statutory Instruments, arising from the frustration at the lack of a nursing and midwifery Irish Medicines Board Act 2005, which will provide directorate, at corporate level in the HSE, which would drug prescribing rights for registered nurses and have the ability to influence, analyse and initiate midwives.At the end of the year the final text of the policies coming from senior levels in the HSE.

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Appointment of Director of Irish Congress of Trade Unions Nursing and Midwifery Services (ICTU) On a more positive note the Organisation warmly INO General Secretary, Liam Doran, and Director of welcomed, on 1 September, the appointment of Dr Organisation and Social Policy, Clare Treacy, continued Siobhan O’Halloran to the post of Director of Nursing to sit on the ICTU Executive Council during 2006. and Midwifery Services within the HR Directorate of the HSE. For the remainder of 2006 the Organisation Social Partnership Agreement developed strong links with Dr O’Halloran, and began work on a very wide ranging development agenda for The main work, during 2006, for the ICTU Executive nursing and midwifery. was the negotiations, held in April/May/June, of a new social partnership agreement entitled T owards 2016. An Bord Altranais This agreement, which provides for a 10% cost of living increase over 27 months, had not been voted on Throughout 2006 the Organisation continued to have a by the Irish Nurses Organisation at the end of 2006, series of contacts, at many levels, with An Bord due to the decision to continue with our pay and Altranais, in order to discuss a range of issues and working hours campaign following the Special matters of concern. In particular, during the year, the Delegate Conference decision of 1 September. Organisation held discussions on the following: The agreement itself, which was formally accepted by ICTU, although this decision is not binding on the INO, Public Health Nurse Rule Change also provides for the following: This continued to be a major source of concern to the • Enhanced regulations with regard to displacement of Organisation, and at the end of the year the matter had workers still not been resolved to the Organisation’s satisfaction. • Increased labour inspectorates • A second benchmarking exercise Future Role of the Healthcare Assistant • A wider developmental programme, spanning 10 During the year under review the Organisation also years, with regard to such areas as housing, raised its concerns, with An Bord, regarding the need infrastructure and related matters. for absolute clarification with regard to the role of the healthcare assistant in all care settings. The Health Policy Organisation expressed growing concern over the increasing use of healthcare assistants to administer ICTU also highlighted, in 2006, a special report, initially medication, particularly in the intellectual disability published in November 2005, on the Irish health sector, and the implications of this practice for service, undertaken by Maev-Ann Wren, Health registered nurses to whom these care assistants were Columnist and Professor Dale Tussing from the United reporting. States. This research which was partly funded by the INO, National Council for the clearly stated that the public health service, in Ireland, is grossly under funded, and undersized, and that we Professional Development of have a two-tiered system which favours those who Nursing and Midwifery have private insurance. During 2006 the Organisation continued to have a ICTU Youth number of contacts with the National Council to Edward Mathews, INO Industrial Relations Officer, discuss various issues of concern. These included: continued to chair the ICTU Youth Committee, during • The continuing failure of the National Council to 2006, and this committee was most active in trying to accredit all public health nurses as clinical nurse attract young workers into the trade union movement. specialists arising from the clear statement contained Edward Mathews continued to serve his term as within the Commission on Nursing report President of the Youth Committee of the European Trade Union Confederation and, in addition, was • The incorrect reporting relationships, stipulated by elected as an Executive Member of the European the National Council, with regard to the director of Youth Forum. public health nursing and senior management • The continued slow growth of CNS and ANP posts, International Nurses Day particularly within general, surgical and medical nursing, and the need to review the criteria to speed The INO, as an affiliate of the International Council of up this process. Nurses (ICN), participated in International Nurses Day

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which had as it theme Safe Staffing Saves Lives. In • Do nurses receive adequate compensation for their preparation for the day, which took place on 12 May work? 2006, the ICN provided some assessment tools To mark the day the INO issued a press release including: detailing the theme, complete with research data, which received considerable media coverage. Employers Work Environment/Organisation • Does the work environment/organisation provide adequate equipment for staff to provide sufficient International Midwives Day patient care? The INO, as part of its affiliation to the International • Does the work environment/organisation have an Confederation of Midwives (ICM), acknowledged appropriate physical plant in that staff can carry out International Midwives Day which took place on 5 May their work in a functional facility? 2006. • Are there work environment/organisation policies The theme for this important event was The World that address safe staffing? Is their enforcement Needs Midwives – Now More Than Ever. monitored? Are the policies reviewed regularly and The aim of the day is to celebrate midwifery and to revised as required? bring awareness of the importance of midwives’ work • Are grievance procedures in place? to as many people as possible. The International Day of the Midwife is an occasion for every individual • Is there clear and influential nursing leadership at the midwife to think about others in the profession, to highest levels of decision making playing a full and make new contacts within and outside midwifery, and proactive role in corporate and strategic planning? widen the knowledge of what midwives do for the • Do nurses receive adequate compensation for their world. work? Do the working conditions allow for optimal nurse recruitment and retention? Staffing Nurse The following staffing changes took place during the • Does the nursing staff contain a mix of adequate year under review: personnel? • Kevin O’Connor resigned his post as Industrial • Is patient complexity considered when determining Relations Officer with the Organisation in March 2006 nurses’ workload? • Joe Hoolan was appointed in May 2006 to the post of • Are regular nurse workload evaluations conducted Industrial Relations Officer including an assessment of the impact of such duties as education and supervisory duties? • Liz Adams was appointed in June 2006 to the post of Professional Policy Adviser to the Organisation • Are nurses involved in staffing decisions? • Jacinta Moyles, following internal competition, was • Do nurses monitor their personal health? appointed in November 2006 to the post of Assistant Office Manager/ Assistant Media Relations Officer Government • Jean Carroll was appointed Acting Section • Do government policies address an adequate supply Development Officer for the duration of Mary of nurses available to meet the health needs of the Power’s adoptive leave patient populations? • Sean Meagher joined the Organisation, on a • Is there a health human resource policy framework? temporary basis, as additional office support. • Is there a mix of regulated health personnel and do they practice together? • Are retention and immigration policies in place to ensure nursing shortages do not occur? • Is government involved in the financing and stewardship of the healthcare system? • Does the government provide a regulatory framework for ensuring safe nurse staffing practices? • Does the government conduct a policy impact assessment before introducing changes to legislation that will impact on workforce demand?

13 Irish Nurses Organisation Annual Report 2006 Industrial Relations Review 2006

2006 was a campaigning year for the immediately referred to the LRC who arranged a Irish Nurses Organisation. It was a conciliation conference for 3 April. year of inertia, inflexibility and All parties, including the LRC, were aware of the confusion in the Health Service significance of the INO and PNA strategy of pursuing Executive and ultimately it was the these claims under the disputes mechanism for the year when the one sided nature of health service rather than opting to go into Irish industrial relations and national benchmarking. A Special Delegate Conference of the agreements was exposed. INO, held the previous September, had rejected the Within the health service where on terms of reference of the Benchmarking Body because the one hand employers failed to of the failure of the employers and the ICTU to include implement agreements or Labour a previously agreed priority provision aimed at dealing Dave Hughes,Deputy General Secretary,INO Court recommendations and with the anomaly between nurses and childcare determinations with impunity, the workers and the 35 hour week claim. INO, who had adhered to all national agreements and The national pay agreement, Sustaining Progress, was industrial relations procedures, were lectured on the due to expire on 30 June and while the social partners merits of a wholly inadequate benchmarking exercise had cleverly constructed a benchmarking process agreed by others and discouraged from pursuing our which would overlap and interlock with its successor members’ legitimate grievances as the independent national agreement, INO/PNA had declared to all that trade union. the eight priority claims must be dealt with outside of that process and that they would be exercising their Pay and Hours of Work right to process the interests of their members as Campaign independent trade unions. On 23 March, in advance of the LRC conciliation On 7 December 2005, having consulted with all of the conference, the Executive Council of the INO and the unions in the former alliance of nursing unions, INO Officer Board of the PNA held a special joint meeting and PNA together lodged eight claims with the Health to consider and decide a joint strategy for pursuance Service Executive for improvement in pay and terms of the claims within procedure and in a high profile and conditions of nurses and midwives. The claims manner which raised awareness among our members. were as follows: The key grievances relating to hours of work and • A 10.6% pay increase to correct the anomaly with relative pay would form the focus of the campaign and childcare workers the officers of both unions agreed on a strategy which would ensure absolute unity of members. • A reduction in the working week to 35 hours The use of political activists within the organisations, • Parity of pay with basic and managerial therapist effective lobbying of TDs and Senators in the context grades of a general election, which at that point could happen • A Dublin weighting allowance at any time in the forthcoming 15 months, regular joint press releases on the campaign and effective and • A review of premium pay regular communications with members at ground • The introduction of a preceptor allowance across level were the agreed tactics. nursing disciplines The LRC conciliation conference was a predictable non • A review of clinical nurse specialist and advanced event with the employers invoking absolute adherence nurse practitioner posts with a view to increasing the to procedures which they had so cynically and easily numbers of both abandoned over the previous three years, effectively squandering industrial peace and any goodwill which • Reckonability of the nine strike days of 1999 for could have been generated from the Sustaining superannuation purposes. Progress agreement. The claims were lodged under the framework for The matter was referred to the Labour Court who set a dispute resolutions in the health service, which date of 20 June for a hearing of the claims. The 26 provides for a 26 week period to process to finality week procedure under which the claims were being such claims with an outside provision of 34 weeks in processed would have seen that hearing happen in exceptional circumstances. That 34 week period was early May and already having adhered rigidly to the due to expire on 2 July and under the procedure one procedure INO and PNA found themselves forced into would have expected INO and PNA of being able to the exceptional 34 week period. process the matter to finality including a Labour Court recommendation by that date. However, as had The joint Council/Officer Board of INO/PNA agreed an become their standard the HSEEA failed to meet with emergency motion for presentation at their INO and PNA until 10 February when they roundly forthcoming conferences. The motion came under the rejected all eight claims. The matters were heading 21 Years is a Mighty Long Time, which

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succinctly captured the anomaly between nurses and midwives and qualified and unqualified childcare workers. Twenty-one years is the length of time that it would take the honours degree 2006 registered nurse graduate to catch up in terms of pay on their unqualified childcare worker colleague. The motion read as follows: “Conference endorses the eight claims lodged with the HSE on behalf of nurses and midwives and the commitment to pursue these claims through the framework for dispute resolutions in the health service. Conference commends the decision of the Executive Council and PNA Officer Board to concentrate on the use of all available procedures to pursue these claims. Kate Walsh from the Castlebar Branch made her message to the government clear when she took to the stage at the pay rally June 2006 Conference notes and calls on the Labour Court to acknowledge that this is in stark contrast with those tedious and lengthy procedures which INO and PNA groups in the health service who used industrial action had adopted in their attempts to address both the to capitalise on the gains made in the 1996-1999 hours of work and pay claim anomaly prior to this campaign and who repeated such action two years hearing. The submission, which was available to every later to achieve the advantage they now enjoy over member via the INO website, spelt out clearly to the nurses and midwives in terms of basic pay. Labour Court that both organisations had pursued a policy of protest and procedure in recently pursuing Against this background Conference declares that: these claims and had put their faith in the ability of •There is no justification for childcare workers being procedure to deal with them. In doing so the paid more than nurses and midwives for the first 21 submission also pointed out that others with similar years of their career grievances had followed an alternative strategy and road map which had involved industrial action on •There is no justification for nurses and midwives every occasion. The Court were asked to vindicate the being the only former officer grade of the public use of procedures and advised that failure to do so service being required to work four hours a week would simply redirect the campaign to the alternative longer than all others route which had been so successful for all other •There is no justification for nurses and midwives groups. being the second lowest paid among frontline While the Labour Court gave a comprehensive hearing healthcare staff. to the submissions made by both sides the Chairman And in advance of the Labour Court hearing of our indicated even then that they would not be adhering to eight claims calls on the incoming Executive Council to the 34 week time limit in the procedure and that we organise a national pay rally to allow nurses and could not expect a recommendation by 2 July, the midwives at all levels express their disgust and anger absolute outside time limit provided. In the meantime at the key injustices of their relative pay and hours of Sustaining Progress had come to an end on 30 June. work.“ In the months and weeks prior to that intensive discussions between the social partners on a new The motion was unanimously endorsed by both programme had stumbled and faltered over the many conferences with many enthusiastic speakers from the cracks that were appearing in the industrial relations floor demonstrating their readiness to take whatever landscape of a booming Irish economy. High among action might be required in pursuance of their the issues on the agenda for the new social legitimate grievances. The pay rally was called for on partnership agreement was the need for strong 14 June at the Helix Centre in Dublin. A week ahead of legislation to prevent the exploitation of foreign the Labour Court hearing on the eight claims a strong workers and the displacement of skilled Irish workers signal was sent to employers and trade unions that for cheaper replacements recruited from outside the INO and PNA were not going away on these issues European Union. when nurses and midwives numbering approximately 1,500 descended on the venue, packing the house, in The scandal of Irish Ferries disposing of their entire what was a magnificent celebration of the professions seafaring workforce and recruiting foreign nationals at of nursing and midwifery and a dignified but resolute rates well below the Irish national minimum wage had demand that their claims be treated with respect by brought thousands of ordinary workers onto the their employers and the Labour Court. streets in numbers which had not been seen since the tax marches of 1980. These demonstrations sent a A comprehensive submission was compiled covering strong message to government and social partners all eight claims and importantly documenting the that there could be no further partnership agreements

15 Irish Nurses Organisation Annual Report 2006

if such exploitation and displacement was tolerated. MANDATE, for their own separate reasons, refused to participate in the vote or be bound by its outcome. The That issue correctly predominated the central pay talks majority vote was in favour of acceptance of T2016 as and the concessions extracted from the employers the larger unions had opted to accept it. There was, were so hard fought for that the rest of the agreement however, a growing number both in the private and was reduced to a debate about the percentage public sector expressing disenchantment with the increase required, the length of time over which it nature of the social partnership programmes which would be paid and the obstacles which could be put in are now emerging. the way of private and public sector workers actually achieving those increases. When at the end of September the Labour Court had still not issued its recommendation, INO/PNA made The failure to address the state of our health services, contact with both the employer and the Court to the failure of the health service reform programme to enquire about the delay. It then emerged that the produce a better quality service and the nursing and employer had not, in fact, responded to the detail of midwifery issues demonstrate the flaws which are the clarifications sought by the Court on 28 August. now emerging in the Irish model of social partnership. The Court, following prompting by the unions, on 16 On the trade union side, at least, it seems incapable of October sent a reminder to the HSEEA and at the end successfully tabling the interests of all members. of the following week a reply issued. In addition to the The new agreement emerged in draft form in July and length of time the Court itself had spent considering was to be called Towards 2016. The title seems to the submissions made to it on 20 June, the employer follow on the theme of overlapping and interlocking had now, by accident or design, frustrated the process such national agreements and involves all parties for a further month and a half. Once again, the signing up to a 10 year plan with only a 27 month pay Organisation had to question the value of procedures agreement. The Irish Congress of Trade Unions called as the time limits agreed by all had now effectively a Special Delegate Conference for September when been abandoned and INO and PNA were just expected unions would be asked to declare for or against T2016. to wait. On 28 August, following enquiries from INO/PNA to The INO Executive Council and PNA Officer Board the Labour Court regarding when it intended to issue agreed a further national rally should be held in the its recommendation, the Court issued a letter to the Helix on 22 November whether or not the Court had HSE and unions asking for clarification on a number of issued its recommendation by that date. A joint press issues relating to the claims. Following consultation conference of both organisations was held making it between the two unions a comprehensive response clear to all the rally would proceed with or without the was made to the Court within 10 days. On 1 September Labour Court recommendation. the INO held a Special Delegate Conference to decide On 7 November, in an attempt to invoke panic among its position with regard to the proposed T2016 social INO and PNA members, the HSEEA instructed all partnership agreement. The absence of a employing agencies to write to every nurse and recommendation from the Labour Court in relation to midwife seeking that they declare non membership of the eight priority claims and the insistence by the INO and PNA in order to be paid the first phase of employers that acceptance of T2016 would commit Towards 2016. INO to pursuing those claims exclusively through benchmarking created a difficult decision for This act of provocation happened in the context of a delegates. However, the clarity of thought displayed by decision not to reject but merely to await the Labour delegates on 1 September was a testament to the Court recommendation before considering T2016 and leadership given by the Executive Council on these was unprecedented. It also happened in the context of issues. a record of the health service never previously having paid the first phase of a pay agreement on time and Delegates decided that, as the Labour Court unlikely to be in a position to pay this one on time recommendation was still awaited and the key either. grievances remained unresolved, they should withhold their decision on T2016 until all the facts INO/PNA issued an immediate advice to members were known. Acceptance of T2016 would prevent telling them to ignore this blatant act of mischief and further progress on the claims which were already to concentrate on the bigger goal of improving the before the Court, while rejection of it would simply be working week and relative pay of nurses and used by others to further isolate the Organisation. The midwives. decision of Conference, therefore, was to note the The Labour Court, on 9 November, issued its terms of T2016 and consider them further when the recommendation. The recommendation was Labour Court recommendation issued. Conference disappointing. The strenuous efforts made by INO and instructed the Executive Council to withdraw from the PNA to demonstrate our use of procedure as a way of congress vote and to advise Congress that it could not resolving these issues was to be ignored. Instead the indicate either acceptance or rejection on behalf of the Court advised that the anomaly on childcare workers INO. On 15 September when Congress met, INO and should be referred to the Benchmarking Body. On the

16 Irish Nurses Organisation Annual Report 2006

reduced working week it recommended a process involving all other groups but without a timeframe. On parity with therapeutic grades it said refer to benchmarking. In relation to both the Dublin weighting allowance and a review of premium pay it rejected the claims outright. It said the preceptorship allowance claim should be referred to benchmarking but in the case of the review of clinical nurse specialist posts it conceded that such a review was indeed needed and should happen and it conceded recognition should be given for superannuation purposed of the nine days relating to the 1999 strike. However, only if all of their other recommendations were accepted. Many members were left wondering why it had taken the Court from 20 June to 9 November to issue such a INO general secretary,Liam Doran spelling out the INO/PNA plan of action at the recommendation and how the Court could reasonably national pay rally in Dublin,November 2006 ask the Organisation to go back to benchmarking with three key claims which had been made clear to them cost of living claim for 3% in line with that paid to all were not properly comprehended by the terms of others in the health service from 1 December. On 11 reference for that Benchmarking Body. December the employers rejected that claim and the matter was referred to the Labour Relations The Executive Council of INO and Officer Board of PNA Commission. The December meeting of the INO met in joint session to consider their position on the Executive Council confirmed a schedule of joint recommendation prior to the pay rally of 22 regional meetings of INO/PNA members and a ballot November. It was decided that the recommendation for a campaign including political and industrial action. should be noted rather than rejected or accepted and Even in advance of the regional meetings political that the campaign should continue until the key lobbying was to intensify and joint delegations of grievances are addressed and resolved. This would be INO/PNA were to meet TDs at local level and party recommended to the pay rally and would be followed leaders at national level. by a series of regional meetings and a ballot for further action up to and including a withdrawal of labour. The It seemed that while the members had demonstrated Helix was, once again, packed by nurses and midwives to packed houses at the Helix on two occasions that who turned out in their own time on the 22 November. no-one should ask how much support the campaign Once again it was a powerful and colourful event if had or how far this could go? Those very questions somewhat more sombre in the resignation and were now to be asked and answered by the rank and acceptance that procedures had now failed and that file members of the INO and PNA in the early months the alternative roadmap must be followed. of the new year. The packed house received the first viewing of the specially commissioned documentary narrated by Accident and Emergency Brenda Power The Long Walk. That video documentary script succinctly encapsulated the 30 year struggle that Department Overcrowding nurses and midwives had embarked on in the 1970s to INO campaigning in the year 2006 was not confined to achieve fair recognition for the professions. It issues of pay and conditions of employment. The succinctly encapsulated the progress made in the 1996 Enough is Enough campaign launched in 2005 entered to 1999 period and the erosion from that by the a new phase in January 2006. The organisation, on concessions made to others in spite of the restrictions behalf of nurses and midwives, have taken the lead of the social partnership agreements that existed at role in highlighting the appalling conditions for the time and which were now being used to prevent patients in accident and emergency departments right nurses and midwives asserting their right to a 35 hour across a range of hospitals in the country. The week and fair relative pay. Speaker after speaker campaign had been unwavering in spite of the demonstrated their sense of frustration with the HSE attempts to victimise the Organisation in March 2005 who put nurses and midwives and their patients at the through the non payment of the final phase of bottom of every list. Sustaining Progress. The pay rally endorsed the proposed campaign and The new phase entered into in January 2006, which the wheels were set in motion for a winter of followed lunchtime protests and the daily trolley count discontent and a campaign of political and industrial which dominated media coverage, involved a series of action in the run up to a general election which was postcards depicting the plight of suffering patients due in the first half of 2007. waiting for long hours in A&E departments under the As part of the strategy adopted INO/PNA launched a banner How Long Must this Keep Going On? The

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Health Service Reform Nurses, midwives and their patients throughout 2006 waited for evidence that the health service was reformed in a meaningful way. All of the reform during 2005 and 2006 appeared to centre around the previous administrative structures of the health boards and the need to assimilate all of the staff employed to service that structure into the new combined HSE. While securing staffing levels on the frontline or acknowledgement for new roles in nursing and midwifery proved impossible, it seemed there was an endless series of promotional posts advertised in the managerial grades with a bewildering array of new titles. The key issues of the continuing role of nursing and INO deputy general secretary Dave Hughes and INO president Madeline Spiers midwifery planning and development units and the delivering postcards to the Department of Health nurse management structures within the HSE postcards were distributed through the A&E combined with the reporting relationship of directors departments and the general public responded of nursing remained contentious throughout the year. enthusiastically filling in their own personal message In April, following a direct meeting with the Chief of the horror that was their experience in an A&E Executive Officer of the HSE, the INO secured department. agreement to a process involving a steering committee, chaired by a member of his project team, At the end of March, in response to media pressure, to oversee the discussions between HSE management the Minister described the continuing overcrowding in and nursing unions on the question of nurse A&E as a national emergency. A task force was created management structures. and commitments were given to providing necessary funding and staff to tackle the issues. Ten thousand The steering committee was formed comprising the cards were returned to the INO and delivered in union officials from PNA, SIPTU and INO and key sackloads by the President and Deputy General management personnel of the HSE. Maura McGrath of Secretary to the Minister for Health and Children, Mary the CEO’s project team was nominated as the chair of Harney during the month of April. the process. Two sub committees were established to report into that steering committee, one involving The immediate manifestation of alleviating measures reporting relationships for nursing and involvement of was the National Hospitals Office initiative in providing directors of nursing and midwifery in the HSE for admission lounges which were essentially a corporate level management structures. The other was comfort measure for those patients who have to wait. to look at the future role and function of NMPDUs and It was accepted, in providing these pre-admission their structure. facilities, that they did require dedicated staff and not just a stretch on the existing accident and emergency The NMPDU group agreed to conduct a future search department staff. Other initiatives included the workshop involving directors of nursing and directors provision for additional consultants where hospitals of NMPDUs along with management representatives met their required targets. to examine the future role and possible structures. The workshop was held on 2 October and Limetree As 2006 was coming to a close winter figures were still Consultants facilitated the day. bearing heavy on our accident and emergency departments and, while an improvement could be The outcome of the workshop was positive in so far as seen in some of the Dublin hospitals a dis- it reaffirmed the absolute need for a continuation of improvement in the numbers in some hospitals was the role of NMPDUs in the interests of the professions being experienced outside of Dublin. It seemed in spite and patient care. It also confirmed that the role was not of describing the situation as a national emergency the merely educational but one of development of the response still fell far short of what might be required professions involving research, quality and the ability to resolve the issue and the provision of home care to integrate nursing practice across the various packages and private nursing home beds seemed to settings in healthcare. While no firm proposals had emerged by the end of the year there were signs that have reached its limitations as the delayed discharge a more definitive approach would emerge early in the issue began to emerge as a significant feature even new year and specific proposals would be put by from those hospitals which had improved in the management. Dublin area. The year, therefore, ended as it had begun with the INO keeping the public informed about the The other working group was less successful, with a continuing overcrowding problem and pledging to dogged insistence by management on the need for continue the campaign. directors of nursing to report to general managers and

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a resistance to that proposition by the unions. In Health Act 2004 – Repeal of relation to involvement in the management structures of the HSE some progress was made when it was Disciplinary Procedures agreed that an assistant director of nursing services would be appointed in the Office of the Director of Arising from the abolition of the health boards and the Human Resources. Health Act 1970 responsibility for discipline up to and including dismissal fell within the ambit of the HSE as This was the most positive development so far in the the direct employer. The former officers of the public health service reform initiative as it affects nurses and service, including nurses and midwives, became midwives and towards the end of the year the employed under contracts of employment with the presence of the assistant director in the HR HSE and were subject to the Unfair Dismissals Act. Department was emerging as a significant influence in an understanding and realisation of the importance of The 2004 Act gave an assurance that the terms and nursing and midwifery leadership in real health service conditions of employment and tenure of office under reform and the delivery of better patient care. the HSE would not be worsened following the date of its establishment. It was, therefore, necessary for employers and trade unions to agree a disciplinary Non Implementation of and dismissal code which was, at least, equivalent to Agreements the protections provided under sections 22, 23 and 24 of the Health Act. The ambivalence of the HSE with regard to Negotiations on the new procedure were conducted implementation of agreements and, in particular, throughout the year 2005 and in February 2006 parties staffing reviews persisted throughout the year and were close to agreement with only minor issues being repeated efforts by INO at local level to have in dispute. Considerable time elapsed before agreements honoured were frustrated. management produced their final draft of the outcome The INO raised the matter through the National Joint of those discussions. Following close examination by Council repeatedly and in September highlighted that the INO it was revealed that the final draft bore no some 23 agreements, many involving Labour Court resemblance to the previously agreed versions and recommendations, had not been implemented. It was essentially entirely changed the meaning of what had agreed at the National Joint Council that such a level been agreed. This was brought to the attention of the of non compliance was undermining the credibility of other unions and the matter was raised at the National the grievance procedures and a high level group was Joint Council and the discussions had to recommence. established to review the non implemented In December 2006 agreement was finally reached on agreements and promote a phased implementation of the new procedure which the organisation endorsed them. as a robust, top division disciplinary code which was, In October the HSEEA produced a plan for regional at least, equal in terms of the protection afforded to implementation of the outstanding agreements and nurse employment as had been the Health Act of 2004. engagement on the phasing of it. As the year drew to a close difficulties were still being encountered in some regions getting engagement but some progress Other National Claims was made. It is an appalling reality that many of the agreements Directors of Public Health Nursing Equal Pay related to the need for additional staffing and had been The first hearing of this equal pay claim was held on 17 extant for up to two years. October. Following the hearing, the Equality Officer This meant that nurses and midwives were working scheduled dates for examination of the INO claim that short staffed and under pressure and also meant that, directors of public health nursing do work of equal value in many instances, patient care was falling short of with their colleague directors of mental health nursing what those nurses and midwives regarded as who are paid considerably more. This exercise is acceptable standards. The flagrant disregard for the expected to take some time and an outcome of the initial pressure such understaffing put on the nurses and Equality Officer’s evaluation is expected by mid 2007. midwives concerned and the risks it posed for infringing their ethical standards is an appaling Hospital Banding indictment of the HSE management. Following a Labour Court conciliation conference in From an industrial relations point of view they have February, agreement was reached to provide band 1 succeeded only in squandering the peace which had status to Kerry General, Mullingar General, Tullamore been provided by the Sustaining Progress agreement General and Our Lady’s Hospital, Crumlin and band 2 and fuelling the flames of discontent which already status to Naas General which had previously been at existed among nurses and midwives with regard to band 3. This was based on the criteria as agreed in the their own hours of work and relative pay position. Blue Book agreement of 1996. An exercise to review

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the banding criteria was then established under the The CAPITA Report, which had been delayed because chairmanship of Phil Flynn. The review group met on of the argument regarding the grading of bed a number of occasions during the intervening months managers, still remained extant at the end of the year but, due to changes on the management side, had and repeated requests through the A&E Forum for its ceased meeting by the end of the year. It is expected implementation lead to a declaration that it would that the review of banding will be recommenced early form part of the recommendations of the A&E Task in 2007. Force. The Task Force had not reported by the end of the year. Application of Allowances to Grades above CNM2 Time Plus 1/6th Claim for Part Time Workers In March the HSEEA confirmed acceptance of Labour Following the enactment in December 2001 of the Court recommendation 18462, which failed to concede Protection of Part Time Workers legislation, the INO allowances to grades above CNM2 but did allow for pointed out to the HSEEA that the eight hour shift those allowances to be taken into account on requirement in order to receive this premium was a assimilation, following promotion, in a manner which breach of the law. Employers ignored the issue when ensured at least one increment at the time of raised by the INO and thus, the Organisation was promotion. Although this was agreed in March of forced to take cases on behalf of individuals to Rights 2006, the actual circular did not issue until December Commissioners. The first of these cases was upheld 2006 and provided for retrospective payments to 1 and the HSEEA sought to appeal the decision to the February. Labour Court for final determination. Having done so, however, the employer postponed or sought adjournments to prolong the process and ultimately in Bed Managers August withdrew their appeal from the Labour Court. During the period 2004/2005 the claim with regard to Thus, in September the HSE confirmed concession of the grading of bed managers was presented to the the claim for payment of time plus 1/6th to all nurses Labour Court on no less than three occasions. and midwives who work between the hours of 6pm Ultimately the Court found in favour of the union claim and 8pm, regardless of their overall number of hours and as was reported in the previous annual report, or the number of hours in the shift they worked. management tried to change the criteria for Payments to the individuals concerned must be appointment of bed managers as a result. The matter applied with retrospective effect to December 2001. was then referred for a fourth time to the Labour Court The implementation circular had not issued at the end for clarification. Once again, the Court upheld the of the year, a full five years after the law was enacted. union position and it was expected that a circular This was yet another example where the law was clear would issue allowing for the appointment of the but the HSE insisted that a test case be proven before existing bed managers to the appropriate they would consider complying with it. administrative grade, albeit that there was still a requirement to be a registered nurse. Student Public Health Nurse Appointments In yet another twist, however, management, in July, The failure to appoint previously unsponsored student issued a draft circular of implementation which sought public health nurses, who had come within the ambit to apply the pay but not the hours of work or other of the sponsorship scheme following a Labour Court terms and conditions of the relevant administrative decision, was the subject of a conciliation conference grade. When challenged their justification for doing on 31 October. At that conciliation conference and, in this was based on the wording of the most recent spite of commitments given by the employer to the Labour Court recommendation on the matter, which High Level Group, they refused to make the simply stated that if the posts had been established as appointments. being administrative grade 8, 7, etc. then there could be no justification for paying them on a lower scale. The agreed national position for appointment as a Management argued that it only referred to pay and public health nurse is that once recruited and not their other conditions. sponsored to participate in the higher diploma in public health nursing the student public health nurse is At a meeting towards the end of October the INO effectively an employee and is required to commit produced all of the Labour Court recommendations themselves to the employer for, at least, two years. and were successfully able to demonstrate that the There is no requirement, therefore, to compete again Court had already decided on the question of terms for a permanent position as the appointment has and conditions in a previous recommendation. already happened. Management, at this point, agreed to upgrade the existing bed managers without further ranker. The In spite of this, the employer is still seeking that circular to do so, however, had not issued as the year previously unsponsored students, who had already came to a close and INO continued to apply pressure competed for sponsorship but because of inadequate for its implementation. quotas had been left out, will have to compete again.

