Black CampaignShirt www.mumn.org Tel: 2144 8542 E-mail: administrator@mumn.org the heartbeat of healthcare Numru 96 - Settembru 2022 MALTAIl-MusbieœNURSINGANDMIDWIFERYJOURNAL Malta Union of Midwives and Nurses
Il-Musbieħ - NUMRU 962 Infinity Mobile Flexible mobile plans for your business. Now offering you unlimited data with no speed limits. Business Mobile Flexibility Unlimited Data No Speed Limits day better every
Kull bdil fl-indirizzi gœandu jiæi kkomunikat mas-Segretarja mill-aktar fis possibbli.
SAMOC: Ronnie Frendo, Chairperson: 77000919
Il-Musbieħ - SETTEMBRU 2022 3
GGH: Joseph Camilleri: 79485693; Anthony Zammit: 79617531; Jennifer Vella: 79277030
Midwives: Catherine Bonnici, Chairperson: 99252438; Abigail Plum, Secretary: 79592466
MUMN Council Members
L-MUMN ma tistax tinÿamm responsabbli gœal xi œsara jew konsegwenzi oœra li jiæu kkawÿati meta tintuÿa informazzjoni minn dan il-æurnal.
MUMN Office: 21448542
Paul Pace - President: 79033033
Joseph Camilleri (Editor) CN M1 MDH
Group Committees - Chairpersons & Secretaries Mater Dei Hospital: Emily Galea, Chairperson: 77440050; Glen Camilleri, Secretary: 79205674
Il-Musbieœ jiæi ppubblikat 4 darbiet f’sena.
Health Centres: Roseanne Bajada, Chairperson: 79671910
L-ebda parti mill-æurnal ma tista’ tiæi riprodotta mingœajr il-permess bil-miktub tal-MUMN. Çirkulazzjoni: 5,000 kopja.
ECG Technicians: Alex Genovese, Chairperson: 79860571; Paul Caruana, Secretary: 79604338
• E-mail: administrator@mumn.org
Colin Galea - General Secretary: 79425718 Alex Manche’ - Vice-President: 77678038
- Female Medical Staff in Hospitaller Malta pages 26-27 - Editorial/President’spagesmessage 4 5 contents
Warner Complex, MUMN, Triq il-Vitorja, Qormi QRM 2508
• Tel/Fax: 2144 8542 • Website: www.mumn.org
Il-bord editorjali jiggarantixxi d-dritt tar-riservatezza fuq l-indirizzi ta’ kull min jirçievi dan il-æurnal.
- From our diary pages 20-21
Editorial Board
Pubblikat: Malta Union of Midwives and Nurses
Ritratti tal-faççata: MUMN
SVP: Therese Decelis, Chairperson: 79809080; Mario Galdes, Secretary: 79449324
Christa Gauci (Member) SN SJ 6 SVPR Norbert Debono (Member) EN
Dan il-æurnal jitqassam b’xejn lill-membri kollha u lill-entitajiet oœra, li l-bord editorjali flimkien mad-direzzjoni tal-MUMN jiddeçiedi fuqhom.
Ħarġa nru Settembru96 2022
RHKG: Graziella Buttigieg, Chairperson: 79275872
Il-fehmiet li jidhru f’dan il-æurnal mhux neçessarjament jirriflettu l-fehma jew il-policy tal-MUMN.
MCH: Angelo Abela, Chairperson: 79594326; Malcolm Bezzina, Secretary: 77822561
Physiotherapists: Pauline Fenech, Chairperson: 79491366; Daren Stilato, Secretary: 77222999
George Saliba - Financial Secretary: 79231283 Alexander Lautier: 99478982 Geoffrey Axiak: 99822288 William Grech: 79011981 Simon Vella: 79703433 Claire Zerafa: 99217063 Ronnie Frendo: 77000919
In favour of frustratedthoseNurses…
cares for 10 pts but is expected to deliver quality
It is the Health Ministry’s responsibility to ensure that any issue that leads to an industrial action be resolved as soon as possible. It is the Ministry’s job to find solutions, not stopping the Union with injunctions. As a gesture of goodwill, the union suspended the directives pending further negotiations on work conditions with the ministry.
In spite that in 2020 the court had ruled that the industrial action ordered by MUMN can go ahead, following an injunction, in June 2022 another injunction was again issued to stop MUMN’s industrial actions.
Prohibitory injunctions
Nurses, Midwives and our Union must not be treated like criminals especially when they are fighting for their rights. MUMN has every right to achieve its goal by continuing to struggle for its members’ rights. To add insult to injury our Ministry is now warning each member, by a joint circular, about the issue of the essential services; each and everyone’s responsibilities; and the patient’s dignity; something that it is so inbred in us that we need no Parliamentary Secretary to preach it to
the island instead of finding another job. It could also result in a momentary increase in students who do not have the vocation or and they would use nursing just as a steppingstone to another job.
Once again, the Health Ministry had no right to order an injunction, whilst a Court Justice ruled out that the industrial actions announced by the MUMN were completely legal.
By giving higher salaries and making special income tax rate for nurses and midwives it would surely result in increasing the number of nurses on
Nurses and midwives must have proper pay and conditions. A qualified nurse and midwife earn the same as an agricultural supervisor, for example. Only with much longer hours, night shifts, serious responsibilities, the threat of being sued for no fault of our own, and the occasional joy of being verbally and physically abused by the public in general. Nurses and Midwives were also heavily discriminated when their allowances and working conditions were superseded by the sectoral agreement of the Allied Health
NotProfessionals.longago,
If a patient goes missing, the nurse is blamed, the pharmacy does not dispense medicines, the nurse is blamed, the kitchen fails to supply meals on time, the nurse is blamed, if the laundry fails to deliver linen, the nurse is blamed, if the hospital is dirty, the nurse is blamed. 1 nurse cares for 10 pts but is expected to deliver quality nursing care. They are stressed out because of resource shortages (both human and material). It is acceptable for every person to have mood swings but not a nurse…
is just not fair that the nursing profession is being flogged to death and that nurses are being blamed for the problem. ❙
Itus.
It 96
during the Covid 19 crisis. Now they must face prohibitory injunctions to fight for their rights, something which is becoming the rule of the day by the health authorities.
Editorial
Our Union has every right to present a dispute especially on staff shortages and nurse : patient compliment, amongst other issues. MUMN has every right to demand a discussion on pensions and overtime tax, as these not only form part of workers’ conditions but have also been offered to other sectors. On the other hand, it is the Ministry’s job to find solutions, to work at recruiting valid nurses with proper working conditions and respect. One must keep in mind that the Nursing and Midwifery professions in Malta like other European countries are suffering from a substantial amount of shortage and should have never been treated as second class professionals. Mater Dei Hospital and other hospitals are momentarily experiencing a migration of foreign nurses to Northern Ireland and the UK due to a much better working conditions in such countries. This is causing further hardships due to heavy workload on the depleted nursing and midwifery workforce in all health care institutions.
nurses were being applauded for going the extra mile
President’s message
there were other indictors (phase 2) which showed that a frame up was planned. When the report was handed to the Active aging Minister, in a matter of hours (not days but just hours) he convened the media hurriedly, provided only abstracts to the media and frenziedly declared that this was ..”Not a system failure”.
