Il-Musbieh No 94 by MaltaUnionofMidwivesandNurses

Il-Musbieœ

MALTA NURSING AND MIDWIFERY JOURNAL Malta Union of Midwives and Nurses

Numru 94 - Marzu 2022

the heartbeat of healthcare

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

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contents

Ħarġa nru 94 - Editorial/President’s message

pages 4-5

- From our diary

pages 20-21

- L-eżekuzzjoni ta’ Edith Cavell

pages 26-27

Marzu 2022 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 Health Centres: Roseanne Bajada, Chairperson: 79671910 MCH: Angelo Abela, Chairperson: 79594326; Malcolm Bezzina, Secretary: 77822561 SAMOC: Ronnie Frendo, Chairperson: 77000919 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; Daren Stilato, Secretary: 77222999 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 Ronnie Frendo: 77000919 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 Warner Complex, MUMN, Triq il-Vitorja, Qormi QRM 2508 • 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: 5,000 kopja.

Ritratti tal-faççata: MUMN

Il-Musbieœ jiæi ppubblikat 4 darbiet f’sena.

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Editorial

Medical Marijuana and Nursing In 2018, Malta enacted the Production of Cannabis for Medicinal and Research Purposes Act which provides the legislative measures to permit the production of cannabis for medicinal and research purposes. This law followed the amendment of the Drug Dependence Act with respect to prescribing of medicinal preparations of cannabis.

photo | weedworldmagazine.org

Medical Marijuana will soon become a part of life for many patients, but nurses must tread carefully around this rapidly evolving issue. Although marijuana is approved in some countries, safety data from clinical trials are not as robust as for other pharmacotherapies. A discussion is required regarding a number of important aspects of medical marijuana: indications, routes, adverse effects, dosing, contraindications, and talking points for patient teaching. Medical cannabis can be administered through various methods, including capsules, lozenges, tinctures, dermal patches, oral or dermal sprays, cannabis edibles, and vaporising or smoking dried buds. Synthetic cannabinoids are also available for prescription use in some countries, such as dronabinol and nabilone whilst other countries allow the medical use of whole-plant cannabis. Essential knowledge about cannabis that is pertinent for nurses, advance practice nurses, and nursing students is that nurses should have a working knowledge of the current state of

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legalisation of medical and recreational cannabis use. Nurses should also be aware of the pharmacokinetics of cannabinoid and endocannabinoid systems and the possibility of any interactions. For example, THC found in medicinal cannabis may acutely impair cognitive function and is best not prescribed to children or adolescents unless the benefits outweigh the risks. THC-containing cannabis products should not be prescribed to individuals with angina or a history of myocardial infarction, or to those who have a personal or family history of psychosis. Safety considerations for patient use of cannabis is a priority. It is important for each HCP to be able to assess cannabis safety for any patient even if acquired from legal sources. Some questions remain: Can cannabis be administered in hospital if acquired from ‘irregular’ or ‘illegal’ source? Can cannabis be always prescribed by patients in any condition? Will general or oncology hospitals allow patients to smoke dried medical cannabis on the premises especially if non-smoking regulations are in place? Can a patient

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bring cannabis into the hospital, both for medical and recreational purposes, and where are these kept during their hospital stay? Nurses are encouraged to proactively raise these considerations to ensure that proper procedures are in place for managing cannabis for medical purposes. One may also be asking if amendments to the Dangerous Drugs Act are expected and if such important changes will affect us on a day-to-day basis. Specialist nurses must be at the heart and at the centre of developing new policies on the medicinal use of cannabis. They must also be the patient’s advocates and offer support, as they have always done. All these queries, all these misconceptions, require a robust educational campaign, seminars, conferences and general awareness for the nursing community and healthcare providers in all our hospitals and clinics. MUMN has already embarked on such initiatives, but this must be on a national level so that everyone will be properly informed and minimise misinformation and stigma.

President’s message

This article is being written on the eve of an election. Elections reflect the democracy of the nation and the will of the people on who is to “lead” the country for the next five years. As a union, we are eager to work with the coming Health and Elderly Minister and the changes which will take place. As the biggest union in the Health and Elderly sector, our members are divided between these two ministries, two ministries which can even be amalgamated into one ministry in the coming legislation. Whatever the outcome, and whoever would be the Health or Elderly Minister, MUMN will have no difficulties to work with. However certain changes irrespective of who gets elected need to take place. The first aim in the new legislation for MUMN would be to finalize the Sectorial Agreement of the Phlebotomists and the Decontamination Sterilization Technicians and other pending issue are the allowances pertaining to the technical officers working in the Engineering Division of MDH. Currently directives are in place on both issues with great loss of overtime but such members are resilient to receive what they thoroughly deserve. Once these two issues are settled, MUMN will then present the Nursing and Midwives Sectorial Agreement and the ECG technicians Sectorial Agreement for discussions. The intention would be that by the end of 2022, both agreements would be finalized so that on the 1st January 2023, the new agreements will come into effect according to newly agreed financial packages. Nursing shortage is hitting hard everywhere with certain areas more than others. Cancellation of Vacation Leave and Study Leave are continuously taking place even in the elderly sector such as SVP and KGH. Lack of staff compliment is being dampened by MUMN directives.

What is most important for MUMN members in the coming legislation?

Sectorial agreements need to be finalized and all procrastination and arrogance which currently exists have to be eliminated.

The shortage of nurses has never been dealt properly by the past and current Health Minister. Poaching Third Country Nationals from the local Private Sector proved to be disastrous. Attractive salaries have to be in place to address the poaching of nurses by the UK and Europe and also to attract young Maltese people into the nursing profession.

The issue of Steward or VGH. Having three hospitals in “limbo” is not right both to the nurses and other Health professionals who work in these hospitals and to Maltese/ Gozitians patients. The current contracts brought hardly any new investments to these three hospitals. Is is clear that everyone is to blame for this mess, both the Government and VGH. What is important is that either the contract is made viable so that the necessary investments are done or the whole contract is scraped. Having three hospitals

being debated in law courts when everyone knows the any court case takes years to be finally finalized is not right at all for all stake holders concerned. MUMN will be voicing and pressurizing both Steward and the Health Division to arrive to a final decision whatever the decision could be. Definitely as things currently stand, the health services deserve better and this should be addressed when will eventually again have a Health Ministry.

As everyone can see, no major capital project has taken place in the Health Sector. The new Paola Health Centre is still being built and major Health projects such as new Mental Health Institution, mother and child Hospital, new outpatients bloke in MDH, new parking area in MDH, refurbishment of Mt. Carmel Hospital, Northern Hub in the Primary Health Care Settings…all projects promised to take place for these last six years, have not even started. So the new legislation has a lot to work on and think about since the Health Sector is an evolving sector and stagnation (or not moving forward) means regression.

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Kelmtejn

mis-Segretarju Ġenerali F’dawn l-aœœar æimgœat konna gœaddejin b’œidma kontinwa sabiex il-premises il-æodda æewwa Œal Qormi jkunu f’kundizzjoni li nistgœu naœdmu fihom u flistess waqt ikunu f’sitwazzjoni li jistgœu jiæu organizzati attivitajiet varji. Dan, barra x-xogœol n-normali tal-union li jibqa’ gœaddej mingœajr waqfien sabiex nagœtu servizz lil dawk il-membri li jiæu bÿonn l-assistenza tal-union.

Issa wara erbgœa æimgœat gœandna lest is-sular ta’ fuq fejn hemm l-uffiçini amministrattivi kif ukoll ilconference area. Infatti ftit tal-æranet ilu æiet organizzata l-ewwel attività fejn il-Florence Nightingale MUMN Benevolent Fund ÿamm l-attività tiegœu annwali billi organizza l-quddies b’ringrazzjament u wara ç-çerimonja gœal dawk il-membri li rtiraw misservizz. Minn qalbi nirringrazzja lil kull wieœed u waœda minn dawn il-membri tas-serviz fejjiedi li wrew mal-pazjenti matul il-karriera twila tagœhom. Issa, minn din il-æimgœa ser nibdew nagœtu skoss is-sular ta’ isfel li ser ikun Training Centre komplut bil-façilitajiet kollha moderni. L-attività li jmiss li tiæi organizzata, issa hija s-seminar ta’ æurnata bit-tema ‘Encouraging Motivation while Coping with Anxiety’. Din ser issir fil-25 ta’ Marzu u qed tiæi organizzata millKumitat Eÿekuttiv li jmexxi l-Institute for