20 Irish Nurses Organisation Annual Report 2006

The matter was unresolved at the end of the year in advocacy, on behalf of their patients’ or their own spite of the fact that the development of primary care interests, is to confront the deficiencies and to be teams appeared to throw up possibilities for the forthright in striving to achieve their aims. The creation of new public health nurse positions. Organisation and its members, found common cause with the Psychiatric Nurses Association in promoting Out of Hours Nurse Managers the key grievances of the professions. Both organisations have painstakingly stuck to the national Following two Labour Court hearings on the issue and agreements which they had signed up to and vowed to a job comparison exercise out of hours nurse resort to industrial action only as a very last resort. managers finally achieved recognition that their role With procedures exhausted at the end of 2006 the was equal to their colleagues who were employed as leadership and executives of INO and PNA have night superintendents. The outcome of the job handed back the prosecution of what is now a national comparison exercise issued in November and the dispute to the activists and members in each local circular providing for the immediate upgrading of the workplace with the opportunity to organise and out of hours nurse managers issued in December. The galvanise support behind a campaign for a 35 hour question of retrospective application of the grading to week and fair relative pay. The evidence, so far, is that the date on which night superintendents received their the activists who have emerged in recent years are upgrading has now been referred to the Labour Court well up to the task. Perhaps it was difficult to rouse for a final decision. nurses and midwives, they are long suffering and patient, but now that they are roused I doubt they will Nurse Representative Training ever be quiet again. The Organisation provided 10 training courses for nurse representatives throughout the year 2006. Eight Regional Round-Up (IROs) of these were basic training courses for the elected nurse representatives and two were specialist courses HSE – Eastern Region – for representatives on partnership committees. East Coast Area Philip McAnenly Just under 120 nurse and midwife representatives attended these training courses. Two training courses St Margaret’s/Maryville: Members for the full time officials of the Organisation were also given parity of pay and terms and held. Such courses are now an essential part of the conditions of employment with INO’s training programme. These training courses colleagues in the public sector in ensure that our industrial relations staff are the best January 2006, resulting in salary equipped in the field in terms of both skill and increases of e9,000 per person. knowledge required to do an ever increasingly Retrospection on this claim led to payments of complex job. approximately e53,000 to a number of members. A delegation of full time officials from the Norwegian Due to the centre closing in January 2007, members Nurses Association visited Dublin and INO voted to accept favourable redundancy terms which headquarters on 21 and 22 August. This provided a paid statutory entitlements plus an enhanced three useful exchange of views between the full time officers weeks pay per year of service. There was no cap on the of both organisations and allowed us draw on enhanced element of this redundancy and all comparisons between the systems in both countries. members were included, regardless of service. An issue of common interest was that of equal pay Payments ranged from e14,500-e130,000 per person. which allowed us explore the differences between Members were also offered continuing employment in Norwegian and Irish law on the matter. Norway is not an adjacent centre, managed by the same employer, a member of the EU and, therefore, not bound by the without their redundancy payments being affected. directives and although it tends to follow European Mount Carmel Hospital: The hospital was purchased in legislation in many respects its equal pay legislation is October from the Little Company of Mary by Harlequin different and arguably worse in some respects than Healthcare. The former owners have agreed to make a ours. The strategies for pursuing equal pay, however, loyalty payment to staff based on length of service. provided interesting and lively debate between the They have also agreed to inject substantial funding into two countries and generated new ideas for both in the the superannuation fund for nurses who were excluded pursuance of their members’ interests. from the scheme in 2001 due to their part-time status. Hume Street Hospital: Following the closure of Hume Summary – A Campaigning Year Street Hospital and transfer of dermatology services to 2006 was indeed a campaigning year for the INO. The St Vincent’s University Hospital agreement was appalling record of the HSE with regard to adherence reached on behalf of members as follows: to procedures has educated nurses and midwives to • Nurses who moved to St Vincent’s were paid a lump the fact that the only road to success in terms of sum equal to statutory redundancy entitlements

21 Irish Nurses Organisation Annual Report 2006

• Nurses who chose to move to alternative sites by • Member awarded e13,000 by Rights Commissioner choice within the HSE were paid a lump sum equal to due to chronic salary errors. statutory entitlements • Member awarded e11,000 by Rights Commissioner • Nurses who chose to exit the health service received due to chronic salary errors. a payment equal to twice the statutory redundancy • Further process agreed to regularise long-term entitlements temporary staff. • Cost of uniforms refunded HSE – Eastern Region – • Compensation for loss of premia payments due to loss of night duty work equal to two years premia Northern Area earnings. Edward Mathews Beacon Clinic Sandyford: Two members were paid a The HSE Northern Area and all the total of e22,000 compensation following grievance work locations therein have with their employer. experienced a very busy year in terms St Vincent’s University Hospital: Member awarded of industrial relations. This has been a e12,000 by Rights Commissioner following an year which has seen much inordinate and excessive delay by management in development in the structures of the progressing her return to work following work-related Irish Nurses Organisation within concern. The same member, in January 2007, agreed a individual workplaces and a year in favourable severance package including a lump sum which the Organisation has faced payment of e182,000 and an enhanced pension of many challenges, both in terms of improving the e10,600 per annum which includes credited service. A terms and conditions of our members and advocating member was awarded a settlement payment of on behalf of individual members in difficult e11,500 and reference following irreparable circumstances. breakdown of relations between her and a colleague. Beaumont Hospital: As the largest hospital in the Eight CNM1s in ICU department upgraded to CNM2. North Dublin area, the Organisation has, of course, National Maternity Hospital, Holles Street: been involved in the provision of representation to Satisfactory outcome to dispute agreed following groups of staff and many individual members in efforts by management to compel 17 overseas nurses relation to difficulties faced on a day to day basis. Most to undertake RM training. This would have led to an notable in this regard is the persistence of our claim intolerable drop in salary and inflexible contracts. All for the appointment of a CNM1 to the phlebotomy nurses were given permanent contracts without department. This claim, while partially conceded, is interview and were facilitated by choice to undertake now associated with an attempt by management to RM training without loss of salary. introduce non-nursing staff within the department and negotiations continue in this regard. Furthermore, a claim for compensation for disturbance involving one ward had continued throughout the year with discussions now taking place at a local level regarding possible arrangements for compensation in general terms for staff who are inconvenienced by renovation work which is ongoing within the hospital.

A&E department: Unfortunately, as in many previous years, this department has been forced to suffer another busy year with patients and staff finding themselves in very difficult circumstances. Despite the ongoing protestations of the HSE in relation to the improving situation within A&E departments, it is clear from the situation faced by Beaumont that a lack of planning and Nurses affected by the National Maternity Hospital’s unfair contract pictured with co-ordination between long stay services and the acute their new contracts negotiated by the INO (l-r): Marcia Asilo,Kendy Bermejo, hospital service continues to pose significant Grace Pascual,Marjorie Gonjales,Sirishe Kora,Philip McAnenly (INO IRO),Shiney Joseph,Sheeja Chacko,Hazel Catibog,Ashamole Clive and Sarah Packiaraj challenges. Towards the year end, delayed discharge patient numbers rose to over 100 in Beaumont Hospital HSE East Coast Area: with an associated peak in A&E activity. Of continuing • Member awarded e2,800 by Rights Commissioner concern to our members is the refusal of management following claim for dual responsibility allowance for to publicly declare the almost constant state of a 10 month period. emergency which exists when delayed discharge patient numbers reached these levels. • Independent review of Dalkey Community Unit has recommended appointment of 155 WTE staff Cappagh Orthopaedic Hospital: The Organisation in including three promotional nursing posts. the earlier part of 2006 was heavily involved in

22 Irish Nurses Organisation Annual Report 2006

representing staff within this hospital regarding an members within this service for the last two and a half attempt by management to enforce a ward years in respect of the non applicability of reconfiguration and, indeed, an attempt by benchmarking and cost of living increases applicable management to enforce roster changes for nurse under Sustaining Progress. We have been successful managers within the hospital. Our members within through our negotiations at a local level and with the this facility united in defiance not of change but of the assistance of the Labour Relations Commission in manner in which change would be enforced on INO accessing the payment of all outstanding cost of living members. increases applicable under Sustaining Progress and the matter of the applicability of benchmarking has Their unity and conviction of purpose has allowed recently been heard by the Labour Court and a them to become partners in the change process within recommendation is awaited. the hospital and not mere subjects of management’s will. St Mary’s Hospital, Baldoyle: The Organisation was intensively involved in the transfer of St Mary’s Connolly Hospital, Blanchardstown: The Industrial Baldoyle to St Michael’s House Services during 2006. Relations Officer and local representatives have been We were successful in negotiating a substantial very busy in providing individual representation compensatory package for the inherent uncertainty throughout the year in Connolly Hospital. Of particular which was involved in the very protracted negotiations note within this facility is the refusal of management to concerning the transfer of services. pay an advanced nurse practitioner the appropriate rate of pay. Individual Cases: The Organisation was successful in representing many individual members within the The Organisation was initially successful in accessing region, both in terms of grievances with their payment for the individual on the assistant director of employers and in the context of disciplinary hearings. nursing non band 1 scale and we continue to advocate, Of particular note is a recommendation from the to a third party, the necessity to remunerate the Rights Commissioner service for compensation in the individual member in question at band 1 level, given amount of e2,000 in respect of a unilateral change of the roles and responsibilities assumed by the member mileage calculation arrangements for a nurse working and the requisite qualifications required to fill the post. in the community within North Dublin. Rotunda Hospital: 2006 saw closure brought to a long Of further note is a substantial judgment from an running dispute between members of the INO and Equality Officer in respect of a community nurse management of the Rotunda Hospital. This dispute whom he found had been discriminated against by her concerned management’s proposal to introduce new employers on the grounds of disability. The rosters for the service and has been the subject of Organisation was successful in accessing e10,000 ongoing negotiations for over four years now. Upon compensation associated with the vindication of our conclusion of negotiations, our members voted member’s position and a rectification of her service overwhelmingly to accept the rosters devised by our record in respect of a period of time when she was fit local representatives in conjunction with management to return to duty but her employers refused to allow and also voted to accept a substantial compensation her do so, and in so doing, conducted no investigation package payable to members working within an as to her capabilities as a nurse certified fit to perform individual department in respect of the loss of a half light duties. hour paid night duty break as part of the new rostering system. The Organisation has also been successful in assisting individual members in reaching an orderly conclusion Daughters of Charity Services: The Organisation has of their employment relationship where relationships been successful within St Joseph’s Clonsilla in had broken down between employer and employee. remedying a longstanding inequity in relation to the Most notable among those were settlements such as payment of night duty premium pay when our e100,000 for a senior manager who concluded her members are required to work through their breaks. employment relationship and e60,000 for a staff nurse While being successful in addressing the issue going who again concluded her employment relationship forward, we are now pursuing retrospection for a with an employer. number of years when our members were unfairly treated by their employer. The Organisation is extremely well served by highly The Organisation was also successful in the Rights competent and dedicated local activists within the Commissioner service in accessing seven days study northern area. This network of activists has become leave for an individual member who was unfairly stronger during 2006 and it is our hope that this treated by management of this service insofar as they growth will continue in 2007. This report provides only refused to allow her avail of study leave while allowing a very brief snippet into the huge work conducted at a another employee to do so. local and regional level by activists within the Organisation in terms of maintaining and improving McAuley House (formerly Beaumont Convalescent the terms and conditions of our members working Home): The Organisation has been representing our within the area.

23 Irish Nurses Organisation Annual Report 2006

HSE – Eastern Region – Our Lady’s Hospital for Sick Children: South West Area • Health and safety issues ongoing in ICU regarding Phil Ní Sheaghdha threatening behaviour and verbal abuse. Agreement St James’s Hospital, Our Lady’s reached regarding the presence of security on the Hospital for Sick Children, unit and strict visiting times Peamount Hospital, Our Lady’s Hospice, Harolds Cross, • Ongoing negotiations regarding the expansion of the Cheeverstown House Ltd, job description for nurses working in ICU Moore Abbey • Staffing levels in ICU remain the subject of ongoing Equality Tribunal: INO member who was not allowed discussions with management return to her post as day centre manager with the • Individual cases regarding sick leave/injury at work Alzheimer Society of Ireland, represented by the INO ongoing. to the Equality Tribunal. Claim was for compensation and return to work as this treatment was Bru Chaoimhin Cork Street: Following protracted discriminatory as the member had been ill and notified negotiations agreement reached to implement her employer of her illness. independent staffing review which significantly improves staffing levels at management and staff The Equality Officer found in her favour instructing nurse level. that she be returned to work and paid retrospectively and that compensation of e20,000 be paid by her Baltinglass District Hospital: Negotiations resulted in employer to her. The employer has appealed this improvements to staffing levels. decision to the Labour Court. Moore Abbey Monasterevin: Agreement reached to Dublin Acute Services: Three INO members were improve staffing levels by increasing staff nurse whole represented following their complaints to their time equivalent by six, following prolonged employer that they were being bullied and harassed negotiations and Labour Court ruling. by their ward manager. Peamount Hospital: INO represented two night sisters An independently chaired investigative team (CNM2) to Labour Court in pursuance of claim to be concluded that the ward manager had offended the regraded, as they were responsible for the hospital at Dignity at Work policy in excess of 23 times. The night. Court ruled that they were incorrectly graded at manager was disciplined and compensation was CNM2. Agreement reached with employer that both afforded to the INO members involved following INO INO members be regraded to maximum of CNM3 representation. salary scale. HSE – South West Region: Eileen Lawrence, staff nurse, Baltinglass, has been granted release from HSE – Midland Region clinical duties for INO work. Eileen will cover work Joe Hoolan locations in the former South West Area Health Board, west Wicklow and Kildare. Tallaght Hospital, The Coombe St James’s Hospital: Hospital Midland Regional Hospital, Portlaoise: • Staffing levels remain the main issue of negotiation Agreement was reached with the INO particularly in cardiac cat lab and ICU and management regarding two shift • The Organisation is involved in ongoing negotiations leader positions in A&E. This was brokered at an LRC with management regarding non-funded posts, ie. meeting in May. This was a long running issue that promotional posts which the hospital have advised began when management interviewed candidates are non-funded and therefore cannot be re- who did not meet the criteria for the posts. Both advertised if they become vacant positions were filled with an element of retrospection involved. • Equality referral lodged on the grounds of race. Submissions have been lodged with the Equality The A&E department continues to increase in activity. Tribunal and date for hearing is scheduled for early Matters were not helped when management decided 2007 to unilaterally change its admission procedures for A&E patients. This saw the day ward being closed to • Issue arose regarding the health and safety of the A&E patients. Intervention by local reps and meetings staff dining facilities in theatre which was referred to between INO and management reversed this decision. the Health and Safety Authority. Hospital A new A&E department is currently being built and management have conceded this claim and discussions regarding staffing levels are taking place. refurbishment is to take place Portlaoise has also secured a new CT scanner and both • Agreement secured for the release, one day per of these developments will greatly enhance week, of an INO member for INO duties. emergency care.

24 Irish Nurses Organisation Annual Report 2006

superintendent before bleeping an NCHD. This was firmly rejected by the INO. St Francis Private Hospital, Mullingar: The INO had a busy and successful year in St Francis which saw the introduction of CNM1s and an agreed new payroll system. The INO are currently pursuing a claim for holiday premium payment for our members and also successfully represented members on individual matters. Benchmarking payments that were not paid to three members were retrospectively applied and local reps are vigilant on IR and professional matters. St Josephs Hospital, Longford: An independent Midwives from Portlaoise Regional Hospital are pictured during a two-hour staffing review completed by Edna Cobain in 2005, has lunchtime protest at the unsafe staffing levels in the hospital. proved to be extremely difficult to implement. This, despite the fact that workloads in this facility were very high. An LRC meeting in July yielded no promise of The maternity unit in this hospital has been under extra staff. This then became the focus of the National intolerable pressure all year. An independent staffing Joint Council where eventually, and only due to review of this unit was finally accepted by constant INO pressure, management have agreed to management in August. This was mainly due to the implement 25% of the recommended staffing between midwives themselves who held a lunch time protest at January and July 2007. the end of June. It has become a very frustrating exercise in trying to get extra posts filled, particularly AMNCH Tallaght: The A&E department reached crisis following HSE reforms where posts take so long to get point in February when on Tuesday, 14 February, up to approved. This has added to the midwives frustration 75 patients were on trolleys awaiting an inpatient bed. and regional management’s intransigence at times has Management within this hospital attempted to not helped. It remains a priority in 2007. introduce extra beds on wards, but this was prevented by the INO following intervention of the LRC. In the The theatre department also secured their third nurse summer Tallaght opened a 40 bedded transitional on call, and the hospital also appointed five CNM1s lounge and this has had a very positive effect on the throughout the service following INO representations. number of patients waiting on trolleys in A&E. An LRC date is awaited to progress a claim for The INO, throughout the A&E ‘Enough is Enough’ supernumerary status for all CNM2s. campaign, have always said that bed capacity is one of Midland Regional Hospital Portlaoise (Phil Ni the main problems in our health service and the Sheaghdha): INO represented a nurse who claimed experiences of Tallaght prove this. By increasing its that his health and work life was negatively affected by bed capacity Tallaght Hospital has gone a long way his ward manager whose treatment of him offended towards addressing their A&E problems. the Dignity at Work policy. The Labour Court awarded Dialysis Unit: A proposed new isolation facility for Hep INO member e40,000 compensation following failure B patients ran into problems when management of his employer to adequately deal with his complaint proceeded to build the unit without proper against his ward manager. consultation of staff. The staff had many concerns Midland Regional Hospital, Tullamore: The main focus regarding the new unit and following work from local in MRHT is the transfer of services from the old reps and meetings between the INO and management, hospital to the new one. The INO is well represented in the unit was declared unsuitable for its intended these discussions with local reps on all committees. purpose. A new consultation process began, this time Progress is slow, with phase one of the move deferred with staff involvement. from December 2006 to April 2007. Staffing levels are Local Issues: The INO represented many members on of course the INO’s main concern, in line with securing individual issues throughout the year. At the time of advanced nursing posts as well. writing specialist qualification and location allowances Midland Regional Hospital, Mullingar: This hospital is were being pursued for two wards with specialist care. one of the pilot sites for the EWTD. Numerous Regional News: A Rights Commissioner hearing in meetings have taken place regarding nurses and January 2006 awarded a financial settlement to a midwives roles under this pilot scheme. The hospital member who had been unfairly dismissed from the had been slow to roll out advanced training in LARCC services. cannulation, venepuncture and male catheterisation to all staff. This is being corrected in 2007 with a series of Five CNM1 posts in MIDOC were upgraded to CNM2 training days planned. The hospital had also following INO representation, this also involved an attempted to introduce a bleep system which would element of retrospection. Claim for holiday premium see nurses and midwives having to ring a night pay for nurses in the IBTS lodged.

25 Irish Nurses Organisation Annual Report 2006

The Pensions Ombudsman recently found in favour of Management deny that a major problem exists but an INO member who had her application for waiver of members are of the view that appropriate discharges pension abatement refused. The member in question are not taking place within the hospital. The INO was recruited out of retirement by the HSE due to her averted a directive from A&E consultants to push skills and expertise in her particular area of nursing. trolleys on to the corridors of wards and HSE They had no other person capable of fulfilling the role. management confirmed that it was not their policy for The nurse was refused waiver of pension abatement same to occur. because the Department of Environment restricted it to St. Anne’s Service, Roscrea: An independent two grades in the health service – consultants and evaluation of the roles of the CNM1 grade within this radiographers. service recommended that three positions be up- The Pensions Abatement Act cites no grade, and the graded to CNM2. Ombudsman agreed with the INO that the only reason Ennis General Hospital: A series of meetings with our member was refused was due to her grade, ie. a hospital management took place over 2006 to seek nurse. The member will receive a full refund of her extra staffing for the A&E department. It was agreed abated pension. nationally that an extra nursing position will be put in place by March 2007. Following referral to the Labour HSE – Mid-West Region Relations Commission management have assisted in Mary Fogarty undertaking a comprehensive staffing review on two medical wards at the hospital with advice from Keith Brothers of Charity Service: The INO Hurst, a UK nursing manpower consultant. successfully negotiated an extra 22 hours annual leave over a two year period for senior nurse managers who North East Region are obliged to carry a mobile phone out Tony Fitzpatrick of hours. St Michael’s House: Shannodoc: An individual case referred to the Rights • Negotiations commenced with Commissioner service secured payment of college management with regard to the fees of e8,134 for a member. takeover of some services within St St. John’s Hospital, Limerick: The INO achieved Michael’s House by the Department of assistant director of nursing grade for the night sisters Education. in this hospital. A staffing review undertaken by Nigel • The out of hours nurse managers who were graded at McCarley revealed some inadequacies in staffing CNM2 have been upgraded to CNM3. Retrospective which have been partially implemented by payments have now been made back to November management. Further implementation is dependent 2004. St Michael’s House was going to take into on reconfiguration of middle management nursing consideration HSE, HR Circular 023-2006 with regards structures in A&E and theatres. The INO were to the retrospective payments to February 2006. successful in reversing a decision by hospital management to terminate the temporary contracts of Mater Hospital: all nurses with less than 12 months service. • A location allowance was achieved for staff working in a high dependency area in one of the medical wards at Croom Orthopaedic Hospital: The INO achieved up- the Mater Hospital. This claim was conceded by the gradings to CNM3 status for night sisters following a Mater Hospital in August with staff receiving recommendation from a Rights Commissioner. retrospective payments back to August 2004. INO Mid Western Regional Hospital: A major dispute arose members were paid out in excess of e30,000 in early in 2006 between the INO and hospital retrospective payments. management following inaccurate media reports • INO is pursuing a claim on behalf of the transplant co- relating to rosters and time off for on call. The INO had, ordinators with the heart and lung service that they prior to this, sought the assistance of an external would have parity with the transplant co-ordinators in facilitator in negotiations with hospital management St Vincent’s Hospital. Negotiations are ongoing. on the introduction of new rosters and to review the nursing services within this theatre department. Conal • A&E overcrowding continues to be a significant Devine undertook this extensive review in 2006 which problem within the Mater Hospital despite the opening is currently awaiting implementation. The Labour of a transit unit in January 2006. Further initiatives are Relations Commission held a number of conciliation planned at the Mater including a discharge lounge and conferences and eventually handed the dispute to its an admissions lounge. Negotiations to commence in own advisory service where discussions are still early 2007 with regard to staffing levels for same. ongoing. • Many individual members represented throughout The emergency department has trundled along for the 2006 with regard to Trust in Care, Dignity at Work, and last year with increasing trolley figures each week. disciplinary matters.

