Il- Musbieh- Issue Number 88

Il-Musbieœ MALTA NURSING AND MIDWIFERY JOURNAL

Malta Union of Midwives and Nurses

Numru 88 - Settembru 2020

Defend Your Rights

the heartbeat of healthcare

www.mumn.org Tel: 2144 8542 E-mail: administrator@mumn.org

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- NUMRU 88

contents

Ħarġa nru 88

Settembru 2020 - Editorial & President’s message

pages 4-5

- From our diary

pages 20-21

- Il-Pandemiji

pages 34-35

Group Committees - Chairpersons & Secretaries Mater Dei Hospital: Emily Galea, Chairperson: 77440050; Glen Camilleri, Secretary: 79205674 SVP: Therese Decelis, Chairperson: 79809080; Mario Galdes, Secretary: 79449324 RHKG: Graziella Buttigieg, Chairperson: 79275872; Vincent Muscat, Secretary: 99455982 Health Centres: Roseanne Bajada, Chairperson: 79671910; Miriam Aquilina, Secretary: 99830893 MCH: Angelo Abela, Chairperson: 79594326; Malcolm Bezzina, Secretary: 77822561 SAMOC: Ronnie Frendo, Chairperson: 77000919; Dennis Darmanin, Secretary: 79826533 GGH: Joseph Camilleri: 79485693; Anthony Zammit: 79617531; Jennifer Vella: 79277030 ECG Technicians: Alex Genovese, Chairperson: 79860571; Charmaine Caruana, Secretary: 99462992 Physiotherapists: Pauline Fenech, Chairperson: 79491366; Luciano Pace Parascandolo, Secretary: 79455083 Midwives: Catherine Bonnici, Chairperson: 99252438; Abigail Plum, Secretary: 79592466 MUMN Council Members Paul Pace - President: 79033033 Colin Galea - General Secretary: 79425718 Alex Manche’ - Vice-President: 77678038 George Saliba - Financial Secretary: 79231283 Alexander Lautier: 99478982 Geoffrey Axiak: 99822288 William Grech: 79011981 Simon Vella: 79703433 Claire Zerafa: 99217063 Joseph Aquilina: 99467687 MUMN Office: 21448542 Editorial Board Joseph Camilleri (Editor) CN M1 MDH Christa Gauci (Member) SN SJ 6 SVPR Norbert Debono (Member) EN

Pubblikat: Malta Union of Midwives and Nurses Les Lapins Court B, No.3, Independence Avenue, Mosta MST9022 • Tel/Fax: 2144 8542 • Website: www.mumn.org • E-mail: administrator@mumn.org Il-fehmiet li jidhru f’dan il-æurnal mhux neçessarjament jirriflettu l-fehma jew il-policy tal-MUMN. L-MUMN ma tistax tinÿamm responsabbli gœal xi œsara jew konsegwenzi oœra li jiæu kkawÿati meta tintuÿa informazzjoni minn dan il-æurnal.

Dan il-æurnal jitqassam b’xejn lill-membri kollha u lill-entitajiet oœra, li l-bord editorjali flimkien mad-direzzjoni tal-MUMN jiddeçiedi fuqhom.

Il-bord editorjali jiggarantixxi d-dritt tar-riservatezza fuq l-indirizzi ta’ kull min jirçievi dan il-æurnal.

L-ebda parti mill-æurnal ma tista’ tiæi riprodotta mingœajr il-permess bil-miktub tal-MUMN.

Kull bdil fl-indirizzi gœandu jiæi kkomunikat mas-Segretarja mill-aktar fis possibbli.

Çirkulazzjoni: 4,000 kopja.

Ritratt tal-faççata: MUMN.

Il-Musbieœ jiæi ppubblikat 4 darbiet f’sena.

Il-Musbieħ

- SETTEMBRU 2020

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Editorial

Student Nurses & Midwives

during COVID-19

Soon after the first cases of Coronavirus were admitted to Mater Dei Hospital, way back in March, student nurses and midwives from all Institutions were sent home, lock stock and barrel. Fear of the unknown at this point was rife. Apart for their safety, the junior nursing/midwifery students have had their clinical placements postponed due to an imminent shortage of supervisory staff and rapid changes within the clinical environment. Student nurses assigned with their mentors faced, yet again, overnight decisions to restart their placement and again stop for the umpteenth time.

Apart from that, the familiar faceto-face model of teaching was ground to a halt. Some teachers and students were driven from their classrooms into the virtual realm of online education by the global COVID-19 pandemic. This became the new normal. This was not easy, but it is viewed as an opportunity to provide care to our students by offering an alternative pedagogical approach.

While didactic learning is an essential element in nursing education, the clinical experience is arguably the more crucial, especially for those students nearing graduation.

Students were faced with unprecedented challenges that had nothing to do with their nursing/ midwifery education. Educationally, students had mounting pressure related to their degree completion requirements. There were also problems of how to complete their clinical hours when they were no longer able to go to their assigned hospital unit. As I write, some final year students are still at a standstill especially when they are assigned to medium to high-risk COVID wards.

Student Nurses were also (and still are) constantly accompanied by fears about health, finances, graduating on time, and transitioning into an overwhelmed and exhausted workforce. Nursing/Midwifery stu-

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dents learn early in their curriculum how to avoid infection and stay safe.

Nobody becomes an expert in a technique overnight. It is therefore debatable whether to allocate students in high to medium risk units and especially during their final year, preparing for their practical assessments.

This pandemic offers some students rewards and comes with risks and costs. 2020 is Florence Nightingale’s bicentennial year, designated the Year of the Nurse and Midwife by the World Health Organisation. This pandemic has reflected the sheer determination, bravery and compassion of nurses across the country. From a student nurse’s perspective, this has been inspirational.

Finally, we have to remember that the students of today are the nurses and midwives of tomorrow. Future challenges to nursing/midwifery education include ensuring that nursing students be instructed in the care of an increasingly non-hospitalbased patient population and the development of new electronic platforms to enhance the learners’ educational experience, the art and science of collaboration.

Nursing and Midwifery students need to stay positive: The world needs nurses!

- NUMRU 88

President’s message We are in the middle of the second wave of covid-19 and new cases are emerging every day with some cases having consequences also on the healthcare staff. The challenges brought about by this virus on the healthcare work force are enormous where even the private lives had been affected.

photo | szonokszuletik.files.wordpress.com

MUMN was proactive, supporting its members when needed from the start. In March, PPE issues were taken seriously and directives were issued accordingly since we have all saw what occured in other countries when PPE was not available to the healthcare staff.

Other important issues were being brought forwarded to MUMN by its members. Loss of allowances due to quarantine leave, no child care support to nurses who resulted with loss of wages and lacw k of staff which is a chronic ongoing problem but worsened with staff sent home due to vulnerability and quarantine.

MUMN was the only union in the Health Sector to support the staff on all these issues. Directives had to be issued and MUMN took a stand in the name of all its members.

MUMN could understand the phone calls from its members especially in the light that there are currently more that 650 healthcare workers who are working with children under 10 years of age. If schools were to remain close such healthcare workers could not be expected to abandon their children.

There are more than 200 staff who are either pregnant or suffering from serous diseases. Although the legal notice which regulates the vulnerability of persons was removed, MUMN still took an active stand on persons who needed support.

That is why MUMN issued directives to its members as to provide the ““covid-19 package” to its members. The outstanding response of its members to the directives was outstanding but there are always certain healthcare staff who are either in another union (such as certain number of E/A nurses) or some health workers who did not comply to the

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directives. Unfortunately, such staff would then present themselves to collect the benefits of the covid-19 package like the rest of us, but that is life where the burdens are not carried by everyone.

On the other hand MUMN is a strong union since the base of members who actively followed the directives was extensive. MUMN would like to thank its members who stood up to be counted and such members are highly appreciated since such they make the union stronger and they are the members who make the difference from all other healthcare workers. Such members are the ones which allow MUMN to bring the benefits to its members and MUMN is proud of such members.

MUMN can boast that for the first time in the civil service, Sunday and feasts allowances will not be deducted since the current practice within the entire civil service is that even an injury on duty leads to loss of allowances.

Winter will bring about an increase in covid cases. News that a vaccine can be available in Malta

by December 2020 is being spread but it is too good to be true. Winter will bring further challenges since the influenza seasonal flu would add more pressures to the existing covid pressures. To make matters worse, the sign and symptoms of both Influenza and covid are identical so the demand for more screening, more segregation of patients will have to take place.

Nurses, Midwives, Physiotherapist, ECG Technicians and Social Workers are represented by MUMN and a crucial vote will soon take place so that the Physiotherapists will be like the nurses and the midwives and the doctors - a separate profession and • continued on page 6

- SETTEMBRU 2020

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Kelmtejn

mis-Segretarju Ġenerali F’pajjiÿna, fil-mument, gœaddejjin minn ÿmien turbulenti u fl-istess waqt sensittiv. Din il-kwistjoni tal-Covid19 qalbitilna œajjitna kemm fil-œajja privata tagœna kif ukoll fuq il-postijiet tax-xogœol. U hawn fejn tidœol l-MUMN. F’Marzu li gœadda lkoll konna maœsuda b’dak li kien qed iseœœ. Kienet xi œaæa ædida gœal kulœadd. Qatt ma esperjenzajna fatti u çirkostanzi simili però tgœallimna minn dak li seœœ. Analizzajna dak li gœaddew minnu l-membri tagœna u l-problemi li œabbtu wiççhom magœhom. Dan l-eÿerçizzju kien siewi œafna meta pajjiÿna reæa’ beda jiffaççja t-tieni mewæa b’numri akbar. Mill-ewwel morna fuq l-awtoritajiet u gœamilna talbiet formali sabiex il-membri talUnion ma jerægœux jgœaddu minn esperjenzi negattivi.

Fost dawn kien hemm:1. Dawk il-æenituri li gœandhom tfal ÿgœar u m’gœandhomx ma min iœalluwhom, f’kaÿ li l-iskejjel ma jiftœux, iridu jiæu mgœejjuna; 2. Ma jistax ikun li numru sostanzjali ta’ professjonisti jintbagœtu jaœdmu mid-dar gœad-detriment ta’ oœrajn li jibqgœu xogœol. Kull min jintbagœat id-dar, irid ikun assigurat li jista’ jagœmel xogœlu kollu minn A sa Z; 3. Min jirriÿulta poÿittiv gœall-virus u jkun æie infettat minn fuq il-post tax-xogœol, m’gœandux ikollu l-paga tiegœu affetwata bl-ebda

President’s message • continued from page 5

not forming part if the Allied Health Professionals. MUMN respected the trust that physiotherapists have put in MUMN and finally the time for such professionals to have their own sectoral agreement, independant from the Allied Health is very imminent indeed.