Health Care Professionals tal-MUMN stess. Gœalkemm in-numru tad-delegati li jistgœu jattendu issa rdoppja, peress li l-premises huma œafna akbar, kwaÿi diæà l-postijiet imtlew kollha. Dawn isseminars ser jerægœu jibdew isiru kull xahar però huwa importanti li dawk li jkunu interessati gœandhom jibbukjaw mill-ewwel. Fis-6 ta’ Mejju ser tiæi organizzata Konferenza fil-lukanda Dolmen bit-tema ‘Challenges as We Grow Older’ fejn ser ikollha numru ta’ preÿentazzjonijiet interessanti œafna fosthom dawk fil-branka tal-Midwifery peress li dik il-æurnata hija ddedikata bœala il-Jum Internazzjonali talMidwives. Diæà gœandna numru sew ta’ minn œallas biex jattendi. Min hu interessat m’gœandux iœalli gœall-aœœar anki gœall-fatt biex tilœqu tibbukjaw gœall-iStudy Leave. Sakemm tœabbret id-data tal-elezzjoni konna qegœdin fil-final sabiex nilœqu

ftehim aœœari biex jiæi ffirmat il-Ftehim Settorali tal-Phlebotomists u DSTs. Barra minn hekk konna wkoll f’taœdidiet sabiex tinstab soluzzjoni gœall-membri tagœna li jaœdmu fl-Engineering Division dwar l-ogœti ta’ allowance li joœroæ mill-Ftehim Settorali tagœhom. Issa kollox ser jiæi pospost gœal wara l-elezzjoni peress li ttieœdet deçiÿjoni mill-OPM li ttrattati kollha mal-unions gœandhom jiæu sospiÿi gœal wara l-elezzjoni. Nistennew u naraw. Din is-sena bdejna nœejju d-dokumenti li jifformolaw il-Ftehim Settorali tanNurses u l-Midwives kif ukoll dak ta’ l-ECG Technicians peress li t-tnejn li huma jagœlqu fl-aœœar ta’ din is-sena u gœalhekk ikun permess li ftit xhur qabel jibdew id-diskussjonijiet sabiex jintlaœqu dawk æodda. Bœal ma tafu issa l-Ftehim Settorali kollha jkollhom skadenza ta’ œames snin. Aktar informazzjoni tingœata ’l quddiem permezz ta’ korrispondenza u laqgœat apposta. Serrœu moœœkom li l-proposti li bagœtulna æew diskussi kollha fiddettal u fejn kien jaqbel u kien fl-interess æenerali, æew inkluÿi fid-dokument. Bœal ma tafu l-MUMN tieœu ÿewæ passi lura f’dawn iÿ-ÿminijiet ta’ kampanja elettorali biex tibqa’ newtrali. Il-Kunsill tal-Union iœoss li dan huwa pass gœaqli sabiex l-MUMN tibqa’ ÿÿomm irreputazzjoni tagœha li ma tœares lejn wiçç œadd u l-unika interess huwa dak tal-membri tagœha. Ilna sejrin hekk gœal dawn l-aœœar 25 sena u hekk hu ppjanat li nkomplu nagœmlu. Trid tkun veru xi œaæa straordinarja li tœalli effett negattiv fuq il-membri tagœna inæenerali sabiex l-MUMN issemma’ leœiniha f’dawn il-æimgœat li æejjien. Irrid nieœu din l-opportunità sabiex nawgura lilek u lil dawk qrib tiegœek Gœid Hieni u Mimli Saœœa. Nselli gœalik, Colin Galea Segretarju Æenerali - MUMN

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Will my pension be enough? photo | saga.co.uk

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• save the amount they want per month; • select the age when benefits become available, • decide when to increase or decrease the monthly savings amount; and • decide when to stop and restart contributions should circumstances change, subject to certain conditions. It goes without saying that the younger one starts to plan for this major milestone in life, the more wealth may be amassed up to retirement. In fact, anyone from the age of 18 to 59 can embark on these plans. Furthermore, these pension plans qualify for tax incentives and therefore one can be eligible for a tax credit of 25% up to the maximum set by Government. Under current legislation, one can enjoy a tax credit of up to ¢750 per annum. Bank of Valletta fully understands that it is not always easy to plan for the future, so the Bank is offering retirement planning support and guidance through its network of Branches and Investment Centres across Malta and Gozo. To set up a free consultation meeting with a

BOV pensions specialist, simply fill in this online form https://www.bov. com/Assistants/set-an-appointment or send an email on bovic@bov.com. Further information can be found here – https://www.bov.com/content/ insurance---retirement-planning Investment returns can go down as well as up and the past is not necessarily a guide to future performance. Changes in the rate of exchange of currencies may also affect the value of investments.

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Times of Malta

Nurse’s transfer to hospital for the elderly was ‘abusive’ Edwina Brincat

A decision by the chief medical ofﬁcer to transfer a qualiﬁed nurse from a highlyspecialised cardiac suite at Mater Dei Hospital to St Vincent de Paul was again struck down as abusive, this time by a court of appeal. An action for judical review of that decision had been instituted by Rita Vella after she was slappedwith an order for immediate transfer from the cardiac catheterisation suite to the hospital for the elderly. That order came in the wake of an incident with a fellow nurse about a pager which had led both nurses to file separate reports to the human resources department. Her union had advised her not to follow the order from her superiors but subsequently stepped in to negotiate Vella’s transfer to the Qormi health centre after the nurse was told that, unless she obeyed the transfer order, her salary would be withheld. She subsequently filed proceedings against the chief medical officer and the Foundation for Medical Services, calling upon the courts to review that administrative decision. In November 2018, the First Hall, Civil Court, presided over by Mr Justice Joseph R. Micallef, upheld her claims, declaring that the chief medical officer (CMO) had acted beyond his powers, breaching the principles of natural justice. Vella was awarded ¢16,270 by way of compensation and the court ordered her reinstatement to her former position at Mater Dei Hospital. The CMO appealed, arguing in the first place that the transfer was an internal matter rather than an administrative decision subject to review in terms of law.

However, the court, presided over by Chief Justice Mark Chetcuti and Mr Justice Giannino Caruana Demajo and Anthony Ellul, said that the issue was not simply about the transfer but as to how and why that transfer had taken place. “Public authorities are always legally bound to perform their duties and exercise their powers strictly within legal limits,” observed the court. Vella claimed that her transfer was discriminatory and that she had not been allowed the chance to defend her position following the workplace incident, whereas her colleague had been afforded more favourable treatment, without any valid reason.

“

“Public authorities are always legally bound to perform their duties and exercise their powers strictly within legal limits,”

The appellant did not justify why Vella had been targeted with “an immediate permanent transfer”, observed the court. The appellant’s argument that Vella was needed at St Vincent de Paul was not credible, even in light of tha fact that such a decision was changed within a day or two when she was redirected to the Qormi clinic. The appellant also failed to prove why it was Vella rather than the other nurse who had to face transfer, went on the court. Vella had bowed down to the move to Qormi health centre only because to defy the transfer order would have meant that her pay was to be withheld. She had “an excellent relationship” with doctors, nurses and even patients who had questioned her absence. Vella used to attent courses and even conferences abroad to further her knowledge in the field because she loved her job, observed the court, which fully confirmed the first judgment and ordered the appellant to foot legal expenses. Lawyer Michael Tanti-Dougall assisted Vella. ❚

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‘Iċ-ċapċip biss mhux biżżejjed’ Kampanja ‘Iva’ Żvizzera Din l-espressjoni fit-titlu kienet inizzjattiva li ttieœdet mill-Kumitat tan-Nursing Care Initiative fi œdan l-iSwiss Nurses’ Association. Din kienet kampanja qalila bi tlett lingwi illi ntrebœet bis-sapport tal-poplu Ÿvizzeru permezz ta’ votazzjoni, speçi ta’ referendum. Li l-poplu jçapçap waqt pandemija ma kienx biÿÿejjed gœall-infermiera Ÿvizzeri allura rebœu s-simpatija ta’ kulœadd biex il-Gvern jimplimenta kampanja ta’ edukazzjoni u taœriæ; u ta’ proviÿjon ta’ servizz awtonomu. Il-Gvern Ÿvizzeru, mit-28 ta’ Novembru ‘il quddiem irid jara wkoll li jittratta n-nuqqas ta’ staff u l-kwalità’ tal-kura infermeristika fi ÿmien 18il xahar. B’hekk irid jiÿdied l-istaff fix-shifts, jitjiebu l-kundizzjonijiet u jiÿdied il-kumpens xieraq gœas-servizz infermeristiku Ÿvizzeru. Il-Parlament Ÿvizzeru issa gœandu obbligu li jonora u jimplimenta din l-inizzjattiva gœall-benefiççju talinfermier u l-pazjent. Ta’ min wieœed japprezza inizjattiva bœal din, jieœu l-eÿempju Ÿvizzeru gœaliex verament, iç-çapcip biss mhux bizzejjed. Din hija l-Media Release tan-Nursing Care Initiative tal-Iÿvizzera.

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ritratt | www.wbur.org

MEDIA RELEASE OF 28 NOVEMBER 2021 Committee submits solution for rapid implementation of the Nursing Care Initiative The committee of the Nursing Care Initiative is delighted by the clear result of the popular vote, which demonstrates that voters expect full and rapid implementation of the Nursing Care Initiative. Better working conditions, sufficient nursing staff on all shifts and appropriate compensation for nursing services must be delivered in addition to the education and training campaign proposed by the Federal Parliament. This is the only way to guarantee high-quality nursing. To save time during implementation, the initiative’s committee is demanding a two-track, parallel procedure. The initiative’s committee is delighted that the Federal Popular Initiative For better nursing care (Nursing Care Initiative) has been so clearly accepted. “We would like to thank everyone whose ‘yes’ vote helped finally ensure that nursing’s position within the healthcare system has been finally strengthened on all fronts,” said Sophie Ley, President of the Swiss Nurses’ Association.

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During the vote campaign, all stakeholders agreed on the need for urgent action. However, there were different ideas on the path to follow. “We expect the government to rapidly implement all the core demands of the Nursing Care Initiative now,” explained Yvonne Ribi, General Manager of the Swiss Nurses’ Association. Parliament’s indirect counterproposal focused on the education and training campaign. The clear result shows that voters feel additional measures, such as better working conditions and appropriate compensation for nursing services, are necessary alongside the education and training campaign in order to alleviate the nursing crisis and guarantee highquality care by ensuring there are sufficient well-trained nurses. To save time during implementation, the initiative’s committee is proposing that the Confederation and Cantons adopt a two-track, parallel procedure. Implementation of the education and training campaign and autonomous service provision The Federal Parliament should approve the education and training campaign and autonomous service provision

Kampanja ‘Iva’ Żvizzera nurse staffing levels on each shift and improving working conditions. These steps will form the basis of the dispatch and draft legislation that Parliament will address at a later stage. The initiative’s committee expects the Federal Council to approve this dispatch within 12 months and transfer it to Parliament for debate. The Federal Department of Home Affairs (FDHA) is called on to set up a working group that includes members of the initiative’s committee and the social partners. “The people who opposed the Nursing Care Initiative also have a duty to contribute constructively to its implementation,” emphasised Sophie Ley. The working group would be tasked with drawing up proposals for the ordinances and Federal Council Dispatch. The expectations of Swiss voters and the 200,000-plus people who currently work in nursing are extremely high following the adoption of the Nursing Care Initiative. “The Swiss Nurses’ Association will make sure that pressure on the government is maintained. Both patients and nurses themselves must quickly feel the benefits of the improvements contained in the Nursing Care Initiative,” said Sophie Ley. ❚

Information Sophie Ley, President of the Swiss Nurses’ Association and member of the initiative’s committee, sophie.ley@ sbk-asi.ch, +41 79 374 49 02

(under which nurses would be able to bill insurance companies directly for certain services) set out in the existing indirect counterproposal. The Cantons should revise their legislation to accommodate the education and training campaign as a matter of urgency, so that the funding can be released without delay.