The frame up on our nurse working in SVP was clear from the start. The inquiry which was hurriedly set up by the Active Aging Minister with term of references according to his agenda was the first phase of the frame up. If one needed proof of a frame up, the prove was given by the fact that the inquiry itself did not follow Natural Justice and the nurse was not even called to give his version of the events. Doctors and SVP management were the only persons, which the retired judge had sent for. This shows the true colours of the Active Aging Minister. But
SVP. Having the whole of SVP (more than 50 wards with just one nurse per shift will be eventually be phased out by downsizing the number of beds in
Having nurses suspended on issues beyond their responsibilities gave a clear message that all nurses are vulnerable on any duty, a nurse can be sacrificed by any Minister and transformed into a holy scapegoat.
a different note, discussions on the sectorial agreement of the ECG technicians and the sectorial agreement of the nurses/midwives have started. The discussions that are taking place are not with the political advisor who was removed after the court mandate, but are being held with the Health Division and the IRU. It is too early to send you any updates since the discussions are ongoing. Once the discussions are considered terminated by the Health Division, MUMN will inform you with all the information since it will be MUMN members to decide if the sectorial agreement is acceptable or not.
The Active Aging Minister even retorted by lying when he defended the doctors by stating that misdiagnosis is not a criminal act. What the Active Aging Minister is lying about is that Mr. Fino’s case was not a case of misdiagnosis since the doctors diagnosed correctly but the fact that Mr. Fino was still left in an open ward with dementia, constituted gross negligence from the doctors side also. The new Active Aging Minister cannot be trusted and has no considerations but to safeguard his political carer and to safeguard his colleagues the doctors, he will sacrifice any nurses unremorsely. SVP is closed from all admissions and will remain closed to downsize the bed state of SVP according to the nurses compliment in
The summer season is nearly over. While summer is always associated with holidays, for MUMN it was surely not a holiday season. Important developments cropped up which were vey important for our members, MUMN had to take a stand and make its voice heard to safeguard the interest of its members.
OnSVP.
Il-Musbieħ - SETTEMBRU 2022 5
As regards to the call of the charge nurses, a meeting will be taking place with the People and Standards division since it was not acceptable that such a call did not follow the current nursing/ midwifery sectorial agreement. The meeting is scheduled on the 14th September and MUMN will keep you updated after the meeting. MUMN is stressing that such a call is to be issued once again urgently according to the sectorial agreement of MUMN which was also signed by the Health Division. ❙
Paul PresidentPace
It was later on revealed that the retired judge had actually never written that this was not a system failure but it was just the frenetic Active Aging Minister’s “conclusion”. The bubble of not being a system failure was busted in a few days when the media discovered that the retired judge had given more than 15 recommendations, which he recommended to be urgently introduced in SVP.
This is why MUMN is voicing its concerns. This is why MUMN is continuously informing the public about what the real situation on the ground is.
Is it too much to ask for a safe work environment? Is it out of this world to ask for a day vacation leave without the need to work overtime?
On a different note, I would like to inform you that discussions on both sectoral agreements are currently underway . Both the agreement regarding ECG Technicians and the agreement related to Nurses and Midwives are progressing with a steady pace. Both agreements are in the final stages regarding salary scales and progression. Once this section is concluded we will turn our focus to allowances, which is considered the most challenging stage but we are optimistic that we will reach an agreement. We will keep you posted.
New graduates were employed last week and have now embarked on the next stage of their professional career. We would like to take this opportunity to wish them all the best in their
acknowledged that there is a crisis, and this crisis is on the increase.
Colin Galea General Secretary - MUMN
In November we will once again be organising a ceremony in recognition of those Members who have retired as a special thanks. Personally, I always cherish this activity and look toward
On the 21stOctober we will be organising a conference titledBridging the Gap - Theory & Practice. I have looked at the presentations and must admit that all of them reflect our reality. It is going to be an exciting day and the Dolmen Hotel always guarantees a comfortable and organised environment. Bookings are already coming in with a steady pace.
On the other hand you need to be clear on what the issues and challenges are before attempting to address them. For instance our salary is below average when compared with our neighbouring European countries, in addition to the limited supporting staff, lack of respect, family issues, and poor working conditions to name a
❙
Is it something special not to be burned out after a day’s work? From 30,000 public service employees is there anyone else in a similar situation?
done, but nothing has materialised. This task force needs to have a clearterms of reference and executive powers to act, otherwise this too is a waste of time.
Now the question is, what is going to be done about it? To acknowledge that there is a problem is a step in the right direction but now action needs to be taken, where we work and strive towards solving the current crisis, and national shortage of nurses .
We have consistently and continuously requested the authorities to set up a task force to determine what can be
The next edition of Il-Musbieœ will be issued just before Christmas. We are approaching the end of summer and will soon start thinking of the festive season. Until then I wish you and your beloved ones the very best of health.
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A word from the General Secretary
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Now, instead of planning further strikes, Finnish nursing unions are scheduling mass resignations, possibly later in the autumn, if an acceptable negotiation
‘These past two years have taught the world just how important nursing care is to our health and our social and economic wellbeing, but the lessons learned are not been heeded by the people with the power to make a difference to the state of their health systems, the quality of patient care and the lives of nurses everywhere.”
Meanwhile,integrity.
“ICN is calling out governments for not tackling the roots of the unrest in our healthcare systems which are fragile, severely weakened and in some cases bordering on collapse. Instead of papering over the cracks they must address the fundamental issues of inequality and gross underfunding which have led to lack of fair pay, shortages and increased risks to patient safety.”
Nursing strike in Spain
Il-Musbieħ - NUMRU 968
The Spanish nurses will also denounce the serious problem of aggression, both physical and verbal, which is suffered by nurses in Spain on a daily basis, and demand safe working environments that protect their physical, psychological and emotional
One of the fundamental root causes is the global shortage of nurses, which is putting unsustainable pressure on the nurses currently working in healthcare systems that have been disrupted by staff shortages, the COVID-19 pandemic and historical chronic underfunding. These pre-existing shortages have led to a worrying increase in industrial disputes and strikes – for example a report from Cornell University’s ILR Worker Institute shows that half of all strikes in the United States in 2021 were of workers in healthcare settings, and this Saturday 18 June nurses in Spain will hold a nationwide demonstration. Among other examples, ICN has pinpointed nurse actions in Europe, the Americas and Africa.