But a new category will join MUMN ranks. MUMN has a new

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mod, lanqas minn nuqqas ta’ allowances tal-Œdud u l-Festi meta dawn ma jinœadmux.

Barra mill-kwistjoni tal-Covid-19, l-MUMN qed tieœu œsieb affarijiet oœra li huma ta’ benefiççju gœallmembri, fosthom:1. L-inæustizzja ma’ dawk il-membri li jaœdmu gœases, u fejn suppost æew ikkumpensati bi 12-il siegœa fis-sena, fejn jirrigwarda il-kumpens tal-Festi Pubbliçi, æew mogœtija biss 8 siegœat; 2. Hemm œtieæa uræenti li jiæi indirizzat in-nuqqas ta’ nurses. Filmument hemm possibilità li dan isir gœal dawn il-ftit xhur li æejjin, dan in-nuqqas jiæi indirizzat peress li hemm 3 riÿultati ta’ sejœiet ta’ applikazzjoni fejn jistgœu jiæu ngaææati 500 nurse fosthom innurses li gœadhom kemm laœqu mill-Università ta’ Malta u minn Northumbria University. Nixtieq nieœu din l-opportunità biex nifraœ lill-Midwives u Nurses æodda nkluÿ dawk li gœaddew b’suççess millkors tal-Mental Health u nawgura lill-istudenti tal-aœœar sena talPhysiotherapy kull suççess.

3. Sa issa rnexxielna nakkwistaw il-Meal Allowances gœal MDH, SAMOC, MCH, SVP, Elderly Homes u Commcare. Gœaddejjin trattativi fuq GGH, SLH U KGRH u kif ilestu dawn it-3 sptarijiet nitfgœu l-attenzjoni kollha tagœna fuq il-PHCD;

group of members. MUMN would like to welcome the Dental Surgery Technicians into the fold of MUMN members. MUMN has requested the sole recognition of the Dental Surgery Technicians and is awaiting the confirmation from the DIER on this regard. MUMN will be proud to represent the dental surgery technicians and a new sectoral agreement will be discussed once the sole recognition is given by the employer.

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4. Iffirmajna l-ewwel Ftehim Settorali tas-Social Workers impjegati masServizz Pubbliku u mal-FMS. Gœal l-ewwel darba, dan il-Ftehim huwa ta’ benefiççju u fih pjattaforma fejn ’il quddiem inkomplu nibnu fuqu; 5. Qegœdin œafna viçin li nagœtu lil Physiotherapists dak li wegœdnihom 4 snin ilu, iæifieri li jinqatgœu minn mal-Allied Group u jsiru professjoni gœalihom bœal ma’ huma l-membri l-oœra kollha tagœna. Dan huwa ÿmien sensittiv œafna u nirringrazzja lil Physios kollha li qed jagœtuna appoææ sœiœ, œlief gœal xi 3 physios mejtin bil-æuœ li ppreferew li jieœdu ¢10 issa, milli jieœduha 3 xhur oœra u magœhom jieœdu l-professjoni tagœhom lura. Tiskanta kemm hawn min jara sa mnieœru u egoist fl-istess waqt. Tœallu lil œadd juÿakom gœal œtiæijiet personali tiegœu biex forsi nilœqu f’xi kariga ædida!

9. Dwar l-ECG Technicians huwa tajjeb li ngœidu li fl-aœœar, l-MUMN u l-Management ser nibdew niddiskutu bis-serjetà l-compliment kif gœandu jkun u t-toroq biex naslu gœalih.

Gœalissa ser nieqaf hawn gœax œadt spazju mhux œaÿin. Sakemm tasal œaræa oœra nixtieq nawguralkom kull saœœa lilkom u l-dawk viçin tagœkom.

Colin Galea Segretarju Æenerali

Challenges are still ahead but we have now the experience and the expertise to do what is necessary.

We can never predict what lies ahead of us but at least all members of MUMN have the comfort of knowing that a strong union is behind them and will always be the true voice of all healthcare staff in all health and elderly institutions.

Paul Pace MUMN President

Sharing

Reflections on the privilege of caregiving NURSING WAS NAMED the most trusted profession for the 18th consecutive year in January 2020.1 This recognition is objective evidence that we do a great job in caring for our patients; however, some moments occur for which we, as a collective, cannot be proud.

As a nurse for over 25 years, I have witnessed numerous situations when nurses missed opportunities to serve patients according to the highest care and practice standards. Excellence in service that promotes dignity, respect, and safety is a right for all patients. Nurses are responsible and accountable for ensuring this right for every patient and family member during each patient encounter.

While these unfortunate situations are a reality, they are exceptions and not the rule. Extenuating circumstances, such as a failure of hospital and nursing leaders to ensure adequate staffing resources in patient care areas, are often catalysts for these unpleasant and unintended patient experiences. Inadequate staffing compels nurses to prioritize

patient safety over spending the necessary quality time with patients and families to prevent adverse and sentinel events.

Because I am so proud and humbled by the privilege of contributing to the well-being of others as a nurse, I feel a sense of moral injury each time I witness or experience anything less. I feel this most acutely when older patients tell me they did not receive something that they needed, from education or pain medication to feeling unnecessarily rushed to communicate, or feeling afraid to ask questions.

The poem below was inspired by their stories. It is meant to offer a voice not only for older adult patients, but also for anyone who has shared similar experiences. I challenge all nurses to become more self-aware and to reflect on the way that they approach caring for each patient during every minute of their encounters.

I ask each nurse to recognize that the title “nurse” is an awesome honor that carries with it a solemn responsibility to humanity.

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Richard-Eaglin, Angela

DNP, MSN, APRN, FNP-BC, CNE, FAANP

Nursing: September 2020

Dear nurse, The impact of first impressions is not a cliché, it is a reality.

Therefore, your initial contact with me should not come across as mere formality.

Those first few moments give rise to the foundation of trust; I need to sense sincerity, warmth, care, and compassion and not be made to feel like I’m just: I’m just the next task on your list of things to do.

No, I’m not a thing or my condition, I’m a person who genuinely needs you.

As a matter of fact, let me say again that I’m not a task.

But it seems as much when you rush around me, so I dare not ask.

I dare not ask you any questions about my disease because I’m afraid to upset you or make you displeased.

If I dare to make you angry, what will my consequences be?

Will you withhold my medicines, prolong my needs, badmouth, and not advocate for me?

Your actions can compound the pre-existing mental and physical anguish that I already felt; I hope you know that I’d rather not be here, but these are the cards I was dealt.

Please use my words as a reference for reflection; Remind yourself that a patient is a vulnerable human being; not a disease, a procedure, or your next injection.

You are the person whom I see the most; I need to trust you and I need our bond to be close.

I realize that I’m not your only patient and you have a lot to do; I’m not trying to make your life difficult but right now, I really need you.

Remember that you are a person and a potential patient, too, So “do unto others as you would have them do unto you.”

- SETTEMBRU 2020

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Megan Ford - Nursing Times

Student nurses ‘being asked to carry out unsupervised drug rounds’

Some NHS trusts are wrongly allowing student nurses on extended clinical placements to carry out unsupervised medication rounds, a leading student representative has revealed.

More than 25,000 students opted to carry out paid extended clinical placements which were designed by the Nursing and Midwifery Council to support the coronavirus response.

But concerns have been raised that because those in their final six months of study are being remunerated at band 4, they are being expected to work like a qualified nurse at this level, rather than students.

Royal College of Nursing student committee chair Jessica Sainsbury told Nursing Times that she had heard from several students who were being asked to carry out drugs rounds without supervision.

“There are some trusts who are basically saying to students ‘you’re being paid at band 4 and band 4s in this trust, if they are competent, can do certain or all meds unsupervised, we’ll sign you off as competent, put you through the competency and

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then you can do it’,” Ms Sainsbury explained.

“So, the students are like ‘well actually, in a couple of months’ times I’ll be doing it anyway so why not?’.

But that’s not within our scope of practice as students.”

Students had contacted the committee directly over the issue and via its closed Facebook group, she noted.

There had been a number of discussions between students in the group around what different approaches trusts had taken over drug rounds.

The fact student nurses on extended placements were no longer supernumerary was being used by some to justify them carrying out additional duties, but Ms Sainsbury said she did not believe this to be a strong counter argument.

“It just got to the point where

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there were so many different people saying ‘my trust says it’s fine’,” noted Ms Sainsbury.

The student nursing lead wanted to raise awareness of the issue and put a stop to it.

“The reason we are being paid is so that we are protected for if stuff goes wrong, things like death in service, and it is a pandemic and we are putting ourselves at more risk than we usually would – that is why we’re being paid, it’s not to make us do meds rounds,” added Ms Sainsbury.

Although carrying out medication rounds was a standard part of placement for final year student nurses, they should be done under direct or indrect supervision, she stressed.

“Of course, as final year students we do get to do, under direct, or indirect supervision, more meds rounds and we are practically doing it ourselves, but that is different in comparison to being signed off on a meds competency and doing your meds rounds on your own and that is what is happening in some places which is really concerning,” she said.

“I don’t want to be all doom and gloom, but I’m looking at it in a sense of what if something goes wrong and how protected are those students really at the end of it?”

Students on extended placement were experiencing “conflict” over whether they should be following the advice of universities or their employer, she noted.

“Once you’re on a placement that is kind of your bubble and your world and now that we’re employed as well, although we are still students, I think some students have that kind of conflict – ‘do you do what your university says or do you do what your employer says?’,” said Ms Sainsbury.

“If your employer is saying, ‘no, it’s absolutely fine, if we think you’re competent to do meds unsupervised, you can do meds unsupervised’, what

Kimberley Hackett - NursingStandard

COVID-19: parents reveal fears over home visits for seriously ill children are you going to do?”

In a statement issued to Nursing Times, the NMC clarified that any care activities undertaken by students “should be with supervision, including the administration of drugs” and that students should not carry out any other activities that would not normally be part of their nursing course.

Survey findings, released as part of Children’s Hospice Week, have revealed that parents of seriously ill children fear home visits by nurses during the COVID-19 pandemic

I don’t want to be all doom and gloom, but I’m looking at it in a sense of what if something goes wrong and how protected are those students really at the end of it?”

Moving forwards, Ms Sainsbury has been in discussion with the NMC to update its website under its ‘frequently asked questions’ section to further clarify its position for students on extended placements.