26 Irish Nurses Organisation Annual Report 2006

Our Lady of Lourdes Hospital, Drogheda: • Two CNM1 positions • The A&E department continues to suffer from severe • Acting-up allowance for the staff nurse on night duty overcrowding with an all-time high record of 36 • All staff to receive a location allowance retrospective to patients being maintained on hospital trolleys within September 2006 the A&E department. As a result of same difficulties • Four temporary staff were converted to permanency. have occurred for the outpatients department as the Monaghan General Hospital: A&E patients often occupy large numbers of the rooms • Treatment Room: This opened in December 2006 utilised by the outpatients department. INO secured following agreement with this Organisation on additional staffing for night duty. However the nurse appropriate staffing levels and management posts. The staffing levels within the department are deplorable in INO secured a shift leader post, in line with the A&E comparison to other hospitals with the same agreement of 2002, by upgrade, and a subsequent back attendance level. This, combined with the grossly filling of posts. inadequate physical facilities within the A&E department, have made 2006 the most demoralising • Loss of theatre on call was referred to the Labour and difficult year for staff. Court. The INO was unsuccessful in securing compensation for staff, details of which are contained • Nurses tea room on the first floor was expanded in in recommendation number LCR18604. order to let fresh light and air in. Our Lady’s Hospital, Navan: Labour Court • Labour Court recommendation 17941 regarding the recommendation 18681 conceded to the INO’s claims for maternity unit – the INO secured the implementation of the provision of: part of a Labour Court recommendation that allowed • Triage staff for the recruitment of an additional 10 whole time • Clerical cover equivalent staff with the theatre department. This • Adequate security within the A&E department of Our additional staffing allowed for the transfer of Lady’s Navan. emergency caesarean sections from the maternity department to the theatre department in line with best Following the Labour Court recommendation the INO practice. raised the matter at the A&E Forum and indeed there has been comprehensive negotiations at local level. At • INO secured extensive cleaning and decoration of the the end of 2006 the Labour Court recommendation had OPD which, due to its overuse, had become dilapidated still not been implemented but negotiations were and unkempt. ongoing. • Negotiations ongoing with management with regard to St Mary’s Hospital, Drumcar: Labour Court inadequate clerical support and staffing levels on the recommendation LCR 17948 – the INO sought the wards of the hospital. provision of seven clinical nurse specialist posts for Cavan General Hospital: intellectual disability services in St Mary’s Drumcar. The • Labour Court recommendation 18289: The INO Labour Court recommended that these posts should be referred the matter of inadequate clerical support to put in place and a joint working group should be front line nursing staff and managers and the Labour established to make arrangements for same. Progress Court issued their recommendation in September 2005 on this has been slow. However at the end of December for the provision of eight additional clerical staff. The 2006 two clinical nurse specialists have been provided HSE failed to implement the Labour Court following the intervention of the high level group, with recommendation and the matter was raised twice by the additional five clinical nurse specialist posts to be in the INO at the National Joint Council. Despite meeting place by the end of 2007. with the network manager the HSE continued to Meath Community Care: implement same. INO members balloted for industrial • INO represented member who had lodged a complaint action and notice was served following the sanction of under the Dignity at Work policy against three nurse the Executive Council. On the eve of the industrial managers, complaint was upheld. action the HSE conceded to the INO’s demands and five additional clerical officers were provided prior to • Rights Commissioner R032707-IR-05-GF. This matter 27 November 2006. Additional clerical staff were to be refers to the inappropriate transfer of a public health provided in 2007. nurse. The Rights Commissioner concluded that the INO complaint was well founded and confirmed that • Oncology Liaison Nurse: The INO pursued this matter the transfer was inappropriate and caused great vigorously once contacted by the clinical nurse distress and anxiety and should not have occurred. The specialists in the oncology unit and following both member was offered first refusal of any vacancy that union and political pressure the post was approved in arises in Dunshaughlin Health Centre. The HSE had November 2006. appealed the decision to the Labour Court however withdrew the appeal on the eve of the hearing. St Christopher’s Hospital, Cavan: INO secured improvements in this facility including: • Rights Commissioner recommendation R033999-IR-05- • Increased staffing levels JT, this matter also refers to the inappropriate transfer

27 Irish Nurses Organisation Annual Report 2006

of a public health nurse. The HSE accepted that the were operating since 1999 had not kept pace with the transfer could have been handled better and the issue introduction of the Act several years later. Therefore he resolved a lot more quickly. The Rights Commissioner found that the part-time workers were entitled to the then believed that the HSE must then take premium pay in question. The HSE appealed the responsibility for contributing to the work related matter to the Labour Court. However in August 2006 stress that the claimant suffered. He recommended they withdrew their appeal. We now await a national that the public health nurse’s period of absence should circular from the HSE-EA amending the eight hour rule only count as two months for the purposes of sick pay on allowing all staff who work between the hours of arrangements. The member had been absent for a five 6pm and 8pm to receive time and one sixth payments. month period. He also recommended that the member Hillview Nursing Home: have the offer of the first job-sharing position to come • The INO represented two members who were available within the four community care areas of her dismissed in breach of the part-time workers choice. legislation. The INO referred the matter to the Rights • Rights Commissioner Recommendation R044340-IR- Commissioner service and it recommended that each 06-JT dealt with another request for another public of our members should receive a payment of health nurse to transfer. However the public health compensation of e2,200 for their employer’s breach of nurse felt that her selection was unfair and the matter the legislation. The employer failed to implement or was referred to the Rights Commissioner. The Rights appeal the decision and the INO then referred the Commissioner found that the HSE North East did not matter to the Labour Court. The Labour Court issued follow its own procedures for selection to the letter and determination number PTD064 and PTD063 confirming thus created an atmosphere of concern and fear with the Rights Commissioners decision on 28 August 2006. the claimant who is suspicious of the motivation for Since that time the owners of Hillview have failed to her transfer. He recommended that the public health implement its determination and the INO has issued a nurse return to work at her base in Summerhill. He notice of motion for relief under Section 18 of further recommended that the claimant’s sick leave Protection of Employees Part-Time Work Act 2001 to record be amended to eliminate the period of sick the Circuit Court of County Meath. Court hearing is set leave surrounding this incident and that the HSE would for 29 January 2007. issue a letter of assurance that there would be no repercussions for the public health nurse as a result of HSE – North Western Region the investigation committee or the Rights Noel Treanor Commissioner hearing. The more things change, the more they Community Registered General Nurses: stay the same and in many ways this is • Labour Court recommendation 18680: The INO true of the issues and disputes which referred the matter of the unfair maintenance of dominated in 2006 in the North West. community RGNs in the North East region on an eight hour contract despite the fact that they work well in The issue of staffing levels remains excess of this contract on a weekly basis. The Labour high on any nursing agenda, Court recommended in favour of INO claim stating that particularly in care of the elderly and learning the HSE North East in accordance with Section 25 of disability environments. No sooner had members in the Flexible Working Agreement 2001 revise where Aras Carolan in Mohill and St Patrick’s, Carrick-on- applicable the permanent contracted hours of each of Shannon secured additional staff to allow two nurses the claimants from the minimum level of eight hours to be on each unit on night duty, than the claim was per week to an average of the hours worked weekly lodged for the Rock Unit in Ballyshannon. Additional excluding holidays over a period of two years prior to staff have been sought for Cregg House also. the 1 September 2006 and that this be accepted by the While the latter issues remain in process, it is reflective union. At the end of 2006 this exercise has been of the growing knowledge amongst members that completed with the results being circulated to the they are sufficiently strong to pursue such issues community RGNs and it is hoped that new contracts successfully. The HSE have at least been consistent, by for the appropriate hours of work will be issued to the prevaricating and dragging their feet in response to CRGNs. such claims. St Oliver Plunkett’s Hospital, Dundalk: With the new HSE West structures in place, meetings • Rights Commissioner Recommendation R033713-PT- were held at a regional level but to date the HSE have 05-GF: The INO referred a matter on behalf of four part- been spectacularly unsuccessful in effective change. time workers who were not receiving their time and Indeed they are now taking the position that further one sixth payments between the hours of 6pm and staffing reviews should not be conceded at any stage. 8pm. The INO argued that this was in breach of the There were a number of third party recommendations Protection of Employees (Part-time Work) Act 2001. throughout the year. A number of these were The Rights Commissioner found in our favour and regrading claims pursued on behalf of some members stated that the national guidelines of the HSE which with success.

28 Irish Nurses Organisation Annual Report 2006

Recognition of the role of night managers has been a HSE – particular theme, but again, the HSE have often sought Southern Region to reinterpret or sometimes ignore recommendations. Michael Dineen/ Patsy Doyle Other third party recommendations included both festival and concession days in the community. While Bon Secours Maternity a recommendation is one thing, implementation is Hospital: The closure quite another and there has been a lot of seeking of of the maternity clarification, reinterpreting, reverting to the Labour services within the Bon Relations Commission and so forth. This may be Secours was announced in November 2005. The satisfactory for the employer but results in company have sought to portray this as a transfer of dissatisfaction amongst the membership. undertakings between themselves and the HSE. The INO referred the matter to the LRC in March 2006 at There has been a marked increase in the number of which time the Bon Secours refused to participate in Trust in Care investigations which have taken place in the conciliation process. The company eventually the North West. Of all of them, I am firmly of the agreed to attend the LRC culminating in a conciliation opinion that only one actually warranted investigation, conference in August which proved fruitless. and this eventually exonerated the member from wrong-doing. The others that I have had to deal with Subsequent to this, the INO balloted its members for have been spurious or indeed quite ridiculous, but industrial action which culminated in the Bon Secours have been investigated. This, I feel, is a reflection of ironically seeking the intervention of the LRC. A managers and HR being more fearful of patient and number of conciliation conferences then ensued relative complaints than of any real sense of abuse resulting in the issues being referred back to local having taken place, and that by pursuing full negotiations which should have occurred in the first investigations they are somehow protecting instance. themselves. This again necessarily puts undue and Some progress has been made at these negotiations unreasonable pressure on our members at the centre with regard to retraining etc. but the Bon Secours of such allegations. refused to countenance the payment of any There were some victories in the year. HSE compensation for disturbance or relocation. management eventually got around to conceding that additional hours worked over and above contracted Mercy University Hospital: Negotiations underway hours, and less than 39, should be recognised for with regard to the opening of an enhanced accident superannuation and pension purposes. While this is and emergency department. Agreement pending on merely common sense, it took much effort and a staffing arrangements for a discharge lounge. couple of valiant individuals and locations to proceed South Infirmary/Victoria University Hospital: Several with cases before management conceded. conciliation conferences have taken place with regard The issue of the payment of premiums by 24-hour to the rates that apply to those providing third on call clock, while not entirely resolved as we are awaiting services within theatre. A further conciliation finality at the Labour Court, at least went some way to conference is scheduled for February. being addressed after a very long time. Each work Brothers of Charity – Lota: The Brothers of Charity are location affected reverted to their normal system prior in the process of transferring clients to the community to PPARs. and restructuring staffing within campus. The matter The issue of patients on trolleys actually got worse in has been the subject of numerous conciliation Letterkenny Hospital over 2006. While there is some conferences. Another one is scheduled for February. light with the anticipated introduction of the modules St Patrick’s Hospital/Marymount: A claim with regard unit in early 2007, there are still many steps to be taken to calculation of holiday premiums was referred to before Letterkenny General is allowed to function as a conciliation. A date is awaited for a Labour Court normal regional general hospital. hearing. Successfully processed a claim with regard to The levels of activism amongst members remains calculation of sick leave arising through a work related variable and a regional activists committee set up in injury to the Rights Commissioner service on behalf of late 2005 has been functioning throughout 2006. It a member employed within St. Patrick’s. appears to be working well and has a valid role in St Joseph’s Foundation, Charleville: Significant supporting branches and activists, ensuring an improvements achieved on behalf of our members exchange of information. It has also focused on issues within Charleville. The company have conceded that such as recruitment and regional strategies for the pay the INO have the right to represent nurses employed campaign. as social care workers within the Foundation. Activists nominated to attend have been very positive Kerry General Hospital: Phase one of a staffing review about its function and it is seen to be an enhancement of Kerry General Hospital was published in December. for the Organisation in the North West. This has highlighted the need for the creation of up to

29 Irish Nurses Organisation Annual Report 2006

70 additional posts across nursing, care staff, portering October. A 15 person committee volunteered to work and clerical grades. Phase two of the review is on collective issues within the hospital. To date currently being conducted. Meetings with the HSE are progress made to raising awareness on: pending. • Non replacement of nurses during absence • Ad hoc management of care assistants Dingle Community Hospital: The application of the • Victimisation Gaeltacht allowance to our members employed in • Grievance procedure. Dingle Community Hospital was the source of a conciliation conference. We are awaiting a date for a It is fair to state that the HSE (SA) currently expects the Labour Court hearing. nurses to work in an unsupported environment. This has increased the turnover of nurses from the system. Listowel Community Hospital: Staffing issues within The INO is committed to making improvements Listowel are the subject of ongoing negotiations under against this rigid management and has made progress the auspices of the LRC. during the year on: Aras Mhuire Nursing Home Listowel: A Labour Court • Upgrades to CNM2-ITU – successful recovering plan hearing was held with regard to our members having • Upgrades for nights sisters public service rates applied to them. The • Regularisation of long term actors recommendation that issued has set a six month • Additional nurses in radiology timeframe to allow the employer to raise the requisite • Securing permission of nurses prior to referral to funding to enable them to pay the appropriate rates of occupational health pay to our members. •Supportive work on long term sick leave • Opposition to paid parking St. Finbarr’s Hospital: • Representation of nurses at investigations • Care of the Older Person: Claims lodged and • Referral to Labour Relations Commission of failure to advanced throughout the year on the need for an allocate parental leave in units of days when every independent staffing review. The site has now been other discipline enjoys it within the hospital. selected to form part of the national pilot on Unified Maternity Services: Recidivistic attempt to workforce planning systems in care settings. suppress the post of director of midwifery on the eve • Children’s Unit: Talks are underway on proposed of proposed relocation to CUH in March 2007. Massive closure of this infection disease unit and subsequent wave of support against this by midwives, relocation to Cork University Hospital. As the move is obstetricians and ancillary staff. Post returned to the viewed as ill thought out by the majority of our service. Full support from other directors of nursing in members, most of the nurses have chosen not to the region. Slow progress on proposed move to Cork relocate to CUH due to poor infrastructure – absence University Maternity Hospital. Building is in excellent of isolation unit for patients or access to car parking. condition. However management has not invested in working with the INO on the recommended staffing Cork University Hospital: A year fraught with an levels, management sub-structure or maintenance of aggressive bed management policy which culminated free car parking. in a reduction in waiting time for beds in the accident and emergency department, an enhanced admission Some progress on: lounge and rapid transit ward, yet the system • Confirmation to permanency for long term actors. continues extremely pressured and many of our • Confirmation to permanency of all temporary members in the emergency department are planning midwives. their departure from this untenable work. • Strengthening links with obstetric and gynae division. Efforts by the HSE to lead out on a pan-Cork initiative have not been successful to date. The CUH and Mercy Millstreet Hospital: Additional twilight hours (nursing) University Hospital continue to struggle to maintain and additional nursing cover on Sunday afternoon service in this area. accepted by the membership. Office Accommodation: Extremely aggressive Bantry General Hospital: Handover time now recorded approach witnessed from the general management as time in lieu and retrieved at a mutually agreeable team which has been countered by INO. Our members time. Regularisation of long term actors at in some cases were literally handed ‘eviction notices’ promotional level (over four years acting). which were vetoed. Lourdes Hospital Inquiry: Full support given to our Industrial Relations Climate: Disastrous IR climate in midwife members during the inquiry and on evidence as no buy-in from senior managers and sub publication of the report in February 2006. plot of avoidance and subsequent circumvention of Midleton Community Hospital and Fermoy fair procedures. Referral to the Labour Advisory Community Hospital: Six CNMs (internal) upgrades Service – CUH refused to participate. with retrospection to April 2006. These posts have full A total of 100 members attended a hospital meeting in access to weekends and night duty.

30 Irish Nurses Organisation Annual Report 2006

O’Brien Street Health Centre: The INO has attended reach out to their staff and: three LRCs on the claim to evacuate our members • Value their contribution to the service from this Victorian building. Some success when, in • Replace sick leave in a structured fashion August 2006, following referral to Fire Officer, Health • Offer term time/parental leave fairly and Safety and radon levels captured, the LHO • Provide a uniform study leave programme manager deemed it “a totally unsuitable building and • Process grievances in a timely fashion as close to the it should be gutted”. At time of going to press the HSE point of origin (SA) have made an offer on a new town centre • Concentrate on retention of nurses premises. • Uphold the duty of managers to provide a safe system of work Cobh General Hospital: Supportive Labour Court • Listen and communicate. recommendation on superannuation – referred back for definitive recommendation. HSE – South East Region Complete breakdown in the internal workings of the Liz Curran Board of Management and our members. The hospital has been allowed to exist in isolation to other Tipperary: community hospitals in the area and unsafe practices • In St Brigid’s Hospital in Carrick-on- had emerged: Suir, the long-overdue independent • Breakfast for patients at 5am staffing review was completed by Betty • Locked supplies cupboard Brady, and her report and • Old fashioned rosters and staffing levels recommendations were issued in • Lack of cohesion between disciplines. September 2006. The report recommends substantial The INO sought the appointment of a clinical additional staffing in the service, as well as facilitator. Our members maintained a three week work improvements in other non-staffing areas of the to rule over Christmas and held a one hour protest on service. Meetings regarding the full implementation of 21 December 2006. On the eve of an INO planned the recommendations have been held with candelight procession in support of the members, the management locally. hospital conceded a clinical facilitator and a • The dispute regarding the implementation of the secondment of a HSE director of nursing. We await remaining elements of the independent staffing progress. The INO applauds the tenacity and review in St Patrick’s Hospital in Cashel was referred commitment of our members in Cobh in support of to the LRC by the INO, and interim arrangements their patients. regarding additional staffing were agreed in May Heatherside Hospital: This hospital has been plunged 2006. Agreement was reached in October 2006 into the spotlight since June 2006. We have supported regarding the implementation of the remaining our members throughout the period, where the death elements by end March 2007. of a patient had been subject to a DPP investigation. • The INO recommenced negotiations with The outcome indicated that the nurses did not have a management in March 2006 regarding the case to answer. We await the commencement of the amalgamation of acute services in South Tipperary HSE investigation. General Hospital. Proposals made at a conciliation PCCC: conference in December 2006, in respect of the compensation package payable to members in • One PHN conceded in Midleton area but claim for Cashel, were accepted and the transfer of services four additional posts lodged with LRC due to occurred on 12 January 2007. Generous staffing population explosion. levels were also agreed for each of the services • Community Intervention Teams: The HSE (South) transferred, and negotiations regarding the staffing refused to incorporate a dedicated ADoN (PHN) on levels and future services in Cashel are underway. this team. Service issues, recruitment and retention Kilkenny and Carlow: issues have now emerged and we attend the LRC in early March in pursuance of same. • In St Luke’s Hospital, a number of upgradings of existing posts were achieved, and more are being Health Service Executive: Some improvement in pursued through the LRC. Negotiations regarding recruitment practices and cessation of dual interviews additional staffing for a number of areas of the following successful Rights Commissioner hospital are ongoing, including increased staffing for intervention in the south requested by the INO. An the stroke unit, A&E department, theatre. Revised on- unfair practice had prevailed whereby a candidate call arrangements for theatre were also agreed. could be interviewed for two posts in one interview. • The implementation of the agreed senior nursing Overall, 2006 has been an extremely difficult year for management structure in the hospital (by way of the nurses in HSE (South) and it is reasonable to contend appointment of a second assistant director of that 2007 will not improve things unless managers nursing) has been conceded in principle, though still

31 Irish Nurses Organisation Annual Report 2006

not implemented. This matter has been raised by the incorporates an additional 21 beds for the service. INO at the NJC and the high level group, and Agreement regarding the conducting of an continues to be pursued. The INO secured agreement independent review of the staffing levels in the on the permanent filling of the director of nursing maternity unit has been reached. post there also. • The Labour Court recommendation on the INO • In Aut Even Hospital, Kilkenny, extensive claims regarding staffing levels and relocation negotiations were held regarding the senior nurse payments in St John’s Hospital, Enniscorthy, was management structure at the hospital which saw an favourable to the INO and additional staff, and additional assistant director of nursing post another independent review of the staffing levels, introduced to the service (following redundancy was secured. negotiations on behalf of one member which • Negotiations regarding the future of Ely Hospital, concluded to the members satisfaction). Wexford, are ongoing. The INO claim for Negotiations continue regarding introduction of compensation for loss of premiums for our members CNM1 posts and night nursing supervisory posts in in the service are underway, and negotiations on the service, among other things. service delivery issues are also ongoing. Some • An independent staffing review has been agreed for individual claims were progressed successfully. St Columba’s Hospital in Thomastown, and in the In community care, a number of claims for upgrading Sacred Heart Hospital in Carlow . of PHN posts were progressed through the various • Agreement regarding the expansion of the CAREDOC structures of the Labour Relations Commission. A service to include DUBDOC has been agreed with the compensatory payment of e8,000 was made to one INO, and the pension scheme is agreed for PHN in lieu of her unmet expectation of being introduction as soon as possible. upgraded to CNM3 grade, while a Labour Court recommendation on the INO claim to upgrade PHN Waterford: pre-school services officers in the region saw the issue • In Waterford Regional Hospital, the two year dispute raised nationally with the HSE-EA. regarding the provision of ‘twins’ in theatre recovery The INO and HSE-SE had convened a working group to was resolved in November 2006 by way of examine and address the issue of excessive PHN concession of the INO claim. The expansion of the workload. In response to the INO claims to service to weekends and obstetric theatre also saw management through this process, the HSE have five additional posts in the theatre department. In the offered a total of 17 additional community nursing neonatal unit, revised pay arrangements were agreed posts across the region for 2007 (eg. 1 ADPHN, 5 PHN for part-time nurses on night duty who, owing to and 2 CRGN posts in Wexford) in return for cessation service need, work frequent night duty and are of this working group. therefore unable to recoup premiums on day duty, retrospective to July 2003. In the ENT ward, an Members have given a cautious welcome to these interim agreement regarding additional staffing posts, subject to clarifications about the future levels was reached at the LRC, and the INO claim for provision of community nursing posts to the region two additional nurses on night duty in the A&E (ie. whether part of primary care or not). department has progressed (one extra conceded, A number of claims for improved pay arrangements funding for the other sought). and working conditions have been lodged with the • Various issues, including ongoing negotiations HSE-SE on behalf of community RGN members, and regarding the use of seclusion in the Brothers of are the subject of ongoing negotiations. Some claims Charity Services in Belmont Park, are being have been conceded in some community care areas progressed nationally by the INO. The upgrading of (phones for community RGNs in Waterford) but others the night CNM2 is also being addressed nationally, remain unresolved, and the INO continue to pursue and had been referred to the Labour Court. same. A number of individual issues were successfully resolved, and more continue to be pursued. Wexf ord: • In Wexford General Hospital, the INO secured an HSE – Western Region independent staffing review of the A&E unit in Noreen Muldoon September 2006, which recommended an additional St Brendan’s Home CNU, Loughrea: 6.7 WTE nurses, 7.4 WTE HCAs and 1.2 WTE clerks Imminent improvements were secured for the unit. Agreement regarding the through the INO for our members in St implementation of these additional posts has been Brendan’s throughout the year. agreed, with all posts to be in place within 12 months An independent facilitator was (all nursing posts being immediately implemented). appointed and agreement was reached Negotiations have commenced on the staffing levels on the following: of the new medical ward at the hospital, which • Equity on premium hours of work, ie. Sundays/bank

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holidays and night duty Mayo General Hospital – Theatre: Agreement has been • Change in roster to include some long days reached, following the intervention of the INO, to • Allocation of all nurses to specific wards. appoint an independent facilitator to resolve ongoing issues. Galway Regional Hospitals – Transfer of Trauma: The trauma service was transferred from Merlin Park S ick Pay – Temporary Staff: One of our members is in Regional Hospital to University College Hospital receipt of e3,000 compensation from the HSE West – Galway in November 2006. Most nursing staff Mayo General Hospital following the INO’s remained working in MPRH. Some from theatre and intervention in the payment of sick pay at the time of the trauma ward were redeployed to other wards/ sickness. The INO referred the claim to the Rights departments in the hospital, whilst others had to Commissioner service. The temporary member has transfer into UCHG. been on short term sick leave on two occasions. Sick pay was deducted from salary. She had to wait six MPRH now provides an elective orthopaedic service weeks to be reinstated. Monday to Friday, with no on-call commitment, which The recommendation stated that temporary or fixed incurs a loss of earnings. This was referred to the term employees’ sick pay entitlement, should be Labour Court – two years loss of earnings was calculated to ensure equal treatment between fixed recommended for loss of on-call and call out. One term and permanent employees in all aspects, days leave was recommended by the Labour Court for including any system of retrospective and pro-rata those who transferred to UCHG. An upgrading to payments. The HSE were requested to correct the CNM2 for a CNM1 in MPRH theatre was agreed and breach and awarded e3,000 compensation to our the introduction of a healthcare assistant to theatre member. was agreed. P ortiuncula Hospital: The INO were successful in Theatre UCHG: The INO were successful in getting an having the correct incremental rate of pay applied to a award of e10,000 for a member who was given member, on appointment, having 16 years service in incorrect information regarding the pre-retirement job- the UK. The member was placed on the 10th point of sharing initiative. She continued to work well over her the scale on returning to Ireland. The INO referred the 60th birthday as a result of this. When she applied for claim to the Rights Commissioner and argues that it retirement, management realised the mistake and did was against the 1998 agreement and European Law. not agree to paying agreed pre-retirement terms. Therefore the matter was referred to the Rights The Rights Commissioner recommended that our Commissioners. member was indeed placed on the incorrect increment and should not be penalised, because her service was Galway Hospice Foundation – Bullying Allegation: outside the Irish state, and should be placed on the Following a number of complaints of allegations of long service increment from the time of her bullying by most of the nursing staff against a member appointment in 2001. This is a great achievement for of the medical team, agreement was reached amongst the member, the INO and nurses generally. However, the parties to approach a resolution in a different way. at the time of going to press, the HSE Western Area An independent facilitator was agreed and a Memo of have appealed this decision to the Labour Court. Understanding was drawn up, agreed and signed by Brothers of Charity – Early Childhood Services: The all parties. This included a training fund for nurses. INO were successful in having an existing CNM2 In addition to local agreements which have now been upgraded to CNM3 for 7.5 hours following the introduced, a joint management forum was intervention of the Labour Court. The CNM2s were established for palliative care in the West of Ireland. reporting to the paediatrician, which was unacceptable to all. This comprises: • Consultants Community Services HSE – Interview Process: One of • Management HSE West our members was awarded e5,000 following the • Management Galway Hospice Foundation intervention of the Rights Commissioner service • Management Mayo/Roscommon – Palliative Care through the INO. The INO referred the case, following • INO. a failed interview. It was found that the interview process was flawed and the member was awarded A locum palliative care consultant has been appointed e5,000 compensation. and the service is now on a very positive footing. A third consultant is to be appointed. Roscommon County Hospital – Theatre: The INO were successful in having additional nursing staff appointed to theatre to enable a third nurse to be on call at all times. In addition a dedicated cleaning service has been put in place. Heretofore nursing staff were providing most of the cleaning service in theatre.

33 Irish Nurses Organisation Annual Report 2006 Organisation and Social Policy

2006 saw a number of new the Polish Information and Cultural Centre, developments in the area of social participated in a research project under the auspices of policy, together with an ever the Immigrant Council of Ireland, and supported by the increasing number of nurses Equality Authority. reported to the fitness to practice Work on this project commenced late last year, and the committee of An Bord Altranais. final document was published in 2006. The project provides a valuable framework through which to Social Policy better understand the particular experiences and Committee situation of migrant women workers. The research included face to face interviews with four Clare Treacy, Chaired by Jo Tully (2nd vice- Director of Organisation nurses from the Philippines, working in both the public and Social Policy,INO president), its members include, and private sector. The research identified a double Derek Reilly, Collette Lynskey, burden of racism and sexism experienced by the Regina Durcan, and Joan McDermott. The committee respondents. met on a monthly basis, and received reports from the Director of Organisation and Social Policy, as well as The report also identified the positive outcomes that working on a number of submissions and reports. existed for migrant women workers who joined trade During the year the committee considered matters unions, or sought support from migrant organisations. relating to the following: The INO was specifically identified as a trade union • Childcare, educational support for new parents that has a positive effect on migrant women workers, • Active citizenship in particular the existence of our Overseas Nurses • Suicide prevention Section is viewed as extremely supportive. • Women’s health strategy • Health services for deaf people The research also concluded that positive outcomes • Workplace disclosure resulted from enhanced co-operation between trade • Sex trafficking unions and migrant support organisations. It should • Domestic violence and abuse be noted that the INO has continued to work closely • Mental health and social inclusion with the Immigrant Council of Ireland (ICI), and has • Immigration legislation developed a working relationship where both • Migrant nurse research organisations work together to provide advice and • National anti-poverty strategy assistance to international nurses. A copy of this • Anti-racism. research is available through the INO, or the Equality Authority (www.equality.ie). As you can see the social policy agenda is very broad and varied and some specific aspects including submissions and reports are detailed below. Recruitment and retention of foreign nurses The INO has been invited to participate in a 2.5 year Intercultural and Interfaith Resources (HSE) research study, on the recruitment and retention of foreign nurses in Ireland. The research is being The INO were invited by the HSE to participate in the conducted by the Department of Epidemiology and development of a resource in response to the specific Public Health in the Royal College of Surgeons. Clare needs identified by health sector staff, in relation to Treacy, together with Annette Kennedy and Liz Adams cultural and religious norms of service users. The from the PDC, are representing the INO. purpose was to develop the capacity of staff to respond appropriately to the health and social care The main aim of the study is to provide nationally needs of minority ethnic service users. The resource representative evidence on international nurses, gives a short guide to the cultural and religious groups including their reasons for leaving their home country, living in Ireland including 19 different religions and 33 their experiences as nurses living in Ireland, their nationalities. It deals with such matters as: future career intentions and to identify factors which will influence if they are likely to stay or move on. • Attitudes to health and illness, pregnancy and birth Figures for 2005 indicated that 12.5% of nurses on the • Death and funeral practices live register are overseas nurses. Of the 5,000 • Organ transplant, post mortem and resuscitation. applications for registration in 2005, most were foreign trained, India (56.6%), Philippines (16%), in Consultation in relation to this document was comparison to Ireland (8.7%). completed in December 2006, and publication is expected in early 2007. It is recognised that the Philippines, and some states of India, have a managed nurse emigration policy. Report on migrant women workers However, a growing number of countries are without such policies. International recruitment of specialist The INO, represented by Clare Treacy, together with staff can have damaging effects on source country

34 Irish Nurses Organisation Annual Report 2006

health systems. It is absolutely imperative that Ireland ICTU Strategic Implementation Committee develops a national policy in relation to international for Equality Initiatives recruitment. The ongoing work of this project will be reported in the World of Irish Nursing and Midwifery. Further to motions at ICTU Biennial Delegate Conference, a new equality initiative committee has Leadership Initiatives for Females in Trade been established within ICTU. This committee is attended by trade unions north and south, Clare Unions (LIFT) Treacy, Director of Organisation and Social Policy The LIFT Development Programme is a partnership represents the INO. The committee is chaired by between the Irish Congress of Trade Unions (ICTU), the Rosheen Callender, Vice President of ICTU. Institute of Public Administration (IPA), and the As part of the work of the committee, consultants were National Centre for Partnership Performance (NCPP). appointed to assess ICTU’s equality initiatives to date, This project is designed to specifically identify why and make recommendations in relation to influencing women are under represented in senior trade union policy at national level, supporting affiliate unions in positions, together with an extensive programme equality matters and promoting equality within trade where women are coached and mentored in the area union structures. One of the main aims of this new of leadership and strategic development. committee is to develop an equality educational course for union activists, which will be shortly It is also hoped that the project will assist trade unions available. The committee is also involved in in developing skills to address the under- developing a programme for the Year of Equal representation of women at all levels of the Opportunity – 2007. movement, ultimately hoping to make a real impact on gender equality, and engaging women at every level of Workplace disclosure/whistleblowing the union movement. In response to a request from the INO, a HSE- The project has actively engaged general secretaries of Employers Agency/health union committee was trade unions to participate in the research and a established with a view to producing a policy on number of educational meetings have been run workplace disclosure within the health sector. throughout the year, targeted at women activists. Meetings took place throughout the year. Currently, the INO is represented by Sheila Dickson However agreement on the final document has been (1st Vice President), and Clare Treacy, Director of deferred on the basis of possible legislation being Organisation and Social Policy. It is envisaged that a published in this area as part of the Health Information number of new developments will be rolled out over and Quality Authority Bill (HIQA). the next 12 months, and further leadership programmes are scheduled to take place. Further Meeting with the Filipino Ambassador information can be found on www.lift.ie.