Trade unions Tehy and SuPer in Finland held a strike in April to call for decent salaries and working conditions.. A second two-week strike planned for April was cancelled because of the threat of the new law, the process of which through the Finnish parliament has been suspended.
This Saturday on 18th June, thousands of nurses in Madrid, Spain will be demonstrating to demand urgent improvements to the Spanish healthcare system and the working conditions of the professionals who work in it. They will also be denouncing the apathy and disinterest of the public and political authorities. The demonstration, convened by Unidad Enfermera, will draw attention to patients being at risk because of the lack of safety in healthcare due to insufficient numbers of nurses.
Ahead of a meeting with the President of the United Nations General Assembly, Abdulla Shahid, at the Palais Nations in Geneva, ICN Chief Executive Officer Howard Catton said:
Mass resignations in Finland
ICN President Pamela Cipriano said: “Industrial action by nurses is always a last resort, but it is not surprising it is happening, given the state of the health systems nurses are having to work in, which do not enable them to deliver the high-quality care they expect to. This is because of the pressures they are working under, the lack of value and recognition they receive, historic inequities related to gender, and poor pay and working conditions.
nurses in Finland are preparing for even more decisive action after a long-running dispute over pay and working conditions with employers, and new legislation from the Finnish government that would have made nurses’ industrial action illegal.
In his statement to Mr Shahid, Mr Catton said: “ICN believes that the current greatest threat to global health is workforce shortages. With a global shortage of six million nurses and 18 million healthcare workers before the pandemic, we are now seeing increased turnover and quit rates which are highly likely to increase these numbers. This matters because there is no healthcare without a healthcare workforce.
Press ComunicadoCommuniquéInformationdepressedeprensa
Alarming increase in industrial action by nurses is a symptom of global crisis in healthcare systems
Geneva, Switzerland, 16 June 2022 – The International Council of Nurses (ICN) says the alarming rise in the number of nurses taking strike action across the world is a direct response to governments’ failure to tackle the root causes of our fragile, severely weakened, and in some cases collapsing healthcare systems. Across the globe ICN has identified numerous examples of nurses engaged in industrial action over a range of basic issues including safety, security and protection, all of which jeopardise both healthcare staff and patients.
‘The pandemic powerfully demonstrated that our health and our economic welfare are inextricably linked. Spending on healthcare is not a cost, but a cast-iron investment that brings huge returns. If we do not make the investments to grow and strengthen our global health workforce, we will continue to struggle economically, and access to high-quality healthcare for all will remain nothing but a pipe dream.”
solution is not reached before then, to show the strength of their feelings and their determination not to allow the current situation to continue.
InState.New Zealand, nurses have voted to take an historic pay equity offer back to the Employment Relations Authority amid concerns that the current proposal does not include full back pay. The New Zealand Nurses Organization said that while nurses would not strike, the workforce would continue to feel disregarded until the issue was resolved.
Further news on industrial action
position statement on industrial action states that “ICN expects nurses to have equitable remuneration and decent working conditions, including a safe environment. As employees, nurses have the right to organise, to bargain collectively, and to take industrial action. Strike action is considered the measure of last resort; to be taken only after all other possible means to conclude an agreement have been explored and utilised.” ❙
ICN’sincrease.2011
President of FNA Nina Hahtela added: “Lack of nurses is at critical point, and
ICN recently sent a statement of solidarity to its two members in Mexico, the Colegio Nacional de Enfermeras, A.C. and the Federación Mexicana de Colegios de Enfermería, AC, concerning recent strikes in Chiapas
In Denmark nurses have warned for years that salaries and working conditions do not reflect nurses’ competencies, tasks and responsibilities. Last year, the Danish Nurses Organization (DNO) balloted its members and nurses went on strike in a bid to put pressure on employers to raise wages. The strike lasted 70 days and was the longest in Danish history, but the government imposed a pay deal that was rejected by the nurses. Now almost 10% of nursing posts (5,000) are vacant, and Denmark is experiencing a severe labour shortage, with fewer younger people than in the past, and fewer applicants for nurse training. The DNO has published a paper with 12 recommendations for government and employers to tackle the issue.
university clinics are protesting against unacceptable working conditions. In the United States, nurses at several hospitals in Oregon, California and Minnesota have been striking to demand better wages and raise nurse staffing levels.
Anna Suutarla, Head of International Affairs at the Finnish Nurses Association (FNA), told ICN that some nurses have already resigned, with some of them even asking for their names to be removed from the Finnish nursing register. Some wards and services have been closed because of a lack of nurses. She said the FNA supports the industrial action aims by Tehy and SuPer and is lobbying for solutions to be found, based on findings in ICN’s Sustain and Retain report and the ICN-influenced World Health Organization’s Global Strategic Directions for Nursing and Midwifery (2021-2025).
Nurses in Uganda have recently suspended their strike action. The Ugandan Union of Nurses and Midwives President, Justus Kiplangat Cherop, explained that following receipt of a letter from the Minister of Public Service promising that increased wages for nurses and midwives would be included in the budget, they had decided to suspend industrial action. However, he added that “Sometimes government can promise and not deliver.” The UNMU will now analyse whether the budget set to come into force on 1 July will reflect their salary
The two nursing unions say that if the new Patient Safety Act were enacted striking nurses could be ordered back to work on the grounds of ensuring patient Employerssafety.have said the unions’ did not provide safe staffing levels during previous disputes and that their plans for mass resignations are ‘completely irresponsible.’ The unions deny that and say that during the strike staffing levels were at some units even better than usual. They say that patient safety is in danger every day during the current lack of nurses, and this should be the main worry of the politicians and employers, not the legal strikes.
On 7 June, health workers in France held a one-day strike to protest about unmet demands on staff recruitment, better salaries and shortages. In North Rhine-Westphalia, Germany, nurses at
we need urgent action. Industrial action is not an end in itself, but necessary if the situation is not otherwise remedied. This cannot continue, wages and working conditions must be rectified as a matter of urgency.”
photo | crna-school-admissions.com
DNO President Grete Christensen told ICN: “There is an urgent need for it to be made more attractive to work as a nurse – and the nurses have said it over and over again - it is first and foremost better pay and working conditions that are needed.”
Symptom of global crisis
EFN briefing note on the European Health Data Space
Il-Musbieħ - NUMRU 9610
On 3 May, the European Commission launched the European Health Data Space (EHDS) which represents one of the central building blocks of a strong European Health Union. The EHDS will allow individuals to check and use their health data in their own country or in other Member States, fostering the development of a digital healthcare market. In this context, a trustworthy space could be created able to use data for improving research, innovation, policymaking and regulatory activities.