“I said to them as long it is in black and white from the NMC…then that will be something that students can wave in their practice facilitators face and say ‘look, I’m not meant to be doing meds’,” she said.

Commenting on the issue, Dr Geraldine Walters director of professional practice for the NMC, said: “As our emergency standards set out, students on extended placements should not be undertaking any activities that would not normally be a part of their course.

“Any care activities they do undertake should be with supervision, including the administration of drugs.”

Dr Walters encouraged students to first raise concerns with their university and assured they could also get in touch with the NMC to ensure its standards and requirements were being met.

Survey reveals parents’ concerns about home visits during the pandemic Parents caring for seriously ill children are worried about nurses coming into their home during the COVID-19 pandemic, a study has revealed.

The study, released as part of Children’s Hospice Week, found 95% of parents were debating the risks and benefits of allowing healthcare professionals into their home to support their children.

A total of 44 parents have completed the ongoing study from Martin House Research Centre, the UK children’s palliative care charity Together for Short Lives, and the University of Southampton.

Of those who participated: • 89% think their child should be isolated from everyone except immediate family during the pandemic.

• 93% fear their child’s treatment will be cancelled or delayed.

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• 59% had struggled to get nursing support during the pandemic, and 66% struggled with inhome care.

Families will need support to negotiate the gradual lifting of lockdown rules Commenting on the report, the charity’s children’s palliative care nurse specialist Tara Kerr-Elliot said it is important that families of seriously ill children are supported when coming out of lockdown as we enter the new phase of the COVID-19 pandemic.

‘While the most seriously unwell children have continued to receive home visits, nurses working in the children’s palliative care sector – in hospitals, community teams and hospices – have tried new ways of reaching these families, whether this is providing virtual support or more doorstep contact.’

- SETTEMBRU 2020

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Ido Efrati

Israel’s Nurses Go on Strike Over Staff Shortage After Failed Negotiations With Treasury Nurses demand hundreds of new positions to improve working conditions that have worsened amid the coronavirus crisis The National Association of Nurses went on strike on Monday over staff shortage and poor working conditions, which have been exacerbated by the coronavirus pandemic, after failing to reach an agreement with the Finance Ministry.

The strike went into effect on Monday at 7 A.M. after the nurses’ negotiations with Finance Ministry representatives broke down on Sunday.

Operating rooms will work similarly to the way they do on weekends, and afternoon surgeries will be cancelled – except for urgent operations approved by the committee for exceptions.

Nursing staff will work according to weekend staffing levels in all inpatient wards. Intensive care departments will have a limited nursing staff, as will neonatal intensive care units, maternity rooms, dialysis, oncology and fertility departments.

But coronavirus testing and treatment will continue with full staffing.

The government’s public health services will operate on a limited basis and only in urgent cases.

Community HMOs will provide only the following services: Home treatments, insulin injections, fertility treatments, oncology and gastroenterology treatments and outpatient services.

“We have no choice but to take matters into our own hands and

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prevent a health system collapse this coming winter,” the chairwoman of the nurses’ union, Ilana Cohen, wrote.

“In addition to the severe manpower shortage, some 1,000 nurses have entered quarantine and 40 wards designated to treat coronavirus patients have been manned by nurses who were taken from other wards,” said Cohen last week. “It is our obligation to give Israel’s citizens the appropriate treatment, and it is our right to do so while having the needed manpower.”

Last week, Cohen wrote a letter to the heads of the hospitals, HMOs and the Health Ministry saying that starting next week nurses will work on an emergency basis “out of national responsibility and in order to stop the collapse of the nursing system and save lives.”

“The coronavirus outbreak solidified and worsened the enormous shortage in manpower and resources” that the health system suffered from even before the crisis, Cohen wrote. But the Health Ministry has “continued to place the burden of hundreds of regulations and tasks on the shoulders of the nurses – and on the backs of the patients.” Without an immediate addition of hundreds of new nursing positions, dealing with the coronavirus outbreak will be “an impossible mission,” Cohen

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added.

At a meeting held on Sunday between representatives of the Israeli Nurses’ Association and representatives of the Finance Ministry, the ministry proposed an addition of one thousand new positions, in addition to the 600 positions approved for the period of March until the end of 2021. The nurses’ union demanded a longerterm commitment, beyond 2021, in order to set up the additional positions and make them permanent.

The Finance Ministry, on the other hand, said that in view of the fact that the ministry is currently operating without an approved budget, it is not possible to guarantee the added positions beyond 2021 at this point.

According to sources in the ministry, the urgent need for additional nursing positions due to the coronavirus crisis is understandable, and indeed an immediate solution of adding more positions is being proposed, but at this stage only for the next year and a half.

The workload in hospital wards has increased over the past few weeks due to the rising number of staff members who had to be quarantined after coming into contact with a confirmed or suspected coronavirus patient. Out of the 2,908 staff members who are in isolation as of Saturday night, 813 are nurses and 513 are doctors.

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- SETTEMBRU 2020

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The Hospital of Christ Who has never heard about Saint George Preca (12 February 1880 26 July 1962), the first Maltese canonized saint? The majority of us, in one way or another, have attended the MUSEUM. As many of us know these catechetical centres are really wellsprings of divine graces!

In his homily at the beatification of Dun Gorg, as we affectionately refer to this giant in the field of catechesis, Saint John Paul II gives us this excellent description about the man: Since his death in 1962, shortly before the opening of the Second Vatican Council, “Blessed” “George Preca” has been renowned for his holiness both in Malta and wherever the Maltese have settled. Dun Gorg was a pioneer in the field of catechetics and in promoting the role of the laity in the apostolate, which the Council was to stress in a particular way. Thus he became as it were “Malta’s second father in faith”. Embracing meekness and humility, and using to the full his God-given talents of mind and heart, Dun Gorg made his own the words of Paul to Timothy: ˜You have heard everything that I teach in public; hand it on to reliable people so that they, in turn, will be able to teach others” (“2 Tim” 2: 2). The “Society of Christian Doctrine ”which he founded continues his work of witness and evangelization in these islands and elsewhere (no. 3).

Dun Gorg’s biography clearly tells us that among the 150 books which he wrote there stands out one which greatly appeals to us, who work at the hospital.

This book is called “The Hospital of Christ “(L-Isptar ta’ Kristu).

“The Hospital of Christ “is, in fact, a curious book. Dun Gorg wrote it towards the end of his life, precisely in the fifties.

For some reason or another this book was never published in his lifetime. After his death this work by Dun Gorg was published in a stenciled form in 1980. It was in the year 1997 that the Society of the Christian Doctrine (M.U.S.E.U.M), published this 58-page book in its then printing press, the Veritas Press at Zabbar.

As he states in the book’s introduction,

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the principal aim of “The Hospital of Christ ”is that the Christian, with his and her imagination, can enter The Hospital of Christ and there finds the âÐœdoctorâÐÐ to provide the care that suits the illness contracted by his and her soul so that the person can get healed from it and attain peace. The Heavenly Doctor, who is Jesus Christ, is not in this hospital. The reason being that “he went away” (Matt 25:15) and will take alot of time to return back. But, in his place, this Heavenly Doctor left other doctors, who he personally trained, in order to cure the patients without the latter would ever doubt their capacity to do so. The patients are bound to trust these doctors and consider them as their friends. In this hospital care is free of charge.

The Hospital of Christ is referring to is the Church to whom Jesus entrusted the spiritual cure of those who believe in Him and approach her with faith.

The present Roman Pontiff, Pope Francis, expresses exactly the same reflection of Dun Gorg when, in his General Audience of August 9, 2017, in the Vatican’s Paul VI Hall, he said: Therefore, the primary and fundamental mission of the Church is to be a field hospital, a place of healing, mercy and forgiveness, and to be the source of hope for all suffering, the desperate, the poor, the sinners, and the discarded.

The kind of illnesses Dun Gorg mentions in his book are vices that each and everyone of us can easily end up being a prey of. Uncontrolled evil traits bring about spiritual wounds that distress the human person’s spirit. When the sick person goes to this particular hospital (the Church), s/he stays at the waiting room in order to think and reflect about the last things (in the plural: eschata or novissimi, which are death, judgment, hell and heaven with the support of four large paintings.

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photo | http://2.bp.blogspot.com/

The Hospital of Christ Then, the doctor calls the patient and asks her/him about the kind of illness her/his soul has contracted. When the patient relates to the doctor about the kind of illness s/he is suffering from the doctor will immediately lead the patient to the ward that is fully equipped to treat that particular condition the sick person has. In that ward the doctor injects the injection according to the illness that the patient has. Essentially, the injection consists of a short teaching which unveils the ugliness and devastation of vice or the spiritual illness in question.

Simultaneously, the doctor advices the patient about the measure s/he has to take in order to be healed. After this injection the doctor gives to the patient a box full of injections so that s/he could complete the injection course for the entire month coupled with a spiritual sentence to meditate upon it. The last word that the doctor says to the patient is the following: “The Lord God will be with you always. “Then, the doctor calls the doorkeeper to accompany the patient up to the door.

In the book “The Hospital of Christ” Dun Gorg deals with 22 illnesses which are fornication, anger, jealousy, enmity, greed, pride, theft, the lie, boastfulness, cursing, idle talk, selfishness, gluttony, revenge, discouragement, spiritual apathy, scruples, litigiousness, obsession, curiosity, sloth, and lack of faith. Much of what Dun Gorg is saying about these subjects is found both in the Bible as well as in the traditional Catholic teaching.

The Letter to the Galatians tells us: “Now the works of the flesh are plain: fornication, impurity, licentiousness, idolatry, sorcery, enmity, strife, jealousy, anger, selfishness, dissension, party spirit, envy, drunkenness, carousing, and the like” (Gal 5:19-21). On the other hand, the traditional Catholic teaching tells us that the seven deadly sins are pride, greed, lust, gluttony, wrath, and sloth.

Obviously, when one is healed from these 22 maladies, which Dun Gorg enlists, one starts flourishing in the fruits of the Holy Spirit, namely: “love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, self-control” (Gal 5:22-23) or in the seven heavenly virtues which are chastity (“castitas”), temperance (“temperantia”), caritas (“caritas”), diligence (“industria”), patience (“patientia”), and kindness (“humanitas”).

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Let us not forget that Dun Gorg had in mind to broaden the list of spiritual maladies by adding supersitition and the excessive craving for comfort.

Before ending this reflection on the book “The Hospital of Christ ”let us now savour it by appreciating what Dun Gorg writes about the disease of litigiousness.

“Doctor: Tell me, what is your soul’s illness?”

“Patient: It is the illness of litigiousness.”