Federal Council under an obligation The new constitutional text requires the Federal Council to issue an ordinance decreeing measures to address the lack of nurses and safeguard nursing quality within 18 months. To achieve this, it will have to implement the additional core demands of the initiative. This will involve increasing compensation for nursing services, ensuring adequate

Yvonne Ribi, General Manager of the Swiss Nurses’ Association and member of the initiative’s Committee, yvonne. ribi@sbk-asi.ch, +41 79 830 48 50 Walter Stüdeli, General Manager of the ‘’Yes to the Nursing Care Initiative” Association, walter.stuedeli@koest.ch ,+41 79 330 23 46 Il-kampanja Nursing Care Initiative tal-Iÿvizzeri (Ritratt, Swiss Nurse Association)

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Resource ThickenUp Clear is tasteless, odorless and does not thicken over time. It is also amylase resistant.

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Press Information Communiqué de presse Comunicado de prensa

“As a profession, globally, we are asking for help” Nurses discuss ways to address critical global nursing shortage

Geneva, 2 February 2022 – Over 630 participants from 115 countries, including leaders of National Nursing Associations across the world, joined a webinar on 28 January to discuss the recent report on the global nursing workforce and the COVID-19 pandemic by the International Council of Nurses (ICN), CGFNS International and the International Centre for Nurse Migration (ICNM). The report, Sustain and Retain in 2022 and beyond, which was launched on 24 January, revealed how the COVID19 pandemic has exacerbated the already fragile state of the global nursing workforce. With a shortage of 5.9 million nurses and another 4 million nurses expected to retire in the next 10 years, the nursing workforce was already in a precarious position prior to the pandemic. The report described how the COVID Effect was leading to increased absences, early retirement and burnout which may likely push many other nurses to leave the profession, increasing the shortage to up to 13 million. In her opening remarks during the webinar, Dr Pamela Cipriano, ICN President, talked about the fear that nurses are facing and the importance of protecting them. “As a profession, globally, we are asking for help. Because our nurses do not feel valued, they do not feel supported, and we know that over the course of time we need to grow our workforce supply and retain that supply, which

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is becoming a much more critical aspect when we look at the conditions affecting us right now.” Professor James Buchan, co-author of the report, explained about the report’s projections of future shortages if there is an exodus from the profession. “If we just have a 4% increase in the number of nurses who leave, we have another million shortfall. The scale of the impact at the global level is going to be huge unless the issues around burnout and stress are addressed quickly. We are looking at a situation where 4% is a very conservative estimate of the level of impact. Toward 8-12% or more, we get a sense of just how problematic the issue is globally, particularly in countries that came into the pandemic with big shortages because that shortage gap is going to become even more exacerbated.”

the same way as offsetting our carbon footprints. “We all want to reduce our carbon footprint, to reduce our emissions and we have offsetting strategies to making alternative choices, planting trees, growing forests...I think there is something to think about how the offsetting mechanism could be used to educate more nurses, build nursing schools, and support the growth and development of healthcare facilities.” The leaders of several National Nursing Associations around the world provided snapshots of the situations in their own countries, praising the resilience of their nurses. Ma. Teresa Maldonado Guiza, President of the Mexican Federation of Nursing Colleges, said that nurses in her country were not being listened to, despite many campaigns. She spoke about the issues of temporary contracts, the need for more appropriate education, and for recognition of nurses with Master’s degrees.

Franklin Shaffer, President and CEO of CGFNS International and co-author of the report, warned of a “tsunami” of international recruitment from lowincome countries to high-income countries who seek a quick fix solution to nursing shortages. Dr Shaffer reminded participants that every nurse has the right to be mobile, but that policies and bilateral agreements must be put in place to ensure ethical recruitment of nurses. Howard Catton, ICN CEO, who is also a co-author of the report, said that there was no magic bullet to solving this problem, but rather a “bundle” of policy initiatives and support needed to retain nurses. He stressed that pay was an important factor along with access to vaccines, personal protective equipment (PPE), and mental health support. He suggested that the issue of international recruitment be seen in

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ritratt | www.healthlinx.com

“As a profession, globally, we are asking for help” Walter de Caro, President of the Italian Nursing Association said that about half of the nursing workforce in Italy had been infected by COVID19. The country has one of the lowest staffing ratios in Europe which means high workloads, stress and burnout. He said, “The politicians have called nurses heroes, promising several improvements for nursing, but nothing changed in terms of salary, in terms of career, in terms of autonomy.” Dr Agung Waluyo, Chief of Home and Foreign Affairs of the Indonesia National Nursing Association said they had been working closely with the government to deliver mass vaccination campaigns

which has greatly increased vaccination levels in the country, but they were still lobbying the government for better pay, career pathways and safety. Dr Ching-Min Chen, President of the Taiwan Nurses Association said that the government had implemented several policies such as prioritizing vaccination and PCR testing for healthcare workers, but that nurses were still facing high workloads and infections rates. The association is predicting a shortage of 15-24,000 nurses by 2024. Dr José Luis Cobos, Third Vicepresident of the Spanish General Council of Nursing, said that his

country had a huge deficit of nurses before the pandemic, that working conditions were very precarious, and the remuneration level was unfair considering nurses have to undertake four years of university training before specialising. Nurses in Spain were hit hard by the pandemic. “We are tired, we are burnt-out, we feel neglected and forgotten,” he said. He also warned about addressing shortages by bringing in less qualified, inadequately trained staff which would pose a threat to patient safety. Ellen Ku, President of the College of Nursing, Hong Kong, described the role of nurses in testing and vaccination during the pandemic, and said that many nurses who had left the profession volunteered to help carry out these programmes due to the shortage of nurses. Ruben Lastra, Secretary General of the Argentinian Nursing Federation, called for better education, working conditions and salary for nurses, and raised the issue of violence in the workplace. Perpetual Ofori-Ampofo, President of the Ghana Registered Nurses and Midwives Association, said that nurses leaving the country was one of the key issues facing Ghana at this time. The association was working with the Ministry of Health to ensure that international recruitment is done ethically and are looking at ways to retain nurses in the country by enhancing training and improving conditions. Dr Cipriano concluded the meeting by summarising the main points raised, specifically retention of the nursing workforce through safe staffing, appropriate and equitable pay, addressing stress, improving working conditions, and ensuring safety through vaccination. She reiterated the need for ethical international recruitment and a positive educational pipeline for the future to encourage new nurses to join the profession. ❚

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A vibrant and caring nurse A dedication to Silvana Farrugia (RMN)

The 31st January 2022 will always be remembered as that sad day when we lost one of our own. Going to work the day after we received the tragic news of Silvana Farrugia’s untimely and sudden death, the atmosphere within the confines of the hospital was palpable with sadness, disbelief, anguish and sorrow. Who could ever have imagined that we would lose this vibrant, boisterous, whirlwind of a woman who emanated strength to both patients and colleagues! Silvana, who was a psychiatric nurse by profession, was one of those who made a difference. She was a stalwart to both her student nurses, colleagues and above all to her patients.

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On hearing about her passing and with the upcoming National Mental Health Nurse Day which was held on the 21st February 2022, the Maltese Association of Psychiatric Nurses decided that this month’s Musbieh article and the day per se, should be dedicated to Silvana. The very celebration of National Mental Health Nurse Day would turn into a tribute to an inspirational nurse, a kind being who appeared rough on the outside, but showed warmth and tenderness whenever it was needed. A myriad of unspoken emotions were rife. She was severely missed and the absence of her loud albeit sweet nature was felt, as everyone knew she would probably be amongst us on that very day, however her presence was there more than ever, and it was felt through