For people
✓ The health data access bodies will be connected to the new decentralised EU-infrastructure for secondary use Covid-19(HealthData@EU).pandemichas demonstrated,
For healthcare professional
✓ Faster access to patient’s health records, including across borders.
more than ever, the importance to develop digital services, products and tools in the healthcare sector. The EHDS builds further on the GDPR, proposed
Data Governance Act, draft Data Act and NIS Directive. The European Commission also launched an open public consultation on the EHDS. The deadline to provide your views on the design of this legal framework is 26 July 2022. The proposal of the European Commission will now be discussed by the Council and the European Parliament.
Feedback from the audience
✓ Digital Health Authorities will be nominated by each Member States and they will participate in the cross-border digital infrastructure (MyHealth@EU) to support patients to share their data across borders.
✓ DigitEasier access to health records
✓ DigitLegal framework for the use of health data for research, innovation, public health, policy-making and regulatory purposes.
✓ A common European Format will be used for sharing patient summaries, ePrescriptions, images and image reports, laboratory results in all Member States.
What do you think is the biggest challenge regarding the Commission’s proposal on the EHDS?
About TEHDAS Event Meeting on 9 May, TEHDAS project invited stakeholders from various fields to share their initial thoughts on the proposal. What is emerged during the event? The stakeholders stressed the importance to clarify the legislation and to pay attention to GDPR for the protection of patients’ data. According to the participants, the European Health Data Space could be an opportunity to implement innovation in the healthcare sector, but it is essential to be careful and to show the real benefits of EHDS to instil trust in the citizens.
What is foreseen in the EHDS?
As stated by the EU Commissioner for Health and Food Safety, Stella Kyriakides: “Today we are putting in place another pillar for the European Health Union. Our vision is becoming a reality. The European Health Data Space is a fundamental game changer for the digital transformation of healthcare in the EU. It places the citizens at its centre, empowering
them with full control over their data to obtain better healthcare across the EU. This data, accessed under strong safeguards for security and privacy, will also be a treasure trove for scientists, researchers, innovators and policymakers working on the next life-saving treatment. The EU is taking a truly historic step forward towards digital healthcare in the EU.”
✓ Easy access to health data in electronic form and free of charge for patients. This data can be shared with healthcare professionals in and across Member States.
from different systems, reducing the administrative burden
✓ Interoperability and security as mandatory requirements.
For research, innovation, and policymaking
✓ Access to such data by researchers, companies or institutions will require a permit from a health data access body, to be set up in all Member States.
continued on page 23
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Il-Musbieħ - SETTEMBRU 2022 13
philosophers of all time, Plato, had this to say concerning midwifery: “The greatest privilege of a human life is to become a midwife to the awakening of the Soul in another person”. This assertion from the father of Western Philosophy struck a deep chord in my heart. In fact, the more I pondered about it the more I was tempted to ask myself: How can I, as a hospital chaplain, serve as a midwife to a patient’s soul? In other words, how can I midwife a soul of a Thatpatient?wepresently
need soul midwifery is urgently attested by the present dire spiritual situation we are living in. Marjorie J. Thompson vividly and accurately describes this current scenario in her book Soul Feast: “There is a hunger abroad in our time, haunting lives and hearts. Like an empty stomach aching beneath the sleek coat of a seemingly well-fed creature, it reveals that something is missing from the diet of our rational, secular and affluent culture. Both within and beyond traditional faith communities, a hunger for spiritual depth and integrity is gaining momentum.”
sin, it is truer than your woundedness, truer than what you have gained or lost, truer than the roles & responsibilities that you have left behind. Your desire for God & your capacity to connect with Him is at the core of all desire. But there is an even greater truth … you are here because God has drawn you here. Gods desire to be with you and His love for you has initiated this journey and will attend you in every moment of it.”
This spiritual hunger for depth and integrity is also commented upon by
My constant presence with the patients at the hospital continually informs me that people, in many ways, echo their innate desire for God. As, above all, is demonstrated in the Bible itself, in its numerous passages. O God, thou art my God, I seek thee, my soul thirsts for thee; my flesh faints for thee, as in a dry and weary land where no water is (Ps 63:1). Why do you spend your money for that which is not bread, and your labor for that which does not satisfy? Hearken diligently to me, and eat what is good, and delight yourselves in fatness. Incline your ear, and come to me; hear, that your soul may live; and I will make with you an everlasting covenant, my steadfast, sure love for David (Isa 55:2-3). Jesus himself gives his reply as to how to come to God for solace and strength when he said in the
“Closeness is more than the name of a specific virtue; it is an attitude that engages the whole person, our way of relating, our way of being attentive both to ourselves and to others… When people say of a priest, ‘he is close to us’, they usually mean two things. The first is that ‘he is always there’ (as opposed to never being there: in that case, they always begin by saying, ‘Father, I know you are very busy…’). The other is that he has a word for everyone. ‘He talks to everybody’, they say, with adults and children alike, with the
of soul companionship and rest. In this the prophecy of Psalm 23 comes true in Jesus: The Lord is my shepherd, I shall not want; he makes me lie down in green pastures. He leads me beside still waters; he restores my soul. He leads me in paths of righteousness for his name’s sake (Ps 23:1-3).
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Thus, if I truly want to midwife the souls of the patients under my spiritual care I have to accompany them. In Pope Francis’ words, as a hospital chaplain I am called to be close to the people I minister to. In his Chrism Mass homily of March 29 2018 the Holy Father beautifully explains spiritual midwifery of the priest when he said:
witnessed at the
Dr Pamela Cipriano, ICN President, acknowledged Dr Tedros for raising the issue of monkeypox as a global health emergency and drew attention to the risk of infection amongst nurses who care for those infected with
height of the COVID-19 pandemic, nurses and other healthcare workers often do not have access to proper protection against infectious diseases. In order to protect our healthcare workforce and prevent the spread of this disease, training and professional guidelines are required along with PPE.
poor, with those who do not believe… Priests who are ‘close’, available, priests who are there for people, who talk to everyone… street priests… A priest who is close to his people walks among them with the closeness and tenderness of a good shepherd; in shepherding them, he goes at times before them, at times remains in their midst and at other times walks behind them. Not only do people greatly appreciate such a priest; even more, they feel that there is something special about him: something they only feel in the presence of Jesus. That is why discerning our closeness to them is not simply one more thing to do. In it, we either make Jesus present in the life of humanity or let him remain on the level of ideas, letters on a page, incarnate at most in some good habit gradually becoming routine.”
it is for me to regard my pastoral role at Mater Dei Hospital as being that of a spiritual midwife to a soul!