“Doctor: Let us go to the ward that is equipped for this illness.”

“Ward no. 18: The Litigiousness Ward.”

“Doctor: Be on your guard for this injection that I am going to inject you with for the healing from this litigiousness disease. May you know that there are three kinds of litigiousness: 1.

Litigiousness with the hands, feet or weapons litigiousness; 2. Litigiousness with the tongue, by pronouncing lies, rude or insulting words that injure the heart when one mentions a person’s disabilities or defects; and 3. Silent litigiousness: no words at all, hatred. ”

Litigiousness of every kind is a sign of a cruel heart. And when the heart is cruel it cannot have joy, tranquility and peace but worry and problems.

People of God are those that have a good heart because God is good; and people who have cruel hearts are of Satan (the devil), because Satan, from the beginning, was a murderer and cruel. Now if one knows that he is of Satan then could it be that he will not change his heart? The person who litigates offends God because man is God’s image. And it cannot be that he who loves a man violates his picture or image. God is highly concerned with our behaviour with our neighbour. And He is so highly concerned that, as Christ teaches, He behaves Himself with us in the same manner we behave with our neighbour. The measure you give will • continued on page 23

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Ethics & Health Care… by Marisa Vella

The Ethics of Vaccination The title for this article is taken from the open access online book with the same title by Alberto Giubilini (2019). It is highly recommended that anyone who is interested in reading more on the topic refer to this readily available text. There is also an abundance of articles published, some quite recently, in response to the impending COVID-19 vaccine. Giubilini (2019) starts off his book strongly, by declaring at the outset his belief of mandatory vaccination for certain infectious diseases.

There are two main approaches that one can adopt to significantly reduce the chance of contracting an infectious disease; getting vaccinated and not being exposed to infected individuals. Giubilini (2019) refers to these approaches with reference to influenza. He links this to an episode that was widely reported in the Italian media, where an entire school population, en masse as explained by Giubilini (2019) got vaccinated against influenza three years ago. Some of the students confessed that they were afraid of needles or the possible side effects and would otherwise choose not to get vaccinated. But that year was different. One of their own, was seriously ill, and immunosuppressed.

If he were to contract the flu, the effects could be devastating.

The only way for this student to be able to continue attending school was for the school population to be vaccinated, and they did, as an “act of solidarity” (Giubilini, 2019) towards this student. The Italian Minister of Health was very vocal in her praise for this school. Giubilini (2019), very effectively and realistically linked this act of solidarity to the ethics of vaccination. He explains that there are three key points to note here; the ethical relevance to herd immunity, the importance of protecting oneself

and others too, and to achieve herd immunity a collective effort must be in place.

Giubilini (2019) provides many facts and examples in his book as well as interesting discussion. However, it is this example that Giubilini puts forward early on stating that the actions of this school should not be “particularly praiseworthy” as he explains it is “unnerving” that the fulfilling of a “basic moral obligation” is “praised and deemed so special as to be worthy of news coverage”. Giubilini (2019) clearly puts forward that being vaccinated is a basic moral obligation and when individuals “fail to fulfil this moral obligation, institutions have the moral responsibility to enforce coercive policies to achieve certain public health and social goods”. To understand this further I strongly suggest you refer to Giubilini’s text available here https://link.springer. com/book/10.1007%2F978-3-03002068-2 It is acknowledged that some health professionals have mixed feelings about mandatory vaccinations.

Reasons for this includes fear of side effects, disbelief of vaccine efficacy, and a fear of injections. There are also issues related to misinformation and therefore health professionals do not feel that they are at risk enough to

Workers

Societies

You may contact Marisa on marisalvella@gmail.com for references and information related to this article.

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Environme Reduced in stress Better ma public hea Better for disabilitie

take the vaccine and for example in the case of influenza there is perhaps a misperception on the probability of risk to patients. Health professionals that more readily take up vaccination [23] https: may have a clearer understanding that for instance influenza can be Nationa very serious and taking the vaccine will not cause influenza. The personal protection aspect should also be acknowledged.

Should the current situation require that our institutions were to introduce mandatory vaccination for https://www.ilo.org/wcmsp5/groups/public/---asia/---ro-b infectious [23] diseases such as COVID19 and influenza for example, this National Commission for the Promotion of Equ T: (+356) 229 should be done by highlighting the ethics of vaccination in a collective perspective but also individual, where the vaccine is ultimately an opportunity that health professionals choose to take up. Respect for choice and autonomy is critical here.

Authorities would do well to promote this by providing information and addressing individual concerns in a timely manner to support and put in practice respect for autonomy. In addition to this, I reiterate referring to Giubilini (2019) and other reliable sources for information.

photo | thefederalist.com

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Some of the potential benefits and disadvantages of telework to employers, workers and societies as a whole as published by the ILO [23]

–family conflict

Missed opportunities

NCPE Newsletter Environmentally friendly

Urban sprawl (workers (workers entally friendly Urban sprawl (workers Environmentally friendly Urban Urban sprawlsprawl (workers lly friendly Reduced overheads can afford to live at a Reduced infrastructure can afford at ato live at a nfrastructure canlive can afford to live to at a afford Reduced infrastructure structure greaterIncreased distancemargins from stress Employers greater distance from greater distance from distance from stress Societiesgreater office) Lower turnover Better management of office) office) Greater talent pool Better management of office) ement of anagement of Reinforced gender public health risks Inexpensive,desirable benefit Reinforced gender Reinforced gender riskspublic Reinforced alth risks health risks division in unpaid Better for gender individuals with division in unpaid division in unpaid Better forwith individuals with viduals with division in unpaid individuals household work disabilities household work household work disabilities household work es

Increased IT demands Security issues May not work for some tasks Some loss of control

Reduced commuting time/costs Life choice flexibility Dependent care flexibility Workers Higher autonomy ://www.ilo.org/wcmsp5/groups/public/---asia/---ro-bangkok/---ilo-hanoi/documents/publication/wcms_738257.pdf Higher job satisfaction Lower stress al Commission for the Promotion of Equality (NCPE) Gattard House, National Road, Blata l-Bajda HMR 9010, Malta Lowered work–family conflict T: (+356) 2295 7850 | E: equality@gov.mt | www.ncpe.gov.mt

Blurring work–life boundaries Working on holiday Difficult to unplug from work Social and professional isolation Missed opportunities

Environmentally friendly Reduced infrastructure stress Societies Better management of [23] https://www.ilo.org/wcmsp5/groups/public/---asia/---ro-bangkok/---ilo-hanoi/documents/publication/wcms_738257.pdf ups/public/---asia/---ro-bangkok/---ilo-hanoi/documents/publication/wcms_738257.pdf public health risks ---ilo-hanoi/documents/publication/wcms_738257.pdf National Commission for the Promotion of Equality (NCPE) Gattard House, National Road, Blata l-Bajda HMR 9010, Malta Better for individuals with bangkok/---ilo-hanoi/documents/publication/wcms_738257.pdf he Promotion Equality (NCPE)Road, Gattard House, National l-Bajda HMR 9010, Malta NCPE) Gattardof House, National Blata HMR Road, 9010, Malta T:l-Bajda (+356) 2295 7850 |Blata E: equality@gov.mt | www.ncpe.gov.mt T: (+356) 2295 7850 | E: equality@gov.mt | www.ncpe.gov.mt 0 | E: equality@gov.mt | www.ncpe.gov.mt disabilities uality (NCPE) Gattard House, National Road, Blata l-Bajda HMR 9010, Malta

Urban sprawl (workers can afford to live at a greater distance from office) Reinforced gender division in unpaid household work

95 7850 | E: equality@gov.mt | www.ncpe.gov.mt

[23] https://www.ilo.org/wcmsp5/groups/public/---asia/---ro-bangkok/---ilo-hanoi/documents/publication/wcms_738257.pdf

National Commission for the Promotion of Equality (NCPE) Gattard House, National Road, Blata l-Bajda HMR 9010, Malta T: (+356) 2295 7850 | E: equality@gov.mt | www.ncpe.gov.mt

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Press Information Communiqué de presse Comunicado de prensa photo | talknetwork.com

Nurses must be prioritised once COVID-19 vaccine available Geneva, Switzerland, 27 July 2020 – The International Council of Nurses (ICN) is calling on governments to acknowledge the essential role of nurses and other healthcare workers by prioritising them once vaccines against COVID-19 become available.

ICN Chief Executive Officer Howard Catton said: “This is the morally and ethically right thing to do for frontline healthcare workers, but also to safeguard healthcare systems that are threatened by the ongoing pandemic, which has not yet reached its peak, and prepare for the threat of a second wave.”

ICN has estimated that 8% of all COVID-19 cases are among healthcare workers, and the World Health Organization (WHO) believes it could be up to 10%, which is 1.5 million cases and rising. The danger is far from over and ICN is still receiving worrying reports from its National Nurses Associations about lack of testing, lack of adequate quality personal protective equipment (PPE), healthcare systems under extreme pressure and staff working long hours and experiencing high levels of stress.

Mr. Catton added: “No excuses, no ifs or buts: nurses and other healthcare workers must be prioritised when a vaccine is available

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so that their health and wellbeing, and that of their patients and the healthcare systems they work in, are protected.

‘Employers owe nurses a duty of care and they should never be exposed to any unnecessary risk in the course of their work. Nurses have human and worker rights, including the right to be safe at work. Yet nurses from around the world have told us about shortages of PPE, a shortfall of testing, the intensity and pressure that they are working under, and a lack of adequate mental health support. All clear examples of where governments have been slow or failed to prioritise health workers.

‘The current dire situation is compounded by the lack of systematic data on infection rates and deaths among healthcare workers, which ICN has been calling for since March.

This does raise a serious question as to why governments have been slow to take this action.

‘Governments must prioritise the protection of nurses and other

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healthcare workers so that they can get on with their job of caring for the sick and preventing the spread of the virus. It is the right thing to do and it will protect patients and help to safeguard the healthcare systems nurses work in, which are creaking under the strain of the pandemic.”

ICN is making this call to governments at a time when we are seeing significant local outbreaks of the virus, increases in parts of Africa and the Americas, and the potential for an even more damaging second wave.

ICN has been working closely with its 130 National Nurses Associations since the beginning of the outbreak of the virus to coordinate its actions, including supporting and leading country responses, as well as advocating for nurses’ rights. Solidarity amongst the national associations in the face of the pandemic has been immense, as has the support of the public but now we need to see an upsurge of solidarity for nurses by governments through action.

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from our

diary A Community District e Midwife (Qabla) in th th ba a early 40’s giving to a new born baby.