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the ceremony, the prayers, the music, her pictures and the messages and memories of her. The event started off with a mass and afterwards, colleagues, friends, MCH management and her relatives shared memories and emotional messages about her. Amongst the tears shed that day, were smiles and even laughter because Silvana had a personality that was described by a colleague as ‘large as life’. The event ended with the planting of a tree within MCH grounds in memory of Silvana and in the presence of her family and colleagues. Silvana can be considered a rock of the Mental Health care in Malta. She was amongst the first students to enter a direct diploma in Mental Health Nursing in 1996. She later continued to advance her studies by reading for a degree in the same field of nursing in 2003. Everyone who knew Silvana could never doubt her vocation to mental health and her patients. In fact, she became a founding member and helped set up the Maltese Association of Psychiatric Nurses (MAPN) in 2005, taking on the role as a treasurer. Silvana worked in various mental health settings; in acute wards, community and even as a psychiatric nurse within the crisis intervention team. She then went on to become a deputy charge nurse and when the multi-purpose unit (MPU) was set up in 2020, Silvana took up the challenge without hesitation. The nurse in charge of the MPU, who worked shoulder to shoulder with Silvana described her as an altruistic, selfless being, who very often forgot herself since she was so immersed in caring for others. He mentioned how she fought tirelessly for the patients’ rights and always showed kindness and compassion whilst always ensuring that they were respected and treated with the dignity they deserve. With simply her presence and her caring bed-side manner, the patient would calm down enough to trust her. She incessantly thought of ways to alleviate any suffering patients may be going through, without ever expecting anything in return. Silvana was consumed by a passion and a drive to help others and she was known to

do this with ‘unconditional positive regard’. A colleague explained how she allowed the younger nurses space to learn and find their wings whilst being there to guide and steer them in the right direction. Furthermore, her kindness and compassion did not only extend to human species; because Silvana was an avid animal lover. Whilst reminiscing, a colleague of her smiled, because he said that there was never a sick animal within the hospital grounds that she would not take home and care for if the need arose. Furthermore, Silvana’s best friend and colleague described her as a ‘champion for the needy’; be it a nursing student who was struggling academically or the most challenging patients. Silvana was also a doting mother, daughter and partner. Her family was the centre of her life. One particular primary school classmate of hers recounted how altruism and fearlessness was something innate within Silvana. Amidst smiles and tears he described how at the tender age of six, she stood up to the school bully who constantly picked on a child with a disability, emphasising that Silvana was born to lead and protect others. A psychiatrist who also worked closely with Silvana for many years explained the pleasure of working with such a conscientious, exemplary and dedicated psychiatric nurse who left no stone unturned when it came to her patients’ needs.

be negotiated with (Gouder, 2022). Silvana practised her profession with a pride and a head that was always held high, irrelevant of the difficulty of the situation at hand. I will end this article with a poem that a patient of Silvana’s wrote for her a short while before she passed. This very poem was presented by Mr. Damian Gouder, charge nurse of the MPU during the tribute that was held on 21st February 2022 in honour of Silvana. May her legacy of unconditional love and inspiration remain with us always. Rest in Gentle Peace dearest Silvana. ❚

To Silvana I want to start this You are the reason I feel bliss Even when I make you go crazy at times You are truly the best Truly better than the rest At times I make you mad You always find ways to make me glad Thank you for accepting me for who I am (Anonymous, 2022)

Sharon Maria Cuschieri Registered Mental Health Nurse

Dear friends, dear colleagues, dear midwives, The 24th of February 2022, war has struck Ukraine, we were petrified. A humanitarian tragedy is unfolding. We are so grateful that countries along the borders of Ukraine have opened their borders to protect and comfort the thousands fleeing their homes. Citizens from countries further away from the conflict zone are getting ready to help. Behind these numbers, there is huge suffering, fear, shattered dreams, separated families and desperate farewells. Women and children are often the first victims in armed conflict. Ukrainian mothers are now giving birth in shelters and metro stations during air raids. EMA hopes that the rights of civilians will be respected at all times. That Peace will push back the brute force of arms. That intelligence and humanity will stop this madness.

Silvana went through her own personal grievances, however, she never allowed herself to become bitter or irate. She dealt with her patients in a consistently sensitive yet determined manner. She was rough yet gentle, headstrong and brave. Silvana thrived with the joy of giving all of herself even if to alleviate just a minimal amount of her patient’s suffering. The welfare of Silvana’s patients was at the base of her logic. Her patients’ rights were never something to

We know that health professionals, the midwives will, as they always have, protect and care for the women and families fleeing war. The European Midwives Association will do everything it can to support their colleagues during these difficult times and forward the voices of the midwives involved in this turmoil. With all our hearts Agnes Simon, President of the European Midwives Association

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Ethics & Health Care by Marisa Vella

The ICN Code of Ethics for Nurses

photo | magazine.nursing.jhu.edu

The International Council of Nurses Code of Ethics is a global document for nurses. This Code was ﬁrst established in 1953 and has been revised a number of times, most recently in 2021. The ICN Code of Ethics for Nurses “is a statement of the ethical values, responsibilities and professional accountabilities of nurses and nursing students that deﬁnes and guides ethical nursing practice within the different roles nurses assume”.

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Within the context of the code these roles are broadly categorised as the first group being nurses, nurses leaders and nurse managers; the second group as nurse educators and researchers; and the third national nursing associations. With regards to the practice of the nursing student, this should be in line with the ICN Code of Ethics for Nurses and is dependent on the level of education and that the responsibility for the student nurse’s conduct is shared between the student and the respective supervisor. The importance of dissemination is highlighted in this document on page four, where the ICN reiterates that in order for the Code to be effective it needs to be familiar to nurses. Dissemination includes to schools of nursing, nurses in their workplace, the nursing press and other relevant mass media. In addition to this the Code should also be disseminated to

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other allied health professionals, the public, policy-makes, organisations representing vulnerable groups as well as employers of nurses. National nursing associations are encouraged to adopt this Code, including the translation of it into local languages and use it as a framework for their own codes of nursing ethics. The Code emphasises the origins of nursing care, where practices of equity, inclusion and respect towards diversity are inherent to the profession. In fact it is acknowledged that nurses acknowledge the following indispensable nursing responsibilities: to promote health, to prevent illness, to restore health, to alleviate suffering and promote a dignified death. In view of this the ICN affirms that “the need for nursing is universal”. The Code has

continued on page 25

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* If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions. † Previous CGM systems have shown to lower HbA1c. JAMA. 2017; 317(4): 371-378. References: 1. Beck RW, et al. DIAMOND - JAMA. 2017. 2. Soupal J et al. COMISAIR, Diabetes Technol Ther. 2016. 3. Heinemann L, et al. HypoDE, Lancet. 2018. 4. Reddy M et al. iHart CGM Diabet Med. 2018. 5. Lind M, et al. GOLD JAMA. 2017. 6. Shah VN, et al. Diabetes Technol Ther. 2018. © 2018 Dexcom UK & Ireland. Dexcom UK (Distribution) Limited, Watchmoor Park, Camberley, GU15 3YL (10040080). VAT 241 2390 40. LBL016669 Rev001.

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from our

diary Photo from the archives – part of the celebrations of MUMN 10 yea rs anniversary where the MUMN Council donated blood.

The IDEA Academy organised its annual graduation ceremony.

MUMN participated at a Career Fair organised in Gozo.

Congratulations to Sylvia Spiteri Charge Nurse at SVP for receiving this prestigious award.

MN The first activity at the New MU gale Premises was the Florence Nightin ed anis org ny emo Cer d Fun Benevolent by the FNBF Group Committee.

Female Medical Staff in Hospitaller Malta Whilst it is a well-known fact that during the time of the Order of St. John in Malta, the management and administration of its hospital - known as the Sacra Infermeria - was almost entirely male-dominated, as indeed was practically every other sector, it is also true that in those cases where the sick were women, female employees also played a prominent role in the medical scene.

by Matthew Camilleri

This was seen for instance in the running of the women’s hospital, as well as in the state-funded care of abandoned infants. During the 18th century, some women were also trained as barber-surgeons, specifically to treat female patients: in 1765, Bali Sigismondo Piccolomini proposed the idea of training female barberotti. Thus we find that in 1772, a young woman was sent at the Order’s expense to study surgery in Florence, while a certain Teresa De Lucca was given the licence to practice as a barberotta at Nadur, Gozo, on 8th July 1782. Women were however mainly employed in three branches of the medical services.

Sacra Infermeria Typical of a Renaissance hospital, the Sacra Infermeria also received unwanted infants. At the rear of the hospital building, a contraption known as the ‘ruota’ enabled mothers to leave their children to the care of the authorities without revealing their own identity. This consisted of a rotating wheel, installed to remain half inside the building and half outside on the road. Alerted by a crying baby or the ringing of a bell, hospital staff would turn the wheel, bringing the baby inside, where

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Female Medical Staff

it could be cared for while the mother slipped away unseen. The Ospedaliera had the duty of caring for the foundlings as soon as they were removed from the ‘ruota’. She was also charged with the supervision of the wet nurses and foster mothers, as well as inspecting the babies every Easter to make sure that they were being well-fed and looked after. She was assisted in her job by the Sotto-Ospedaliera. The ‘ruota’ enabled mothers to leave their children to the care of the authorities without revealing their own identity. The infants would then be cared for by female hospital employees. The wet nurses, known as Balie della Casa, resided at the hospital and were thus available at all times to breastfeed the babies, although in the event that there were too many foundlings, and it became impossible for these wet nurses to cope with them, goat’s milk was also used. Before being employed at the Sacra Infermeria, the wet nurses were examined by hospital physicians to ensure that they were free of disease, and they were constantly supervised by the Ospedaliera to make sure that they were not failing in their duties. By 1779, it was also customary for the Sacra Infermeria to provide breastfeeding services to the legitimate offspring of mothers who suffered from insufficiency of their breast milk. In addition, by 1574 it had also become customary to engage foster mothers or extra-mural wet nurses known as Balie di Fuori. These women, who were required to be honest Christians and persons of integrity, were appointed by the Infirmarian and were required to periodically bring the infants back to the hospital for inspection by the Grand Hospitaller.

Casetta delle Donne Despite the excellent medical services provided at the Sacra Infermeria, its

wards were reserved exclusively for male patients, and since women in need of care had nowhere to go, for quite some time, the need for a number of hospital beds to care for sick women had been felt. This need was somewhat addressed in the first part of the 17th century when a certain Caterina Scappi was responsible for setting up the first local hospital dedicated exclusively to women. Known as the Casetta, it was run by the Governatrice, who resided on the premises, and was responsible for the reception of the patients, the entrance of any visitors, and the closing of the hospital gates at night. She also looked after the use of the bed linen, and the cleanliness and comfort of the sick, as well as supervising the duties of the other members of staff.