Women’s health strategy A women’s health in Ireland strategy paper launched by the National Women’s Council of Ireland (NWCI), was welcomed by the President Madeline Spiers, and Clare Treacy, Director of Organisation and Social Policy, in October 2006. This extensive document identifies the barrier to women achieving, and maintaining, optimum levels of health. In particular it takes a feminist perspective, highlighting the relationships between women’s unequal status in society, their access to resources, and the health care that they receive. The INO actively participated in the conclusion and development of this Filipino diplomatic delegation visit INO HQ in Dublin; Back (l-r) Tony Fitzpatrick INO policy. IRO; Madeline Spiers,INO president; Clare Treacy,INO director of social policy.Front (l-r): Jainul Rasul Jr,Labour Attaché; John Ferris,Honorary Consul of Ireland; Consul This extremely significant piece of work was launched General Mario de Leon; and Fidel Taguinad,INO Overseas Nurses Section by the Minister for Health and Children, Mary Harney, during which she acknowledged that there have been A delegation from the INO, including two many delays in relation to screening, ie. breast representatives from the Overseas Nurses Section screening. However, she indicated it was her intention (Fidel Taguinod and Cres Abragan), met with the to ensure that the cervical cancer screening was rolled Consul General Mario de Leon, Jainal Rasus Jr. Labour out in a much more effective, and speedier manner, Attache, and John Ferris, Philippine Honorary Consul than the breast screening programme. of Ireland. The delegation also included the President

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of the INO, Madeline Spiers; Director of Organisation All applications are to the President of the High Court, and Social Policy Clare Treacy; together with IROs and An Bord Altranais are generally successful. Philip McAnenly and Tony Fitzpatrick. However, in 2006, the INO was successful in preventing two nurses from being temporarily The Consul General was particularly concerned with removed from the Register of Nurses. the growing number of reports of exploitation by recruitment agencies in the private sector. Examples The complaints made against nurses in 2006 range were given where nurses were required to pay out across a number of areas, including: large sums of money in the Philippines, in order to • Alleged incompetence to practice nursing travel to Ireland. • Alleged physical or verbal assault of a patient The Consul General Mario de Leon confirmed that this issue was being examined by the Philippine • Alleged misappropriation of medication for self use Government, in an effort to apply sanctions to • Alleged inappropriate professional behaviour whilst recruitment agencies if appropriate. The Honorary on duty Consulate indicated that he would keep the INO informed of any developments in this area. • Alleged consumption of alcohol whilst on duty The positive effects of recent legislative changes that • Alleged unfitness to practice due to illness, including allowed for family re-unification were also discussed. alcohol addiction. However, it was noted that a number of nurses found There were five inquiries into nurses on the grounds of it extremely difficult to cut through the ‘red tape’ with alleged professional misconduct, and or alleged regard to this issue. unfitness to practice due to a disability. Overall the Ambassador confirmed his country’s • Two nurses were erased on the basis of alcohol positive on-going relationship with Ireland, and addiction. particularly thanked the INO for actively representing, and supporting Filipino nurses, who are working in • One nurse had conditions attached to her registration Ireland. following self administration of intravenous drugs whilst on duty. Conferences • One nurse who had been working in a private The INO attended a number of conferences throughout nursing home did not have a case proven against her the year as follows: in relation to allegations of stealing drugs and equipment from the nursing home. • ICTU Women’s Conference – This conference was attended by 15 delegates from the INO, including the • One nurse was accused of professional misconduct, President, Madeline Spiers, and Clare Treacy, on the basis that she had not revealed to her Director of Organisation and Social Policy employer the existence of a previous District Court • Suicide Prevention Conference – This two day conviction. In this case the Board re-examined the conference was attended by Mary Walsh, Executive District Court conviction, as it had related to her Council, and Patsy Doyle, IRO conduct as a director of nursing in a nursing home, in addition to examining the allegation of the non- • Social Policy Conference – This conference was disclosure. No sanctions were imposed upon the attended by Derek Reilly, Executive Council. nurse. This is an interesting case to note, in particular because she was convicted in the District Court as Fitness to Practice being the designated person in charge of a nursing home, under the Nursing Home Act, albeit that she A growing number of nurses and midwives continue was on annual leave when the incident occurred. to be the subject of reports to the fitness to practice committee of An Bord Altranais. In addition four nurses contacted the INO seeking representation, however, they were not members of INO Fitness to Practice Cases the INO at the time of the incident, and therefore were not eligible for representation. There were 19 members of the INO reported to fitness to practice in 2006, and surprisingly a Prima Facia case was found in all cases considered to date. A decision is awaited on six cases. In addition to this there were five hearings under Section 44. Section 44 of the Nurses Act 1985 allows for the Board to apply directly to the High Court, seeking to temporarily restrain a nurse from practising if they genuinely are of the view that the public interest is at risk if the nurse continues to practice.

36 Irish Nurses Organisation Annual Report 2006 Professional Development Centre Overview meet specific needs on an in-house basis has increased. Several in-house programmes were held within Now in our new headquarters, the hospitals, as well as at the PDC. Professional Development Centre Workshops provided by the PDC in 2006: (PDC) is continuing to expand and develop at pace. The PDC offers • Active Birth nurses and midwives an essential • Be Assertive and dynamic base for career development, with high spec meeting • Building Effective Workplace Relationships rooms, education and training rooms, • Care Planning conference and library facilities, as Annette Kennedy, • Care and Management of Peripheral Intravenous Director of Professional well as the informative INO and Cannulae Development, INO Nurse2Nurse (N2N) websites. • Challenges in Infection Control The demands on the PDC are great. More students than ever before are studying nursing and midwifery at • Decision Making university level, INO membership is continuing to grow, • Designing and Conducting an Audit of Clinical Practice and changes are ongoing within the healthcare system. • Ethical Dilemmas in Nursing Practice This year we have been involved in national, European and international health related issues, as well as • Heartsaver Healthcare Provider CPR offering, when compared to 2005, an additional 38 • Heartsaver Healthcare Provider AED workshops to INO members. In addition, the library has had a very successful mail shot campaign with regard • How to update your professional Curriculum Vitae to its new database, and the highest number of • Interview Skills enquiries ever. The PDC is committed to offering nurses • Introduction to Palliative Care and midwives the best possible continuing professional development. • Making Meetings Work • Management Skills for Clinical Nurse Managers and Workshops 2006 Staff Nurses • Management Competencies for CNM/CMM Workshops No of Workshops Attendance • Managing Difficult People 2006 2005 2006 2005 • Providing a Framework for Delegating Responsibility Internal 107 55 1,432 775 to Healthcare Assistants (held in PDC) • Recording Clinical Practice and Devising Guidelines, External 10 11 193 210 Policies and Protocols (held outside PDC) • Recruitment Interviews Special Customised 15 4 260 55 Programmes – • Research Workshop internal & external • Risk Management Total no of workshops 132 84 1,885 1215 • Setting up a Parent Education Programme • Speaking with Confidence The PDC increased the number of workshops available • Teaching Skills for Parentcraft Education to INO members. New individualised, discipline-specific and restructured programmes were developed, which • Telephone Triage included: • Understanding People Through Facilitation • Management development programme for directors • Working Creatively with Older People of nursing/midwifery and assistant directors of • Wound Care nursing/midwifery • Writing Skills. • Focus on residential care and older people • Focus on intellectual disability. Conferences While at different stages of the year there have been problems regarding attendance at external workshops Midwives Conference: 220 attended (145 Republic of and conferences, in-house courses were very Ireland, 75 Northern Ireland) successful. Problems with attendance related to the Operating Room Nurses Conference: 56 attended difficulties nurses and midwives encountered when trying to take time off, due to nurse and midwife Occupational Health Conference: 60 attended shortages. The demand for customised programmes to Student Section Conference: 128 attended

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The poster competition was won by Dr Marilyn Richardson-Tench, who examined the evolving role of the nurse practitioner in Australia. Her poster posed the question: what is the role of the nurse practitioner in perioperative nursing? The Conference reflected Ireland’s highest ever number of postgraduate researchers, and advances in clinical training, with 13 Irish speakers.

Ireland’s Annual Joint INO Midwives Section/RCM Midwives Conference was held on 19 October 2006 at the Landmark Hotel, Carrick-on-Shannon. Sponsored by Pictured at the EORNA conference were (l-r): Leonita Iglesia,Bernadette Butler, Johnson Baby, the Conference’s theme was Women Lillibeh Niere,Mary Jane,Melanie McHugh,Eileen Malone,Ruth Kavanagh,Erica and Midwives – Politics and Partnerships. One hundred Flood,and Louise Martin and forty-five INO delegates and 75 Royal College of Midwifery delegates attended the Conference. The Fourth European Operating Room Nurses Association planning committee for the Conference put together an (EORNA) Congress held on 25-28 May 2006 at the RDS, excellent programme, maintaining the high standards Dublin, was hosted by the INO on behalf of the of education that has been achieved over the last few Operating Department Nurses (ODN) Section and years. organised by EORNA. This event replaced the usual ODN Section Annual Conference. President of Ireland, The papers and presenters were very relevant to Mary McAleese, opened proceedings on the largest today’s service provision and the caliber of the ever professional gathering of nurses in Ireland, with speakers was excellent. The poster display, which has over 2,500 delegates from all over the world. The become an integral part of the Conference, exceeded President of Ireland argued that the priority for all expectations and the number of posters displayed healthcare professionals was to provide the best care was 28. environment possible for patients, and praised EORNA for its influencing voice in perioperative care and its The proceedings, which were opened by HSE Nursing/ “many excellent initiatives in practice development, Midwifery Services Director, Dr Siobhan O’Halloran, education and research”. included lively and engaging discussions on topics such as respecting differences; making it happen for women; Turning to home matters, the President of Ireland noted consumers as partners?; integrating community and that Ireland’s “dynamic [health] profession [was] hospital midwifery services; the politics of establishing committed to radical self-updating and upskilling.” new partnerships for practice; and making it happen for President of the INO, Madeline Spiers, praised the midwives. Consultant midwife Faye Macrory, from Conference’s promotion of the profession of nursing, Manchester Specialist Midwives Services, discussed and in particular, perioperative nursing. the challenges midwives faced when caring for families The importance of the Conference was reiterated by in difficulty, particularly those involved in child Irini Antoniadou, President of EORNA, who told protection cases. delegates, “This is your Conference, make it beneficial to you. Participate, maximise your experience. Use this First Annual National Student Nurse and Midwife gathering to bond and let our voices be heard.” The Section Conference was held on 9 November 2006 at Conference’s theme was P reoperative Care: On the the Radisson SAS Hotel, Athlone. The National Student Shores of Excellence. Maureen Flynn, assistant director Section Conference was organised by the Student of nursing at St Vincent’s University Hospital, Dublin, in Section of the INO, which had been set up following the her keynote address, examined works of art to show the implementation of the degree programme. The theme intangible art of perioperative nursing. The Conference of the Conference was Student Today, Nurse Tomorrow centred on the ways operating room nurses are – Nursing the Future, with the keynote address on extending the professional boundaries of their work ‘Nursing the Future’ by Professor George Castledine (a through research and innovative application of new renowned academic and nurse who had set up the first technology, as well as new advances in clinical practice. nursing degree course in the United Kingdom). With a core scientific programme, group sessions were Professor Castledine spoke specifically on caring for held on risk management and the needs of patients, older people and the importance of education. with discussions centering on the complexity of the Other invited speakers were INO President, Madeline nurse’s role and what the future holds for the Spiers; INO General Secretary, Liam Doran; and Marc profession. In addition, EORNA’s new website was Evans, from Cornmarket Group Financial Services. The launched www.eorna.org. Conference provided an insight into the transition Finnish doctoral student Brita Pasila was awarded the students make when they become staff nurses. In prize for the best paper, in which she found post- addition, workshops on record keeping, and Curriculum operative patients desired more information about their Vitae and interview skills, were offered. The Conference surgery, and to be encouraged to ask more questions. was a great success.

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Occupational Health Nurses Conference was held on 10 November 2006 for the first time in the enjoyable surroundings of INO headquarters. The theme was Diversities in Occupational Health, reflecting not only today’s evolving workforce, but the diverse topics discussed during the Conference. Speakers included Dr Derval Igoe, HSE Health Protection Surveillance Centre and Specialist in Public Health; Dr Abbie Lane, Consultant Psychiatrist and Postgraduate Tutor, St John of God Hospital, Stillorgan; Dr Marie Elaine Grant, Clinical and Research Physiotherapist/Head Physiotherapist of Olympic Council of Ireland; and Stefania Minervino, Cultural Diversity Officer from St James Hospital, for Occupational Health. At the ‘Nursing: Celebrating a New Era’event in Farmleigh were (l-r): nursing During the AGM for occupational health nurses (OHNs) graduates,Marie Murphy and Jane Byrne; INO president,Madeline Spiers; Health Minister Mary Harney; Eugene McGinly,graduate; Mary McCarthy; David Wallace, Annette Kennedy updated delegates on exciting student; Ciara Dunne,graduate forthcoming European-led educational opportunities for OHNs. Diploma in Health Services Management – INO/University of Limerick – Distance Degree Celebration Learning Programme To mark the first nursing degree students to graduate in BA Honours in Health Service Management: This Ireland, a celebration, Nursing – Celebrating a New four year programme is aimed at the managerial Beginning, was held jointly by the INO and Department competencies required by nursing and midwifery of Health and Children at Farmleigh House on 6 managers in health service organisations, focusing on November 2006. Students, new graduates, all those developing core competencies. It requires college involved in educating the graduates, clinical staff and attendance one day every three weeks. This year 24 chairpersons from various sections attended the nurses and midwives graduated with a diploma and for celebratory event. While the Department of Health and the first time 12 nurses and midwives were awarded a BA Children organised the invitations and catering, the INO Honours in Health Service Management. Seventy six organised the afternoon event. students have enrolled on the BA programme, and 24 A short video presentation regarding new technology in students on the diploma programme. health and a glance at the future was developed by web Third Management Development Programme for designer Dr Javad Ahmad. Nurses working in the Community (in Room Hire conjunction with the INO, the HSE Western Region, and the University of Limerick): The Several organisations hired our conference facilities programme ran from 2 November 2005 to 21 June 2006. over the past 12 months, including: ESBi, Partnership A total of 23 participants registered on the programme. Rep Training Group, Irish Heart Foundation, Irish It was decided that the programme should be extended Congress of Trade Unions, University of Limerick, and to include all nurses working in the community, FAS. including public health nurses, psychiatric nurses, community registered general nurses, and practice nurses, which brought an interesting and challenging Distance Learning Courses diversity to the group. The programme was designed to The MSc in Nursing (Distance Learning) – INO/RCN/ develop nurses skills in self-management, people Manchester University – This distance learning management, and reflective practice, focusing on the programme continues to be popular. The programme pivotal role nurses have, both individually and comprises of six modules at Masters level. On average, collectively in the community. The programme between eight to 18 people attended each module. provided an opportunity to look at practical steps that could improve the delivery of service to the local Certificate in Health Service Management – community. INO/University of Limerick – Distance Learning Programme. This distance learning programme continues to be highly successful. During the academic National Report year of 2005-2006 30 students undertook, and Prescriptive authority for nurses and graduated, with a Certificate in Health Services Management. The Dublin study centre produced 11 midwives graduates, while the Limerick study centre had 19 The INO has been seeking for many years prescriptive graduates. The graduation took place at the University authority for nurses and midwives and is pleased that of Limerick. the Department of Health and Children has finally

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package of care to the patient. The INO will work with the Department of Health and Children, the HSE and other stakeholders in the implementation of this process. National Qualifications Authority Ireland (NQAI) Accreditation Update The INO prioritised the issue of ensuring that all nurses and midwives are accredited at the same level under the National Framework of Qualifications irrespective of academic qualification, certificate, diploma or degree. The INO has challenged the assumption that nurses and midwives, although having different qualifications to practice are responsible and accountable for delivering INO ADC 2006 delagates look on as they are assured that nurses and midwives the same standards of care and for these and other would have the power to prescribe by the time the 2007 ADC arrived reasons should be accredited at the same level. completed the necessary legislation. The EU Commission has been notified about the legislation as University College Dublin Research: Five required under the Transparency Directive. The Minister Points of Entry will sign the regulations at the end of the three month A comprehensive report on the five points of entry was notification period provided that there are no objections completed following extensive research by UCD on from other EU Member States. behalf of An Bord Altranais. The research found that the The extension of nurse and midwife prescribing majority of respondents to the questionnaire and focus provides enormous potential and benefit for patients/ groups were in favour of retaining the five points of clients and service delivery, including increased entry. accessibility and reduction in treatment time, earlier The report made two recommendations. The first intervention, improved quality and more effective use recommendation was in relation to the retention of five of the nursing and midwifery expertise and skills. The points of entry with some amendments, which the INO is firmly convinced that this is an example of real board agreed to. The five points of entry was retained reform within our health service which will increase the on the basis that a common core training programme responsiveness of the health service to patient need. would negatively effect the recruitment in the following The legislation provides for a registered nurse (the only disciplines: psychiatry, intellectual disability and regulated professional available on a 24 hour seven day paediatrics (and the need for direct entry for midwifery). basis in all care settings) subject to having undertaken an approved education programme, with the Nursing and midwifery staffing levels appropriate clinical experience, to prescribe a range of medications within their scope of practice across a wide The research on nursing and midwifery staffing levels range of settings, including community, continuing has been held up for almost a year by the HSE- care, or acute care. The introduction of nurse and Employers Agency for no justifiable reason. Following midwife prescribing under an appropriate clinical intervention by the INO, steps have now been taken to governance structure will ensure safe and competent complete the tender, which has been posted on the HSE practice. website, with a closing date of February 2007. The final drafting of this legislation marks the end of an The proposed research on staffing levels will provide a extended period of research, pilot studies and template to determine nurse to patient ratio, and nurse evaluation, all aimed at ensuring that this initiative to healthcare assistants (HCAs) ratios. The HSE project could be brought forward in a manner which is Piloting of Appropriate Systems to Determine guarantees patient safety, enhances the ability of the Nursing and Midwifery Staffing Levels. The first stage nurse or midwife to respond to patient needs and to of this research will examine staffing levels in the acute allow for the planned expansion of the role of the sector (including paediatrics), elderly care sector, registered nurse and midwife in this country. general teaching and non-teaching, and psychiatry. The INO has worked tirelessly for this expansion of the The recent studies by Keith Hurst on Beaumont, Mater, role of the nurse and midwife. This new development and Tallaght Hospitals will be used to inform the study, has the potential to transform the clinical setting by as will Michael Shannon’s doctoral research. The 7.63 allowing new models of care to be developed in parallel report and literature review will be incorporated into the with the traditional medical model. This will allow the study. The second phase will examine midwifery (birth nurse or midwife, having carried out a full assessment rate plus), community care, intellectual disability and based upon their competence, and within their scope of children. The research will be: practice, to develop and deliver a more comprehensive • To pilot the workforce planning systems in the care

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settings identified by the steering group in accordance • To determine the level of functioning of the HCA in with the principles and recommendations set out in relation to the 2006 job description. the Report of the Working Group to Examine the The research will be undertaken by Anne Flood, Development of Appropriate Systems to Determine Director of Letterkenny Centre of Nurse Education (and Nursing and Midwifery Staffing Levels last year’s INO research award winner with Ann • To report on the outcome of the above pilot project, McHugh). The project will start in January 2007 and will including assessment of the appropriateness and assist the INO in writing up their policies. efficacy of the tools utilised. It is envisaged that the successful candidate to Sexual Assault Forensic Treatment undertake the research will be familiar with systems The INO has been actively involved for a number of that determine staffing levels. The successful tender years in seeking to improve services for victims of will report to the steering group at regular intervals. The sexual assault and has worked with a number of INO is a member of the steering group. stakeholders regarding nurses and midwives becoming forensic examiners in this area. Following a report by Resuscitation in Care of the Elderly Angela O’Shea, on behalf of the Sexual Assault Review In response to the investigation into resuscitation in Committee, entitled Sexual Assault Treatment Services: care of the elderly facilities, in which a joint statement A National Review (2006), of which the INO was a from the Royal College of Nursing, the British Medical member, the INO lobbied the Department of Health and Association, and the Resuscitation Council United Children to ask for funding for nurses and midwives to Kingdom provided a very explicit framework in relation undertake a postgraduate course in forensic nursing, to resuscitation, the INO sought clarification concerning which will enable them to become clinical nurse/ whether legislation in Ireland equally applies. midwife specialists in the area of forensic examination of sexual assault victims. The Department of Health and The INO discussed issues surrounding definition of Children has granted e3.8 million for new units and the competence, incompetence, children, as well as legal education of 25 nurses and midwives. and ethical points. A guidance document, Cardiopulmonary Resuscitation Guidance, was An implementation group for the introduction of a pilot produced for the Annual Delegate Conference 2006 programme in forensic nursing in Ireland has been set up under the chairmanship of Jim Brown, Director of Nursing/Midwifery Planning and Development to action Healthcare assistants recommendation 3.1 of the report. The On 7 February 2006 a report by the High Level Group on recommendation sets out for “the introduction of a pilot healthcare assistants (HCAs) was received. The programme” in forensic nursing in Ireland, where outcome was that the HSE, under the auspices of the nurses undergo a higher diploma in order to qualify as Nursing/Midwifery Services Director, Dr Siobhan clinical nurse specialists in forensic nursing. O’Halloran, will conduct an evaluation on the impact of Rape/sexual assault is one of the most serious the role of HCAs in the delivery of healthcare. The unreported and under recorded of violent crimes and, research is part of the agreed introduction for the HCAs’ therefore, the prevalence of sexual violence in Ireland is programme. unknown. The 2002 study on sexual abuse and violence The aim of the study is to examine the role and function in Ireland found that more than four in 10 women (42%), of HCAs in the HSE who have undertaken the and over a quarter of men (28%), experienced some Healthcare Support Course (FETAC Level 5). The form of sexual assault in their lifetime. Despite these objectives are: figures only 1% of the men and 7.8% of the women had reported to the Gardaí. • To examine the integration of HCAs as part of the clinical nursing/midwifery team There is currently a very poor service for those victims who have the courage to report the crime, as there are • To establish the transferability of the course content many gaps in the service. There are often long delays in into the clinical practice setting a victim being examined and receiving treatment and in • To develop an understanding of how the course many cases Gardaí have to transport victims to a content could be developed or enhanced treatment unit in another part of the country because of • To identify best practices and structures at local health the unavailability of a medical doctor who is competent service provider level that supports effective to undertake forensic examinations of sexual assault integration of HCAs in the provision of direct patient victims. The INO welcomes the initiative by the Minister care in the clinical practice setting for Health and Children, Mary Harney TD, to fund a pilot programme in forensic nursing. • To identify challenges and shortfalls at local health service provider level in supporting the integration of Forensic nursing has been successfully introduced HCAs in the provision of care in the clinical practice internationally in Europe, the USA and Canada. In the setting and monitor subsequent interventions to USA forensic nurses now conduct the majority of address such challenges forensic medical examinations on both adults and children who are victims of sexual assault. This

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initiative will no doubt improve the service and quality midwife, medicines or class or any other condition that of healthcare to these patients in the future. the Minister may set down. The Irish Medicines Board (Miscellaneous Provisions) Act 2006, Number 3 Child disability contains the enabling provision for the extension of prescriptive authority to nurses and midwives subject The INO continues to be involved in the research to regulations made by the Minister for Health and conducted by the National Federation of Voluntary Children. Bodies on the development of National Best Practice Guidelines and Training for Informing Families of their The Department of Health and Children invited public Child’s Disability, and recently the INO supported the consultation on the extension of prescriptive authority inclusion of registered nurses of intellectual disability to nurses and midwives in order to inform the (RNIDs) in discussions, as RNIDs play a central role in preparation of the Statutory Instrument of the the early intervention of child disability. Regulations. In July 2006, the INO, on behalf of its members, submitted a detailed response that Australian visitors supported the extension of prescriptive authority to all nurses and midwives across all healthcare settings Professor Christine Dufflied, Director of Health through the provision of dedicated funding, and their Sciences, University of Technology, Sydney discussed support for the profession in the clinical environment her innovative research work on skill mix and patient and access to appropriate education programmes. outcomes at INO headquarters on 14 November 2006, while Ros Elms, Executive Area Director of Nursing and The submission, supported by international evidence, Ambulatory Care, Perth, Western Australia, having identified that independent prescribing has a positive undertaken a tour of the USA, Canada, and the United impact on the quality of patient care, patient access to Kingdom to discuss models of nursing care and medicines, and has enabled the skills of nurses and recruitment and retention, took time to have a meeting midwives to be used more effectively and efficiently. at the INO headquarters on 10 November 2006. Response to the Mental Health Commission EU Book Launch 2007 on the Draft Code of Practice Relating to the Admission of Children under the Mental To celebrate INO’s achievement of having four INO representatives holding positions as Presidents of Health Act 2001 European nursing organisations: Barry McConnaghy, In September 2006 the INO was invited to participate in President of the European Student Nursing Association; the Mental Health Commission consultation process on Edward Mathews, President of the European Trade the Draft Code of Practice Relating to the Admission of Union Confederation Youth Committee; Deirdre Daly, Children under the Mental Health Act 2001. President of the European Midwives Association; and Annette Kennedy, President of the European The INO commended the work of the Mental Health Federations of Nurse Associations, the INO are Commission which is attempting to ensure that the planning to publish a book of essays, entitled Forming admission of such a vulnerable group of children under EU Healthcare Policy: a showcase of Irish involvement. the Mental Health Act 2001 is dealt with in an effective, efficient, safe and compassionate manner that best Having four such influential positions is unparallel serves the individual child. The INO supported the among Irish trade unions, and consolidates the INO’s broad principle of the draft code that stated the position as the principle nurse and midwife principal consideration must be the best interests of the representative body. The book will be a series of child and that the child should be involved in the thought provoking essays relating to the role of Irish planning, implementation, and evaluation of their care healthcare representatives in shaping EU debate. The and treatment. launch was due to take place on 5 March 2007 at Dublin Castle. The patron will be Minister for Health and In addition, a number of constructive comments were Children, Mary Harney, TD. detailed that supported the Mental Health Commission in further developing an appropriate and practical code of practice that foremost protects the rights of children Response to National and provides guidance and fundamental principles for healthcare professionals in difficult and often delicate Consultation Strategy circumstances. Response to the Department of Health and Response to the Health Promoting Hospitals Children Regarding the Public Consultation Network on the Best Practice Guidelines to on the Extension of Prescriptive Authority to Support Compliance with National Policy in Nurses and Midwives Relation to Tobacco Management in the In 2006 legislation came into effect that enabled the Mental Health Setting Minister of Health and Children to make regulations to In September 2006, the INO provided feedback on the extend prescriptive authority in respect of the nurse or Best Practice Guidelines to Support Compliance with

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National Policy in Relation to Tobacco Management in the Mental Health Setting, a policy that had been developed by the expert group as an initiative of the Irish Health Promoting Hospitals Network. The INO’s comprehensive response addressed the core principles of commitment, communication, education and training, cessation support, environmental factors, healthy workplaces, and compliance monitoring.