A common scene on any given day in Malta during the World War 1. Wounded and convalescin g soldiers just disembarked from Gallipoli mainly on stretchers to be transported to a hospital, mo st probably the Cottonera Hospita l.

A nurse on the right checks her list while other health personnel are near the ambulance on the left .

nce MUMN holding a Press Confere of ons diti in Gozo regarding the con ses.

Nur work of the Gozitan

MUMN holding meetings with its members but still respecting covid precau tions

MUMN organised a Press Conference in front of Castille.

MUMN Administration met with H.E. President of Malta

MUMN organised a meeting to newly recruited Indian/Pakistani Nurses.

Matthew Xuereb - Times of Malta

Gozitan nurses being treated as second class citizens, union says Seeks intervention of Robert Abela

The nurses’ union has accused the government of treating its Gozitan members like second class citizens as it refused to stop Steward Healthcare from employing foreign workers at the Gozo Hospital.

Addressing the media on the steps of Castille, Malta Union of Midwives and Nurses President Paul Pace called on Robert Abela to intervene.

On Sunday, the courts provisionally upheld a warrant of prohibitory injunction filed by Steward Healthcare to stop planned industrial action by the MUMN. Pace said on Wednesday there were 100 vacancies for nurses in Gozo but instead of transferring Gozitan workers from Mater Dei Hospital, Steward Healthcare employed 10 Indian and Pakistani nurses.

Pace said there was “collusion” between the government and Steward Healthcare which was being allowed to run roughshod over everything and everyone.

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He said there was a transparent transfer list for transfers from Malta to Gozo but Steward ignored this and directly employed foreign staff. This was disrespectful towards the hardworking Gozitan nurses.

The union proposed that the foreign workers are employed at Karin Grech rehabilitation hospital, where there are also vacancies, so that the Gozitan workers could be transferred to the Gozo Hospital. However, Steward refused this suggestion.

“This is not about racism and neither is it a partisan issue but we want the Prime Minister to intervene so that these Gozitan nurses are not discriminated against,” he said.

MUMN said it expected Steward to prevent the suffering of Gozitans who had no choice but to travel to Malta daily for work or to study.

“Employing foreign nurses to work at GGH is an insult and shows great lack of respect not just towards Gozitan nurses but towards all people who live in Gozo. It shows that Steward is just a cold-blooded organisation.”

Steward says it has been requesting deployment of nurses to Gozo since March.

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In a statement later, Steward categorically denied it did not want to deploy Gozitan nurses working in Malta to Gozo.

It said that, since March, and until Tuesday afternoon, it had reiterated its request to the Health Ministry to release nurses from the Gozo transfer list of nurses for deployment to Gozo.

To date, it had not received any communication from the ministry to confirm that Gozitan nurses could be released to work at Gozo General Hospital, it said.

As part of its proposals to the Health Ministry, Steward on Tuesday said it would consider immediately withdrawing all legal proceedings in relation to the injunction, subject to an agreement being reached with the ministry and the union.

In a letter sent to the ministry on Tuesday, Steward Health Care said that in the context of the current discussions, the interests of its patients remained Steward’s sole focus.

The letter added that adequate staffing to maintain full COVID-19 capabilities mandated by government and safety of patients and staff was at the heart of the dispute.

Steward said in the letter that MUMN’s position, which came as a complete surprise, jeopardised those goals without any workable or constructive solutions being proposed.

In the best interests of its patients, Steward said it was reserving its right to take further legal action against the union in relation to the directives announced on Tuesday in reaction to the injunction.

Such directives had clearly been issued in an attempt to circumvent the court order and were seriously impacting several healthcare services in Gozo, which Steward was legally and morally obliged to provide.

Steward proposed to the ministry the release of 10 nurses from the Gozo list, being the equivalent number of third-country nurses Steward had to engage, in agreement with ministry

The Hospital of Christ • continued from page 15

and union, to make up the necessary staffing levels.

These 10 nurses would be over and above the eight currently earmarked for replacement.

In the interim, the current thirdcountry nationals already recruited

by Steward would remain at Gozo General Hospital until the 18 nurses were released to Gozo General Hospital. They would then be transferred to Karin Grech Hospital.

This is said, was subject to the union withdrawing all its directives with immediate effect.

PN expresses support with nurses In a statement, the Nationalist Party expressed its support with Gozitan nurses working in Malta.

It called for the government’s immediate intervention to ensure that vacancies in Gozo were filled by Gozitans.

be the measure you get mercy by mercy, justice by justice and revenge by revenge.

According to nature one needs to harden his heart with hatred even to pronounce an insulting word and much more to punch with his fists. Litigiousness is not from God because God is love. And he who is litigious loves neither God nor Christ that teaches us that every good and every evil we do to our neighbour he considers done to him personally. At the same time such a person does not love himself simply because he wants to go to (hell) to be burned eternally.”

“This is the injection that I have given you for the healing from your illness that is so dangerous for the destruction not only of the soul but also of the body. Now I shall be giving you a box full of injections of the same quality for the entire month to inject one on a daily basis and with it I shall give you a sentence: If possible, so far as it depends upon you, live peaceably with all,”as Saint Paul teaches us.

The Lord God is with you always. ” Get a copy of “L-Isptar ta’ Kristu” (The Hospital of Christ) magnificently written by Dun Gorg Preca.

Fr Mario Attard OFM Cap

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French nurse: We cared for COVID patients, who will care for us?

French health workers attend a protest in front of the CHU hospital in Nantes as part of a nationwide day of actions to urge the French government to improve wages and invest in public hospitals, in the wake of the the coronavirus disease (COVID-19) crisis in France REUTERS/ Stephane Mahe PARIS (Reuters) - At the peak of the COVID-19 crisis in France, 29-year-old nurse Justine Debrie volunteered to work in a hospital coronavirus unit. Now she wants to know how the French state is going to recognise her sacrifice.

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“I don’t know if the public really understood us,” she said in her studio apartment in Paris, the day after completing a 12-hour shift in the Robert Debre children’s hospital.

“We give them care, and we’ll need care too, sooner or later. We’re human beings too,” she said.

On Tuesday, dressed in her hospital scrubs and carrying a sign she painted at her apartment, Debrie met up with colleagues outside her hospital and together they marched towards the health ministry headquarters.

They were protesting for better wages and working conditions from the French government.

French health workers made the same demands before the coronavirus epidemic, but the outbreak has given their campaign new urgency.

In recognition of their contribution, the government paid healthcare workers a ¢1,500 bonus.

- NUMRU 88

For weeks, people came onto their balconies every evening at 8 p.m. to applaud carers.

But for Debrie, these felt like empty gestures.

Debrie’s basic pay is around ¢1,900 per month, only ¢200 more than she earned when she first started in nursing eight years ago. She said staffing levels were such that she and colleagues had to rush through their shifts and could not give patients the attention they needed.

“The management of the pandemic, of the crisis, within the hospitals was made possible because each hospital worker was devoted,” she said. “I’m angry because they’re trying to appease us with charity.”

The French government has promised a reform of the healthcare system which it says will involve massive investment and greater appreciation shown for healthcare workers.

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‘PPE breach’ blamed for Christchurch healthcare workers catching Covid-19 Katie Todd – RNZ New Zealand

Canterbury District Health Board says damp and unchanged personal protective equipment (PPE) was likely to blame for three of its healthcare workers getting Covid-19.

The staff tested positive for the virus last week, after caring for the coronavirus patients from Rosewood Rest Home and Hospital and helping move some of them to Burwood Hospital in Christchurch.

Technical experts from the health board had been investigating how the staff became unwell, and today the health board said a “PPE breach” was the most likely scenario.

Chief Medical Officer Dr Sue Nightingale said on 6 April when the patients were transferred, some staff were unable to change PPE as frequently as recommended.

“It appears that due to the demands on staff, in particular on the day of resident transfer from Rosewood to Burwood and the day after, it was not always easy for them to interrupt care for very unwell dependant patients,” she said.

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“Some staff reported their PPE had become moist with the physical exertion that occurred over some hours that day. This factor is likely to have led to exposure to Covid-19.”

At that time, RNZ understands staff only had access to paper masks, rather than the full-filter N95 masks. The health board moved to provide them with those masks, and visors more than a week later on 15 April.

The health board says staff caring for Rosewood residents now change their PPE at least every two hours, and a buddy system has been introduced to ensure they use PPE correctly.

But the Nurses Organisation said that should have happened sooner because staff had already been asking for better PPE by the time,

When there is a genuine reason for someone to be wearing PPE, then they should be wearing the full kit that’s required, not just part of it,” he said.

- NUMRU 88

they moved patients to Burwood Hospital, citing shortages of supplies, and gowns that ripped.

Its kaiwhakahaere Kerri Nuku said it was unfair for the health board to effectively point the finger at employees - “It’s unfair to lay the blame on the nursing staff not changing regularly when there actually wasn’t stock available, or quality stock to make them feel comfortable and be safe at work,” she said. “I appreciate that this is still under investigation but employers have an obligation under the Health and Safety at Work Act to ensure that all staff - when you’re dealing with a situation needing PPE gear - are kept safe.”

Nuku said PPE availability had improved across the country over the past four weeks, but it was important to ensure that “steady supply” continued.

“We need to make sure that we’ve got PPE to deal with Covid-19, should we have cluster outbreaks, but we also need to make sure that we’ve got supplies to cope with winter ailments.”

Inadequate PPE supplies not a factor - DHB Canterbury DHB incident Controller Dan Coward said staff had been supplied with adequate PPE throughout the pandemic and it was “most certainly not a factor” when the three Burwood Hospital workers picked up Covid-19.

PPE breach Some staff reported their PPE had become moist with the physical exertion that occurred over some hours that day. This factor is likely to have led to exposure to Covid-19.”

“In fact, as a result of a staff member’s request we made additional items available to some staff caring for residents with Covid19 and this included N95 masks in addition to the standard surgical masks. We have also added visors to

the PPE available as an alternative to goggles,” he said.

“These aren’t required in the ward for clinical reasons but were made available to provide alternative options for staff.”

However, that was a concern for Mark Thomas, an associate professor at the University of Auckland School of Medical Sciences, and on the Auckland District Health Board.

He said health boards needed to be clear about what PPE was necessary to protect staff from Covid-19.

“When there is a genuine reason for someone to be wearing PPE, then they should be wearing the full kit that’s required, not just part of it,” he said.

“This sort of sloppiness of ‘Oh yes, if you feel like it then you should use it’, with regard to N95 masks, helps to weaken the message of what staff

should be doing when they’re at risk and when they’re not at risk.”