The Casetta also employed a midwife or Ostetrice, and one of the wards was reserved for expectant mothers. Other members of staff included a Barberotta, or barber-surgeon, as well as a Spezialotta, or pharmacist, who would accompany the doctors and surgeons on their ward rounds to administer any medications that were prescribed. A Spalmante was responsible for mercurial inunctions, and the anointing or smearing of the skin with an ointment containing mercury - the recognised method of treatment for syphilis during this time. Another form of treatment for syphilis was for patients to sit in so-called “sweat wards”. Patients would sit in a heated room, while the Stufarola, or steam bath attendant, would tend to the heat source in the underlying chamber.

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Female Medical Staff continued from page 23

The Casetta was the first local hospital dedicated exclusively to women. The staff working here were also female.

to generations of sick females and unwanted infants who would otherwise have suffered and succumbed to disease without anyone to provide them with comfort and relief.

The food for the women’s hospital was usually cooked and prepared by the kitchen staff of the nearby Sacra Infermeria. Nonetheless, the Donna della Mancia was responsible for warming up the food and serving it after its arrival at the Casetta. A number of Serve performed the dual role of carrying out nursing duties and domestic chores, such as making the beds and anything else that might be required to make the patients more comfortable. In addition to the members of staff already mentioned, the Casetta also had a portress and three washerwomen on the list of its employees towards the close of the 18th century.

well-documented, the contributions by women employed within the same health services have not always been given the recognition they deserve. Although it is true that female employees were generally engaged in more junior roles, some of them rose to posts of responsibility and competence, such as the ospedaliera, the governatrice, or the barberotta. It is also clear that these women made a significant contribution particularly

The latest development in the long history of the Sacra Infermeria came only last year, when a new virtual museum, titled ‘Reliving The Sacra Infermeria’, was inaugurated. The idea of a virtual museum, which brings together history and technology, was brought about by the need to satisfy visitors’ curiosity about the building’s former history without interrupting ongoing conferences or theatre performances that are regularly held here. Now, by downloading a mobile application that makes use of augmented reality, one can once more relive the building’s former days as a hospital. Re-Living the Sacra Infermeria is a project co-financed through the European Regional Development Fund. ❚

District Medical Service Another important job carried out within the community by females was that of the Pitanziere, or alms-givers. These were four elderly women who were tasked with visiting sick women being treated within their own homes. Every day, the pitanziere would bring them the medicaments and the food ordered by the doctor, as well as financial relief and items of bedding. Helped by four female assistants who carried the bread, they were each assigned to a specific area: Valletta, Vittoriosa, Cospicua, and Senglea. The pitanziere also distributed money to poor and crippled women who had no one else to turn to for help. Whilst the role of males within the excellent medical services provided by the Knights of St. John has been very

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A form of treatment for syphilis was for patients to sit in so-called “sweat wards”. Patients would sit in a heated room, while the Stufarola, or steam bath attendant, would tend to the heat source in the underlying chamber. REFERENCES: Cassar, P. (1978). Female employees in the medical services of the Order of St. John in Malta. Melita Historica, 7(3), 225-233. Rozena, S. Disease and Dissection: A History of Surgery in Malta. Museum of the Order of St. John. Retrieved June 16, 2021, from https://museumstjohn.org.uk/disease-anddissection-a-history-of-surgery-in-malta/

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CMY

Ethics & Health Care continued from page 18 four principal elements as a framework to guide ethical conduct. These elements are: nurses and patients or other people requiring care or services, nurses and practice, nurses and the profession, and nurses and global health. The ICN emphasises that the Code is “a guide for action based on social values and needs. It will have meaning only as a living document” when applied to all settings where nurses practice. Therefore the ICN reiterates that the Code must be understood, embodied and applied in all aspects of nursing. Accessibility to the Code should be encouraged and faciliated throughout their study and careers. In this regard the ICN recommends the following activities to strengthen this: study each element of the Code and the related standards; reflect on each standard and how these can be applied individually as well as in education, BL_ADV_A5_Pregnancy_Mag_21.pdf

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research, management, leadership and policy development; discuss the Code with colleagues; identify how the Code guides in addressing dilemmas. If possible it is recommended that a reflective approach to develop a more practical understanding of how the Code can support nursing in various contexts; apply to ethical decisionmaking; and collaborate with national nurses associations, colleagues and others to promote the stable application ethics in nursing practice, education, management, research and policy.

the four principal elements identifed by the ICN. Please refer to this link https:// www.icn.ch/system/files/2021-10/ ICN_Code-of-Ethics_EN_Web_0.pdf to access the latest ICN Code of Ethics for Nurses. This write up is based on excerpts from the ICN Code of Ethics for Nurses revised edition 2021 as per the link shared in support and acknowledgement on the importance of its dissemination. ❚

Nursing is a broad and wide-reaching profession, and it is important to ensure that the ethical duties and values of the profession are applied in all contexts of nursing services and roles, namely clinicians, educators, students, researchers, managers, policy makers, and professional associations. The Code depicts a diagram that provides a visual representation of these duties and professional values in relation to 09:16

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

CMY

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L-eżekuzzjoni ta’ Edith Cavell Nurse Ingliża iffuċċillata ﬁl-Gwerra l-Kbira

Joe Camilleri C.N. Din hija l-istorja ta’ Edith Louisa Cavell (4 ta’ Diçembru 1865 – 12 t’Ottubru 1915), nurse Ingliÿa li hija mfakkra talli salvat il-œajjiet ta’ suldati miÿ-ÿewæ naœat tal-kamp tal-battalja mingœajr diskriminazzjoni. Kienet ukoll gœenet biex mal-200 suldat talAlleati jaœarbu gœall-Belæju li kien okkupat mill-Æermaniÿi filGwerra l-Kbira. Cavell twieldet f’Swardeston, villaææ œdejn Norwich, l-Ingilterra, u wara li rçiviet l-edukazzjoni tagœha, serviet bœala governessa ma’ familja fi Brussell. Wara daret b’missiera li kien marid serjament, esperjenza li æagœlitha ssir infermiera wara li missiera kien fieq. Ta’ 30 sena Cavell applikat biex issir nurse probationer fil-London Hospital. Wara li œadmet f’œafna sptarijiet fl-Ingilterra bdiet taœdem bœala infermiera privata barra minn pajjiÿha, sa anke meta kien hemm l-imxija tat-tifojde. Fl-1906 kienet temporanjament appuntata matron fil-Manchester and Salford Sick and Poor and Private Nursing Institution. Fl-1907, Cavell æiet impjegata fl-’École Belge d’Infirmières Diplômées fi Brussell u fl-1910 bdiet tippubblika æurnal professjonali blisem ta’ L’infirmière. Sa sena wara bdiet tœarreæ l-infermiera fi tlett sptarijiet, 24 skola u 13-il kindergarten. Meta faqqgœet il-Gwerra l-Kbira waqt li kienet qed iÿÿur lil omma armla, irritornat Brussell fejn il-klinika u l-iskola tal-infermiera tagœha œaduhom is-Soçjetà tas-Salib l-Aœmar. Cavell æiet offruta l-posizzjoni ta’ matron fi klinika f’Brussell fejn il-kura pprovduta mill-istituzzjonijiet reliæjuÿi ma kienux ÿammew mal-avvanzi mediçi ta’ dik ilœabta. F’Novembru 1914, wara l-okkupazzjoni tal-Æermaniÿi fi Brussell, Cavell bdiet tagœti kenn lil suldati Ingliÿi u

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Edith Cavell Il-fdalijiet tagœha æew irritornati lejn ilGran Brettanja wara l-gwerra permezz tal-HMS Rowena. Fi Trafalgar Square ta’ Londra wieœed gœandu jilmaœ monument ad unur Cavell. Biex titfakkar din l-istorja ta’ din l-infermiera eroj inœadmu diversi films u drammi fosthom The Martyrdom of Nurse Cavell, The Woman the Germans Shot, Nurse and Martyr, The Price She Paid, Nurse Edith Cavell (1939), To Serve Them All My Days, u Patriot. Interessanti li anke muÿika æiet ikkomponuta fosthom dik imsejœa Edith Cavell, it-tielet u l-aœœar opra lirika ta’ kompoÿitur Malti Paolino Vassallo (1856–1923). Din kienet melodrama fi tlett atti b’librett ta’ Alfonso Giglio, u l-première sar fir-Royal Opera House, Valletta, nhar il-21 ta’ Marzu 1927, fejn kienet suççess kbir. Kanzunetti oœra li jirreferu jew ispirati minn Cavell kienu “Amy Quartermaine” u “Que Sera”. tœarrabhom mill-Belgju okkupata, gœall-Olanda newtrali. Cavell æiet akkuÿata li kienet kisret il-liæi militari talÆermanja. Is-suspetti fiha kienu dejqu l-awtoritajiet, barra li ma kelliex œajta f’ilsiena. Hi æiet arrestata fit-3 t’Awwissu 1915 u æiet maqfula fil-œabs ta’ SaintGilles gœal gœaxar æimgœat, b’xahrejn minnhom segregata f’çella waœedha. F’qorti tal-liæi marzjali instabet œatja wara li ammettiet l-akkuÿi u ffirmat dikjarazzjoni. Il-kundanna kienet ilmewt flimkien ma erba’ oœra minœabba tradiment fi ÿmien ta’ gwerra.

kienet saret ikona propagandistika speçjalment gœar-reklutaææ militari flIngilterra u gœas-simpatija lejn Alleati tal-Istati Uniti. Mill-banda l-oœra l-eÿekuzzjoni tagœha kienet saret tirrappreÿenta l-att barbaru Æermaniku u dak kollu li kien jidher immorali. Cavell kienet inqatlet ta’ 49 sena u kienet ikkunsidrata bœala pijuniera tannursing modern fil-Belgju. Waqt l-atti erojçi tagœha hija qalet: “Ma nistax nieqaf sakemm hemm il-œajjiet li jridu jiæu salvati”.