Response to the Garda Síochána on the Provision of Medical Services The Garda Síochána Working Group on the P rovision of Medical Services invited the INO to provide comment EFN president and INO director of professional development Annette Kennedy on the development of an appropriate, effective client- with Dr Jesper Poulsen,Standing Committee of European Doctors centered service. In October 2006, the INO responded by providing a detailed paper on the developments in from 30 national nursing associations. nursing and midwifery practice since the R eport of the Commission on Nursing – A Blueprint for the Future Annette Kennedy, EFN’s President, opened conference (1998) and the rapidly changing healthcare proceedings with a presentation on Patient Safety and environment. Quality of Care and Standards. In addition, the paper outlined the legislative Issues highlighted during the conference included the framework, rules and regulations that govern the fact that the USA will require one million nurses by profession and the scope of practice. The paper 2012, while Canada requires 100,000 and the United outlined the many new initiatives involving nurses and Kingdom currently requires 35,000 nurses. EFN has midwives, including nurse-led and midwife-led clinics, lobbied successfully on a number of issues including and new roles such as advanced nurse/midwife migration, continuing professional development, practitioners and clinical nurse/midwife specialists. sharps injuries, reuse of medical devices, healthcare, care of the older person and mutual recognition of Response to Population Health, of the Health professional qualifications. EFN position papers can be Service Executive, on the National Guidelines found on their website www.efn.be. for the Prevention and Management of EU Services Directive – Health Services Childhood Overweight and Obesity On 16 February 2006 a majority vote was passed in the Population Health, a section of the HSE, requested the European Parliament in which health, both public and INO to comment on the National Guidelines for the private, was withdrawn from the Services Directive. In Prevention and Management of Childhood Overweight addition, the country of origin principal was amended and Obesity. The HSE’s Programme of Action for and passed. Children had developed guidelines in consultation with experts, service providers and users. In October 2006, MEPs and Irish civil servants in Europe had given the INO commended the guidelines for providing good general consensus to this move. In September 2006 DG clinical practice for practitioners and promoting the SANCO released a document entitled EU Consultation importance of intersectorial collaboration in addressing on Community Action on Health Services for childhood overweight and obesity in Ireland. organisations/countries to provide a written response by 30 January 2007. The European Federation of Nurses Associations (EFN) and the INO have issued a response European Report to this consultation document.

EFN News European Men’s Health Forum The European Federation of Nurses Associations (EFN), Annette Kennedy, as President of the EFN, met the formally known as the Standing Committee of Nurses European Men’s Health Forum (EMHF) Director, Erick of the EU (PCN), held a launch on 28 February 2006 to Savoye, and President, Ian Banks, in Brussels on 27 celebrate its new headquarters, name and constitution. September 2006 to discuss issues of mutual interest. A conference was held in the European Parliament, The EMHF gave startling statistics. One man an hour followed by a reception in the EFN’s new headquarters, dies of prostate cancer in the EU 15, while Irish men and dinner in the Renaissance Hotel. Approximately 100 have one of the lowest life expectancies in the EU. The people attended the event, with representatives from EMHF also stated that men are often under-diagnosed the European Parliament, EFN’s General Assembly, as having diabetes and osteoporosis; one in five cases officials from the European Commission, the WHO and of osteoporosis occurs in men. In addition, EMFH argue the International Council of Nurses, as well as delegates doctors often diagnose impotence as a lifestyle

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problem, instead of examining whether it is an requirements regarding OHNs practice within the EU, underlying symptom of heart disease. as well as monitoring any developments within the core curriculum (HOHNEU). European Nursing Student Group Current data on the education of OHNs within the EU is The INO’s Student Section Nurses, who are members of primarily based on anecdotal information, though the European Nursing Student Group (ENSG), hosted a findings have shown major discrepancies between meeting for officers of the ENSG at the INO countries. headquarters on 9-10 March 2006. FOHNEU has also made contact with all the new The group held discussions with INO’s IRO Eddie member states of the EU. Ireland has been twinned with Mathews, President of the European Trade Union new member state Hungary, who although have been Confederation Youth Committee, and INO’s Director of unable to attend any of the meetings, are being briefed the PDC and President of European Federation of on the work of FOHNEU by Irish delegates. Nurses Associations (EFN), Annette Kennedy, to explore how ENSG could achieve greater involvement in relevant European groups, as well as to discuss International Report various issues regarding the education of student nurses in Europe. International Centre on Nurse Migration – Positive Practice Environments European Health Forum The International Centre on Nurse Migration (ICNM), The European Health Forum was held on 4-7 October the International Council of Nurses and the Commission 2006 in Gastein. The title of the forum was Health on Graduates of Foreign Nursing Schools without Frontiers. commissioned the INO to research and write a paper on positive practice environments, focusing on Annette Kennedy participated in the plenary session on international nurses who have migrated and are the European Commission's recently released working as a registered nurse in a given country. document on EU consultation on community action in health services, as well as the workshop Health As positive practice environments for international Professional Migration, which discussed the issues of nurses cannot be considered in isolation, the document managing migration across the EU. provides an overview of the influences of international policies and agreements, the social and personal Harmonising Occupational Health Nursing in benefits and the costs of migration for international nurses based on their experiences. the European Union (HOHNEU) The document offers an outline of issues that need to The PDC is working with five other EU countries - be considered in order to develop a possible positive United Kingdom, Denmark, Slovenia, Poland and practice environment framework that would support Switzerland – on a distance learning programme for long-term integration and the retention of this valuable occupational health nurses (OHNs), in order to develop resource. a standardised and recognised qualification at degree level for nurses who are involved in workplace health Authored by Elizabeth Adams, INO’s Professional Policy management in Europe, primarily OHNs. With Sheffield Adviser, and Annette Kennedy, INO’s Director of the University, from the United Kingdom, taking the lead, PDC, the paper, Positive Practice Environments – Key each country has the responsibility of writing an Considerations for the Development of a Framework to individual module. Support the Integration of International Nurses, was presented by Annette Kennedy at the ICNM conference The partners are ardently working on their modules and held on 20-21 February 2006 in London, before being it is anticipated that the completed programme will be published. The paper is available on the internet at: launched at the Fourth International Federation of www.intlnursemigration.org/download/ICNM_Pos_ Occupational Health Nurses within the European Union Practice_Env.pdf (FOHNEU) Congress on Occupational Health, entitled The Challenge, which is taking place on 19-21 September 2007 in the New Connaught Rooms, Covent Strategic Advisory Group Gardens, London. Annette Kennedy became a member of the strategic advisory group, alongside 11 other representatives The Federation of Occupational Health Nurses from policy, research, nongovernmental and within the European Union (FOHNEU) governmental agencies with expertise and/or interest in migration. The group aims to: Finland and Spain hosted FOHNEU’s meeting in 2006, with Una Feeny attending as the Irish delegate. • Provide advice to the ICNM management group on FOHNEU has undertaken a survey on the education of migration policy, practice, research and strategic occupational health nurses (OHNs) within EU countries, issues to find out how OHNs are educated, and the statutory • Act as a preliminary audience for any papers

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commissioned through this initiative The main focus of this second symposium was patient • Guide the evaluation of, and improvements of the safety, highlighting the critical role of health project. professionals, with Annette Kennedy attending as a representative of the International Council of Nurses. Biennial WHPA Leaders’ Forum ICN Credentialing Forum The biennial World Health Profession Alliance (WHPA) Leaders Forum was held from 20-21 May 2006 in The International Council of Nurses (ICN) credentialing Geneva. WHPA represents over 20 million healthcare forum was held from17-19 November 2006 in professionals from around the world who are Copenhagen on the credentialing of unlicensed attempting to achieve better health worldwide though practitioners. communication and dialogue. Annette Kennedy presented a paper on the Since 1999 WHPA’s most important contribution has development of healthcare assistants in Ireland, as well been to bring leaders representing the founding as giving a country report. organisation, International Council of Nurses; The International Pharmaceutical Federation; The World Publications Dental Federation and The World Medical Association, • 2050 A Health Odyssey. Thought provoking ideas for together in a symposium. policymaking.

45 Irish Nurses Organisation Annual Report 2006 Online and Information Technology

This year the INO library and information services has prescribing in Ireland, the INO library started to continued to develop both in terms of its acquisitions expand its pharmacology collection in 2006, with the and its usage. As can be seen from the figures below, plan to continue obtaining acquisitions in 2007. there has been an increase in the number of nurses During 2006, the library catalogue system was using the INO’s library online services. upgraded. The new INO library catalogue now enables all staff and INO members to view and search the Library catalogue on-line, as well as access on-line reports and documents. The INO library holds a very comprehensive range of material on nursing, healthcare, and industrial relations, including: Photocopying and Document Supply • 55 journal titles In addition to a photocopying service, all documents not held in the INO library are available to members • 77 E-journals through the Irish Healthcare Journal Holdings Co- • 5,700 books, reports and official publications operative, The Nursing Union of Journals (UK), or the British Library Document Supply Centre. • Directories An increase in the outside use of our inter-library loans • Newsletters service has been due to the INO library housing An Bord Altranais journal collection. • Online databases. Services offered by the INO library during 2006 Literature Searches included: The number of literature searches carried out by the Journal Collection library staff decreased in 2006 due to increasing access to online nursing and medical databases, including the The INO library provides access to a comprehensive new EHS on line database. journal collection, holding subscriptions with all the core nursing/medical and industrial relations journals, Current Awareness Services as well as offering online access to the INO library’s growing collection of electronic journals. The monthly Current Awareness Bulletin, which contains the contents pages of all the journals received Computerised Services by the INO library during the previous month, is available to all INO staff and members who subscribe The library offers access to the following online to this service. reference databases: Other resources, such as daily newspapers, journal • Cumulative Index to Nursing and Allied Health articles, and websites are scanned on a regular basis in (CINAHL) order to keep INO staff and members up-to-date on current events and information. • Medline (Clinical) With an increase in the amount of full text information • The British Nursing Index available on the Internet, scanning websites has • Cochrane Library (evidence-based research, some become increasingly important. full text) • MIDIRS (Midwives Information and Resource User Education Service) In 2006 a number of workshops were held on • Clinical Resource @ Ovid. information and library skills, including courses on: planning literature searches; journal literature; During 2006 all INO members could avail of the free references and referencing; practical sessions in the online databases CINAHL, British Nursing Index, and library; research process; library skills, and full-text journal literature, as well as having access to computerised information retrieval. the recently obtained databases MIDIRS and Clinical Resource @ Ovid, through the INO’s website Tours of the library’s facilities is offered to all nurses, www.nurse2nurse.ie. midwives, and other librarians who visit the library.

Book Collection Statistics January – December 2006 The INO library holds a comprehensive collection of The library and information service has seen an books, reports, and official documents on nursing, increase in the use of its services during the past year. medicine, health, industrial relations, and other related The following statistics have been recorded from areas. With the proposed introduction of nurse January 2006 to December 2006.

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from a range of countries. The highest number of Inter-library loans queries 1,183 visitors to the INO website came from the United INO photocopying requests and 1,950 Kingdom, United States, and Australia, followed by queries received by telephone/post/ Spain, Canada, and the Netherlands. fax/email Most Irish visitors come from Dublin, Limerick, Cork, Louth, Galway, Westmeath and Waterford. The INO Queries relating to Nurse2Nurse, 1,500 website currently has a total of 5,568 pages. and online services A statistical analysis of www.ino.ie showed that the site had almost four million visits in 2006. The INO Personal visitors to the library 540 website is referenced in over 9000 Internet pages globally. As the INO website is one of the only websites Online and Information providing a comprehensive industrial relations Technology Update question and answer section, traffic to the website continues to rise. INO website The INO website is updated on a daily basis with the INO website, now in its 10th year, has continued to be latest news and events in the world of Irish nursing a great success both in Ireland and abroad. Site and healthcare. Pay campaigns are highlighted and Analyze now provides us with a detailed analysis of promoted extensively via the INO website, while the INO website, including daily statistics, visitor trolley watch figures are heavily accessed by the demographics, website traffic patterns, search engine media. INO members who visit the website at effectiveness, and many other website metrics. www.ino.ie are provided with a broad range of information about all of INO services. Following this detailed analysis a new front page of the INO website was designed to enable the user to The INO website gives INO a very valuable presence in easily access areas within the website, such as rights today’s online world, providing answers to queries 24 and entitlements, PDC, media news, and the library. hours a day, seven days a week. Since October 2006, statistics have been compiled on a monthly basis. They show that the INO site pages are Nurse2Nurse (N2N) Website viewed by over 90,637 users, with an average of 10,000 The website/one-stop shop www.nurse2nurse.ie new visitors per month. (N2N) provides up to date education and research information for nurses and midwives in Ireland. The In November and December the number of users of content of N2N is comprehensive, credible, the INO website was similar, with many users being convenient, and current. INO members are provided referred to the INO site by search engines such as with the opportunity to search for information from Google, Yahoo, and MSN. work, home, or from any other location where the Interestingly, the users visiting the INO website come nurse/midwife has Internet access.

www.ino.ie – Page Views Oct-Dec 2006

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www.ino.ie – User Sessions Oct-Dec 2006

[email protected] and [email protected], which is Busiest days and hours in terms of page views N2N’s email system, is currently being used by 6,306 nurses on a regular basis. The usage of this email Busiest hour on average 15.00-15.59 (223 page views) service has increased in 2006. Busiest week day on average Thursday (3,498 page views) Information Office Busiest day 22 Nov 2006 (5,062 page views) During the year 2006, a comprehensive industrial Busiest hour 14.00-14.59, 23 Nov 2006 relations research and information service continued to (675 page views) be delivered by the information office to activists, members and staff of the INO.

N2N has received acclamation from many individual In addition to meeting the ever increasing requests for nurses and organisations for its user friendliness, information and advice, a wide range of information presentation of up-to-date information, and its links for continued to be collected from a variety of sources and accessing a host of nursing and/or midwifery related disseminated to the various levels of the Organisation. information. N2N is the only website of its kind in Throughout the year the staff of the information office Europe. responded to requests for information and advice on a A new clinical database, Clinical Resource @ Ovid broad range of issues including pay, superannuation, (CR@O), was added to Nurse2Nurse in 2006. This workplace issues, policies and procedures applying to database is an excellent source for clinical nurses, health service staff, employment legislation and other providing quick answers to clinical questions at the matters of concern to members. point of care. Proactively, the staff of the office continued to utilise a Searching CR@O allows the user to run one search number of different ways in which to communicate across numerous resources, including evidence based information to INO staff and members. These included treatment guidelines, Medline, drug facts and the production of explanatory leaflets on employment comparisons, guidelines, and CINAHL. rights, publication of information booklets, the maintenance and development of a rights and N2N continues to prove very popular with its entitlements section on the INO website, and the members. Around 200 new nurses register monthly. production of articles for inclusion in the INO journal, the During 2006, the total user population varies between World of Irish Nursing and Midwifery. 10,000 in the summer, up to 15,000 during the winter months. The total number of users registered on N2N The staff of the information office continued to support with valid username and password on 31 December the training activities of the Organisation. 2006 was 14,127. Research The front page of N2N had 677,690 hits in 2006, with the largest number of hits in February 2006 (87,250) The information office continues to provide a and December 2006 (90,000). comprehensive research service for the industrial

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relations staff of the INO. It conducts research and officers, nurse representatives and section officers for statistical analysis and is involved in the preparation of display on nurse stations and other visible areas in their reports on issues relating to nurses’ pay and conditions places of work. of employment. In addition to providing the latest information on key In addition, the staff of the office regularly reviews pieces of employment legislation and nurses’ rights and industrial relations and employment law journals and entitlements at work, the calendar also contains contact websites to identify precedent-setting decisions/cases. details of INO regional offices. The calendar continues to be very popular with staff and members alike. Explanatory Leaflets During 2006, the information office continued to add to Practice Nurse Booklet its extensive collection of explanatory leaflets on nurses’ The Information Guide for Practice Nurses provides rights and entitlements at work. details of the up-to-date pay and conditions of The leaflets are updated on an on-going basis to take employment of practice nurses as recommended by the account of developments in both employment rights INO. Details of the INO’s professional indemnity legislation and conditions of employment of nurses. insurance cover and guidelines in the event of a claim During the year a number of leaflets were up-dated to are also contained in the booklet. reflect such legislative developments. Training INO Diary 2007 The staff of the information office continued to support The INO 2007 Diary was distributed to Executive Council the INO’s training activities, providing training in members, branch officers, section officers, nurse information skills and employment legislation to both representatives and staff. The diary contains up-to-date INO staff and nurse/branch representatives. information on members’ rights and entitlements at work, useful names and addresses, and details of the full INO Website – Rights and Entitlements range of services and benefits available for INO Section members. The rights and entitlements section of the INO website INO Desk Calendar 2007 continues to be an important information resource for INO members and activists. It is compiled and The INO 2007 Desk Calendar was distributed to each maintained by the Information Office and is continually member along with the December issue of the World of updated to reflect the latest legislative developments in Irish Nursing and Midwifery. As in previous years, employment rights and nurses’ pay and conditions of additional calendars were also distributed to branch employment.

49 Irish Nurses Organisation Annual Report 2006 National Section Reports Overview The enhancement of effective communication between and within the national special interest The past year has been a groups continues, and has been further enhanced by particularly productive year for ongoing development of the sections’ webpages and the Organisation’s special the dissemination of a dedicated newsletter on all interest groups. There are section activities twice annually. currently 25 active sections within the Organisation, with The section pages within the World of Irish Nursing sub-sections and national and Midwifery magazine are growing from strength to network groups aligned to them. strength with many contributions from members of our national sections relating to their current and Mary Power, A great interest exists within the ongoing activities continuing to attract great attention. Section Development Officer, membership of these sections to INO further draw on the enthusiasm An SMS texting service has also been put in place within the section by running conferences, workshops through the section office, whereby members can be and courses for their membership. A significant reminded of their forthcoming meetings by text number were organised throughout the year through message directly to their mobile phones. the section office, and brief details are as follows: This service is primarily being used within the Student • Accident & Emergency – February – attended by 40 Section, but it is being rolled out across all the national sections. • GP Practice Study Day – September – attended by 53 The Midwives Section are into their second year of • Telephone Triage – September – attended by 86 publishing their own newsletter which is aimed at keeping the midwifery members up to date on all • Clinical Nurse Managers/Clinical Midwife Managers – relevant issues of both a national and international September – attended by 24 nature. • Midwives – October – attended by 200 A very successful nursing and midwifery student • Students – November – attended by 125 recruitment campaign was conducted over September and October during which we attracted in excess of • Care of the Older Person – November – 1,151 nursing and midwifery students into the attended by 60 Organisation (see Table). • Occupational Health Nurses – November – attended by 60 New sections which developed during the year College No Students Recruited include: Waterford IT 105 Clinical Nurse Planners Athlone IT 40 Their mission statement is to provide staff and Dundalk IT 144 patients with an excellent clinical environment for provision of care and support services. The clinical Tralee IT 44 nurse planner will advise on the development of UL 104 optimal clinical and support facilities, based upon professional nursing and midwifery expertise, in a UCC 222 collaborative process and in accordance with a design DCU 190 brief. TCD 178 Third Level Student Health Letterkenny IT 85 The Third Level Student Health Section was formed GMIT 19 earlier this year. This group is made up of members and affiliates coming from both the universities and NUI Galway 20+ the Institutes of Technology, both of whom employ Total 1,151 nurses who have responsibility for student health. This group issue their own newsletter entitled UNIT News which is published on a quarterly basis. We also have a very dedicated team of nursing student The allocations liaison officers networking group was officers and representatives who are committed to reactivated in late 2006. A strong interest was progressing issues both nationally and internationally expressed by the members for same. The next through the Student Section relevant to the nurse and meeting is scheduled for March 2007. midwife of the future. This year saw the election of our

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former Student Section vice information and support nurses within this specialty. A chairperson, Barry McConaghy, to major trauma study is planned for June 2007 to the position of President of the promote both personal and professional development European Nursing Student of emergency nurses in this country. Association (ENSA). The annual general meeting of Assistant Directors of Nursing/ ENSA is currently being organised through the section office, and this Public Health/Night four day event was scheduled to Superintendents Section Jean Carroll,Assistant take place in the INO head office in Section Development Three meetings of this Section have taken place since Officer July 2007 the AGM in 2005. The first meeting took place in It is expected that nursing and February in INO head office. David Hughes, Deputy midwifery students from across 20 countries will be General Secretary addressed the meeting on the role represented at this event, and members of the Student of the assistant director and salary. A delegate and Section see it as a great honour to be hosting this observer were elected to attend the Annual international event. Conference. The following publications were also finalised during The second meeting, held in April 2006 in the INO the year: Galway Office was addressed by Dermot Ryan, • Guidance document on the process steps towards Regional Manager, Cornmarket, on the issues of accessing an advanced nurse practitioner position pensions, tax entitlements, AVCs and the changes to within the community care service same in view of recent legislation. • CPC ratio review and survey outcomes were The third meeting held in Tullamore in July was well published attended. A report from the Annual Conference was given and a delegate for the Special Conference in • Care of older persons facilities survey completed Croke Park was elected. Dermot Ryan from • RNID Provision of educational services for people Cornmarket was again in attendance with severe and profound Intellectual disabilities document was completed. Care of the Older Person The success of the following on-line surveys Section continued, and will further be developed throughout 2007: Three meetings took place throughout the year, in addition to the annual workshop and AGM in • On-line nursing student questionnaire (ongoing) November in Dublin. Sixty people attended, as this is • A&E incident audit report (ongoing) the maximum number that could be catered for. Two excellent speakers participated in the annual workshop We would like to extend our sincere thanks and and they were Maria Bailey on End of Life Care and appreciation to all our national section officers, both Kay Craughwell on Skill Mix and Risk Management. outgoing and incoming, who continue to support and work so tirelessly on behalf of their special interest The Section was represented by Breda McHugh, groups. national chairperson, at a number of events during the year. They included: Accident and Emergency • Improving Quality of Life for Older People Conference Section • Healthy Ageing Conference The A&E Section actively promoted the specialty of emergency nursing during the year. A new Section • A joint celebration by the INO and Department of secretary was appointed and three meetings Health and Children entitled – Nursing – Celebrating conducted – two in Dublin and one in Tullamore. a New Era to celebrate the first nursing student graduates. The Section actively addressed the issue of the bed crisis at national level striving to promote dignity and The Professional Development Centre also ran an respect for all patients. extensive series of workshops on the care of the older person which were very well attended. It also continued an incident audit form to keep track of what nurses are exposed to in accident and emergency with the aim of promoting a safer Clinical Nurse/Midwife workplace. Manager Section The webpage was developed to help share The Section was formed in November 2004 to include

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all CN/MM1s and CN/MM2s and the Section met three Sub-groups were formed to address some of the times during the year. above issues and the work is ongoing. A steering committee headed by Maura McGrath and directors of The mission statement of the Section is: The Clinical nursing/midwifery representatives are in dialogue to Nurse/Midwife Managers Section will be the move forward the agendas. representative clinical voice for nurse/midwifery ward managers committed to raising the job profile thereby The other issues discussed at the meetings included: enhancing the standards of patient/client care. • General industrial issues pertaining to the 35 hour The aims of our Section are: week • Highlight the role of present day ward manager as • The salary levels of the directors of nursing/ head of clinical practice at unit level midwifery. • Secure supernumerary status for all CN/MM2s acting up CN/MM2s Midwives Section • Protected time for CN/MM1s for management duties. The Midwives Section meets regularly at venues The Section objectives are: around the country. A quarterly newsletter is produced • Lobby Department of Health and Children/HSE to to keep midwives up to date with national, European ensure the provision of relevant education for ward and international issues relating to midwifery and managers maternity services. • Influence nursing/midwifery policies locally and Annual Delegate Conference: At the ADC in May the nationally chairperson represented the Section. The motion proposed by the Section requested the INO to actively • To ensure that ward managers are represented on all work for the full implementation of the Commission on hospital/regional groups relevant to patient care, Nursing report. inclusive of service planning, etc. The ADC was a very disappointing occasion for • Uniformity/equality of role for clinical managers midwives. The delegates voted to reject the motion to (review of workload weighting/measurement tool) change the name of the Organisation to the Irish • Mandatory administrative support for ward Nurses and Midwives Organisation. The International managers Day of the Midwife, falling two days later, was not a time of celebration for Irish midwives. • To network and share information among membership Annual Joint Conference: The 13th Joint RCM/ • Forge links/partnerships with other sections within Midwives Section Conference was held in Carrick-on- the INO. Shannon in October 2006. It proved to be an attractive venue with increased numbers attending. This year the During the past year the Section has concentrated on conference will take place in the Armagh City Hotel on increasing its membership and strives to have a 18 October, 2007. Johnson’s Baby was the main representative attending Section meetings from every sponsor for the 2006 conference and negotiations with hospital in the country. the company are ongoing for this year. The networking opportunities proved very valuable over the last year. An educational workshop was held in September 2006 which was very successful. The Section would like to make this an annual event.

