INDUSTRIAL RELATIONS ACTS, 1946 TO 2001
SECTION 26(1), INDUSTRIAL RELATIONS ACT, 1990
ST. JOHN'S HOSPITAL
(REPRESENTED BY THE IRISH BUSINESS AND EMPLOYERS CONFEDERATION)
- AND -
IRISH NURSES' ORGANISATION
Chairman: Ms Jenkinson
Employer Member: Mr Grier
Worker Member: Mr O'Neill
1. Provision of a 3rd on-call nurse.
2. St.John's Hospital is a voluntary acute hospital providing a variety of medical and surgical services in the Limerick region. It is a Band 3 hospital.
The Union states that the theatre in this facility currently operates from 8am to 5pm, Monday to Friday. At all times during normal daytime operations there are three theatre trained nurses present to provide services in the operating theatre.
However, the hospital also provides "on-call" services outside normal operating hours. This service is used to treat emergency or acutely ill patients. The Union claims that only two theatre nurses are available and argues that there should be three nurses available to provide this service.
Management rejected the Union's claim because of the financial cost involved.
3. 1. The current system is forcing nurses to work outside their scope of practice, compromises them professionally and leaves them open to professional and organisational consequences in the event of an error.
2. The dual standard whereby day operations are properly staffed and "on-call" procedures are completed by a diminished compliment is illogical and places patients at risk.
3. The present situation is untenable and in order that a safe level of care can be provided in the operating theatre of St. John's Hospital it is imperative that a third "on-call" nurse be provided.
4. The National Association of Theatre Nurses (NATN) recommended that there was a necessity to have three theatre nurses present during operations to ensure the safety of patients.
4. 1. It is management's position that the current practice at St John's Hospital in relation to theatre on-call arrangements are very much in keeping with practice generally in the public health system.
2. Management is not aware of any documentary evidence that suggests that the existing on-call arrangements are unsafe. The only document received is one produced by the NATN, a staff representative organisation, which includes a recommendation for the provision of three nurses.
3. The claim before the Court should be dealt with at national level between the relevant bodies concerned.
4. The hospital is currently experiencing serious financial difficulties. Management is seeking to manage a projected budget deficit of €1 million for 2003 which has necessitated the closure of 24 of its 94 in-patient beds for June, July and August and the closure of its 10 day surgery beds for the month of July in an effort to effect savings.
The Court has considered the position of both parties. An issue of safety has arisen concerning theatre nurse staffing levels during surgical procedures, which are carried out after hours. The Court is aware that similar claims have been lodged in other Band 3 hospitals. Therefore, the Court is of the view that the most appropriate manner to deal with this claim is for discussion to take place at national level between the appropriate bodies. The Court recommends accordingly.
However, in the meantime, the Court recommends that an independent review should be carried out at local level on the basis of agreed terms of reference between both parties. The results of such a review to form the basis of the Hospital's submission to the Department on their Theatre 2004 Service Plan.
Signed on behalf of the Labour Court
7th July, 2003______________________
Enquiries concerning this Recommendation should be addressed to Larry Wisely, Court Secretary.