“Ma nibÿax u m’inhix se nirtira; tant iltqajt mal-mewt, li gœalija mhix xi œaga stramba u ma tbeÿÿanix”, dan huwa kliem ta’ veru u ta’ vera eroj, mara b’kuraææ ta’ sur u ta’ eÿempju gœalina lkoll. Illum ftit gœadna naraw eroj ta’ dan it-tip. L-eroj tal-lum huma nfermiera li permezz ta’ xogœol sfiq ta’ kuljum, tbatija u kuraææ jeççellaw speçjalment fi ÿmien ta’ epidemiji u pandemija li qed ngœixu llum. Œajjiet dawn l-eroj hija f’riskju wkoll, meta jikkuraw u jissapportjaw lill-batut, lillferut jew il-marid. ❚

Lanqas l-Ewwel Konvenzjoni ta’ Æinevra ma kienet biÿÿejjed biex tipproteæi lil Cavell, li minœabba li kienet fil-professjoni medika, setgœet inœelset mill-mewt. Hemm minn jgœid li l-gvern Ingliÿ ma qabiÿx biÿÿejjed gœall-Cavell gœax skont Lord Robert Cecil, kull intervent min-naœa tagœhom “kien se jagœmlilha aktar œsara milli æid”, waqt li l-Æermaniÿi ma wrew l-ebda klemenza. Dan kien ikkunsidrat bœala att ta’ spjunaææ u tradiment speçjament fi ÿmien ta’ gwerra. Fil-lejl ta’ qabel l-eÿekuzzjoni tkellmet u tqarbnet permezz tar-Reverendu H. Stirling Gahan, kappillan Anglikan. Cavell kienet qalet li “l-patrijottiÿmu mhux biÿÿejjed, m’hemmx lok gœallmibgœeda jew mrar kontra œadd”. Fil11 t’Ottubru sittax-il raæel li jiffurmaw ÿewæ skwadri tal-mewt, esegwew issentenza æewwa Schaerbeek. Wara mewtha nkiteb œafna fuq Cavell, fosthom æurnali, fuljetti, kotba u dan biex jirrakkuntaw l-istorja tagœha. Hi

Riferenzi: Sarolea, Charles (1915). The Murder of Nurse Cavell. London: George Allen & Unwin Ltd. www.theguardian.com/uk/2005/oct/12/freedomofinformation.politics Ritratti: Norwich Castle Museum (edithcavell.org.uk) WORLDWAR1POSTCARDS.COM (www.bbc.com/news/ukengland-norfolk-34401643) Getty images

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Weight Loss

Management Supplements OPTIFAST VLCD Soup is part of a nutritionally complete, very low-calorie diet program, which contains all the nutrients required for safe and effective weight loss, including protein to help you preserve lean muscle mass while you lose fat stores. This Vegetable Flavour Soup is an easy to prepare product and is a perfect option for a savory, hot and satisfying meal that can be enjoyed, any time of the day. Individuals that require a very low energy diet may embark on the intensive level of the program, replace all meals with three OPTIFAST VLCD products per day. Additionally, a minimum of two liters of calorie-free fluid and at least two cups of low starch vegetables with one teaspoon of vegetable oil per day, should be consumed. This intensive level of the program delivers all the nourishment needed in very low-calorie content meals, thereby inducing a mild ketosis. The state of mild ketosis results in rapid weight loss, and individuals may expect to lose at least 3-5 kg within the first week of the intensive phase. An alternative to the intensive program is to replace one meal with one serve of OPTIFAST VLCD Soup or any other product in the OPTIFAST VLCD range (Desserts, Shakes, Bars). A program of regular light exercise enhances wellbeing and the likelihood of success. OPTIFAST vegetable soup is easily prepared by adding 200-250mL of water to the contents of the single serving sachet. This makes it very convenient and may be used as a quick alternative meal at home or at work. So, start your journey towards a healthier future with the OPTIFAST VLCD Program. Enjoy a great tasting vegetable soup for lunch or dinner as an alternative to OPTIFAST VLCD Shakes, Bar and Desserts. OPTIFAST VLCD shakes, desserts bars and soup are available in leading pharmacies.

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The biblical foundation of the medical image Fr Mario Attard OFM Cap When one leaves through the pages of the Bible one remains marvelled at how this sacred text is highly impregnated with the medical metaphor. The great Russian Orthodox theologian, Vladimir Nikolayevich Lossky (Russian: 1903–1958), in his book In the image and likeness of God, wrote: “In the Fathers, generally, as well as in the Scriptures, we find many images expressing the mystery of our salvation accomplished by Christ… There is also a ‘medical’ image, that of a sickly nature cured by salvation as the antidote to a poison” (p.100). The medical image has a long scriptural tradition behind it. Thus, the Redeemer is the Saviour simply because if we have been ransomed it is natural that we have been also saved. Let us never forget that the Greek verb (sózó), which means to save, that is commonly used in the New Testament, does not simply mean “to deliver” or “pull from danger” but it also means “to heal”. Likewise, the word (sótéria), demonstrates not just deliverance but also involves healing. Interestingly enough, in other languages the same thing happens. The first example that comes to mind is that taken from the Italian language, where la salute means both ‘salvation’ and ‘health’. Then, there is also the very name of Jesus, which, in Hebrew is (Yeshua) whereas in Greek (Iesous). In both languages it signifies “God saves”. The Bible explicates Jesus’ name in two instances. The first one is taken from the Matthean Gospel, precisely in its very first chapter. The angel of the Lord says to Joseph in a dream that Mary will bear a son, and you shall call his name Jesus, for he will save his people from their sins (Matt

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photo | christianitymalaysia.com

The biblical foundation

1:21). The second instance where Jesus’ name is fully explained is found in the book of Acts. Here, Peter, full of the Holy Spirit, says to the Jewish leaders concerning the name of Jesus Christ of Nazareth: And there is salvation in no one else, for there is no other name under heaven given among men by which we must be saved(Acts 4:12). Seen from this perspective we can say that the very name of Jesus is equivalent to healing. The gospel is clear about this overshadowing reality. How many times Christ presents himself as a physician in the gospels! For instance, Matthew 8:16-17 tells us: That evening they brought to him many who were possessed with demons; and he cast out the spirits with a word, and healed all who were sick. This was to fulfil what was spoken by the prophet Isaiah, “He took our infirmities and bore our diseases”. In Mark 2:17 we find: And when Jesus heard it, he said to them, “Those who are well have no need of a physician, but those who are sick; I came not to call the righteous, but sinners.” Another text that drives home this fact is Luke 4: 18, 23: The Spirit of the Lord is upon me, because he has anointed me to preach good news to the poor. He has sent me to proclaim release to the captives and recovering of sight to the blind, to set at liberty those who are oppressed … And he said to them, “Doubtless you will quote to me this proverb, `Physician, heal yourself; what we have heard you did at Caper’na-um, do here also in your own country.’” Let us not forget that the prophets, in the Old Testament prophecies, already attributed to the Messiah the power of healing. The prophet Isaiah says of the Lord’s suffering servant, the Messiah:But he was wounded for our transgressions, he was bruised for our iniquities; upon him was the chastisement that made us whole, and with his stripes we are healed (Is 53:5). Whereas the book of Psalms, precisely in Psalm 103, speaks of the Lord who forgives all your iniquity, who heals all your diseases (Ps 103:3). As we have already seen in the Matthean gospel, particularly in Matthew 8:1617, the evangelists represent Jesus as a physician.

has perished from the earth, and there is none upright among men; they all lie in wait for blood, and each hunts his brother with a net (Mic 7:2); From the sole of the foot even to the head, there is no soundness in it, but bruises and sores and bleeding wounds; they are not pressed out, or bound up, or softened with oil. (Isa 1:6); Is there no balm in Gilead? Is there no physician there? Why then has the health of the daughter of my people not been restored? (Jer 8:22); O that deliverance for Israel would come out of Zion! When the LORD restores the fortunes of his people, Jacob shall rejoice, Israel shall be glad (Ps 14:7); For the enemy has pursued me; he has crushed my life to the ground; he has made me sit in darkness like those long dead (Ps 143:3).

Furthermore, the gospel parable of the Good Samaritan can truly be regarded as an image of Christ the Physician. For instance, the great Origen of Alexandria (c. 184- c. 253), a Christian scholar and theologian and one of the most distinguished of the fathers of the early Christian Church, whose writings are important as the first serious intellectual attempt to describe Christianity, in hisCommentary on the Gospel of Saint John comments: “But John baptizes beyond Jordan, in the regions verging on the outside of Judæa, in Bethabara, being the forerunner of Him who came to call not the righteous but sinners, and who taught that the whole have no need of a physician, but they that are sick. For it is for forgiveness of sins that this washing is given” (Book VI, 25). Therefore, if from the biblical data we have available in our hands there is ample evidence that Christ is a physician and the salvation He brings is, in fact, a healing, this must be so because humanity itself is ill. Fallen mankind is sick simply because it is deeply infected from sin. The Word of God plainly affirms this state of affairs in at least four places: The godly man

In front of this human tragedy God’s answer in the Bible always remains that He himself is the physician, the doctor and the healer: If you will diligently hearken to the voice of the Lord your God, and do that which is right in his eyes, and give heed to his commandments and keep all his statutes, I will put none of the diseases upon you which I put upon the Egyptians; for I am the Lord, your healer (Exod 15:26); He heals the brokenhearted, and binds up their wounds (Ps 147:3); But when he heard it, he said, “Those who are well have no need of a physician, but those who are sick”(Matt 9:12); And Jesus answered them, “Those who are well have no need of a physician, but those who are sick” (Luke 5:31); and “Come, let us return to the Lord; for he has torn, that he may heal us; he has stricken, and he will bind us up” (Hos 6:1). No wonder than that Pope Francis, during his Angelus address of Sunday, 11 February 2018, rightly exhorted us with the following words: “Let us contemplate Jesus as the true physician of bodies and souls, whom God the Father sent into the world to heal humanity, marked by sin and by its consequences”. In this regard it is hoped and prayed for that this simple reflection has been a humble attempt in that direction. ❚