Fr Mario Attard OFM Cap
“ProtectMonkeypoxnurses, combat stigma” says International Council of Nursesphoto|en.newsner.com
- SETTEMBRU
“Asmonkeypox.weregrettably
Press ComunicadoCommuniquéInformationdepressedeprensa
At the frontlines of healthcare, nurses play a central role in the response to this health emergency, particularly by providing health education on prevention and infection control, as well as safeguarding against stigma and discrimination. Nurses and other healthcare workers require access to protection personal equipment (PPE) and materials in order to protect them from exposure and limit the spread of the virus. They must also have access to up-to-date information on modes of transmission, prevention, diagnosis, treatment, infection control procedures, counselling and care, through in-service or continuing education.
ICN urges national nursing associations to actively participate in sensitizing and educating the public about monkeypox; take measures to combat stigma and discrimination; and help secure a safe practice environment, including protective equipment and materials, that permits adequate care to people with monkeypox and ensures protection of nursing personnel from exposure to the virus.”
Nursing care is non-discriminatory and ICN deplores the stigmatisation or marginalisation of anyone requiring healthcare. The monkeypox global health emergency once again exposes, and risks exacerbating, health inequalities.”
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photo | rove.me
When confronted with such a life-giving meditation by Pope Francis it would be wise, as a chaplain, to ask now myself the following questions: (1) How much am I spending time with the patients, relatives, staff and other people at the hospital? (2) Am I paying attention to God in a person together with his and her life circumstances? (2) Am I listening for the silences between the spoken words which the person is speaking? (3) How much am I letting the Spirit of God to guide me in accompanying that soul, no matter of its graces and ills, in order to help it grow? (4) How much am I celebrating with my patients their lives as fathomless mystery, in their boredom and pain, excitement and gladness? (5) Am I communicating to my patients that their life is itself a Howgrace?transformational
Geneva, Switzerland; 25 July 2022 –– The International Council of Nurses (ICN) today called for protection of nurses and other healthcare workers who are caring for patients infected with the monkeypox virus. The World Health Organization (WHO) has declared monkeypox a global health emergency with more than 16 thousand reported cases from 75 countries and territories, and five deaths.[i]
Howard Catton, ICN’s Chief Executive Officer, added: “COVID-19 is far from over, and now we have a new public health emergency in the form of monkeypox. Global health must be the number one priority for all countries and investment in nursing has never been more important for the achievement of healthcare for all. Never forget that it will be our healthcare workers who will be on the frontline responding to this latest public health emergency.
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The findings in this study indicate a gap in knowledge and lack of
& Health Care
End of Life: Orthothanasia, Euthanasia & Dysthanasia
The study also investigated resulting care implications. From the results, it was interesting to note that none of the participants were able to define euthanasia, half of the group of participants were familiar with the term dysthanasia, while one third of the cohort defined orthothanasia. Just over 65% of the group acknowledged some of these processes in their practice, while just under 26% believe that being familiar or not with these processes is futile as they cannot contribute to them. In addition to this, while more than 80% of the participants acknowledged that having knowledge of bioethical principles linked to this aspect of care is relevant, less than 15% were able to identify what these principles are.
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photo | ethics.org.au
adequately defined orthothanasia. Less than half of the participants however adequately applied this knowledge to related practices. The researchers also noted that the more years of practice was inversely proportionate to knowledge of these concepts.
Ethics by Marisa Vella
Generalisations or links to professional groups or settings cannot be made based on the findings of these studies. It would be interesting to investigate local understanding of these concepts noting that euthanasia and dysthanasia while diametrically opposing each other are equally viewed as ethically challenging and orthothanasia on the other hand, which is closely linked to palliative care.
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confidence in providing end of life care as well as being able to apply bioethical principles to practice. In 2018, Rimet Alves de Almeida and Freitas de Melo carried out a qualitative study in a Brazilian oncology setting. The focus of this study was on the perceptions of health care professionals regarding orthothanasia and a dignified death for cancer patients. Here the findings showed the awareness and sensitivity care providers had on ensuring orthothanasia is practiced and supported with palliative care.
During a literature search on the topic of euthanasia, a study that was done back in 2009 got my attention. The study carried out in Brazil by Biondo et al. (2009) explored the perceptions of nurses working in the intensive care unit of a university hospital on orthothanasia, euthanasia & dysthanasia.
A study published by Wilson de Alencar Cano et al. (2020) evaluated the conceptual knowledge of a group of doctors working in an intensive care unit in Brazil on euthanasia, dysthanasia and orthothanasia. A third of the participants did not define euthanasia adequately, whereas dysthanasia was defined well by 75% of the participants and just over 60%
The literature suggests that challenges of end-of-life care need to be explored further. Perhaps even more importantly knowledge on end-of-life care concepts needs to be strengthened amongst health care professionals. It is certainly worth considering further exploration locally.
He said that the working week of nurses was of 46 hours and that in order for a nurse to take vacation leave, one had to get a colleague working overtime to cover for him/her.
He claimed that the nurses’ shortage at the public hospitals meant that certain wards were operating with one or two nurses per ward instead of four.
MUMN General Secretary Colin Galea said the government was showing a lack of courage in addressing the issue. He said that the union decided to hold the annual conference at their premises instead of the Health Ministry for the first time.
MUMN President Paul Pace said many nurses were choosing to either become doctors, get into the iGaming sector or work outside of the country. He said the national health service of the UK was also “poaching” Maltese nurses due to their fluency in the English
MUMN proposed that student nurses receive a minimum wage instead of a stipend and then commit themselves to three years’ work in the public service, in a bid to attract more youths to the profession. Pace said the union made proposals to the government that focused on attracting back the nurses that had left the job.
Nurses’ union MUMN says there is a shortage of 600 nurses in Malta, with many abandoning the profession and choosing alternative careers.
Poor working conditions leading to exodus of nurses and midwives
The Malta Union of Midwives and Nurses (MUMN) said that poor working conditions were leading to an exodus of nurses and midwives, with many abandoning the profession and choosing alternative careers.
Pace added that certain wards could not be opened at Mater Dei and that an average of 150 beds at St Vincent De Paul were not being utilised.
On the occasion of the International Day of Nurses and Midwives, MUMN said the government was not properly addressing the shortage of professionals in the sector.
a shortage of 600 nurses in this country, which was never tackled by the government. The solution offered by the Health Ministry was to issue a call for third country nationals and poach them from the private sector,” Pace said.
Galea and Pace touched upon the case involving Joseph Pace, the nurse manager who is potentially facing a prison sentence over a 2017 incident where a patient harmed himself. The patient in Mount Carmel Hospital had been ordered by doctors to have Level 1 supervision but due to shortages, staff were unable to intervene and assist a patient from self-harming.