Directors of Nursing/Midwifery/ Public Health Nursing Section The Section met on four occasions. The issues of concern during 2006 were: • The reporting relationship of directors of nursing/ midwifery • The future of the nursing midwifery planning and development units The conference organising committee from the Midwives Section and RCM were (l-r): Katie Alvey,secretary; Sally Miller,vice-chairperson; Mary Higgins,chairperson; Mary • The banding structure of hospitals affecting the Caddell,RCM Regional Officer; Breedagh Hughes,RCM Northern Ireland; Deidre Daly, salary levels of directors of nursing/midwifery. international officer; Ann-Marie O’Neill,RCM conference co-ordinator

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International Confederation of Midwives: In February separate representation is not understood or accepted. the first meeting of the Central European Region (CER) Pre-registration midwifery education began in 2006 took place in Berlin. It was very well attended and a and it is expected that post-registration midwifery considerable amount of work was done in identifying education will transfer to third level institutions this the issues that the CER needs to consider over the year. coming two years. Belfast was the venue for the November 2006 meeting. The move to third level institutions, while welcome, raises issues for the Section and for the future of It was hosted by our colleagues in the Royal College of midwifery in general. At present it appears that those Midwives, Northern Ireland Board. Two further in midwifery education will not be represented on the meetings are planned one of which will be a Pan Executive Council. The review of the rules of the European meeting to plan an organised and united Organisation gave us an opportunity to remedy this approach to the Council meting in 2008. situation. We await the outcome of the review. Planning for the next Triennial Council meeting and Congress is well advanced and Irish midwives are Nurse and Midwifery Education actively involved in the preparations. Deirdre Daly is on the scientific committee and Kay O’Sullivan is on Section the social committee. The 2008 Council and Congress The Section had a challenging year and the following will be held in Glasgow and its proximity means that a represents an update on some of their initiatives large number of Irish midwives are likely to attend. during 2005-2006. European Midwives Association: Deirdre Daly is the Transfer of midwifery and children’s nursing education President of the EMA and she had a busy year. The to the third level sector: Following an announcement EMA Board met regularly throughout the year and by Mary Harney, Minister for Health and Children, that there were also meetings with EU health sector the above initiatives would commence in autumn officials. In September the AGM was held in Cyprus. 2006, the Department of Health and Children The interest of the Cypriot Department of Health in the established a National Implementation Group (NIG) in issues of midwifery education and regulation was January 2006. Representatives from key stakeholders encouraging. The Cypriot Nurses and Midwives formed this group which was chaired by Rosemary Association hosted the meeting. Ryan former Director of Nursing, St James’s Hospital. Of interest to Irish midwives is the fact that when The inaugural meeting took place on 11 January 2006, Cyprus joined the EU the Cypriot Nurses Association at which Ms Ryan outlined the responsibility of the changed its name to the Cypriot Nurses and Midwives group as “overseeing the implementation of the Association. The change was in consideration of the undergraduate midwifery and integrated children’s/ EU Directives relating to the midwifery profession. general degree programmes. Issues of an IR nature arising in the implementation process will not be for Miscellaneous: As usual the Midwives Section the NIG but will be dealt with in an appropriate responded to requests to review reports and made alternative forum”. submissions on issues pertaining to midwifery and the maternity services. Most recently a submission was Claim for parity between nurse educators in midwifery made on the proposed changes to the prescribing of and paediatrics and their colleagues who transferred drugs legislation. We also assisted with the to the third level sector 2002: The Labour Court organisation of focus groups for midwives and recommendation (LCR 18430) regarding the above neonatal midwives/nurses in a project that seeks to was issued on 19 December 2005. The court produce best practice guidelines for informing parents recommended that on actual transfer to the third level of their child’s disability. each claimant should receive a once-off lump sum The Future: The main aims of the Section are to payment. promote the development of midwifery in Ireland and This was not a satisfactory outcome for all members to seek improved maternity services for women and as there was no benefit to those who wished to retire their families. However midwifery remains welded to and very little benefit to those who would remain in nursing and there appears to be little appetite to posts in the designated centres for nurse education. honour the recommendation of the Commission on Nursing. Centres for nurse education: The Labour Court hearing on our claim to allow each individual member revisit The Minister for Health and Children has stated that their three options as per 2002 agreement/circular took the Nurses Act 1985 will be amended but midwives are place on 20 April 2006. The hearing lasted over two weary of hearing about the proposed change. hours and was attended by a large number of Midwives and nurses are represented jointly at the members from the centres for nurse education Department of Health and Children. From the nationally. The Labour Court recommendation correspondence between the Minister for Health and (LCR18555) from the hearing was issued on 9 May Children and the Section it is clear that our request for 2006. In essence the Court recommended that the

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union would identify its concerns regarding the Operating Department Nurses shortcomings of the centre to the HSE-EA. It further recommended that the 2002 agreement with regard to Section CNEs be implemented in full and any residual issues referred back to the Court. Annual Delegate Conference 2006: The ADC was held from 3-5 May 2006 in Slieve Russell Hotel Cavan. The Section motion: Be it resolved that the INO will promote the development of a clinical and educational directorate to represent nursing and midwifery at executive level of the HSE – was debated and unanimously carried. Executive Council Elections 2006: Mary Connor, Centre of Nurse Education University Hospital Galway and Mary Cotter, Acting Principal Nurse Teacher, AMNCH, Tallaght, were elected to the two Educational Seats.

Priorities for the coming year: Some of the ODN Section (l-r): Mary Slattery and Caroline Guinan of Tullamore General Hospital,and Nicola Breslin of Portlaoise General Hospital • To secure the pivotal place of the designated centres of nurse education as educational providers as per It was an eventful year for the Operating Department the 2002 and the 2006 agreements Nurses Section. The following goals were set for 2006: • To actively review the Nurse and Midwifery • Host the Fourth European Operating Room Nurses Education Section with regard to its role and Association (EORNA) Congress in May membership taking cognisance of the changes in nurse education in 2002 and 2006 together with the • Organise four Section meetings incorporating an potential changes/rule changes regarding filling the educational presentation and AGM educational seats on Executive Council from 2008 • Continue to represent the INO ODN Section at onwards. national, European and international level • Continue to update the ODN Section webpage Occupational Health Nurses • Update INO ODN Section Safety and Health in the Section Operating Theatre 1990 document in 2005. This work is ongoing. This year the Occupational Health Nurse Section divided their meetings regionally with the Southern All of the above goals were achieved. Region and the Eastern Region meeting Achievements: The Section was represented at a independently. These regional meetings are proving to number of fora throughout the year namely: be a very good idea with numbers attending ranging between 25-32. These meetings are seen as a very • American Operating Room Nurses Congress in valuable source of networking, support and Washington opportunity for discussion, and members are in favour • INO Annual Delegate Conference – Cavan, May 2006 of continuing to meet this way. • INO pay rally – Helix Theatre, DCU, June 2006 The educational component of these meetings included talks on: reproductive hazards; burns; and • Special Delegate Conference regarding the pay NPL and communication. The entire Section then had campaign – September 2006 the opportunity to come together at the annual • Pay rally – Helix Theatre, DCU, November 2006 conference, which was held in Dublin this year. • Nursing: Celebrating a New Era with the graduation FOHNEU: Una Feeney attended two meetings of of the first group of honours degree registered FOHNEU – Turkey in April 2006 and Tarragona, Spain nurses – 6 November, 2006. in September 2006. Ireland is currently the chair for the fundraising committee for FOHNEU, and the Section • EORNA board meetings – the spring meeting was are actively seeking sponsors for the FOHNEU website held in Dublin and the autumn meeting in Brussels and also for the fourth FOHNEU Congress which is • The Section funded a number of Section members to taking place in London from 19-21 September 2007. attend conferences this year. HONEU Project (Harmonising Occupational Health in Europe) is to be rolled out at the FOHNEU Congress European Operating Room Nurses Association 2007. More information is available on the FOHNEU (EORNA): Anne O’Brien, Children’s University Hospital website – www.fohneu.org. Temple Street Dublin and Caroline Higgins, St

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Vincent’s University Hospital, Dublin, who are ensure that information is current. Two members of the currently on the EORNA Board, continue to work very Section travelled to RCN Society of Orthopaedic and hard as ambassadors of Irish ODN nursing. Trauma Nursing conference in the UK on a bursary awarded by the Section. Feedback was provided by one European Operating Room Nurses Association of the participants at the December meeting. To further Congress (EORNAC): The ODN Section of the INO were our professional knowledge, we developed links with a delighted, and honored, to host the fourth EORNA specialist publication, the Journal of Orthopaedic Congress held in the RDS, Dublin in May. Over 2,500 Nursing. delegates attended the conference, which was the largest attendance ever at a European conference, and the largest nursing conference ever held in Ireland. Overseas Nurses Section Mary McAleese, President of Ireland, opened the Annual Delegate Conference: The Conference was congress and it was a great honor for us. There were attended by one delegate and one observer from the 76 trade stands in the exhibition area. Section. Two motions were tabled and approved A total of 20 Irish nurses presented papers at the unanimously by the Conference delegates. congress and Maureen Flynn, a past ODN Section The main motion approved was that the INO will officer, presented the keynote address of the opening negotiate with the HSE to create a position of a Multi- ceremony. Six Dublin hospitals facilitated over 220 Cultural Nurse Liaison Officer to support the delegates to visit Irish theatres. The winner of the integration of the growing multiculturalism and European Klinidrape Foundation competition, increasing diversion in the Irish health service. Catherine Tierney, Mid Western Regional Hospital, Limerick, was presented with her prize following her Section Meetings and AGM: The Section officers presentation Peri-Operative Nurses Experiences of decided during its first meeting in the INO Cadaveric Organ Donation – A Phenomenological headquarters in Dublin to hold meetings in areas Study. outside Dublin in order to gain more participation from overseas nurses. Section meetings were held quarterly Orthopaedic Nurses Section in areas like Galway (May 2006), Tullamore, (September 2006) and Limerick (December 2006). This group was established in 2005 to provide a forum Special Delegate Conference: The chairperson of the for orthopaedic nurses to network, to exchange practice Overseas Nurses Section participated and voted information and to promote education events relevant during the Special Delegate Conference in Croke Park. to this specialist area. Its main objectives are to: The Conference was to reaffirm their pay claims and • Protect and promote the professional interests of provide updates to delegates on the progress based members on what has been agreed during the Annual Delegate Conference in May 2006. • Meet twice yearly (once in Dublin and to rotate the second meeting to various areas around the country) Pay Rally: Overseas nurses were actively involved in the two pay rallies in the Helix, Dublin City University. • Network with colleagues locally, nationally and The chairperson of the Section was given the internationally opportunity to speak to delegates and expressed the • Promote study days/conferences Section’s full support to the INO pay claims. • Provide financial assistance to attend conferences/ Representation/Assistance to Overseas Nurses: study days Assistance was provided to INO overseas nurses through representation at workplace level and • Present/discuss pertinent research relevant to coordination with our INO industrial relation officer(s) orthopaedic nursing and with the Director of Organisation and Social • Promote developments in orthopaedic practice Policy. There were five overseas nurses assisted in nationwide 2006 by the chairperson. The Section is also in the process of making a new database of nurses at the • Establish links with other areas of interest, eg. hospital/nursing home/institution level as contact rheumatology, rehabilitation, Irish Nurse Practice persons. This will also facilitate coordination with their Development Association. concerns and issues at the workplace. The Section is open to all nurses who are engaged in Professional Development: To assist in the awareness orthopaedic nursing and/or any related speciality, as of overseas nurses on fitness to practice issues and well as members who have an interest in orthopaedics concerns a seminar was conducted by Clare Treacy, irrespective of their work location. During 2006 our INO Director of Organisation and Social Policy, in meetings were held in Dublin and Sligo. The Sligo September 2006. meeting was coupled with an educational event, which proved interesting and informative. As a group we This seminar was attended by the officers of the continue to update our web page on the INO site and Section, together with active members. The continually request that information is sent to us to chairperson also attended the introduction to

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partnership training (held in conjunction with the this is a necessary task and one few of our members Health Service National Partnership Forum for the feel they have the ability to deal with competently. Health Service), in November 2006. Following a comprehensive presentation by Dave Hughes those attending felt better equipped to face Co-ordination and Networking: The Overseas Nurses this task. This was further enhanced by a presentation Section is regularly co-ordinating with other by Colette Tarrant on assertiveness. organisations especially the Immigrant Council of Ireland on the progress of the Immigration and Some members felt that too much emphasis was Residence Bill as well as the implementation of the being given to the pension issue when there were green card system and employment permit. This has many day to day issues with no forum where they been one of the main agenda items of the Sections’ could be dealt with. meetings. It was suggested that local IROs be invited to attend The Section is also in regular contact with the INO the INO time allocated at the IPNA monthly meetings media relations officer when looking for overseas so that members could meet and get to know their nurses for interviews on television, newspaper and representatives and have access to help on individual radio on issues that affect their work, living conditions, issues. This proposal was passed by the IPNA their contribution to the Irish health system and the executive. country they came from. A request was sent to Dave Hughes to accept an The chairperson was also invited to talk and attend invitation to meet with the ICGP to discuss allocation discussions and activities of other groups including of structured study time and access to further University College Dublin social department which education. addresses concerns, and conducts research, to status The year closed with much discussion following the and other issues of migrant workers especially HSE’s attempt to set up 100 primary care teams (PCTs). overseas nurses. Practice nurses were represented at two meetings with Immigration and Residency Bill: The INO and the the HSE (24 October 2006 and 8 December 2006). The Overseas Nurses Section are continually involved in HSE participants were unable to inform the meeting of addressing issues that affect overseas nurses’ where these 100 PCTs in development would be residency status. Inclusion of the Bill and other located and admitted that it was probably not the best information relating to new implementations from the way forward to recruit 300 plus health professionals Minister of Justice are included in the Section before a national template for these teams had been meetings. devised. The proposed green card system and employment It was also revealed that there was no evaluation permit scheme will be among the main topics on the available on the 10 pilot PCTs. The issues affecting our future meetings of the Overseas Nurses Section. The Section’s members will mainly be what the status of Irish health system is also dependent on migrant practice nurses within these PCTs will be, the impact nurses and the Bill or the Ministerial power should on existing structures, cross professional working protect and address concerns of overseas nurses and roles of each profession and how team members their families. Coordination will continue with the relate to each other and peer support management. Immigrant Council of Ireland, Migrants Information Liam Doran issued a directive to members calling for Centre, Law Society of Ireland and other NGOs. non-cooperation with any work related to PCTs. The INO proposed that an independent chair be appointed Practice Nurse Section to guide negotiations. The HSE then counter-suggested that discussions The year began with renewed attempts to have should include the establishment of a joint steering members of our Section included in the public health group to be co-chaired by Tadgh O’Brien, Assistant service pension scheme. This agenda was progressed National Director in the HSE and Liam Doran, INO by having our motion for renewed efforts by the INO General Secretary. This proposal was accepted and the to realise this endeavour passed at the ADC. Dave directive was withdrawn. The next meeting of this Hughes attempted to make the issues of the practice group is now awaited. nurse an integral part of the PCCC talks and have our attempt to be included in the pension scheme The past year saw a revitalisation of the Section with discussed. Unfortunately the INO were forced to attendance up on previous years. This is due in no withdraw from these talks but it is hoped when issues small part to the collaboration between the IPNA and are resolved and the talks resume that our interests the Section which has led to greater dissemination of will be represented. information to our members. An education day was held in September to help Our members are facing difficult, but hopefully provide practice nurses with the tools necessary to be exciting, times and solidarity will enable us to move effective when negotiating their individual pay and forward into a new community care system with conditions. As practice nurses are privately employed confidence.

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Public Health Nurse Section Retired Nurses/Midwives The PHN Section aims to enhance the professional Section development of public health nurses working around the country by disseminating information about the latest developments in community health nursing to all members. The Section also aims to support PHN members regarding any concerns they may have in relation to the changing face of nursing in the community. Four meetings of the Section were held during the year. The Section was represented at the Annual Delegate Conference in May and at the Special Delegate Conference in September by the chairperson. It continues to be a challenging time for PHNs as they still await a hearing in the High Court regarding the Members of the Retired Nurses/Midwives Section designation of PHNs as clinical nurse specialists. The Section was launched when Mary Power, Section Despite many meetings and huge correspondence the Development Officer invited a group of retired associate rule change introduced by An Bord Altranais in INO nurses/midwives to meet in head office in March December 2004 remains in place. The Bord effectively 2005. Those present agreed that a Section dedicated to abandoned the consultation process in May 2006 and retired nurses/midwives would be established. there has been no progress since. Added to all of this was the attempt by the HSE to Mission Statement: The Retired Nurses and Midwives establish primary care teams around the country Section is dedicated to providing opportunities for without consultation or agreement with nurses already retired members to pursue retirement in a visionary working in the community, on a range of important and positive way and promote the continued issues, including roles and reporting relationships. wellbeing of retired nurses/midwives through informative, social and cultural initiatives. In spring 2006 Getting Started – the PHN Guide to Commencing the Process of Developing an ANP Role Aim: Members will meet to maintain and develop within the Community was produced. This will prove friendships, to retain an interest in the nursing and to be an invaluable tool to support PHNs who wish to midwifery profession and continue to contribute to the pursue an ANP role in the community. Irish Nurses Organisation. It is anticipated that the Section will be an information source for With the unprecedented changes that PHNs are facing nurses/midwives who are retired or preparing to retire in the community, the Section continues to have and provide: enthusiastic and dynamic members who are willing to engage proactively with other stakeholders to ensure • Access to the resources of relevant INO services that the quality of care delivered to our client – the • A lobby forum aimed at protection, improvement and community – is of the highest standard possible. defense of pension and rights arising from previous employment • A linking structure to other sections of the INO and Rehabilitation Nurses Section Irish Congress of Trade Unions (ICTU) through Two meetings were held over the past year – one in member representation March, and one in September. The June meeting had • Social opportunities through a national network of to be postponed due to the national pay rally in the members sharing broadly similar interests Helix Theatre. • Dedicated website for information on the Section Both meetings were held in INO Head Office. Unfortunately attendance was poor and did not reflect • The monthly journal (World of Irish Nursing and the enthusiasm that was shown at the study day in Midwifery) posted directly to members. 2005. The Section held three meetings since its inception in During these meetings the Section compiled a future 2005. The numbers attending continue to grow with 41 educational list, which had been requested by the INO, attending in September 2006. Discussions at meetings and forwarded it to Jean Carroll. A lengthy time was to date have centred particularly on accessing the spent working on the draft vision and mission social welfare pension and other entitlements and statement for the Section. Discussions were held on issues arising from previous employment. The Section the idea of running another study day, to emphasise welcomed guest speakers to two meetings. The INO that rehabilitation is intrinsic to all areas of nursing. President Madeline Spiers made a very welcome visit

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to the meeting in September 2006. She encouraged members to put on record ‘nursing folklore’ and views on current issues in nursing/ midwifery and forward them to WIN for publication. Dave Hughes, Deputy General Secretary, spoke at our meeting in February 2006 on pensions and other entitlements relating to previous employment addressing concerns for many members. The Section secretary and a member attended the ADC Members of the RNID Section who made up some of the 1,200 plus nurses who as observers in May 2006. They reported at the gathered for the pay rally at the Helix theatre in DCU in June 2006 September 2006 meeting outlining the excellent contributions and the social activities at the ADC. • Greater clarity on the introduction of CNS posts The Section has considered affiliating to other throughout the ID sector. organisations and at our last meeting it was agreed to We need answers to these issues and we need them establish contact with the Retired Nurses Association now. to pursue mutual interests. Two members were nominated to represent the Section on the Retired 2006 also brought much discussion on the An Bord Workers Committee of the ICTU. Altranais rule change, which would allow access by any registered nurse to the Higher Diploma in Public Links are being established with the following Health and having completed the mother and child organisations: module be eligible for employment as a PHN. • Age Action Ireland September 2007 sees the first traunch of registered general nurses, who do not have midwifery, access the • Senior Citizens Parliament PHN training – the Section awaits the day when the • An annual subscription has been made to receive RNID will do likewise. However their lack of guidance copies of the Senior Times magazine. and direction in the area of medication management is disappointing. Our eight claims were lodged with the Several outings have taken place to date organised by Labour Court in June and once again we were the social committee: disappointed with the outcome. If this Labour Court • May 2006 a trip to Rathwood Garden Centre, the first recommendation is a true reflection of the value of our annual trips placed on nurses and midwives in the Irish health service, then this health service is in serious trouble, as • October 2006 a tour of the Dáil for a few members is the person that should be central to this, the service • October 2006 a visit to over 50’s show in the RDS user. • November 2006 a tour of Dublin Castle. As all members know the pay anomaly claim dates back to 2001. Year after year the Section has spoken on It is hoped to visit another historic site in March 2007. the impact of this unjust anomaly and the impact this The next annual day trip is planned for the Tuesday 22 is having in providing a person centred, quality service May, 2007. Following a request by the Section there is for the person with an intellectual disability. We will a possibility of a visit to Áras an Uachtaráin to meet the wait no longer. No is not an option. Our anomaly will President, Mary McAleese, during 2007.The Section is be addressed but we need every nurse, every RNID to looking forward to its first AGM and to meeting old stand up and be counted. Don’t just talk the talk, you and new members at the meetings during the year. A must walk the walk. 2006 also saw the re-election of representative from Cornmarket Group will speak at Catherine Doyle and Marie Gilligan to Executive the AGM on issues relating to its services for Council. nurses/midwives who have retired or are due to retire.

RNID Section Student Section The Student Section in the past year have continued 2006 draws to a close with little progress being made the good work which was started in the latter half of on a number of issues affecting RNIDs. Questions 2005. The text message system was updated together remain on what progress has been made on the the email address list. The Student Section of the following outstanding issues: website was also updated on a regular basis and this • The reporting relationship of the registered nurse has been an invaluable way of keeping student nurses across the country informed on issues pertinent to • Scope of practice/delegation of tasks, such as the them. The effectiveness of dividing up the Schools of administration of medication Nursing between the Section officers has yet to bear • Role of the RNID in the education of the severe and fruit, but the officers believe that this will be the most profoundly intellectually disabled person effective way of facilitating communication between

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student nurses. The biggest event for the Section in 2006 was its student conference which was a resounding success. Surgical and Medical Day Services Section Three meetings were held during the year including the AGM. The first meeting held in Cavan General Hospital on 3 July 2007 saw a presentation by Mary Marron on pain management. The ADC was discussed and new officers were elected. The second meeting took place in INO head office. A specialist post for pre- INO Student Section committee officers 2006-2008 (l-r); Caroline Cullen,chairperson; assessment was discussed. The Section agreed to hold Moira Wynne,ex officio; Jack Collins,secretary; and Dave Wallace,vice chairperson a national conference in day services. The third meeting, the AGM, took place in INO head office in the Section and the students.The Section, alongside December 2006. New officers were elected and further the industrial relation officers, continued to fight for discussion took place on the Section’s national the rights of students and was successful in obtaining conference to be held in 2007. free vaccinations for most students with the promise of being 100% successful next year. The Section was delighted with the election of its Telephone Triage Nurses Section nomination for the student seat of Executive Council, Claire Lynch. Claire is a valued member of the Student Section and will undoubtedly represent the student body of the INO very well at Executive meetings, by keeping student issues to the forefront. The ADC was attended by a large number of students. The students mingled well and information on the Section’s activities, and the officers contact details, were passed around to all branches and sections. This was an idea from the Section officers to spread the good news of the Section and to ensure that all branches could point student members in the direction of the Section if needed. The Section also tabled a motion at the ADC which was very well received and subsequently passed. At the Telephone Triage Nurses Section 2006 annual conference were (l-r): Mary Sheeran; Camilla O’Donoghue; Aideen Hanly-Platz; Regina Delaney Buchanan; The officers of the Section were interested in building Margaret Curran; and Sally Costello links with other student organisations and were nominated by the General Secretary to the youth The Telephone Triage Section held four regional committee of ICTU. Later in the year a delegation from meetings throughout the year. The first meeting in the INO, made up of mostly student members, Limerick on 2 February 2006, had an excellent attended a conference in Dundalk held by the ICTU attendance and benefited from a brilliant presentation youth committee. from Dr Cathal O’Donnell, A&E consultant from the Section officers once again attended the annual Mid-Western Regional Hospital on “assessing the meeting of ENSG in Copenhagen. At this meeting patient with chest pain over the telephone”. The decisions were taken to make this group much more second meeting took place in Galway on 25 May 2006, effective in its role. The name of the organisation was where a very informative talk was given, from Patricia changed to ENSA (European Nursing Student Doherty, Psychiatric Social Worker, regarding the new Association) and the Section’s vice-chair, Barry Mental Health Act. In September, the second McConaghy, was elected to the Presidency, while the Telephone Triage Nursing Conference took place in Section’s chair, Moira Wynne, was elected to the Portlaoise. This conference enjoyed a large attendance Executive Committee. and received exceptional feedback. The annual general meeting of ENSA will be held in The AGM was held in INO headquarters where Bernice INO head office in July 2007. The next task for the Baker give an outstanding presentation and insight Section was the recruitment of the new intake of into “the legal aspects of triaging by telephone”. It was students. Thanks to the investment from the INO the with sadness that the Section saw Margaret Curran recruitment packs were a resounding success and with step down from her position as vice chairperson and the help of students and IROs across the country we extend a warm welcome to Angela Tysell from recruited a significant portion of the new intake of Nowdoc who has taken up the position.

59 Irish Nurses Organisation Annual Report 2006 Press and Media

2006 began, like so many other his mother was unable to use the one available toilet years, with the health services for two days and nights – he said “This was an continuously in the news. The unspeakable indignity to a woman of her generation A&E crisis was again highlighted and standards of personal hygiene”. In the week that as the INO trolley watch showed followed many papers, national and regional, carried a rise in the numbers of patients stories of increasing trolley figures, eg. Sligo on trolleys. Champion (15 March) – A &E crisis has become intolerable; Drogheda Independent (15 March) – A&E Lourdes A&E set to ‘burst at the seams’. On 10 January, the INO launched The HSE Task Force announced new admission Ann Keating, lounges for patients waiting for a hospital bed. In the Media Relations Officer,INO a postcard campaign which formed part of phase two of the Irish Examiner (22 March) – ‘ Extra nurses needed’ for ‘Enough is Enough’ campaign to A&E plan – Liam Doran said “The transit lounges will highlight the on-going A&E crisis. This was well not work, they cannot work and they will not be covered in the media – on 11 January in the Irish Times opened unless there is an additional quota of staff – – Postcard campaign targets A&E problem – Liam inpatient nursing staff, not A&E nursing staff”. Doran said, “Politicians have got to listen to the However the chair of the Task Force, Angela Fitzgerald general public. They are in denial about the extent of refused to rule out using existing A&E nurses. this problem”. He continued “It was incredible, that at On 21 March we read in the Irish Times – Drumm says a time when 2,400 more beds were needed in the A&E problem larger than ever – “He said he now health service to comply with the Government’s own wanted to put in place long term solutions to solve the health strategy, the Department of Health and Children crisis, as well as taking short term measures to ease e returned 159 million in unspent funding in 2005 to the the plight of those who have to spend part of their Exchequer.” hospital stay in A&E. But he warned it could not be The Irish Times (15 February) carried the story of 75 done within a matter of months.” On 22 March Liam patients waiting on trolleys and chairs in Tallaght Doran said in the Irish Examiner that “Providing more Hospital – On trolleys in ‘Mary Harney suite’. beds is the only solution to A&E crisis”. Describing the conditions one patient said “There are Finally on 28 March the Tánaiste declared that the A&E only two toilets for all of us and yesterday our shower problem had to be treated as a national emergency. was blocked. We call it the Mary Harney suite”. Deputy This was covered in many papers including the Irish General Secretary Dave Hughes said “the INO had Times (30 March) – Parties turn on Harney over A&E suspicions the hospital was keeping beds free for remarks – Liam Doran said the admission must be patients due to be admitted for elective surgery, even matched with concrete sustained action. He said “In though people were ‘out the door’ on trolleys.” Ireland this context the INO will be seeking clarification as to on Sunday (26 February) carried a story that “Hospitals what real differences this declaration will make to A&E will be fined by the Health Service Executive if they and all related services. This is necessary in view of all allow overcrowding in A&E departments” under the the previous statements from Government and health headline – Hospitals will be fined if the A&E is service management that all that could be done was overcrowded. Liam Doran described the plan as being done”. “ridiculous and said it would penalise the A&Es that actually did the most work.” In a story in the Irish Medical Times (7 April) – Beaumont plan did not ease pressure on A&E – On a However the A&E crisis reached an all time high with day when there were over 30 patients on trolleys and almost 500 patients on trolleys around the country on ambulances waiting for extended periods, IRO Edward 8 March. The HSE, while still disputing the INO trolley Mathews said: “The hospital’s escalation policy has figures, announced a new task force to tackle A&E been in operation all day but is not having any problems. Liam Doran, commenting on the proposed significant effect.” He said “the plan is equivalent to an task force to the Irish Times (9 March) said, under the emergency plan.” headline – New task force to tackle A&E problems – “Every aspect of A&E was examined in 2002. They had In April the INO delivered 10,000 postcards to the the 10-point plan, different fora, meeting after Minister for Health. In the Evening Herald (27 April) – meeting, everything was examined, but we still Harney gets 10,000 protest cards – Dave Hughes was haven’t addressed the core problem of bed capacity. quoted “Thousands of cards express harrowing What added weight will this task force bring? Very stories of seriously ill patients suffering further little. The only answer is additional beds and services indignity, humiliation and torment as they waited to meet the ever-increasing demand.” excessive lengths to get a bed.”