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Il-Gvern jinnomina l-ewwel Kummissarju għall-Ħarsien u l-Iżvilupp tal-Priġunieri Il-Ministru gœall-Intern, isSigurtà Nazzjonali u l-Infurzar tal-Liæi nnomina lil Christopher Siegersma biex jinœatar millPresident ta’ Malta fil-kariga l-ædida ta’ Kummissarju gœallŒarsien u l-Iÿvilupp tal-Priæunieri. Siegersma gœandu 38 sena u æej minn snin twal ta’ esperjenza f’œidma fil-qasam mediku u soçjali. Fl-irwol professjonali tiegœu hu kien responsabbli minn timijiet multidixxiplinarji fis-setturi tassaœœa mentali, ewlenin fosthom il-Crisis Intervention and Home Treatment team (CIHT) u l-Young People’s Unit (YPU). Siegersma huwa gradwat bœala infermier b’Masters mill-

Università ta’ Malta fil-kura tassaœœa mentali. Fil-preÿent qiegœed fil-proçess li jikseb PhD mill-Queen Margaret University ta’ Edinburgh fl-Iskozja. F’dan id-dottorat, is-Sur Siegersma qed jispeçjalizza fit-trawma psikoloæika li tirrelata ma’ atti kriminali. Il-Kummissarju gœall-Œarsien u l-Iÿvilupp tal-Priæunieri se jkun fdat li jsegwi l-implimentazzjoni tar-rakkomandazzjonijiet skont kif proponuti mill-bord ta’ inkjesta li evalwa l-operat tal-Aæenzija gœasServizzi Korrettivi. L-Aæenzija gœas-Servizzi Korrettivi hija responsabbli mit-tmexxija talFaçilità Korrettiva ta’ Kordin. ❚

BioGaia Tablets

A solution for the whole family Clinical studies with L. reuteri Protectis have shown decreased: ȱȊȱȱ ȱ ȱ ȱ ȱ ȱ ¢ȱ ȱ ȱ ȱ ¢ȱ ȱŵǲ ȱȊȱȱ ¢ ȱ ȱ ȱ ȱ ǰȱ ȱ ǰȱ ȱ ǰȱ ȱ ȱ ȱ ¢Ȭ ȱŵǲ

Clinically proven probiotics to prevent stomach upsets and infections

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Clinically proven probiotics to prevent stomach upsets and infections - NUMRU 94

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INCREASING GUT COMFORT WITH BIOGAIA PROTECTIS

The natural healthy ageing process leads to small changes in the gut function that can give rise to functional symptoms, like for instance constipation. Constipation is a common functional gastrointestinal disorder, with a prevalence of around 20% in the general population. The incidence increases with age and affects more women than men. Chronic constipation has a major economic impact on society. In addition, it can have a significant impact on mental health, social behaviour and the overall quality of life.1

KEEP THE GUT MOVING

The probiotic strain Limosilactobacillus reuteri DSM 17938 (L. reuteri Protectis) have positive effects on gut motility2 which is important for proper food digestion and constipation relief. A clinical trial in 20 adults with chronic constipation showed significant improvements in bowel movements after 4 weeks of daily supplementation with two tablets of L. reuteri Protectis.3

REDUCING SIDE EFFECTS OF ANTIBIOTICS

Since the 2000s, the number of antibiotic prescriptions has increased by more than 20% in elderly patients.4 Antibiotics have a negative impact on the balance in the gut microbiota and can often cause unpleasant side effects such as diarrhoea, bloating or abdominal pain. L. reuteri Protectis has been shown to significantly reduce the incidence of diarrhoea and other gastrointestinal symptoms during antibiotic treatment.5–7

BIOGAIA PROTECTIS FOR GUT COMFORT

BioGaia Protectis contains L. reuteri DSM 17938 that has a clinically proven effect on constipation and antibiotic-associated side effects, thereby contributing to increased gut comfort and a better quality of life.

References: 1. Bouras E & VazquezRoque M. Clinical Interventions in Aging. 2015;10:919-930. 2. Wu RY et al. Neurogastroenterol Motil. 2013;25(3):e205-e214. doi:10.1111/nmo.12072. 3. Ojetti V et al. Eur Rev Med Pharmacol Sci. 2017;21(7):1702-1708. 4. Bernier A et al. Antimicrob Agents Chemother. 2014;58(1):71–7. 5. Cimperman L et al. J Clin Gastroenterol. 2011;45:785-789. 6. Ojetti V et al. Gastroenterol Res Pract. 2012: 740381. 7. Lionetti E et al. Aliment Pharmacol Ther. 2006;24:1461-1468.

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Newsbook

Nurse shortage ‘a crisis in waiting’ - Malta Chamber The Malta Chamber has called on the government to ﬁnd a solution for the shortage of nurses within residential homes and within the health sector, calling it ‘a crisis in waiting’. According to the Care Home Operators Executive Committee within The Malta Chamber, Malta has, to date, lost over 600 nurses to the UK. It said that due to the rise in Covid cases, care homes are being stretched to their limit, with staff being burnt out after two years of dealing with the pandemic. The Chamber’s committee urged the government to meet the private healthcare sector to discuss and find solutions that would be “beneficial for both the private and public healthcare sector.”

14 nurses resign from Karin Grech Hospital in two weeks It went on to propose the addition of staff within the Nursing and Midwifery Council, so as to enable it to vet foreign nurses’ applications quicker. It also suggested the practice of family reunification for foreign healthcare workers, which is already implemented in other European countries, as well as better residency terms. The Chamber also recommended putting into place

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incentives to attract more local nurses to start or return to the profession. “Last year, The Malta Chamber was in discussions with the government to enable care home operators to extend and renew contracts for third country national nurses within the private sector for up to a 3-year period just like the public sector, and this initiative was taken on board. Similarly, The Malta Chamber is confident that the above three recommendations are also taken on board for the benefit of all senior citizens,” it said. The Chamber also noted that many private care homes do not only cater for private clients, but are also on a public private partnership agreement, relieving the state from cases that would otherwise be taking up beds in state hospitals. “Yet,” the Chamber went on, “they find themselves in a

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battle with the state as staff is being poached from the private sector instead of recruited otherwise.” The Chamber also mentioned that the only assistance given to care home operators was a one-time grant given to those that had gone in full lockdown during the months of April, May and June of 2020. It said that despite being a business sector caring for the most vulnerable during the pandemic, no financial support was provided from July 2020 to date. Earlier in October, the Malta Union of Midwives and Nurses similarly warned that if the current shortage of nurses is not addressed immediately, Malta will witness a crisis in the health sector. The Union’s president, Paul Pace, warned that unless the conditions and pay are improved, the healthcare system will face a bigger crisis. ❚

EFN Brieﬁng Note on Launch of Nursing and Midwifery Euro Roadmap The EFN participated in the “Launch of Nursing and Midwifery Euro Roadmap” event organised by WHO Europe to present the new roadmap which aims to give concrete responses and actions to the healthcare sector, with special focus on Nursing and Midwifery professions.

Nurses and midwives make up half of the professional healthcare workforce globally and have the highest rate of patient interaction. Their dedication and preparation allow them to guarantee the right care for patients and the most vulnerable groups. Protecting and ensuring their safety and good working conditions would allow them to carry out their profession to the fullest of their strength and potential. For this purpose, the Euro Roadmap was developed and launched today.

Hans Kluge, WHO Regional Director for Europe, highlighted that the WHO agenda for the next 5 years contributes to key areas such as long-term care and primary care, improving the skills and working condition, offering clear career pathway. This WHO roadmap comes at a crucial moment! Kluge urged for strong collaboration from nurses and midwifery associations to walk together and to build political commitment which include financial and non-financial instruments.

Natasha Azzopardi Muscat, Director, Division of Country Health Policies and Systems, WHO Europe, stressed that covid-19 continues to test healthcare professionals every day and the need emerged to face the gap in skills, but also in values and recognition. It is time to recognise the invaluable contribution of nurses and midwifery. It is time to move from “talk” to “action”. Strengthen the nursing profession and midwifery workforce is in the political agenda.

Elizabeth Iro, WHO Chief Nursing Officer, stressed the importance of nurses and midwives in responding to future health crisis. The regional roadmap has a crucial collaboration to address the needs of nurses and midwives. Their problems require concrete actions. Furthermore, Rachel Kenna, Chief Nursing Officer, Department of Health, Ireland, emphasised that the Covid-19 pandemic showed the

crucial role of nurses and midwives. It is time to recognise their leadership and to give nurses new skills with mental health and digital health being 2 key features to take into consideration. Nurses’ education is an important point of the new roadmap. The development of new policies and new regulations is essential to make sure the well-being and safety of nurses is addressed. Nurses need to influence policies. Covid-19 highlighted really what is important for nurses: influence and implement policies. Gabrielle Jacob, who is now Special Adviser, Transformation and Organisational Development in WHO Europe, added that this roadmap is a new and concrete step forward. It is crucial to work together and to collaborate for the implementation of this roadmap. ❚

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Press Information Communiqué de presse Comunicado de prensa

#NursesforPeace:

Ukranian nurses tell International Council of Nurses of mounting humanitarian crisis

photo | phentermineinformation.com

· ICN launches #NursesforPeace social media campaign · ICN, EFN and EFNNMA demand protection of healthcare and end tohostilities Geneva, Switzerland, 3 March 2022 – The International Council of Nurses (ICN) yesterday hosted a special webinar with European nurse leaders bringing together nursing groups to discuss the crisis in Ukraine. Several Ukrainian nurse leaders joined the meeting from the basements of their hospitals.Participants voiced their solidarity and support for the nurses and people of Ukraine in a message of unity from nurses around the world. Following the meeting, ICN, the European Federation of Nurses Associations (EFN) and the European Forum of National Nursing and Midwifery Associations (EFNNMA) issued a joint statement strongly condemning the Russian invasion of Ukraine, the disruption to health services and the attacks on healthcare facilities and innocent civilians. ICN, EFN and EFNNMA are calling for an immediate ceasefire, an end to all