Canterbury DHB’s PPE problems had also stirred up uncertainty elsewhere in the community.

Dorothy - who did not want her last name used - said her mother, who is in a wing of Burwood Hospital separate from the Rosewood patients, was now having trouble trusting its ability to contain Covid-19.

“I just read the news article this morning and got a wee bit upset, because it’s like they’re saying the protective equipment that the nurses and staff are wearing aren’t up to code. That is worrying, for someone who has a mum in hospital that’s a very vulnerable person anyway.”

The Nurses Organisation said it was watching health boards to ensure PPE supplies remained plentiful as the winter flu season approached.

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Maintaining mobility as part of healthy aging Aging and impact on mobility?

Mobility is the joy of moving freely and easily and is key for a good quality of life. Healthy muscles, bones and joints allow us to perform all types of movements - from everyday tasks to enjoying our favorite hobbies.

Some of the first visible signs of aging may be changes to posture and gait, as well as fatigue and general weakness doing everyday tasks.

People may notice an impact on mobility when engaging in activities such as walking. Aging affects muscle mass and strength, bone density, and can make joints stiffer and less flexible due to reduction of cartilage thickness1.

As we age, muscles, bones and joints undergo physiological changes that affect mobility and which can ultimately impact our independence.

In fact, 37% of people aged over 50 experience discomfort related to mobility. Daily physical activity combined with weight management and a healthy balanced diet that includes proper intake of protein, vitamin D and C, and calcium can support the health of your muscle, bones and joints and keep you moving.

Importance of muscle health The age-related loss of muscle may decrease mobility. Loss of muscle mass can begin as early as 30 years and it can become more prominent

from the age of 50 onwards. The rate of muscle loss is influenced by the amount of regular physical activity people do throughout their lives. An injury or temporary illness can also affect the amount of skeletal muscle mass. Daily consumption of protein contributes to healthy muscle mass.

Importance of bone health Bone health is important at any age. The reduction in bone density that is common in older age makes bones weaker which in turn may lead to increased risk of fractures.

Good nutrition including the necessary amounts of vitamins and minerals like Calcium and Vitamin D combined with exercise can help maintain good bone health during later stages of life.

Importance of joint health Joints become more vulnerable to damages as the cartilage that lines them becomes thinner and the lubricating (synovial) fluid is reduced as we age. This means that joint surfaces aren’t able to slide as smoothly over one another, causing discomfort. Joints become stiffer as the ligaments and tendons become more rigid and muscle tone and bone strength is reduced. These changes make physical tasks more and more difficult. Vitamin C contributes to collagen formation for the normal function of cartilage.

Key tips to maintain mobility A decrease in mobility can have a significant impact on a person’s wellbeing especially when it interferes with one’s ability to enjoy favorite hobbies, social outings and to remain independent. Key ways of tackling the issue include: Good nutrition – consume the daily recommended amount of protein - essential for maintenance of muscle mass and strength. Ensure proper intake of micronutrients such as vitamins (e.g. C and D) and minerals (e.g. calcium, magnesium, potassium, zinc).

Regular physical activity – including weight / resistance training to help maintain muscle mass Weight management – maintain the optimal weight for your height and age

Meritene Mobilis Meritene Mobilis is a Food Supplement designed with targeted ingredients to help muscle, bone and joint health. It is available in convenient sachets for easy daily use!

A great tasting supplement with only 67Kcal. Each serving delivers 10g of high quality protein to support the muscle mass, calcium and Vitamin D for the maintenance of bone health and Vitamin C which contributes to collagen formation for the normal function of cartilage. On top of this, Meritene Mobilis contains no added sugar, is gluten-free and is low lactose.

Taking care of your bone health has never been easier or tastier!

Scientific References 1. American Academy of Orthopaedic Surgeons. Orthoinfo. Available at: http:// orthoinfo.aaos.org/main.cfm 2. English KL and Paddon-Jones D. Protecting muscle mass and function in older adults during bed rest. Current Opinion in Clinical Nutrition and Metabolic Care.

2010;13(1):34-39.

3. Bauer J et al. Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14(8):542-559.

4. Rousset S, et al. Daily protein intakes and eating patterns in young and elderly French.

Br J Nutr 2003; 90:1107-1115.

5. Fulgoni VL 3rd. Current protein intake in America: Analysis of the National Health and Nutrition Examination Survey, 2003-2004. Am J Clin Nutr 2008; 87:1554S-1557S 6. Paddon-Jones D et al. Role of dietary protein in the sarcopenia of aging. Am J Clin Nutr 2008; 87(suppl):1562S– 1566S

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A Texas ICU nurse is hospitalized with Covid-19 after testing negative

by Alisha Ebrahimji, CNN

An ICU nurse in Texas has found herself in the position of some of the very same patients she is spent the last few weeks treating - hospitalized with Covid-19 even after testing negative for the virus.

Heather Valentine, 24, is not exactly sure whom she may have picked it up from and told CNN on Tuesday that she was reluctant to even accept that she had symptoms.

Valentine was exhausted a week ago after her third daily hospital shift in a row in Houston, she said, but did not think much of it until the body aches, a fever and a small cough surfaced.

On Wednesday, Valentine said she took a rapid antibody test, which came back negative.

Antibody tests can help identify recent past infections, not current ones, though even when antibodies are present, the tests can be wrong up to half the time, the US Centers for Disease Control noted in May. The next day, she took a viral test that also came back negative. Issues with samples, testing or timing of tests can all lead to false negatives. It is not clear whether she was tested again.

On Saturday, her doctor, Joseph Varon, called and asked Valentine to go in for a CT scan, she said.

Between the CT scan results indicating the virus’ effect on her lungs and other lab results, Valentine said Varon told her he was certain she had Covid-19, even though her swab test had come back negative.

“I could’ve required intubation if I would have waited a couple days

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If you have any kind of symptom, stay home, get checked out, don’t wait until you can’t breathe to go get help,” Heather Valentine more,” Valentine said, “which is so crazy to hear as an ICU nurse.”

Texas reported 10,351 new cases

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Saturday, topping the previous record of 10,028 set July 7, according to the Department of State Health Services. With a surge in new cases, hospitalization rates across the US are simultaneously increasing, causing some emergency room doctors to worry about the immediate future.

Regardless of how young or how healthy someone thinks they are, Valentine said it is important to still be careful.

As a frontline worker, it has been hard, Valentine said. She and her colleagues are getting tired, but they are making every effort to make sure patients are taken care of.

The way to fight the coronavirus, Valentine said, is to respect one another and to understand that even though someone does not have symptoms, there is still no guarantee they may not have it.

“If you have any kind of symptom, stay home, get checked out, don’t wait until you can’t breathe to go get help,” she said.

Valentine is still in the hospital but said she is doing much better than the day she was admitted.

“You never think it’s going to happen to you, but I’m a perfect example,” she said. “Take every precaution, wear a mask, don’t go out if you don’t have to, it’s not worth it.

COVID-19…

is washing uniforms at home a risk?

Researchers suspect that domestic washing machines fail to reach the right temperatures, therefore increasing risk of COVID-19 contamination

Kimberley Hackett Nurses’ uniforms should be washed at work to reduce the risk of COVID-19 contamination at home, researchers say.

Researchers at Leicester’s De Montfort University and the University Hospitals of Leicester NHS Trust are asking nurses to fill out a survey on how COVID-19 has affected their home laundry routine.

Principal investigator Katie Laird said healthcare workers could be at risk of spreading COVID-19 through the way they do their laundry.

‘It’s well-known that a domestic washing machine no longer reaches the temperatures stated after it has been used for some time,’ she said.

‘Although nurses may be conscientious and follow the government guidelines, they

may not be achieving the right temperature, through no fault of their own.’

Comparison of outcomes of household washing machines with industrial ones The survey questions include: What do you take your uniforms home in?

Where are you changing?

What temperature are you washing your uniform on?

Researchers will recreate the

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scenarios described in the survey results and compare the outcomes of using household washing machines with industrial ones to see which remove the virus most effectively.

The survey aims to investigate the effects of the pandemic on nurses’ laundering of uniforms, and their attitudes towards doing so at home. It is specifically related to uniforms/scrubs (workwear clothing) and excludes shoes and personal protective equipment.

The researchers also want to know about the psychological effect on healthcare workers and their families of washing uniforms at home.

The survey, which is anonymous, is for all healthcare staff working in the NHS, private and social care settings.

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Press Information Communiqué de presse Comunicado de prensa

Reports of More Than 1,200 Incidents of Violence Against Health Care in 2019 Demand Accountability and Concerted Global Action New Safeguarding Health in Conflict Coalition annual report documents incidents of violence and threats against health workers, facilities, and transport in 20 conflict-affected countries and territories Washington, D.C.; 10 June 2020 More than 1,200 violent attacks and threats were perpetrated against health workers, medical facilities and transports, and patients in 20 conflict-affected countries in 2019, according to a new report published today by the Safeguarding Health in Conflict Coalition. The report – the most in-depth assessment of violence and threats to health care in regions experiencing armed conflict and political violence – finds that attacks on health in 2019 continued with impunity, undermined public health, and denied civilians access to lifesaving medical services.

The report finds that at least 150 health workers were killed, 90 were kidnapped, and at least 500 more were injured in attacks on health care in 2019.

The 2019 data mark an alarming increase in the number of reported violent incidents compared to 2018, when the Safeguarding Health in Conflict Coalition reported 973 such incidents across 23 countries studied. The true extent of violence against health care in conflict may be much higher due to significant underreporting. These assaults on health occurred in the months prior to the COVID-19 pandemic, in which strong health systems and protected health personnel are more essential than ever in every country in the world.

2019 was characterized by the aerial bombardment of hospitals in Libya, Syria, and Yemen; medics shot at while attending to injured protestors in Iraq, the occupied

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Palestinian territory, and Sudan; and health workers kidnapped in Burkina Faso, the Democratic Republic of the Congo (DRC), and elsewhere.

In Afghanistan and Syria, attacks on health care have continued at very high levels for many years. 2019 was no exception, with more than 100 reported incidents of violence each.

The violent incidents severely undermined efforts to respond to major public health threats in 2019.

There were more than 400 attacks on health care in the DRC, most of them in connection with the response to the Ebola outbreak. In Pakistan, where polio remains endemic, violence inflicted on vaccination teams led to the suspension of immunization campaigns that left 1.8 million children unvaccinated.

As conflicts escalated in Burkina Faso and Libya, so did the number of attacks on health care, with 73 incidents in Libya alone.