The Sunday Mirror (12 March ) – My A&E Trolley Horror Tea breaks – outlined what the actor Brendan Gleeson had said on the Late Late Show on the previous Friday night. Both The Limerick Leader (12 January) carried a story – of his elderly parents had spent time on trolleys and Dossing cancels 1,800 ops: claim – in which Mary

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Harney expressed serious concerns over claims that hospital staff in the Irish Independent (18 March) – unofficial tea-breaks, late starts and early finishing by Violence hits wards as over 900 attacked Dave Hughes theatre nurses have led to around 1,800 patients not said “he was concerned so few prosecutions were having operations at the Mid Western Regional Hospital taken by gardaí after violent and upsetting incidents in Limerick. The INO viewed this as retaliation for the for staff members and patients.” Later, on 5 April we postcard campaign. In the Irish Times (13 January) – read in the Irish Examiner – Stronger penalties in store Nurses’ working practices mean fewer operations, says for assaulting emergency workers – Liam Doran, HSE – “The Irish Nurses Organisation said it was a welcoming the amendment to the Criminal Justice Bill “smoke-screen” to deflect attention away from 2004, said “Making it a criminal offence to assault or overcrowding in A&E units, which it was constantly threaten to assault or impede or obstruct people in highlighting.” In the Irish Examiner (13 January ) – hospital grounds is long overdue and we very much Angry nurses hit out at claims of ‘dossing’ culture – IRO welcome the amendment and want it law as soon as Mary Fogarty said “the HSE statement was antagonistic possible”. and totally unhelpful in addressing the shortcomings of services at the hospital. She said the INO was Victims of sexual assault demanding an external review of theatre practices.” In the Irish Examiner (25 March) – Nurses call for sex Benchmarking assault report to be implemented – the INO called for implementation of recommendations to overhaul the The Irish Times (14 January) ran a story on how the treatment of victims of sexual assault. Director of new benchmarking process “hit an early obstacle with Professional Development, Annette Kennedy said “the a decision by the Irish Nurses Organisation to refuse to report, if implemented, would make a huge difference co-operate with it” under the headline Nurses refuse to sex assault victims. We have not got a to work with pay review process. INO Deputy General comprehensive service at the moment. A lot of Secretary, Dave Hughes said “it would play no part in services depend on voluntary contributions and that is the benchmarking process as it had become an not appropriate.” obstacle in the union’s claim for a reduction in the nurses’ working week from 39 hours to the health- Pay campaign sector average of 35.” He went on “benchmarking would do nothing to reduce the pay gap which had The INO and the PNA held a joint press conference on recently opened up between nurses and social care Friday, 24 March to highlight the claims lodged with workers due to a special payment that had been made the HSE ahead of the Labour Relations Commission to the latter in 2001”. Conciliation Conference. This was carried in the Irish Examiner (25 March) – Unions join forces in nurses’ Overseas nurses pay protest – Dave Hughes and Des Kavanagh said “Both unions will be making every effort to resolve Seventeen overseas nurses who came to work in these issues through existing procedures but will not Holles Street Hospital were offered different contracts tolerate the ‘no comment’ approach adopted by the to what they had agreed and were threatened with previous benchmarking body in the past.” The claims repatriation unless they signed them. IRO Philip were subsequently referred to the Labour Court – Irish McAnenly was quoted in the Irish Examiner (18 Examiner (4 April) – Nurses’ Pay Row – Dave Hughes February) – Foreign nurses told sign up or be sent said “The claims of nurses and midwives in relation to home, says INO. He said the contracts “would have their working hours and pay anomaly with childcare returned them to student midwife status with the workers will not go away”. equivalent loss of earnings which, over two years, would have amounted to up to e26,000 each.” Mallow Health Centre Whistleblowers The appalling conditions at Mallow Health Centre were highlighted on the front page of The Corkman (20 The Lourdes Hospital Enquiry was published on 28 April) – Health service centre posed a ‘significant risk February. Speaking to the Metro newspaper on 6 to life’ from fire. IRO Patsy Doyle said “The INO is March in an article entitled – Call to protect appalled at the complete failure of the HSE to accept, whistleblowers – Liam Doran said “If someone makes and act upon, the fire officer’s report which quite a mischievous complaint they should be penalised, but clearly indicated that the building is unsafe and the patient comes first. We’ve got to create a culture therefore a risk to anyone who works there or is where people with genuine concerns can come required to visit in order to obtain care.” forward without fear and have those concerns examined.” Annual Conference Amendment to Criminal Justice Bill 2004 Media coverage, both print and broadcast, of our Annual Conference in Cavan this year was In a story on the continuing violence being endured by unprecedented. The following is just a short insight

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papers including the Irish Examiner (14 June) – Nurses to vent anger over pay and conditions. Dave Hughes said “The protest rally would send a loud message in advance of next Tuesday’s Labour Court hearing of their claims that they would not be treated as second- class professionals. He went on to say “It seems in our health service that the further you get from the patient, the higher your earnings and the shorter your hours.” On 15 June the Daily Mail carried a headline – All we want is fair pay – Nurses take to the streets to demand shorter working week and better pay. Dave Hughes was again quoted “Nurses and midwives have come from all over the country to show solidarity with the decision of both unions not to participate in INO ADC 2006 delegates unanimously support a motion that the INO lacks benchmarking and instead to pursue our claims confidence in the absent Health Minister through the Labour Court. No more time wasting – we need an answer now.” into what was said in the papers. One of the big stories In the Irish Examiner on the same date – Nurses issue was of course the non-attendance by the Minister for pay threat to Taoiseach – President, Madeline Spiers Health and Children, Mary Harney because of her said “We are exhausted and demoralised and we have commitment to address a conference in Philadelphia reached the end of the road. Today we say to the on 5 May. In the Irish Times (3 May) – Row over Government and Labour Court that ‘no’ is not an Harney’s decision on INO Conference – Liam Doran option.” Dave Hughes said “We are waiting since 1980 said “We hope her absence is not as a result of the when the Labour Court itself said nurses’ and public position the INO has taken, on behalf of midwives’ hours were too long. We have been waiting patients, nurses and midwives, on A&E overcrowding 26 years for them to finish that job and next Tuesday and other issues over the past 12 months”. In the Irish they have their chance.” Daily Mail (4 May) – Minister’s diary latest weapon in nurses’ snub war – Ms Harney said “There is no question of this being other than a diary issue for me.” Portlaoise Hospital She went on “Anybody that thinks I’m afraid of any A lunchtime protest highlighting inadequate staffing group would want to think again.” levels was held outside Portlaoise Hospital on 29 June. On the INO’s pay claim on behalf of nurses and The issue made the front page of the Leinster Express midwives the Minister for Health and Children said, in (5 July) – Hospital row worsens – Midwives reach the Irish Times on the same day – Pay claim by nurses breaking point. Following the protest, IRO Joe Hoolan is ‘not affordable’, “This is not sustainable. That it is said that “the midwives were invited to discussions not affordable. That it will not be paid.” In response with HSE management on 13 July. Liam Doran said: “The Tánaiste’s views are not surprising but they are not the final view.” Second National Hygiene Audit The decision to hold a rally in Croke Park on 14 June Much coverage was given to the results of the Second ahead of the Labour Court hearing on 20 June was National Hygiene Audit which reported substantial well covered in the papers including Irish Times (5 improvements. In the Leitrim Observer (July 21) – May) – Nurses plan June rally to vent anger over pay – Hospitals see hygiene improvement following audit – Dave Hughes said “A week before the Labour Court we Liam Doran said “No matter how well resources are have the opportunity to say to all and sundry, but managed hospital hygiene will not be fully addressed especially the Labour Court, that this is it, this is the until the persistent overcrowding and lack of power of nurses and midwives.” appropriate infection control facilities are addressed For the first time in the INO’s history, delegates at the through the building of increased capacity in our Conference passed a motion of lack of confidence in hospitals”. the Minister for Health and Children – INO united in vote against Harney (Irish Times – 6 May). The 50 Labour Court and Equality Tribunal Cases minute debate heard delegate after delegate relay horror stories from their everyday experiences in the IRO Phil Ni Sheaghdha took a case on behalf of a health service. member employed by the Alzheimer’s Society to the Equality Tribunal. The story was covered in the Sunday ? June rally in the Helix Tribune (16 July) – Nurse awarded 20,000 in equality claim against Alzheimer Society – The INO claimed We held a press conference on Tuesday, 13 June, that the member had been discriminated against on ahead of the rally, and this was well covered in many grounds of disability. The Society were ordered to pay

62 Irish Nurses Organisation Annual Report 2006

?20,000 compensation for distress and the salary she Midwives threaten strike action over redundancy – should have had as manager since October 2003. Since a decision was made to cease obstetric services at the Bon Secours Hospital, the Bon Secours A successful outcome for Phil in the Labour Court was Organisation insisted that the closure is covered under covered in the Laois Nationalist (21 July) – ?40,000 for the Transfer of Undertakings legislation and that nurse who was bullied – “A male nurse at Portlaoise members should either move to another setting in the hospital has been awarded e40,000 after a complaint hospital or to the new Unified Midwifery Service at of bullying was not properly dealt with. CUH. However, the INO insisted that the entire issue should be addressed under the Redundancy Payments Professor Drumm’s first year… Act which would make a redundancy package available. Professor Drumm's first year in office was reported on in the Irish Examiner (15 August) – The doctor’s orders. IRO Michael Dineen said “midwives were given no Director of Organisation and Social Policy, Clare choice at the moment…Its either move or nothing.” Treacy was quoted “There is no doubt that he has a However as covered in the Irish Examiner (20 October) massive job to do but we have to start seeing results”. – Midwives hold off on industrial action to engage in She went on “just 31 advanced nurse practitioners talks – Michael Dineen said: “They have agreed to were working in Ireland since the Commission on engage with us on all aspects of the closure which Nursing recommended their development in 1998”. hadn’t previously been the case.” On the A&E crisis she said “the INO was firmly of the view that the A&E crisis would not be averted in the Cavan General Hospital absence of increased bed capacity.” Meanwhile proposed industrial action at Cavan General Hospital in a dispute over the non Special Delegate Conference implementation of a Labour Court Recommendation The Organisation held a Special Delegate Conference on the provision of clerical staff was postponed – on 1 September to discuss ‘Towards 2016’ and the pay Anglo Celt (26 October) – Nurses strike averted at claim. Much space was give to this on 2 September – Cavan General – According to Tony Fitzpatrick “We are Irish Examiner – Nurses and Midwives to boycott postponing the action until 27 November in order to unions’ pay deal vote. A decision was taken to boycott allow the HSE to implement the recommendations. If the ICTU special conference where members would they fail to do so we will proceed with the industrial vote to ratify the social partnership deal. action.” According to Liam Doran “This is a unique, and Labour Court recommendations unprecedented, decision of the INO which demonstrates the commitment of the Organisation to The Labour Court issued its recommendations on our achieve progress on its pay issues.” eight pay claims on 10 November. The outcome received coverage in many papers on 11 November including – Irish Daily Mail – Labour Court snubs Letterkenny General Hospital nurses – “Nurses pay demands have been rejected by IRO Noel Treanor speaking to the Donegal Peoples the Labour Court which told two of the main unions Press (22 August) about bed capacity at Letterkenny that their claims can only be addressed through the General Hospital – INO spokesperson condemns lack public service benchmarking process.” of beds at Letterkenny said “It is clear that there is not On 14 November the executives of both the INO and enough bed capacity…There are three hundred beds PNA met to discuss the Labour Court at present in Letterkenny General Hospital and there Recommendations. The story was carried in the Irish are three times the amount of people coming through Independent – Nurses set to battle for pay increase – the A&E doors of the hospital.” Liam Doran said “no one wanted to use the ‘nuclear weapon’ of strike. Industrial action is not inevitable. Aut Even Hospital We remain available for discussions, we are willing to reform work practices. But the management stance of The Kilkenny People (8 September) carried a story no, no, no is not acceptable.” In the Examiner of the about privately owned Aut Even Hospital where staff same date – Nurses to consider strike action in fight feared their jobs were in danger following financial for better pay and conditions – Liam Doran said “the losses at the facility – Aut Even staff and management approach by management to date had been in talks over job security. IRO Liz Curran said “Some of shortsighted, was naval gazing and would never the issues are close to resolution. Others may well address their problems.” require third party referral.” Second pay rally in the Helix Bon Secours Hospital, Cork A second successful pay rally in the Helix in late The Irish Examiner (10 October) carried a story – November received much space in the papers the

63 Irish Nurses Organisation Annual Report 2006

following day, 23 November. In the Irish Times – ‘Door heading – Nurses unleash rolling campaign of open’ on working hours for nurses – The Minister for industrial action in new year – “The INO feel they are Health and Children, Mary Harney, speaking on the 35 being singled out. The two unions have lodged a cost hour week said “My door and that of the Government of living claim directly on health employers for 3% and the HSE is open to having meaningful discussions from 1 December, 2006.” around change. Changing work patterns, greater flexibility, a better skill mix….we are more than happy Some improvement in A&E at end of year to engage in fruitful dialogue on that agenda.” However, Dave Hughes said that “while the INO would In December the INO published a comparative analysis be interested in anything Ms Harney had to say of the trolley watch for the months of October and regarding working hours, this on its own would “not November 2005/2006 which showed a reduction in be enough”. Dublin but overcrowding was still a huge problem in some of the major hospitals outside of the capital. Irish In the Irish Independent – Strike action push by nurses Independent (19 December) – A&E trolley crisis eases – Liam Doran commented “Industrial action, involving but still severe in some hospitals. the withdrawal of labour, is not inevitable and is not our preferred approach to progress these issues. Liam Doran said “despite welcome improvement, the However, the 40,000 members of the INO and PNA pace of progress in October and November has been have waited for up to 26 years for movement on these uneven and in a number of hospitals the situation has issues and they will not wait any longer.” worsened.” Irish Examiner – Strikes by nurses ‘will not damage patient care’ – Liam Doran stressed that “While Care of the elderly essential services would be maintained, there was no In the Roscommon Herald (19 December) – INO question of nurses working without pay.” He said “The welcomes new inspectorate – The INO welcomed the aim was to cause minimal disruption to patient care publication of the Health Bill 2006. Liam Doran said and maximum disruption to health service “There must be no hesitation in the granting of legal management.” powers, to HIQA and the Social Services Inspectorate, which allows them to measure, and assess, completely UCHG – Paediatric Unit free from other pressures, the standards of care that are being provided to vulnerable people in our The Connacht Sentinel (21 November) carried a story society”. on the delay in the opening of a new paediatric A&E unit in University College Hospital, Galway – Doors On 20 December the Evening Echo carried a story on remain shut on children’s unit. IRO Noreen Muldoon industrial action to take place in Cobh General said “We welcome the opening of a new unit for Hospital, a facility for older people – Cobh nurses to children. There are some issues still to be worked out take industrial action. Patsy Doyle said “In taking this as we want to ensure best practice for any new action, the nurses are acting as advocates for their services”. She said “the INO was calling for the patients.” She continued “INO members in Cobh are paediatric A&E unit to be open 24 hours and to be concerned at the continued gap in service delivery for staffed at all times by a qualified paediatric nurse.” patients.”

Withholding of 3% pay increase The above is only a very small snapshot of the huge media coverage afforded to the INO in the past year. The proposed withholding of the 3% pay increase due Officials and activists also gave frequent interviews on to members on 1 December was carried in the national and local radio and also on TV during the Industrial Relations News (23 November) under the year.

64 Irish Nurses Organisation Annual Report 2006 Affiliations

The INO is affiliated to the following bodies: Madeline Spiers, Clare Treacy (Secretary) • ICTU Disability Committee National Cora McGrath, Noreen Muldoon • Irish Congress of Trade Unions • ICTU Global Solidarity Committee – Mary McCarthy • Economic and Social Research Institute • ICTU Retired Workers Committee – Peg Nealon • Irish Society for Quality in Healthcare • Mental Health Association of Ireland Other Bodies/Committees • Inclusion Ireland (formerly National Association for National Mentally Handicapped – NAMHI) • National Council for the Professional Development of • National Women’s Council of Ireland Nursing and Midwifery – • Institute of Public Administration Nine INO members are on this Council • Irish Association for Industrial Relations • National Implementation Committee – • Irish Labour Society Midwifery/Children’s Nursing • Health Informatics Society of Ireland. Undergraduate degree programme Liam Doran, Denise Lawler, Sara Raftery The Organisation also sponsors the Open University Programme at the National College of Ireland, and • High Level Group – Role of the Healthcare Assistant contributes to the Economic and Social Research Fund Madeline Spiers, David Hughes, Annette Kennedy Raising Campaign. • Eur opean Working Time Directive – NIG Medical Liam Doran International • European Working Time Directive – Nursing and Midwifery • International Council of Nurses (ICN) Expert Group – Liam Doran, David Hughes, Annette • Nursing and Midwifery Forum of the World Health Kennedy, Phil Ni Sheaghdha, Joe Hoolan, Jo Tully, Teresa Organisation (WHO) Hayes • European Federation of Nurses Associations (EFN) • HSE Nursing and Midwifery Staffing Levels Steering • European Midwives Association Committee – Madeline Spiers, Annette Kennedy • The Midwives Section of the INO is affiliated to the • HSE Resource and Implementation Group on Nurse International Confederation of Midwives (ICM) Prescribing – Liam Doran, Annette Kennedy • The Operating Department Nurses Section is affiliated to • Department of Health and Children Sexual Assault the European Operating Room Nurses Association Treatment Services Review Committee – Annette Kennedy (EORNA) • National Women’s Council – Clare Treacy (Board of • The Occupational Health Nurses Section is affiliated to the Directors), Madeline Spiers, Bernie Smyth Federation of Occupational Health Nurses in the European • Inclusion Ireland (formerly National Association for the Union (FOHNEU) Mentally Handicapped of Ireland – NAMHI) • European Healthcare Management Association Marie Gilligan • Workgroup of European Nurse Researchers (WENR) • Irish Deaf Society – Clare Treacy • American Nurses Credentialing Centre (ANCC) • National Anti-Poverty Strategy (NAPS) – Clare Treacy International Advisory Council • European Student Nurses Group – Barry McConaghy INO Representation on Irish Congress of (Pres) • ETUC (European Trade Union Confederation) – Youth Trade Unions and Other Bodies Committee – Edward Mathews (Chair) • ICTU Executive Council – Liam Doran, Clare Treacy • An Bord Altranais Five Points Entry Steering Group – • ICTU Public Services Committee Annette Kennedy Madeline Spiers, Liam Doran, Dave Hughes, Patsy Doyle, Phil Ni Sheaghdha, Philip McAnenly, Mary Fogarty, Tony International Fitzpatrick, Michael Dineen, Edward Mathews, Liz Curran. • ICN Council of National Representatives Madeline Spiers, Annette Kennedy • ICTU Equality Network – Clare Treacy • ICN Credentialing Forum – Madeline Spiers, • ICTU Third World Committee – Liam Doran Annette Kennedy • ICTU Youth Committee – Edward Mathews (Chair) • ICN Remuneration Network – David Hughes • ICTU Health and Safety Committee – Catherine Samuels • European Federation of Nurses Associations (EFN) • ICTU Representatives on the following Annette Kennedy (President 2005-2007) Bodies/Committees • European Midwives Association The Women’s Health Council – Clare Treacy Deirdre Daly (President 2005-2009) Maynooth NUI – Governing Authority Member – Annette Kennedy • European Forum of National Nursing and Midwifery Institute of Public Administration – Board Member – Associations and WHO – Madeline Spiers Annette Kennedy • American Nurses Credentialing Centre Advisory Body – Institute of Public Administration – Member of Audit Annette Kennedy (Executive member) Committee – Annette Kennedy • International Centre on Nurse Migration Strategic • ICTU Women’s Committee Advisory Group – Annette Kennedy

65 Irish Nurses Organisation Annual Report 2006 For the Record Benevolent Fund official journal of the INO which is published monthly, aims to cover a wide range of issues of interest to Irish The Finance and General Purposes Committee, and/or nurses and midwives. This includes industrial relations the President and General Secretary, continued to news and ongoing developments within the INO, authorise payments from the INO Benevolent Fund to general nursing/midwifery news, profiles, members, and retired members, who find themselves international news, features about innovation in in difficult situations. nursing/midwifery, clinical articles, education and research. The Benevolent Fund is primarily funded by income generated from the Organisation’s affinity The journal also has an expanding classifieds section partnerships with different commercial companies. In with nursing recruitment advertising and a return for access to our membership, for the purposes comprehensive diary of events. Forthcoming courses of offering services at competitive rates, these organised by the Professional Development Centre are companies make payments to the Benevolent Fund featured each month. arising from the generated income. In 2006 contributions were, in this context, received The journal is produced in a full colour A4 format and from the following: is posted to members’ preferred addresses. It continues to go from strength to strength and the • Friends First Finance Direct (preferential loans) – feedback from the membership remains very positive. e34,000 The journal welcomes ideas and suggestions for • MBNA (affinity credit card) – e10,916 articles and the editorial team at MedMedia is available to discuss these in detail with members. • HMCA (health insurance) – e22,472. Circulars Educational Loan Fund In addition to WIN, regular circulars to branch officers, The Organisation continued to grant interest-free section officers and nurse representatives were issued loans, in accordance with the regulations of the fund, from the General Secretary and the officials to ensure to members in 2006. The Organisation believes that that members were fully briefed on issues as they this investment is of major significance in the ongoing developed, during the year. development of the nursing and midwifery professions. Government Departments/ Irish Nurses Rest Association Other Bodies Two members, from each of the following, are We would like to formally thank the Minister for Health represented on the committee of the Irish Nurses Rest and Children, the Ministers of State, and the officials of Association: the Department of Health and Children, for the courtesy shown to us during a very challenging year of • Irish Nurses Organisation negotiations and discussions. • Irish Guild of Catholic Nurses We would also like to thank the Health Service • Irish Association of Nurse Managers Executive, and the Health Service Executive – Employers Agency, for numerous engagements • Director of Public Health Nurses Association. during the year, and we look forward to working constructively with them in the years ahead. Teresa Hayes (Executive Council) and Winifred Collier, represent the INO. Our thanks is also due to officers of An Bord Altranais, the National Council for the Professional Development The Association is open for applications from nurses/ of Nursing and Midwifery and the Irish Congress of midwives in need of convalescence or a holiday, for a Trade Unions. limited period, who are unable to defray all the expenses they may incur, or for the provision of grants We also wish to express our appreciation to the to defray other expenses incurred in the purchase of a officers of the Labour Court, Labour Relations wheelchair or other necessary medical aid. Commission and the Irish Business and Employers Confederation (IBEC). Publications Finally we also wish to thank the many other government departments and bodies, with whom we The World of Irish Nursing and Midwifery met during the last year, including the Department of (WIN) Justice, the Department of Enterprise and Employment, the Employment Equality Agency and The World of Irish Nursing and Midwifery (WIN), the Health and Safety Authority.

66 Irish Nurses Organisation Annual Report 2006

Press and Media and without whose excellent work the INO could not develop. To those currently in office and to those who The Organisation continues to maintain a high media have now resigned we are most grateful. profile to promote the Organisation’s policies and activities in the media. We would like to place on A list of current officers can be found in Appendices I record our sincere gratitude for the media coverage in and II. the last year. INO Staff Honorary Officers We wish to express appreciation for the very hard It gives us great pleasure to place on record our deep work and commitment of all of our staff, in our head appreciation to all our honorary officers and nurse and regional offices, during the year. It is greatly representatives for their talent, time and commitment, appreciated.

67 Irish Nurses Organisation Annual Report 2006 Appendix I: Branch Officers – Currently in Office

Correct at the time of going to press BRANCH CHAIRPERSON VICE-CHAIRPERSON SECRETARY TREASURER ATHLONE Mary Nooney Teresa Guinan Patricia Hayes Joan Scanlon Athlone District Hospital Athlone District Hospital Loughloe House St Hildas M’Cap Services Athlone, Co Westmeath Athlone, Co Westmeath Athlone, Co Westmeath Grace Park Athlone, Co Westmeath ATHY/ Michelle Wall Anne Ball Philomena McNamara BALTINGLASS St Vincent’s Hospital St Vincent’s Hospital St Vincent’s Hospital Athy, Co Kildare Athy, Co Kildare Athy, Co Kildare BALLINA Sheila McAndrew Ita Timlin Evelyn Doherty Kathleen Sheehan Ballina District Hospital St Augustine’s Welfare Home Inver, Barnatra St Augustine’s Welfare Home Ballina, Co Mayo Ballina, Co Mayo Ballina, Co Mayo Ballina, Co Mayo BALLlNASLOE Ethel Leonard Bernadette Griffin Mary Barrett Mary Fallon Portiuncula Hospital Portiuncula Hospital St Brendan’s Home Portiuncula Hospital Ballinasloe, Co Galway Ballinasloe, Co Galway Loughrea, Co Galway Ballinasloe, Co Galway BALLYSHANNON Valerie McGonigle Bríd Curristin Marie Hunter Audrey Sheerin Sheil Hospital Donegal Town Community Sheil Hospital 2 Clyhore Ballyshannon, Co Donegal Hospital, Donegal Town Ballyshannon, Co Donegal Ballyshannon, Co Donegal BANTRY Elizabeth O’Sullivan Elaine O’Mahony Aileen O’Donovan Collette Walsh Murphy Bantry General Hospital Bantry General Hospital Bantry General Hospital Bantry General Hospital Bantry, Co Cork Bantry, Co Cork Bantry, Co Cork Bantry, Co Cork CARLOW Carmel Shannon Aine Kearney Lorna Elmes Carlow District Hospital Carlow District Hospital CAREDOC Carlow Town Carlow St Dympnas Hospital Athy Road, Carlow CARNDONAGH Maria McLaughlin Rita Doherty Geraldine Diver Margaret Mary Gilmore Carndonagh Community Glenmarkee Carndonagh Community Carndonagh Community Hospital, Carndonagh Carndonagh Hospital, Carndonagh Hospital, Carndonagh Co Donegal Co Donegal Co Donegal Co Donegal CASHEL (SEHB) Mary Fanning Claire Gleeson Josephine Tobin Judy Lee Our Lady’s Hospital Our Lady’s Hospital Our Lady’s Hospital Our Lady’s Hospital Cashel, Co Tipperary Cashel, Co Tipperary Cashel, Co Tipperary Cashel, Co Tipperary CASTLEBAR Regina Durcan Margaret Lydon Jacinta Flynn Patricia O’Boyle Mayo General Hospital St Fonnan’s Nursing Unit Gurteen, Ballyhaunis Monroe, Knockdoe, Castlebar, Co Mayo Achill Island, Co Mayo Co Mayo Claregalway, Co Galway CAVAN Raymond Boyle Mary Angela Durkin Patricia Allen Mary C Reilly Cavan General Hospital Lisdarn Hospital Cavan General Hospital Virginia Health Care Centre Cavan Lisdarn, Co Cavan Cavan Virginia, Co Cavan CLARE Concepta Lillis Brigid Mullins Oliver O’Halloran Josephine McGrath ‘Copper Beech House’ Main Street St Joseph’s Hospital St Joseph’s Hospital Ballyalla, Ennis, Co Clare Kilfenora, Co Clare Ennis, Co Clare Ennis, Co Clare CLONAKILTY/ Ann Josephine Harnedy Margaret Pat Murphy Rosarie Coffey SKIBBEREEN Skibbereen District Hospital Skibbereen District Hospital Mount Carmel Hospital Skibbereen, Co Cork Skibbereen, Co Cork Clonakilty, Co Cork CLONMEL Karina Nugent David Clarke Marie Corry (HSE – Sth East) South Tipperary South Tipperary South Tipperary General Hospital General Hospital General Hospital Clonmel, Co Tipperary Clonmel, Co Tipperary Clonmel, Co Tipperary CORK HSE Maura Lombard Julia Redmond Lorraine O’Connor Adrienne Murphy BRANCH St Finbarr’s Hospital St Finbarr’s Hospital Cork University Hospital St Finbarr’s Hospital Douglas Road, Cork Douglas Road, Cork Wilton, Cork Douglas Rd, Cork CORK Gobnait Magner Helen Carey Margaret Frahill Katherine Moylan VOLUNTARY/ Mercy Hospital Bons Secours Hospital Mercy Hospital St Joseph’s Hospital PRIVATE BRANCH Grenville Place College Rd Grenville Place Mount Desert, Lee Road Cork Cork Cork Cork DROGHEDA Martin Smith Kathleen Smyth Andrea McCabe Our Lady of Lourdes Hospital St Mary’s Centre Our Lady of Lourdes Hospital Drogheda, Co Louth Drumcar, Co Louth Drogheda, Co Louth