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hostilities and for the commencement of intensified diplomatic negotiations to secure peace. Entitled #NursesforPeace – Ukraine and the nursing response, the webinar brought together leaders of the national nursing associations of Ukraine, Hungary, Moldova, Poland, Romania and Slovakia, as well as the leaders of ICN, EFN and EFNNMA to share intelligence and decide on actions to safeguard nurses and other healthcare workers, protect facilities and supplies, and ensure access to humanitarian aid. In addition to the joint statement, ICN has launched a #NursesforPeace social media campaign to join nurses across the world in solidarity with the nurses of Ukraine. Banners, social media tiles and other campaign resources can be downloaded here. ICN encourages campaign supporters to post photos of

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themselves holding the banners on social media using the tag #NursesforPeace. ICN President Pamela Cipriano said, “ICN, EFN and EFNNMA are adding their voices to the calls for an end to hostilities in Ukraine and a concerted push for a diplomatic solution to end this invasion. The world’s 28 million nurses stand in solidarity with their colleagues in Ukraine and speak with one voice demanding an end to the aggression which has already seen an unknown number of deaths, and hundreds of thousands of people displaced. No more lives should be lost. Under the banner #NursesforPeace we will continue to use every avenue available to us to support the humanitarian efforts in both Ukraine and its bordering countries, where nurses are once again playing a central leadership role. We owe a huge debt of gratitude to the courageous Ukrainian nurses and those in neighbouring countries who are

Mounting humanitarian crisis endeavouring to find practical solutions to protect and care for their patients in seemingly impossible circumstances. The stories from the ground we heard on the webinar were both humbling and awe inspiring.” Howard Catton, ICN Chief Executive Officer, recognised the incredible testimony of the Ukrainian nurses saying, “Health and peace are inseparable and as a global nursing community, our values are to promote health, provide care and compassion and through healing bring reconciliation. The pandemic is not yet behind us but once again the people of the whole world are witnessing the unwavering courage and strength of nurses to protect our health and humanity. We call on everyone to show their solidarity with Ukrainian nurses and support #NursesforPeace”.

Nurse Testimonies Nataliya Lishchenko, the former director of a nursing school in Ukraine who is working with ICN to liaise with Ukrainian nurses, facilitated translation for the Ukrainian nursing colleagues who joined the call. She spoke about the situation of nurses in the Ukraine, many of whom are living in the hospitals where they work in order to care for patients. “I know that my colleagues in Ukraine need a lot of psychosocial support, emotional support. The situation is incredibly difficult, dangerous, and traumatic for Ukrainian nurses, but they are committed to care. Knowing that they have the support of the international nursing community is really important and helps to sustain them during these incredibly difficult times.” Tetyana Chernyshenko, President of the Nursing Association of Ukraine, joined the webinar from Kyiv. She spoke about the ongoing conflict, saying that a lot of cities are under fire and many civilians have been wounded or killed. “Our people are looking for shelter in subway stations, and bombs are hitting not only places of residence but also hospitals...

Babies have even been delivered in the subway shelters or in the hospital basements.” She thanked the bordering countries who have taken in and cared for many Ukrainian refugees. Aneliya, a senior nurse from Kyiv, is one of those nurses who are living in the hospital. “We are seeing increased attacks in Kyiv and preparing for a large number of wounded. We are particularly worried about the growing lack of basic medical supplies, including tourniquets. We are also providing first aid training for civilians, but we desperately need more supplies.” Halyna, a nurse leader in Ukraine, said she had received messages from nurses across the country who are spending the nights in the shelters and in hospitals. “They are sending their children and grandchildren to neighbouring countries and I am very thankful for this help.” Svitlana, a nurse leader in Ternopil, said nurses have done everything themselves. As Ternopil is in the west of Ukraine, the situation is calmer than in Kyiv and Kharkiv. “We have distribution centres with students and other volunteers, and we are receiving supply chains from Poland and other countries. We are distributing everything we receive to the cities that need it.” The Ukrainian nurses made an appeal for psychosocial support and medical supplies including wound care supplies such as tourniquets, medication and antibiotics, as well as disposable scrubs. Anyone wishing to donate to the ICN Humanitarian Fund in support of nurses in Ukraine, can do so here. Representatives of the national nursing association in countries neighbouring Ukraine spoke of the situation of refugees and how they are helping to get supplies into Ukraine. The nursing leaders from Slovakia, Poland, Romania and Moldova spoke of the “huge

wave of solidarity and support from individuals” to help refugees flooding their borders. They described the influx of people – mainly women and children – arriving after days on the road: tired, cold, hungry and in shock. Many nurses are taking refugees into their own homes, but the nurse leaders warned of the danger of trying to get supplies through to Ukraine on an individual basis and recommended that people who want to help use official channels. ICN’s Humanitarian Fund offers a way for nurses to provide financial support to their nursing colleagues in Ukraine. Elizabeth Adams, EFN President, thanked ICN for its great leadership in hosting the meeting, saying, “Our heartfelt condolences and thoughts are with all our colleagues in Ukraine. We know the incredible work you are doing, and we are looking for any opportunity to be able to support you in any way possible. We have heard your pleas today, particularly to try and move towards a more peaceful resolution in the future. You have EFN’s full support, and we continue working with all our colleagues to continue to support you. We sincerely thank our other colleagues in border countries for the incredible work they are doing as well.” Mervi Jokinen, Vice President of EFNNMA, also expressed solidarity in support of all nurses and midwives in Ukraine. She highlighted the importance of working together, “We should have a united front, we can be influential in our own organisation and work in collaboration with international agencies experts in health crisis management and we need to have practical psychosocial support for all our nurses and midwives.” ICN will continue to work with national nursing associations in the region to support the people of Ukraine, including those who have been forced to flee their country. To show your support for the nurses and people of Ukraine, please sign the joint ICN-EFN-EFNNMA statement here, donate here, and join our social media campaign #NursesforPeace here. ❚

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continued from page 35 Margrieta Langins, WHO nursing and midwifery policy advisor, gave an overview of the new roadmap: WHAT is the Roadmap? • Guides regional implementation of Global Strategic Directions for Nursing and Midwifery; • Recognizes region-specific priorities and challenges for nursing and midwifery; • Supports National Health Strategies; • Reinforces the importance of monitoring and evaluation; • Accelerates evidence-informed workforce policy making; • Supports regional, sub-regional and national dialogues; • Catalyses a fit -for-purpose nursing and midwifery professionals for individual and community benefit. HOW is the Roadmap structured? 4 Policy focus Areas: • Service Delivery • Jobs • Education • Leadership • Proposed activities for Member States; • WHO areas of support; • Country Case Studies. 4 Country Case Studies During the event, 4 country case studies were presented: Valentina Sarkisova, President of the European Forum of Nurses and Midwifery Associations (EFNNMA) and President of the Russian Nurses Association (Russia), presented their experience with the delivery of care to patients at home. The experience turned out to be positive and possible to be implemented. Mervi Jokinen, Professional Advisor Royal College of Midwives and Vice President of the European Forum of Nurses and Midwifery Associations (EFNNMA) (UK), presented their experience aimed at improving working conditions. They implemented campaigns, concrete actions and good practices to improve mental well-being and safety of nurses and midwives. As

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she stated “well-being of facilities is linked to well-being of workforce”. Bente Dahl, Professor of the Faculty of Health and Social Sciences Department of Nursing and Health Sciences at University of South-Eastern (Norway) presented the experience in Nurses and Midwives education. They worked to reform bachelor and master level, introducing research-based education and practice experiences. They, also, introduced new full time and part time master’s degree. Hilla Fighel, Director, professional Development Department, Nursing Division and Ministry of Health (Israel) presented the experience in react and rethink the health sector. They put in place a series of projects to build a strong leadership of nurses and midwives. As she stated “Covid-19 allows to rethink nurses and midwives’ leadership. Nurses had to manage the situation and to cope it. Build a strong leadership of nurses and midwives is essential”. Finally, Tomas Zapata, Regional Adviser, concluded that it is clear that nurses and midwives play a key role to strengthen the resilient of the entire healthcare system. Providing mental health support to healthcare professionals is one of

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the most important points to take in consideration. The new Euro Roadmap for Nursing and Midwifery aims to be a concrete and helpful instrument to protect, defend and build a strong leadership in the healthcare sector. Nurses and Midwives, above all during the Covid-19 pandemic, demonstrated to be able to face health challenges and to manage difficult situations. But they need support, protection, and safety! Implementing this Roadmap could be a concrete action for all nurses and midwives in Europe and, at this stage, collaboration is an essential starting point. ❚ Some useful links for consultation: • https://www.euro.who.int/en/media-centre/events/ events/2021/01/2021-international-year-of-healthand-care-workers • Monti Report: https://www.euro.who.int/en/ media-centre/events/events/2021/09/drawing-lightfrom-the-pandemic-launch-of-the-final-report-of-thepan-european-commission-on-health-and-sustainabledevelopment • WHA 74.15: https://apps.who.int/gb/ebwha/ pdf_files/WHA74/A74_ACONF3-en.pdf • SOWN: https://apps.who.int/iris/ handle/10665/331677 • SOWMY: https://www.unfpa.org/publications/ sowmy-2021 • GSDNM: https://apps.who.int/iris/ handle/10665/344562 • https://nursingandmidwiferyglobal.org

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