While the Safeguarding Health in Conflict Coalition annual report covers calendar year 2019, violence against health care has also marred the COVID-19 pandemic response in countries in conflict as well as in countries at peace. Insecurity Insight, a Coalition member, reports 265 incidents of attacks and threats against health care from January through May 2020 across 61 countries in response to COVID-19 health measures. These included violent responses to testing, quarantine measures, and attacks against health workers arising out of fear that they could spread the infection. In some countries, law enforcement entities

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have used violence to implement quarantine measures and to punish people expressing concerns about the pandemic response.

“Our disturbing findings reveal again that commitments to stopping violence against health care remain thin, more rhetoric than action,” said Leonard Rubenstein, founder and chair of the Safeguarding Health in Conflict Coalition and professor at the Johns Hopkins Bloomberg School of Public Health and Center for Humanitarian Health. “It has been four years since the United Nations Security Council committed the international community to take concrete steps toward prevention and accountability, but the health workers and patients they serve are still waiting.”

The report findings were announced today at an online briefing event hosted by coalition member Physicians for Human Rights (full recording of the briefing event will be posted here).

“Violence against health care continues during the COVID-19 pandemic, both related to ongoing conflicts as well as attacks specifically against COVID-19 response efforts,” said Christina Wille, director of Insecurity Insight. “According to our analysis, community members or members of the security forces who act out of personal interest perpetrated most of the COVID-19related violence. Violence against health care will make it even harder to address the COVID-19 pandemic.”

In recognition of the 2020 International Year of the Nurse and

photo | images.theconversation.com

the Midwife, the Safeguarding Health in Conflict Coalition dedicates the annual report to the nurses and midwives who work every day on the front lines in conflict settings to promote health and save lives.

“Nurses comprise the majority of the health workforce worldwide, and they are often the first and only point of care in many communities around the world,” said Erica Burton, senior advisor, nursing and health policy at the International Council of Nurses, who wrote an essay focused on nurses for the report. “Every time a nurse is taken from the health workforce due to violence against health care, communities suffer.”

“Impunity prevailed for attacks on health in 2019,” said Susannah Sirkin, director of policy for Physicians for Human Rights. “Despite a few limited and narrow investigations, governments, militaries, and the United Nations Security Council have utterly failed to live up to their duty to hold perpetrators of the gravest attacks on health facilities and personnel to account. The global community must do better for the nurses, midwives, EMTs, doctors, and other health workers under siege from Libya to Ukraine to Myanmar.”

The report makes detailed recommendations to prevent and respond to attacks on health, including specific appeals to United Nations (UN) member states, ministries of defence, ministries of health, the UN Security Council, the UN Secretary-General, the World Health Organization, civil society, and donors. Among other recommendations, the Safeguarding Health in Conflict Coalition calls on countries to: • Prioritize improvements to and investments in data collection, surveillance, and reporting mechanisms for attacks on health.

• Develop a national policy framework that builds upon best practices and establishes clear institutional roles for protecting civilians and civilian objects in the conduct of hostilities. Fulfil UN Security Council resolution 2286, which seeks to end attacks against health facilities and personnel in conflict situations.

• Reform laws and police and prosecutorial practices so as not to impede humanitarian and medical services or punish those who provide care to people who are wounded or sick, regardless of their affiliation.

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• Strengthen national mechanisms for thorough and independent investigations into alleged violations.

• Ensure that perpetrators are held accountable for violations.

• Take forceful diplomatic actions, such as public statements and démarches, against perpetrators of incidents of violence.

• Ensure respect for international humanitarian law, as set forth in the very first article of each Geneva Convention. Governments should initiate investigations of instances where partner military forces or their own may have targeted hospitals or other health facilities.

• Improve, support, and invest in the World Health Organization’s Surveillance System of Attacks on Healthcare (SSA).

“Health workers receive muchdeserved applause and tributes for their lifesaving work in response to COVID-19 and other emergencies, but it should outrage all of us that many continue to face bombs, political violence, kidnapping, and threats,” said Carol Bales, advocacy and policy communications manager atIntraHealth International, which oversaw the report’s production.

“Health workers must be safe to save lives. And ensuring safety for health workers includes states taking action to protect them from violence during conflict and holding perpetrators accountable.”

The report implemented an eventbased approach to documenting attacks on health care and used multiple, cross-checked sources.

The information was consolidated into a single dataset of recorded incidents that were coded using standard definitions, which is available on the Humanitarian Data Exchange. The data was compiled and analysed by Insecurity Insight.

Coalition member organizations contributed additional material from their respective areas of focus and research.

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Il-Pesta ta’ Ġustinjanu

Il-Pandemiji

Il-kelma ‘pandemija’ ġejja mill-Latin pandêm(us), mill-Grieg pándêmos “komuni, pubbliku” (pan + dêm(os) “tal-poplu” waqt li l-kelma ‘mxija’ jew ‘mard l-imxija’ ġejja mill-kelma ‘mexa’ u tfisser “mard li jidħol p.e f’belt u jfittex li jdur lil kulħadd; mard mexxej li joħduh bosta nies, bħall-influwenza, l-ħosba eċċ; mard li jintrikeb; passa; li tittieħed minn bosta nies; epidemija; jew, jekk tinfirex wisq pandemija. Tajjeb però niċċaraw li f’xi rħula bi mxija jifhmu ‘l-influwenza’ jew ‘id-dijarea’.

Waœda mill-konsegwenzi talbniedem li jgœix viçin xulxin fl-ibliet kienet li l-infezzjonijiet kienu aktar façli li jaffettwaw lill-popolazzjoni, bil-mard jittieœed aktar malajr minn persuna gœall-persuna. Fattur ieœor kien is-suq u n-negozjar minn belt gœal oœra fejn il-mard kien jimxi minn naœa gœall-oœra tad-dinja bir-riÿultat li maÿ-ÿmien dan ÿdied speçjalment mill-invenzjoni tal-avjazzjoni ‘l hawn.

F’xi popolazzjonijiet, çertu mard sar endemiku. Soçjetajiet sœaœ kellhom it-tendenza li jaddattaw: ilmard kien sar parti mill-œajja jew ilmewt ta’ kuljum. Xi kultant però xi mard kien jisplodi f’epidemija, jimxi aktar fil-wisgœa fi fruntieri u kontinenti u jinbidel f’pandemija.

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Il-kelma ‘pesta’ hija terminu li tirreferi gœal bosta epidemiji qattiela; bœall-pesta msemmija fl-Antik Testment u l-Pesta ta’ Ateni (430427 QK). L-ewwel kaÿijiet setgœu kienu l-pesta bubonika (ikkawÿata mill-mikrobu Yersinia pestis, permezz tal-far u l-bergœud tiegœu) fejn ilmarid kien jippreÿenta b’nefœa fl-abt u bejn is-saqajn. Dan seœœ fil-Pesta ta’ Æustinjanu (fi ÿmien l-Imperatur Æustinjanu bejn is-sena 541-4 WK.) Din l-epidemija infirxet malMediterran u jaœsbu li qatlek madwar kwart tal-popolazzjoni tar-reæjun.

Dan seœœ meta kien jidher possibbli li l-qawwa tal-imperu antik Ruman terga’ tqum fuq saqajha. Waqt li l-imperu Ruman tal-Punent kien

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Avviż mid-Dipartiment tas-Saħħa Pubblika dwar l-Ispanjola

gœadu kif inœakem mit-tribujiet Æermaniçi fiç-çentinarju ta’ qabel, l-imperatur tal-Lvant Æustinjanu kien fuq kampanja ambizzjuÿa biex jeræa’ jirbœilhom. Il-kaos u l-œerba minœabba l-pesta œarbtet kull tama tar-rijunifikazzjoni.

F’Malta m’gœandniex evidenza ta’ epidemija fl-era Biÿantina imma pestilenzi li seœœew fil-baççin talMediterran setgœu affettwaw lillgÿejjer tagœna u kkawÿaw gœadd ta’ mwiet f’daqqa. Ir-rekords arkejoloæiçi ta’ dal-perjodu ma jindikawx prattiçi mediçi f’Malta f’dan ir-rigward.

It-tieni mewæa tal-pesta magœrufa bœala l-Black Death, li mxiet millAsja fl-14-il seklu, qatlet bejn wieœed u ieœor terz tal-popolazzjoni ta’

Il-Black Plague

l-Ewropa u probabbli kienet taœlita tal-pesta bubonika, pnewmonika u settiçemija. Il-Black Death kien il-punt ta’ tluq fl-istorja soçjali, ekonomika u intelletwali Ewropea. Peress li mietu œafna œaddiema li kienu jaœdmu fissettur agrikolu, dawk li salvaw bdew jitolbu pagi aœjar. Issidien tal-art irreÿistew u din ipprovokat rivolta tal-bdiewa. Œafna œasbu li dil-pesta kien sinjal minn Alla li ma kienx kuntent bilpoplu tiegœU u bil-Knisja tiegœU. Œafna gruppi saœansitra ddubitaw fuq l-awtorità tal-Papa, antiçipati mirRiforma Protestanta tas-16-il seklu.

F’Malta l-imxija tal-pesta œakmet bejn l-1592 u l-1593, fis-sena 1623, fis-sena 1655 u bejn l-1675 u l-1676.

Din ta’ l-aœœar kienet l-aktar severa meta qatlet madwar 11,300 ruœ.

Il-pesta infirxet mal-Ewropa millBaœar l-Iswed permezz tax-xwieni tal-merkanti Æenoveÿi. Fis-16-il seklu, waqt il-famuÿi vjaææi mill-Ewropa gœad-Dinja l-Ædida, il-pesta kkawÿat œerba simili.

Viçin il-bidu tal-seklu 20 kien hemm rivoluzzjoni fl-gœerf dwar il-kawÿa tal-marda, imma dan ma waqqafx l-iÿvilupp ta’ pandemiji æodda. Waqt li imxiji ta’ l-influenza li

Il-viru tal-Coronavirus

seœœew gœal sekli sœaœ, il-mikrobu li œakem id-dinja bejn l-1918 u l-1919, magœruf bœala l-Ispanjola, gœamel œerba bla preçedent. Huwa kkalkulat li mietu bejn 50 u 100 miljun ruœ (5% tal-popolazzjoni dinjija), œafna aktar mill-imwiet totali tal-Gwerra l-Kbira. Ilvittmi waqt din l-imxija kellhom l-età ta’ bejn l-20 u l-40 sena, li gœamlet impatt demografiku qawwi.