68 Irish Nurses Organisation Annual Report 2006

Correct at the time of going to press BRANCH CHAIRPERSON VICE-CHAIRPERSON SECRETARY TREASURER DUBLIN EAST Madeline Spiers Marian P Hendrick Bernadette Smyth Eileen Mary Kelly COAST BRANCH St Columcille’s Hospital Mount Carmel Hospital St Columcille’s Hospital Clonskeagh Hospital Loughlinstown Braemor Park Loughlinstown Clonskeagh Co Dublin Churchtown, Dublin 14 Co Dublin Dublin 6 DUBLIN Moira Wynne Clare Lynch Katie Alvey Josephine Ryan NORTHERN Dublin City University Dublin City University Rotunda Hospital St Joseph’s Centre BRANCH Glasnevin, Dublin 11 Glasnevin, Dublin 9 Parnell Square, Dublin 1 Clonsilla, Dublin 15 DUBLIN SOUTH Alan O’Riordan Eileen O’Farrell Norman Jones WEST BRANCH Adelaide & Meath Hospital 57 The Park, Kingswood St James’s Hospital Tallaght, Dublin 24 Heights, Tallaght, Dublin 24 James’s St, Dublin 8 DUNDALK Geraldine McCabe Colette Vize Anne E Gilligan Louth County Hospital Louth County Hospital Louth County Hospital Dublin Road Dublin Road Dublin Road Dundalk, Co Louth Dundalk, Co Louth Dundalk, Co Louth GALWAY Ann Martin Maureen Lydon Mary P Burke Mary Esther Walsh Galway University College St Francis Nursing Unit Galway University College Bon Secours Private Hospital, Newcastle Road Newcastle Hospital, Newcastle Road Hospital, Renmore Galway Co Galway Galway Galway KlLDARE/NAAS Margaret Armstrong Mary P Coonan Derek Reilly Edwina Elizabeth Weir Naas General Hospital Naas General Hospital Naas General Hospital Naas General Hospital Naas, Co Kildare Naas, Co Kildare Naas, Co Kildare Naas, Co Kildare KILKENNY Olive Cullen Margaret Dalton St Patrick’s Centre Kilcreene Orthopaedic Kells Road, Kilkenny Hospital, Kilcreene Co Kilkenny KILLARNEY Shelia Dickson Mary Joy Nora Deirdre Buckley Kathleen Pyne St Columbanus Home St Joseph’s Nursing Home Killarney Community Hosp. 113 Woodlawn Park Killarney Ballykissane, Killorglin Killarney Killarney Co Kerry Co Kerry Co Kerry Co Kerry LAOlS Tony Arthur Mary Flynn Bernadette Parsons Cora McGrath Midland Regional Hospital Midland Regional Hospital Midland Regional Hospital Midland Regional Hospital Portlaoise, Co Laois Portlaoise, Co Laois Portlaoise, Co Laois Portlaoise, Co Laois LElTRIM Irene Argue Maureen Guihen Anne Marion Cox Drumharkin Glebe St Patrick’s Hospital St Patrick’s Hospital Cloone, Carrick-On-Shannon Carrick-On-Shannon Carrick-On-Shannon Co Leitrim Co Leitrim Co Leitrim LETTERKENNY Teresa Cassidy Mary Howley Edel Peoples Nuala Richardson Letterkenny General Hosp. Chapel Road Letterkenny General Hosp. Letterkenny General Hosp. Letterkenny, Co Donegal Dungloe, Co Donegal Letterkenny, Co Donegal Letterkenny, Co Donegal LIMERICK Thomas Ryan Eileen Mullane Thomas Murphy Theresa Doody St Vincent’s Centre St Ita’s Hospital St John’s Hospital Regional Orthopaedic Hosp. Lisnagry, Co Limerick Newcastlewest, Co Limerick St John’s Square, Limerick Croom, Co Limerick LONGFORD Kelly Neville Elizabeth Heaslip Marie McGivney Trean St Joseph’s Hospital Cloonagh Mohill, Co Leitrim Longford Dring, Co Longford MALLOW Mary Roche Mary J Ryan Ellen Feehan Lower Gurrane Mallow General Hospital Kanturk Community Hospital Fermoy, Co Cork Mallow, Co Cork Kanturk, Co Cork MEATH Margaret O’Reilly Dympna Fegan Anne Tully Evelyn Maguire Our Lady’s Hospital Our Lady’s Hospital Our Lady’s Hospital Hanlonstown Navan, Co Meath Navan, Co Meath Navan, Co Meath Navan, Co Meath MONAGHAN Linda McAree Rita Corcorcan Margaret McMahon Margaret Keenan Monaghan General Monaghan General Hospital Monaghan General St Mary’s Hospital Hospital, Monaghan Monaghan Hospital, Monaghan Castleblaney, Co Monaghan

69 Irish Nurses Organisation Annual Report 2006

Correct at the time of going to press BRANCH CHAIRPERSON VICE-CHAIRPERSON SECRETARY TREASURER MULLINGAR Ann Quinn Catherine Tormey Ann Farrell St Mary’s Hospital Mullingar General Hospital St Mary’s Hospital Mullingar, Co Westmeath Mullingar, Co Westmeath Mullingar, Co Westmeath OFFALY Mary McCafferkey Mary Keane Margaret Carton Brigid Grogan Tullamore General Hospital Tullamore General Hospital Tullamore General Hospital Tullamore General Hospital Tullamore, Co Offaly Tullamore, Co Offaly Tullamore, Co Offaly Tullamore, Co Offaly ROSCOMMON Mary Freeman Marie Gunning Ursula Morgan Catherine Gallagher Roscommon County Roscommon County Roscommon County Roscommon County Hospital Hospital, Roscommon Hospital, Roscommon Hospital, Roscommon Roscommon SLIGO Catherine Judge Delia McDevitt Breda McHugh Mary Walsh Sligo General Hospital Sligo General Hospital St John’s Hospital Sligo General Hospital The Mall, Sligo The Mall, Sligo Ballytivnan, Sligo The Mall, Sligo TIPPERARY Mary Nevin Mary B Tierney Patricia Ryan NORTH Nenagh General Hospital ‘Lanespark House’ Nenagh General Hospital (HSE – MidWest) Nenagh Ballynonty, Thurles Nenagh Co Tipperary Co Tipperary Co Tipperary TRALEE Eileen Carmody Veronica Houlihan Noirin Taylor Johanna Dillane The Old Bridge, Laharn Dingle Community Hospital Kerry General Hospital Bon Secours Hospital Listowel Road, Tralee Dingle Tralee Tralee Co Kerry Co Kerry Co Kerry Co Kerry WATERFORD Claire Mahon Fiona McKeown Mary McCormack-Sandison Waterford Regional Hospital 48 The Strand, Somerville Waterford Regional Hospital Ardkeen, Waterford Tramore, Co Waterford Ardkeen, Waterford WEXFORD Hanna Nolan Mary Mooney Mary Kehoe Wexford General Hospital Wexford General Hospital Wexford General Hospital Wexford Wexford Wexford WICKLOW Marion Byrne Mary P Esmonde Nancy Grennan Wicklow Town District St Colman’s Hospital Wicklow Town District Hospital, Wicklow Rathdrum, Co Wicklow Hospital, Wicklow

70 Irish Nurses Organisation Annual Report 2006 Appendix II – Section Officers – Currently in Office

Correct at the time of going to press SECTION CHAIRPERSON VICE-CHAIRPERSON SECRETARY A&E SECTION Sile O’Sullivan Patrick Gallagher Naas General Hospital Beaumont Hospital Naas, Co Kildare Beaumont, Dublin 9 ASSISTANT DIRECTORS Anna Winters Helen Buckley Marie Hoey OF NURSING SECTION Assistant Director of PHN Naas Hospital Connolly Hospital HSE-Midland Region Co Kildare Blanchardstown, Dublin 15 CLINICAL NURSE Annette Morgan Mary Gallagher Monica Cunningham MANAGER SECTION Eye and Ear Hospital Letterkenny General Hospital Beaumont Hospital Dublin 2 Co Donegal Beaumont, Dublin 9 CLINICAL NURSE Geraldine Hogan Jacinta Mulhere Margaret Sullivan SPECIALIST SECTION Naas General Hospital Peamount Hospital Limerick Regional Hospital Naas, Co kildare Newcastle, Co Dublin Dooradoyle, Limerick CLINICAL PLACEMENT Catherine Conlon Mary Fergus SECTION Tullamore General Hospital Mayo General Hospital Tullamore, Co Offaly Castlebar, Co Mayo COMMUNITY NURSES Sarah McKiernan Marie Lucey-O’Connor SECTION (RGNS) 161 Hillside 99 Watson Drive Greystones, Co Wicklow Killiney, Co Dublin DIRECTORS OF NURSING Imelda Browne Evelyn Barry Breda Hayes SECTION Cherry Orchard Hospital Baltinglass Hospital St Mary’s Hospital Dublin 10 Baltinglass, Co Wicklow Phoenix Park, Dublin 20 GP PRACTICE NURSE Cathriona Conlon Ann Kernan Catherine Murphy SECTION 9 Corrig Drive 4 Phoenix Court, Palantine Square Trasna-an-Bhothair, Ballinvarig Dooradoyle, Limerick Arbour Hill, Dublin 7 Whitechurch, Co Cork INTELLECTUAL Marie Gilligan Thomas Ryan Josephine Ryan DISABILITY SECTION Cregg House St Vincent’s Centre St Joseph’s Centre Sligo Lisnagry, Co Limerick Clonsilla, Dublin 15 MIDWIVES SECTION Sally Millar Hollymount Peterswell, Co Galway NATIONAL CARE OF Breda McHugh Claire Fardy Geraldine Deegan OLDER PERSON St John’s Hospital, St Columbas Hospital St Vincent’s Hospital SECTION Ballytivnan, Sligo Thomastown, Co Kilkenny Mountmellick, Co Laois NATIONAL Maureen Woodnut Joan Clifford INTERVENTIONAL St James’s Hospital Adelaide & Meath Hospital RADIOLOGY SECTION James’s Street, Dublin 8 Tallaght, Dublin 24 NURSE MIDWIFERY Mary Cotter Sara Raftery EDUCATION SECTION Adelaide & Meath Hospital Dublin City University Tallaght, Dublin 24 Glasnevin, Dublin 9 OCCUPATIONAL HEALTH Una Feeney Patricia English Regina Durcan SECTION 9 Woodlands Haulbowline Navan Base Mayo General Hospital Cappagh Haulbowline Castlebar Kinsale, Co Cork Co Cork Co Mayo OPERATING Sandra Morton Kate Nagle Theresa Cummins DEPARTMENT NURSES Adelaide & Meath Hospital Connolly Hospital Mater Misericordiae Hospital, SECTION Tallaght, Dublin 24 Blanchardstown, Dublin 15 Eccles Street, Dublin 7 ORTHOPAEDIC SECTION Rosemary Masterson Charlotte Hannon Paula Devitt Cappagh Orthopaedic Hospital Sligo General Hospital Merlin Park Hospital Finglas, Dublin 11 The Mall, Sligo Merlin Park, Galway OVERSEAS NURSES Carmelito Abragan Emmanuel Etcheri Judith Tabuena SECTION 11 Prospect Avenue, St Loman’s Psychiatric Unit St. Vincent’s Centre Glasnevin Adelaide & Meath Hospital Lisnagry Dublin 9 Tallaght, Dublin 24 Co Limerick

71 Irish Nurses Organisation Annual Report 2006

Correct at the time of going to press SECTION CHAIRPERSON VICE-CHAIRPERSON SECRETARY PHN SECTION Fiona McKeown Ann O’Neill Deirdre Duffy 48 The Strand, Somerville 23 Rosewood Grove 5 Grange Close, (Off Pottery Rd) Tramore, Co Waterford Balgaddy, Dublin 22 Dun Laoghaire, Co Dublin REHABILITATION Eileen Crowley Mary Carrie Eva Wallace NURSES SECTION St Ita’s Hospital Currabeg National Rehabilitation Hospital Newcastlewest, Co Limerick Ardee,Co Louth Rochestown Avenue Dun Laoghaire, Co Dublin RETIRED ASSOCIATE Teresa Phil O’Mahoney Catherine Marnane Angela O’Donoghue SECTION 138 Hillcrest Park 27 Templeogue Wood 7 The Woodlands Ballygall Road East, Dublin 11 Templeogue, Dublin 6W Rathfarnham Castle Rathfarnham, Dublin 14 SCHOOL NURSES Julie McTiernan SECTION 80 College Park Newbridge, Co Kildare STUDENT SECTION David Wallace Moira Wynne Jack Collins Trinity College Dublin City University Trinity College Dublin 2 Glasnevin, Dublin 11 Dublin 2 SURGICAL/MEDICAL Aideen Cassidy Noreen Flannelly-Kinsella Aine Davern DAY CARE SECTION Adelaide & Meath Hospital Our Lady’s Hospital Beaumont Hospital Tallaght, Dublin 24 Navan, Co Meath Beaumont Road, Dublin 9 TELEPHONE TRIAGE Dorcas Collier Angela Tysall Camilla O’Donoghue NURSES SECTION CAREDOC NOWDOC-GP Service Shannon Doc St Dympna’s Hospital High Road c/o St Camillus Hospital Athy Road, Carlow Letterkenny, Co Donegal Limerick

72 Irish Nurses Organisation Annual Report 2006 Appendix III: INO Secretariat – 2006

General Secretary: Liam Doran MA BA RGN RMHN Deputy General Secretary: Dave Hughes MA (Industrial Relations) Director of Professional Development: Annette Kennedy MSc BNS Director of Organisation & Social Policy: Clare Treacy RGN RPN Dip IR Dip EO Industrial Relations Staff HSE South West Area and other Dublin health agencies: Phil Ní Sheaghdha MA, RGN Dip IR & TU Studies HSE East Coast Area and other Dublin health agencies: Philip McAnenly BA (Pers Mgt & IR) RGN RPN HSE Northern Area and other Dublin health agencies: Edward Mathews RNMH HSE Midland Region and some Dublin health agencies: Joe Hoolan HDip A&E, RGN (Appointed May 2006) HSE Mid-West Region: Mary Fogarty Dip Communications, RGN HSE North East Region and some Dublin health agencies: Tony Fitzpatrick HDip A&E, RGN HSE North West Region: Noel Treanor BA (Hons) RGN HSE Southern Region: Michael Dineen RPN, Patsy Doyle BSS RPN HSE South East Region: Liz Curran RPN HSE Western Region: Noreen Muldoon RGN Media Relations Officer: Ann Keating Information & Research Executive (IR): Colette Mullin Dip Emp Law, BA IR & PM Information Officers: Catherine Hopkins Dip Mgt & Emp Rel, Dip IT, JEB Lorraine Monaghan Dip Emp Law, BA IR & PM Administration Administration Manager: Dorothy Mullarkey Dip Management & IR Office Manager: Claire Cluxton Assistant Office Manager/Assistant Media Relations Officer: Jacinta Moyles Personal Assistant to General Secretary: Michaela Ruane Dip HRM, JEB Dip IT Personal Assistant to Deputy General Secretary: Martina Dunne Personal Assistant to Director of Social Policy: Noeleen Smith Admin Support Staff: (HQ) Edel Bose Phyllis Foody Ann O’Brien Mary Cradden Admin Support Staff (Cork): Rosemary O’Sullivan Admin Support Staff (Galway): Kylie Matterson Admin Support Staff (Limerick): Karen Buckley Accounts Manager: Una O’Brien MIATI Accounts Assistants: Dolores Byrne Sinead Loy Angela Coffey IATI Membership Services Officer: Kevin Downey Membership Assistant: Una McEvitt Telephonist/Receptionist: Marion Behan Office Support Staff: Sean Meagher (Temporary) Professional Development Centre Education and Promotion Officer: Kathy Foy-Newman RSCN Dip IR, Dip PR Professional Policy Advisor: Elizabeth Adams MSc BNS RGN Course Co-ordinator: Marian Godley Assistant Course Co-ordinator: Linda Doyle Research/Personal Assistant to Director of Professional Development: Maria Moynihan Admin Support Staff: Helen O'Connell Section Development Section Development Officer: Mary Power MA RGN RM Assistant Section Development Officer: Jean Carroll BA Psychology Dip BS Admin Support Staff: Geraldine McNamee Library Librarian: Muriel Haire Dip LIS Assistant Librarian: Niamh Adams MA BA HDip LIS Library Assistant : Rhona Ledwidge Aileen Rohan Dip LIS Maintenance/Housekeeping Maintenance Officer: Stuart Mc Neill Cleaner/Housekeeper: Edita Stasitiena Jurate Jakubonyte (part-time)

73 Irish Nurses Organisation Annual Report 2006 Appendix IV: Salary scales applicable from 1 December 2006

Payment of 3% towards 2016 increase with effect from 1 December, 2006 Incremental point 1 2 3 4 5 6 7 8 9 10 Student Nurse (Degree students 23,795 12 month rostered placement)

Student Nurse Mental Handicap (Degree 23,795 students 12 month rostered placement)

Staff Nurse (including Registered Midwife, 29,744 31,233 32,725 34,215 35,698 36,981 38,267 39,547 40,828 42,087 Registered Sick Children’s Nurse, Long service increment after three years on maximum of scale 43,430 Registered Mental Handicap Nurse)

Senior Staff Nurse/Midwife 45,603

Dual Qualified Nurse 33,644 35,875 37,065 37,981 38,990 40,333 41,642 43,568 (registered in any 2 of the 5 disciplines) Long service increment after three years on maximum of scale44,913

Senior Dual Qualified Nurse 47,159

Clinical Nurse/Midwife Manager 1 42,913 43,732 44,887 46,060 47,217 48,380 49,677 50,886

Clinical Nurse/Midwife Manager 2/ 46,747 47,551 48,230 49,340 50,566 51,769 52,973 54,328 55,588 Clinical Nurse/Midwife Specialist (plus allowance of E787 pa payable on a red-circled basis to Theatre/Night Sisters who were in posts on 5 Nov 1999)

Clinical Instructor 48,853 49,672 50,278 51,404 52,538 53,762 54,992 56,221 57,448

Clinical Nurse/Midwife Manager 3 54,058 55,162 57,955 59,053 60,158 61,276

Nurse Tutor 55,332 56,108 56,880 57,657 58,432 59,209 59,979 60,758 61,533 62,308

Principal Nurse Tutor 58,116 59,246 60,278 63,501 64,628 65,689 67,015 68,793

Student Public Health Nurse 31,025

Public Health Nurse 45,505 46,288 46,957 48,012 49,224 50,398 51,582 52,911 54,149 (plus allowance of E1,573 pa payable on a red-circled basis to staff who were in posts on 5 Nov 1999)

Asst. Dir. of Public Health Nursing 54,061 57,129 58,389 59,550 60,724 62,329

Director of Public Health Nursing 63,457 64,878 66,303 67,724 69,147 70,577 71,996

Advanced Nurse Practitioner 54,597 55,688 56,742 59,975 60,993 62,175 63,280 64,378 68,797

Assistant Director of Nursing 54,597 55,688 56,742 59,975 60,993 62,175 63,280 64,378 68,797 (Band 1 hospitals)

Assistant Director of Nursing 51,761 52,902 54,062 57,128 58,389 59,550 60,724 62,329 (Non Band 1 hospitals)

Director, Nursing & Midwifery 92,009 Planning& Dev Unit – HSE ERA

Asst. Director, Nursing & Midwifery 82,980 Planning& Dev Unit – HSE ERA

Director, Nursing & Midwifery Plan 82,980 & Dev Unit – HSE Non ERA

Director of Nursing/Matron Band 1 73,207 75,242 77,281 79,312 81,346 83,388 85,419 (plus performance related pay)

Director of Nursing/Matron Band 2 68,888 70,827 72,772 74,709 76,657 78,598 80,542

Director of Nursing/Matron Band 2A 68,336 69,556 70,779 71,996 73,219 74,437 75,658

Director of Nursing/Matron Band 3 63,457 64,878 66,303 67,727 69,147 70,577 71,996

Director of Nursing/Matron Band 4 59,177 61,021 62,859 64,705 66,553 68,392 70,227

Director of Nursing/Matron Band 5 55,246 56,480 57,713 58,943 60,175 61,412 62,646

Director Centre of Nurse Education 63,787 65,830 67,872 69,915 71,957 74,000 76,042 78,170

74 Irish Nurses Organisation Annual Report 2006 Location and Qualification Allowances applicable from 1 December 2006

Eligibility Nurses eligible for payment of location/qualification allowances are Staff Nurses, Senior Staff Nurses, CNMs 1 & 2 (incl. Theatre Sisters). A nurse may benefit from either a qualification allowance or a location allowance when eligible – the higher of the two – when working on qualifying duties. Pro-rata arrangements apply to job-sharing and part-time staff. Grade Nature of Allowance Registered General Nurses Employed on duties in the following locations: ¤1,825 Accident & Emergency Depts, Theatre/OR, Intensive Care Units, Renal Units, Cancer/Oncology Units, Geriatric Units/Long-stay Hospital or Units in County Homes Registered Nurses Employed on duties in the following locations: ¤1,825 Units for Severe and Profoundly Handicapped in Mental Handicap Services, Acute Admission Units in Mental Health Services, Secure Units in Mental Health Services, dedicated Care of the Elderly (excluding Day Care Centres) and Alzheimers Units in Mental Health Services and the Intellectual Disability Sector* (including Psycho- geriatric Wards, Elderly Mentally Infirm Units, Psychiatry of Later Life Services). (*Allowance effective from 1 January, 2004.) Registered Nurses a) Employed on duties in specialist areas appropriate to the ¤2,741 following qualifications where they hold the relevant qualifications: With effect from 1 March, 2002 • Accident & Emergency Nursing Course payment of the specialist qualification • Anaesthetic Nursing Course allowance is extended to all specialist • Behaviour Modification Course courses confirmed as Category II by • Behavioural Therapy Course An Bord Altranais • Burns Nursing Course • Child & Adolescent Psychiatric Nursing Course • Coronary Care Course • Diabetic Nursing Course • Ear Nose & Throat Nursing Course • Forensic Psychiatric Nursing Course • Gerontological Nursing Course • Higher Diploma in Midwifery • Higher Diploma in Paediatrics • Infection Control Nursing Course • Intensive Care Nursing Course (incl. Paediatric Intensive Care & Special and Intensive Care of New Born) • Neurological/Neurosurgical Nursing Course • Operating Theatre Nursing Course (incl. Paediatric Op. Theatre) • Ophthalmic Nursing Course • Orthopaedic Nursing Course • Higher Diploma in Cardiovascular Nursing/Diabetes Nursing/ Oncological Nursing/Palliative Care Nursing/ Accident & Emergency Nursing • Rehabilitation Nursing Course • Renal Nursing Course • Stoma Care Nursing Course Registered General Nurses b) Holding recognised post-registration qualifications in midwifery ¤2,741 or sick children’s nursing and employed on duties appropriate to their qualification All Public Health Nurses & Receive Qualification Allowance of ¤2,741 Assistant Directors of Public Health Nursing

Dual Qualified Scale: Applies to nurses in possession of two of the five registered nursing qualifications or in training for the second qualification on 1 October, 1996. In the case of midwifery and sick children’s nursing, the dual qualified scale is effective from 1 August, 1998. A staff nurse can only receive either a dual qualified scale or an allowance, whichever is the greater. The exceptions to this are: (a) Nurses who were paid on the dual qualified scale on 1 October, 1996 and in receipt of a location allowance at 1 August, 1998 or eligible for a new location/qualification allowance from 31 March, 1999. In such cases the value of the location/qualification allowance is ¤1,370 which they receive in addition to their dual qualified scale; (b) With effect from 26 November, 2003, nurses who are paid on the dual qualified scale and who then move to an area that attracts a location/qualification allowance will continue to be paid on the dual qualified scale and will also receive the abated value of the location/qualification allowance of ¤1,370. Payment of the allowance will cease if the nurse moves out of the qualifying area.

75 Irish Nurses Organisation Annual Report 2006 Other allowances applicable from 1 December 2006

Grade Nature of Allowance Relevant Nursing Staff Nurse Management Sub-structures – Special Allowance for weekends/public holidays ¤2,923 Psychiatric Nurses Community Allowance ¤4,874 Nurses assigned to Occupational Therapy (Qualified) ¤3,666 Nurses assigned to Occupational Therapy (Unqualified) ¤1,672 Public Health Nurses Island Inducement Allowance ¤1,735 Public Health Nurses Fixed payment ¤27.64 Week-end Work First call on Saturday and first call on Sunday ¤36.69 Each subsequent call on Saturday and Sunday ¤18.38 Payment in lieu of time off for Emergency work ¤27.61 Theatre Nurses who participate On-Call with Standby – Each Day in the On-Call/standby Monday to Friday ¤41.59 Emergency Services Saturday ¤53.42 Sunday and Public Holidays ¤72.21 All of these figures based on a 12-hour period. Pro rata to apply after hours. Call-Out Rate – Monday to Sunday (a) Fee per operation per 2 hours (17.00-22.00 hours) ¤41.59 (b) (i) Operation lasting more than 2 hours and up to 3 hours (17.00-22.00 hours) ¤62.37 (ii) Operation lasting more than 4 hours and up to 5 hours ¤103.96 (c) Fee per operation per hour (after 22.00 hours) ¤41.59 On-Call without Standby (a) Fee per operation, call-in without standby ¤83.17 (b) Overruns from roster at normal overtime rates (no time back in lieu) On-Call over Weekend In situations where no rostered duty is available over the weekend, the following will apply on a pro-rata basis (ie. appropriate rate divided by 12, then multiplied by number of hours available). No time back in lieu will apply. Nurse Co-Ordinator Allowance A shift allowance of ¤17.77 will be paid to a staff nurse who undertakes the role of formalising the reporting and accountability relationship with the Theatre Superintendent. The allowance only applies to a nurse who fulfils specified duties when called in (DoHC circular refers). Midwives providing Domiciliary Fee per service ¤122.24 Care under the Maternity and Reduction with a/n visit is after 36th week of pregnancy ¤7.62 Infant Care Scheme Patient removed to hospital before onset of labour and not accompanied by midwife ¤45.36 Patient removed to hospital before onset of labour and accompanied by midwife ¤60.57 Patient removed to hospital after onset of labour and not accompanied by midwife ¤75.90 Patient removed to hospital after onset of labour and accompanied by midwife ¤90.79 Abortions and Miscarriages ¤60.55 Special Co-ordinator Allowance ¤4,242

76 Irish Nurses Organisation Annual Report 2006 Appendix V: INO Private Nurses Fees – (Emergency & General Nurses Section Effective 1 July, 2006-20 June, 2007)

Mon—Fri Mon—Fri Saturday Saturday Sunday Sunday 24, 25 & 31 Dec Day Night Day Night Day Night Day & Night

Up to 4 Hrs E103 E122 E156 E204

5 Hrs E110 E131 E170 E242

6 Hrs E126 E149 E195 E280

7 Hrs E144 E167 E221 E316

8 Hrs E159 E174 E184 E195 E247 E255 E354

9 Hrs E167 E185 E194 E208 E258 E271 E391

10 Hrs E188 E208 E217 E233 E284 E306 E428

11 Hrs E208 E230 E238 E259 E309 E340 E466

12 Hrs E228 E255 E261 E286 E334 E374 E504

13 Hrs E251 E279 E284 E312 E360 E408 E541

Specialist areas: eg. ICU/CCU/A&E/Haemodialysis/Midwifery Theatre Allowance 15%

• Nurses are advised to ensure that a Doctor is in attendance on cases in Private Homes to which they are called. • Responsibility for payment of fees: The person (employing authority or individual) who engages the nurse is responsible for the payment of his/her fees within one calendar month. • Shift payments outlined are inclusive of statutory rest periods as per the Organisation of Working Time Act (1977).

Twilight Shift 8pm - 12 Midnight Escort Rates On-Call Fees Mon - Fri E145 1st Hour E64 Mon - Fri E72 Saturday E168 2nd - 8th Hour E14 Saturday E79 Sunday E206 After 8 Hours E21 Sunday E87

• If called during a period of Theatre On-call/Sleep Over the full night duty rate (not the on-call allowance) should be paid from the time the on-call period started • Private Industry Fee E31 per hour daytime. Shifts commencing AFTER 6pm should attract an additional 25% • Nurses must send receipts to patients immediately on receipt of fees.

77 Irish Nurses Organisation Annual Report 2006 Appendix VI: Subsistence Rates

Subsistence (Normal) Rates:

Class A (salary above E50,535 per annum) E

Night Allowance 140.44

Day Allowance 10 hours or more 41.55

Day Allowance 5 hours but less than 10 16.95

Class B (salary E50,534 and below) E

Night Allowance 132.18

Day Allowance 10 hours or more 41.55

Day Allowance 5 hours but less than 10 16.95

Mileage Rates Official Mileage in a Calendar year up to 4,000 4,001 & over

cent cent

Engine capacity up to 1,200cc 86.05 44.42

Engine capacity 1,201cc to 1,500cc 102.58 51.33

Engine capacity 1,501cc and over 129.88 61.07

78