“It hurts that we are then sometimes treated as criminals. We might come across as vociferous as we are not appreciated despite all that we do. Nurses and midwives are the once that run the hospitals, they are they backbone of every service,” Pace Galeasaid.
by Luke Vella
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Il-Musbieħ - SETTEMBRU 2022 17
“Therelanguage.is
said that the case was mishandled to the point that the police inspector had called up the nurse to identify the patient at the morgue, even though he had survived. He questioned why the magistrate had not called up the nurse prior to the police interrogations. ❙
FROM LEFT TO RIGHT MUMN General Secretary Colin Galea, MUMN President Paul Pace and MUMN Vice President Alexander Manche
“Last year we launched a mental health wellbeing programme. We did our part but the government didn’t and it seems like it doesn’t care. It is useless making promises prior to the election and then never deliver,” Galea said.
She said it meant a sudden increase of around 1,000 extra visits a month for the service with no extra resources.
I have been utterly humiliated, my life has been left in chaos and my “questionedintegrityprofessionalhasbeenleavingmyreputationirreparablydamaged,””
Teesside Live reported in March 2020 how she had successfully challenged her employer’s decision to dismiss her. But the impact of the ordeal had a “profound” effect on her, said her legal team, and she was left unable to work.
From 2008, Mrs Fairhall was employed as a clinical care co-ordinator for the Stockton region and then transferred to Hartlepool in June 2013. In 2015, she was commended by
the Care Quality Commission for her quality of care and leadership skills. Later that year she raised concerns over a new requirement for district nurses to monitor patients’ prescriptions.
Whistle-blower nurse fired after 40-year career ‘vindicated’ as she wins £460,000 pay-out
The Billingham woman said she felt “vindicated” by the ruling adding: “I want other nurses to know you can speak out. The law does protect you.” At the appeal, Judge James Tayler said the original tribunal had “reached an unimpeachable decision”.
by Jeremy Armstrong
Linda Fairhall, 62, raised concerns on patient safety in 2016 and was fired. A tribunal upheld her unfair dismissal claim but the Trust appealed - but a judge blasted health chiefs
A tribunal upheld her unfair dismissal claim but the trust appealed. But a judge blasted health chiefs and set what is believed to be a record award for lost salary and remedies. Mrs Fairhall, who has had cancer and lost her partner, raised concerns on patient safety in 2016, reports the Mirror.
A loyal NHS nurse fired after warning that increased workload contributed to a patient’s death has won a £462,000 pay-out. Mum-oftwo Linda Fairhall, 62, had an unblemished 40-year career when she blew the whistle at North Tees and Hartlepool NHS trust.
Over the next 10 months, she reported 13 matters alleging that that the health or safety of patients and staff was being or was likely to be put at risk. Ms Fairhall, who oversaw a team of around 50 district nurses, was concerned about their workload, employee stress and sickness, as well as risk to patients.
Whistle-blower Linda Fairhall was unfairly sacked by North Tees and Hartlepool NHS Trust
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The death of a patient on October 4, 2016, prompted a meeting where Mrs Fairhall expressed the view that it may have been prevented, had her earlier concerns been addressed. And later in the month, she told the trust’s care group director Julie Parks that she wished to instigate the formal whistleblowing procedure. She then went on annual leave. But, on her return to work on October 31, she told she had been suspended over allegations of potential gross misconduct relating to her Mrsleadership.Fairhallremained suspended for 18 months. During this period, she
The clinical care-coordinator was sacked after trying to whistle-blow over patient safety concerns. Linda had an “unblemished” record at the trust where she had worked since 1979. But she was suspended in 2016, and then later sacked, after trying to start a whistle-blowing process.
The directive targeting the nurses’ breaktime was issued because nurses were being ordered to take their break at 7am, before they even started their working day and before consultants turned up at hospital. As a result, the nurses would end up working the rest of their day without taking a break.
”
The panel also noted the close proximity between the beginning of her whistle-blowing process and the trust’s decision to suspend her. Mrs Fairhall previously said she was “absolutely devastated” by the effect it has had on her
been utterly humiliated, my life has been left in chaos and my professional integrity has been questioned leaving my reputation irreparably damaged,” she said. “I am devastated that after almost 40 years in a career I have been passionate about and working in an organisation that I have always been proud to be part of, that I am left in this situation.
A spokesperson said the Trust has “continued to learn lessons and implement processes that impact positive change”. ❙
“ As a result of the impact on my physical and mental health it has been necessary to allow my professional registration to lapse and come to terms and grieve for the loss of my career.”
Mr Justice Ian Spiteri Bailey upheld arguments by the Malta Union of Midwives and Nurses that its directives did not endanger patient care but were aimed at addressing a prolonged staff shortage that was putting patients at risk and draining its members.
The12.union
The employment tribunal found the trust’s investigation into her alleged misconduct to be “inadequate and unreasonable in all the circumstances of the case”. It said witnesses referred to little more than “themes” or “perceptions” by staff, none of which contained a level of detail which would have enabled Mrs Fairhall to respond.
The directives included taking a twohour break each day at operating theatres, not to leave the ward to accompany patients unless the ratio is one nurse to five patients and not admitting patients to particular hospital wards and at the government’s home for the elderly.
argues this is affecting “in the most detrimental way” the primary objective of providing quality public health to the community. ❙
“
also battled her own personal tragedies. She was still recovering from breast cancer treatment and her teenage son was also unwell. Eight months into the suspension, her partner died from a heart attack. After various investigations and appeals, Mrs Fairhall was dismissed in April 2018.
“Ilife.have
“It does not appear that the industrial actions announced by the MUMN are illegal nor does it appear that the applicant has any right to the injunction,” the judge ruled. While it did not appear that the action ordered would cause any disproportionate prejudice to the patients, the court said it was nevertheless aware that patients in state hospitals would be adversely affected by this and every other strike.
Industrial action ordered by the nurses’ union will not endanger patients’ lives and can go ahead, a judge decided yesterday as he lifted the temporary ban on the union’s directives.
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While the court said it understood there was a serious shortage of nurses, with the state doing a lot to address
Thelater.judge
On the staff-to-patient ration problem, the union said that the ration should be one nurse for every four patients in each of the 65 wards at Mater Dei Hospital. However, the staff shortage had reduced this ration to one to six, one to eight and sometimes even one to
Court upholds nurses’ action, urges state to solve shortagebyMatthewXuerebTimesofMaltaNational
Nurses end up working the rest of their day without a break
The judge stressed it was the responsibility of the health ministry to ensure that the problem causing the industrial dispute is addressed as soon as possible. Mr Justice Spiteri Bailey noted that it was up to the ministry to find a solution to the staffing problem.
the issue, this shortage alone was affecting patient care so it needed to be addressed sooner rather than
had provisionally blocked the industrial action across the entire health service after the union issued a raft of directives in a dispute over shrinking staff numbers.
Colourful logos of MUMN, the Florence Nightingale BenevolentFund and the Institute for Health Care Professionals were setup at the main door of the new premises.
from diaryour
MUMN organised a meeting for its Activists to convey feedback regarding the sectoral agreements
MUMN delivered a press conference together with its members at SVP to protest about the suspension from work of one of their colleagues.