Madwar mitt sena ilu dilpandemija tal-influwenza waslet Malta wkoll u fuq perjodu ta’ sena kienu rappurtati 16,000 kaÿ iÿda probabbilment affettwat mal-50,000

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ruœ. Il-mejtin f’Malta laœœqu l-elf ruœ. Mewta minn kull gœaxra seœœet f’Gœawdex biss. L-aktar li æew affetwati f’Malta kienu n-nisa li kienu jiœduha mingœand uliedhom. Interessanti li l-vapur tal-art, mill-Belt Valletta salŒamrun, Birkirkara, Œ’Attard u r-Rabat, kien dak li l-aktar li mexxa l-influwenza.

L-aœœar pandemija li qed ngœixu bœalissa hija l-imxija talCoronavirus 2019 (COVID-19) ikkawÿat permezz tas-SARS-CoV-2.

Dan il-viru æie identifikat f’Diçembru 2019 f’Wuhan, Hubei, iç-Çina, li rriÿulta fil-pandemija preÿenti. Sakemm qed nikteb l-artiklu aktar minn 23.4 miljun kaÿ æew irrapurtati madwar 188 pajjiÿ u territorju, fejn s’issa mietu 809,000 ruœ. S’issa aktar minn 15.1 miljun ruœ fiequ mill-Covid-19. F’Malta s’issa mietu 10 bil-pandemija u fiequ 766 minn 1667 kaÿ poÿittiv.

Riferenzi

kelmakelma.com The Little Book of Big History, Ian Crofton u Jeremy Black Ancient and Medieval Medicine in Malta, C. Savona Ventura Il-Miklem Malti, is-Sitt Volum, Erin Serracino-Inglott

Joe Camilleri

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Jayne O’Donnell and Adrianna Rodriguez - USA Today

Nurses say Covid-19 hazard pay could help offset unsafe working conditions, infection fears

BOWIE, Md. – Cadence Washington, 6, wants to run up and hug her grandmother when she gets home after her shifts at a hospital in nearby Washington.

That cannot happen for at least a half-hour.

Debra Washington, 64, keeps Lysol spray, a robe and a bag by the front door, and her family knows she needs privacy. She sprays herself with the disinfectant, puts her uniform in the bag, dons the robe and slips upstairs to shower and shampoo her now-natural hair style every day.

Only then can she greet her grandchildren and husband whose hypertension and age, 68, puts him at high risk.

Since the coronavirus pandemic started, Washington can have up to six patients who are either COVID19-positive or need to be treated that way until test results come back. Like beleaguered nurses across the USA, she has to change gowns and gloves between rooms, disinfect her goggles and face shield and wear the same hospital-grade N-95 mask covered with two blue surgical masks all day.

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Washington, vice president of the District of Columbia Nurses Association, said she did not sign up for all that or the constant risk she puts her family in when she became a registered nurse almost 40 years ago. As cases soar in new parts of the country and nurses treat a steady stream of infected people, many fights to get the kind of “hazard pay” many in the military get during war.

Many nurses in Illinois and at several New York City hospitals got some form of bonus pay during the pandemic, but that is ended, and hospitals and government officials in the nation’s capital and elsewhere resist pressure to pay nurses more.

“The bottom line for hospitals is often more important than the quality of care and safe working conditions,” said Wala Blegay, staff attorney for the D.C. Nurses Association. “A lot of that

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was illustrated in the pandemic.”

Hundreds of nurses at Howard University hospital and United Medical Center, where Washington works, signed petitions demanding hazardous pay. Blegay said the conditions nurses in her group have had to work under, with insufficient personal protective equipment, are bad, “but what our patients have to go through since the beginning of this is even worse.”

In a statement, United Medical Center said it “is evaluating the possibilities on how to recognize and support our team during these times.” The hospital noted no other hospital that is only in D.C. is offering hazard pay.

“UMC truly appreciates all the work our entire team has done as we stay committed to providing quality healthcare to our patient community during this pandemic,” said the statement. “We will continue to acknowledge, show appreciation, and honour our staff as we have been doing over the last few months.”

The American Hospital Association asked Congress to give hospital workers $5,000 bonus pay tax credits in addition to any money from the Coronavirus Aid, Relief and Economic Security (CARES) Act. “The front-line caregivers in the COVID-19 crisis, including nurses, physicians, facilities management personnel, technicians and other health care providers, are working around the clock to provide the care that our patients and communities need,” the AHA told House Speaker Nancy Pelosi, D-Calif., in a letter in March. “These essential workers need, and deserve, additional resources to both continue their work and support themselves and their families after this crisis.”

The House passed a bill including bonuses, but it has not been taken up by the Senate.

Does the pandemic merit hazard pay for nurses?

The U.S. Department of Labour defines hazardous pay as additional

money for work that causes extreme physical discomfort and distress not adequately alleviated by protective devices and deemed to impose a physical hardship.

Kathleen Bartholomew, a nurse, author and patient safety advocate, posted a question last week for members of the online group Show Me Your Stethoscope about hazard pay. Within a day, she got nearly 4,000 responses, more than 3,100 in favour.

Some argued the job itself is a hazard, and the majority said the unprecedented pandemic conditions merit extra compensation.

One anonymous respondent said those in the military know what they signed up for, too, and still get hazard pay in “active fighting areas.”

Though many nurses favour hazard pay, some said it’s a temporary fix for what nurses – and patients – really need in the pandemic and beyond: more protective equipment and adequate staffing. Bartholomew is among those opposed, saying “hazard pay is not the answer” because nurses need the support necessary for them to do their jobs.

“Just asking the question, I discovered that the vast majority of nurses are hungry for respect,” Bartholomew said.

“They want a country that values them enough to provide the right equipment, adequate staffing and compensation when they are out of work for two weeks due to COVID, and for organizations to care enough to provide hotels so that nurses do not infect their families, and mental health days if needed during a crisis.”

Cokie Giles, a registered nurse and vice president at the union National Nurses United, said, “Having additional compensation during extreme working conditions would be welcomed, but it should not replace the ethical, moral responsibility for the employer to protect us.”

As of July 8, 149 nurses and nine other health care workers have

died from COVID-19, according to NNU data. The union said it’s an undercount because many deaths aren’t publicly reported.

Nurses who said they are overworked and under protected have left hospitals to protest. In Illinois, more than 720 nurses of AMITA St. Joseph’s Medical Center are on strike, alleging management intimidation and demanding more pay. At least 78 nurses left Chicago Medicine Ingalls Memorial Hospital in the past six months, citing a high RN coronavirus infection rate of 6% and poor hospital protocols, the National Nurses Organization Committee said.

In a statement to USA TODAY, the hospital said, “It is unfortunate that National Nurses Organizing Committee seeks to exploit the pandemic for gains in a labour dispute.” The statement noted the hospital remains committed to providing a safe work environment for nurses and health care workers by ensuring they’re equipped with PPE “despite widely reported national and local shortages of medical supplies

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through the COVID-19 pandemic.”

Giles said, “There’s not enough money in the world” to risk catching COVID-19 and bringing it home, but Washington said more money would help.

Her son and Cadence’s father, Jermaine Washington, also works at the hospital, transporting patients, so there is an even greater risk of exposure at home.

There is also the difficulty of simply doing her job. Wearing all that protective gear, she often has to fight to breathe through her nose, sweats heavily and struggles to see through cloudy glasses and goggles.

It is a balancing act between limiting time in rooms for safety, as she’s told to do, and doing the job for which she was trained.

“We take the time to be a nurse with the hope of helping them get back to a healthier state,” Washington said. “Their families can’t be with them, and they feel isolated, so we spend that extra two to three to five minutes because we want to give comfort.”

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Simply buying a dream property

Buying a property ushers with it a period of excitement but also uncertainty, worry and stress. Here are some tips for a smoother home buying process.

•

• Talk to your bank’s home loan expert early so you set your budget and focus on viewing the best properties within your price range.

• Inform yourself about the various home loan products on the market and choose the best product for you.

• Budget properly and save more money than you think you’ll need. Apart from the upfront down payment on the purchase price, there are additional costs such as notary fees, architect fees, stamp duty and processing fees.

• View as many properties as you can. When you find the right property, negotiate the final price, set up an inspection by a trusted architect, check that the necessary

•

•

• •

Planning Authority permits are in order and sign the promise of sale at your notary.

Complete the loan application with your bank and once it is approved, collect your sanction letter from the bank, making sure that you fully understand its conditions, seeking legal advice if need be, before signing.

Provide a copy of the sanction letter to your notary and supply the bank with any required security items such as life assurance policy; building’s insurance policy, and pledging of assets held.

If your property requires alterations, submit the necessary development applications with the Planning Authority.

Check with your notary whether searches have been completed or if there are any issues.

Prior to expiry of the promise of sale, ensure that the necessary arrangements with the bank and the seller have been made and date for the deed of sale is set.

• On the agreed date sign the contract for the purchase of property and the bank loan.

• Ensure that the deed of sale has been registered by your notary with the Public Registry within 15 working days from contract date.

• Enjoy the property of your dreams!

You’ve certainly earned it!

At Bank of Valletta, we have a whole suite of solutions to help you finance the property of your dreams.

The BOV Home Loans come with enhanced features and advantageous rates of interest and are tailored specifically for whichever life stage you’re at, whether you are a first-time buyer; upgrading to a larger home; downsizing; or buying a property for investment purposes.

Set up an appointment with our BOV Home Loan specialist by calling on 2131 2020 or send an email on info@bov.com.

Let us help you turn your dream property into reality!

All loans are subject to normal bank lending criteria and final approval from the Bank. The term of the loan must not go beyond retirement age. Security may be requested including mortgage or other comparable security. Further terms and conditions are available from www.bov.com. Issued by Bank of Valletta p.l.c., 58, Triq San Ðakkarija, Il-Belt Valletta VLT 1130. Bank of Valletta p.l.c. is a public limited company regulated by the MFSA and is licensed to carry out the business of banking in terms of the Banking Act (Cap. 371 of the Laws of Malta).

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Il-Musbieħ

- NUMRU 88

mumn.org new website Dear Member, As you are probably aware, MUMN has launched a new website. Please visit and stay updated with MUMN’s latest news and events, learn about the membership benefits, and much more.

When you will visit www.mumn.org for the first time, please follow the below guidelines:

Already a Member? ✔ ✔ ✔ ✔

Go to the LOG IN Button Click on Already a Member Fill up the Registration Form Wait for a Verification Email Please do not hesitate to contact us on administrator@mumn.org should you require any assistance.

Regards Claire Mulligan Office Administrator - MUMN

Il-Musbieħ

- SETTEMBRU 2020

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