FULL RECOMMENDATION
INDUSTRIAL RELATIONS ACTS, 1946 TO 1990 SECTION 26(1), INDUSTRIAL RELATIONS ACT, 1990 PARTIES : BEAUMONT HOSPITAL - AND - IRISH NURSES ORGANISATION DIVISION : Chairman: Mr McGee Employer Member: Mr Murphy Worker Member: Ms N� Mhurchu |
1. Staffing Levels- Intensive Care Unit
BACKGROUND:
2. The issue before the Court concerns a claim by the Union for an increase in staffing levels at the Intensive Care Unit (ICU) of the Hospital. The Union argues that the ICU of the Hospital is currently staffed at a lower level than its comparator hospitals and at a level lower than that recommended by expert societies. The Union's members have raised serious concerns regarding the tiring and stressful environment in which they are working because of claimed staff shortages. The ICU must be staffed at an appropriate level as it is an environment in which there is little room for error. The Union is seeking an additional 18 nursing posts in the light of the professional concerns of its members. Management reject the claims made by the Union. It is Management's position that there is no recognised international standard for nurse to bed ratios in ICUs rather it would advance that the international trend is to concentrate on skill-mix and effective bed management as the most effective way to ensure patient care.
The dispute could not be resolved at local level and was the subject of a Conciliation Conference under the auspices of the Labour Relations Commission. As agreement could not be reached, the dispute was referred to the Labour Court on the 31st March, 2008 in accordance with Section 26(1) of the Industrial Relations Act, 1990. A Labour Court hearing took place on 23rd July, 2008.
UNION'S ARGUMENTS:
3. 1 The staffing levels applicable in the ICU of the Hospital are significantly below those applying in all comparable hospitals within the Dublin area. The staffing levels do not conform with best practice within the Dublin area.
2 The current environment is a cause of significant stress and anxiety to staff and is causing a deterioration in terms of skill-mix within the department. The staffing levels in the ICU should be capable of responding effectively and safely to rapidly changing demands. The levels applicable at present are below those necessary to do this appropriately.
3 The employer has commissioned a national review of critical care services over which the staff side has no control and the results of which the Union will not necessarily see and which in any event can not be used to deal with the immediate and long-standing problem facing the ICU at the Hospital. The Union is seeking an independent review at local level.
COMPANY'S ARGUMENTS:
4. 1 Management does not believe that an independent review of the ICU would provide a solution to this particular case because the Health Service Executive has commissioned a review of all ICUs within the State. Management believes this is the correct process to address the Union's concerns.
2 The Union claim for a ratio of one staff nurse to each ICU bed is groundless. The international research has shown that a combination of experience, skill mix and effective bed management are the most effective ways to ensure patient care.
3 Management does not have the power to grant the increase in staff that the Union is seeking. Under the terms of Towards 2016, this is a cost-increasing claim.
RECOMMENDATION:
The Court, has considered the submissions of both parties, and the evidential material submitted by the INO, and also notes the repeated formal complaints by the Union concerning alleged short-staffing.
The Court has neither the expertise nor authority to recommend on staffing levels in the ICU Department of a General Hospital but, having heard the submissions, is of the view that a review of staffing levels should be carried out as soon as possible by an appropriate independent person(s) or body with the requisite expertise agreed by the parties. Should the parties be unable to agree on this matter, the Court will nominate such a person(s) or body to conduct the review. This service review should also include involvement by the nursing staff concerned.
Signed on behalf of the Labour Court
Raymond McGee
17th September,2009______________________
DNDeputy Chairman
NOTE
Enquiries concerning this Recommendation should be addressed to Ciaran O'Neill, Court Secretary.