MUMN signed the sectoral agreement forthe Phlebotomists and the DecontaminationSterile Technicians (CSSD).
The Institute for Health Care Professionals organiseda conference in May and is going to organiseanother important one on the 21st October.
The Institute for Health Care Professionals continued to organise the monthly seminars at the new MUMN premises
Vice-President and General Secretary attended the National Blood Transfusion Centre
REDUCINGProtectis.3SIDE EFFECTS OF SinceANTIBIOTICSthe2000s,thenumber 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
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
GastroenterolGastroenterol.2014;58(1):71–7.4.Revdoi:10.1111/nmo.12072.2013;25(3):e205-e214.3.OjettiVetal.EurMedPharmacolSci.2017;21(7):1702-1708.BernierAetal.AntimicrobAgentsChemother.5.CimpermanLetal.JClin2011;45:785-789.6.OjettiVetal.ResPract.2012:740381.7.LionettiEet
BIOGAIA5–7 PROTECTIS FOR GUT COMFORT
treatment.FOR
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
Il-Musbieħ
changes in the gut function that can give rise to functional symptoms, like for instance constipation.
References: 1. Bouras E & VazquezRoque M. Clinical Interventions in Aging. 2015;10:919-930. 2. Wu RY et al. Neurogastroenterol Motil. al. Aliment Pharmacol Ther. 2006;24:1461-1468.
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.
BIOGAIA PROTECTIS
COMFORT
KEEP THE GUT MOVING
INCREASING GUT WITH
and services which can really facilitate and help frontline nurses in their daily job. Address the needs of nurses’ means ensuring better patient care! Useful links to be consulted:
✓ Objectives
BioGaia Tablets A solution for the whole family
The European Health Data Space represents a great opportunity for nurses and for all the healthcare professionals to have an easy access to the health data of patients, ensuring protection and high-quality care. For EFN, the central issues in the weeks, months and years ahead will be about public trust and keeping the citizen/patient in the centre of proceedings. The EFN placed and will be placing a lot of focus on the health data space, as demonstrated by the 2 EU projects almost coming to an end in the Health Data Space context: Smart4Health and InteropEHRate. The focal point is to engage nurses the European Health Data Space cocreation for developing instruments
Proposal for a Regulation on the European Health Data Space Questions and Answers
DataFactsheetStrategy of 19 February 2020 EFNWebpageBriefing Note – 08 06 2022
Tel: +32 2 512 74 19
✓ Primary and Secondary use of data
✓ Impact assessment
continued from page 10
Communication A European Health Data Space: Harnessing the power of health data for people, patients and innovation
✓ The main area of actions for creating the EHDS Detailed presentation available for consultation here.
How strongly do you agree with the following statements on the secondary use of health data?
Discussion with Digital Europe on EHDS
Clinical studies with L. reuteri Protectis have shown decreased:
Fax: +32 2 512 35 50 Email: efn@efn.eu Website: www.efn.eu
Thomas Hellebrand, the project manager of Digital Europe presented the European Health Data Space focusing on:
Clos du Parnasse 11A, 1050 Brussels, Belgium
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The European Federation of Nurses Associations (EFN) Registration Number 476.356.013
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In addition, by 1574 it had also become customary to engage foster mothers or extra-mural wet nurses known as Balie di Fuori.
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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.
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.
Female Medical Staff in Hospitaller Malta
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.
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.
SACRA INFERMERIA
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.
by Matthew Camilleri
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.
This was seen for instance in the running of the women’s hospital, as well as in the state-funded care of abandoned infants.
The Ospedaliera had the duty of caring for the foundlings as soon as they were removed from the ‘ruota’.
Women were however mainly employed in three branches of the medical services.
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.
of a bell, hospital staff would turn the wheel, bringing the baby inside, where it could be cared for while the mother slipped away unseen.
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.
Alerted by a crying baby or the ringing
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 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.
CASETTA DELLE DONNE
Another important job carried out within the community by females was that of the Pitanziere, or alms-givers.
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.
The pitanziere also distributed money to poor and crippled women who had no one else to turn to for help.
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. would then be cared for by
continued on page 28
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.
Knownwomen.as
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.
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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.
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.
Whilst the role of males within the excellent medical services provided by the Knights of St. John has been very
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
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.
Female Medical Staff in Hospitaller Malta
DISTRICT MEDICAL SERVICE
A Spalmante was responsible for mercurial inunctions, and the anointing or smearing of the skin with an ointment containing mercurythe recognised method of treatment for syphilis during this time. Another form of treatment for syphilis was for patients to sit in so-called “sweat
The Casetta was the first local hospital dedicated exclusively to women. The staff working here were also female.
rose to posts of responsibility and competence, such as the ospedaliera, the governatrice, or the barberotta.
one else to turn to for help.
Il-Musbieħ - NUMRU 9628
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.
well-documented, the contributions by women employed within the same health services have not always been given the recognition they deserve.
continued from page 27
Re-Living the Sacra Infermeria is a project co-financed through the European Regional Development Fund. ❙
Although it is true that female employees were generally engaged in more junior roles, some of them
It is also clear that these women made a significant contribution particularly to generations of sick females and unwanted infants who would
Matthew Camilleri is Tours Manager at www.colourmytravel.com
otherwise have suffered and succumbed to disease without anyone to provide them with comfort and relief.
Female Medical Staff in Hospitaller Malta
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.
The pitanziere distributed money had no
to poor and crippled women who
Although advancements in the mental health sector in the past two decades promotes that the majority of individuals who are diagnosed with a mental health disorders are treated in the community, there are still a number of people who require psychiatric care as an inpatient (Rae, 2007). Such cases may require involuntary admission to hospital and certain circumstances may lead to the possibility of patient escalation and at times increased aggression (Cleary, 2014). According to Cutcliff (2018), it is the therapeutic relationship between nursing staff and patients that may lessen the probability of an act of violence occurring.
• Increased safety and reduced coercion
WhatEurope.is
The Safewards Model influences the rates of conflict and containment in wards since some wards may prove to have more conflict and containment than others. Psychiatric wards are social and physical locations, away from the patients normal residences. These wards provide 24/7 mental health care on a basis of either voluntary admissions or admissions that are involuntary and are bound by the Mental Health Act. The Safewards Model indicates that there are a set of conflict-originating factors that may give rise to specific flashpoints which can then trigger a conflict incident leading to containment. The model also reveals how containment is in a dynamic reciprocal relationship with
continued on page 34
As healthcare professionals in a psychiatric setting, it is not uncommon that we come faceto-face with situations which include conflict, escalation and aggression. As we are taught what to do and how to handle a psychiatric emergency albeit from a theoretical aspect.
“Safewards, reducing Conflict & Containment in in-patient Psychiatric Setting”
• Better therapeutic relationships between staff and patients
• Fewer assaults which lead to fewer injuries
We are also taught how to recognise if a patient is going to escalate and what to do to swiftly de-escalate and diffuse the situation by using professional therapeutic skills. When we graduate, we are provided further training in deescalation techniques. The role of the PDU is to constantly strive and raise the bar of professionalism within the nursing profession. The introduction of the Safewards Model to one of the admission wards in March 2020 was a pilot project organized by the PDU. Nurses showed commitment in introducing some of the 10 interventions and attended the follow up sessions organized. Geoff Brennon from King’s Collage in London, came to Malta to train nurses specifically for the pilot project and consequently to train the remaining wards at Mount Carmel Hospital. Geoff Brennon has been instrumental in making Safewards available in several hospitals in the UK and
The Safewards model, developed by Bowers (2014), was purposely
• An environment that is peaceful and conducive to supporting individuals in their journey of recovery
Theparamount.social
interact with them in a more efficient and empathic way (Tonkin, 2016). Through various studies and research it has been proven that empathic staff fare better in reducing the use of seclusion and restraint (Yang, 2014). The connection with peers is known belonging, as well as for group identity Safewards2018).isa
theoretical model that
the Safewards Model?
theoretical model that consists of ten associated interventions designed to improve the safety of everyone in inpatient wards. This is done by reducing the possibilities of situations whereby conflict and containment may have to be used. The main objectives as to why adopting the Safewards Model in the inpatient wards has been proved to be beneficial are:
Il-Musbieħ - SETTEMBRU
• Less time wasted on containment and more invested in engagement
interact with them in a more efficient and empathic way (Tonkin, 2016). Through various studies and research it has been proven that empathic staff fare better in reducing the use of seclusion and restraint (Yang, 2014). The connection with peers is known to be crucial in developing a sense of belonging, as well as for group identity (Lavik, Safewards2018).isa
climate of the psychiatric ward is known to correlate with how motivated the patients are, how they adhere to treatment, their therapeutic alliance and how satisfied they are with the care being offered (Long, 2011). All these aspects relate to how secure the patients feel, the level of disturbance experienced by both the inpatients and staff and the use of seclusion (Ching, 2010). Furthermore, patients tend to assess the social climate of the ward; in other words how supportive the ward is when it comes to their therapeutic needs from their point of view. This is known as the therapeutic hold (Milsom, 2014). If staff members ensure that they know the patients and their personal histories, this will make it easier for them to be able to
by Bowers (2014), was purposely created to reduce conflict (physical/ verbal aggression, abscondment) and containment (seclusion, restraints and enforcing medication) in inpatient settings whilst improving the safety of both patients and staff. It offers an extensive understanding how flashpoints tend to vary depending on the ward (Bowers, 2014). Conflict and containment are highly concerning issues for both hospital management and the nursing practice. Violent incidents may lead to serious injuries to both staff and patients (Lansgrud, 2007). Moreover, when a situation escalates to the point whereby containment is required, this may have an effect on the nurse-patient therapeutic relationship (Journal of psychiatry and Mental Health Nursing, 2014). Therefore, reducing the frequency and severity of such events is
the weight is on the organisation and delivery of teaching (Furmedge et al, In2013).other
The demand for registered nurses continues to grow in the UK and there is a great need for strong collaboration between higher education institutions (HEIs) and clinical practice placement providers. Student nurses are still an asset to health service delivery, but placement availability and capacity challenges highlight the need for colleges and universities to forge closer partnerships with their practice providers. This would help to make sure that academia and practice are seen as one equal entity for students undertaking their nursing education.
photo | students-residents.aamc.org
Il-Musbieħ - NUMRU 9630 continued on page 35
vital difference in the perspective of CTFs and CNEs: CTFs focus wholly on undergraduate nurses and are an alliance between practice and university education and, as such, share a mirrored focus on the curriculum and student
Thereoutcomes.are
INTRODUCTION
many benefits of having CNEs. These include bedside teaching and preceptorship programmes for employees and students, with the rise in CNE posts encouraging the formation of a network (derby.ac.uk) that is home to more than 1,000 members (Pearce, 2019). The demand seen for supporting students in the 1950s – when increased pressures correlated with a significant rise in attrition rates for student nurses (Menzies, 1960) – is a trend we must avoid mirroring, given the current climate in clinical practice.
In most institutions, the nursing profession is yet to exploit the benefits of joint CTF posts between local universities and their associated NHS trust providers, but the idea of clinical nurse educators (CNEs) is not a novel concept. There have been CNEs across most NHS trusts since as early as the 1950s, with a focus on improving recruitment, retention and skills modernisation (Whitehead, 2019). It is important to acknowledge the similarities between CTF posts and the CNE roles that are well established in healthcare, although there is a
“Sessions have been student focused, rather than outcome based, and have taken place in the trust and at the university’s simulation unit”
A recent bulletin from the Council of Deans of Health (2021) has stated that joint appointments between HEIs and practice providers should be encouraged, as close partnerships are essential. The role of a clinical teaching fellow (CTF) adheres to this advice; it is well established in medicine, with the number of medical CTFs rising to meet the demand, but the nursing arena is still to follow suit in many institutions.
A significant amount of literature has been published around medical CTF pathways, and many of these studies describe the roles in detail. However, the articles and job descriptions found through job searches and a survey conducted by Wilson et al (2008) show there is little uniformity in the activities undertaken in posts. Some roles have clearly distinguished the responsibilities between the two organisations; some
medical CTF posts are on a temporary basis of one year, with the emphasis being on developing medics’ teaching portfolios for future positions. This is not the case for the CTF for nursing post in York; permanent contracts are offered to both candidates, cementing the need to have permanent positions as viable career options in education for registrants.
OUR AIMS WITH THE ROLE
Since I started in the CTF for nursing role in February 2021, the focus has been on exploring the gaps in service provision from the perspective of student nurses. It was my first academic appointment after working in critical care nursing on qualifying from the University of York in 2019. There is a significant benefit
How introductionthe of clinical teaching fellows can benefit nursing
NURSING TIMES
The need to provide further supervision for student nurses is supported by the Council of Deans of Health’s (2018) claims that higher education institutions and practice partners must forge stronger partnerships, giving way to nurses taking on the role of the CTF that is commonly found in medicine.
LITERATURE ON THE SUBJECT
Clinical teaching fellows can help bridge the gap between practice providers and academic education and improve student nurse experiences
Many2020.
CTF roles are not well established in most nursing institutions in the UK, as they are in medicine. The University of York, along with York and Scarborough Teaching Hospitals NHS Foundation Trust, led an innovative and cohesive partnership to improve student nurse experiences by creating vacancies for two full-time clinical teaching fellows that were initially advertised in October
state that, in medical schools, CTFs focus mainly on curriculum development and assessment design while, in trusts,
reviews of the subject (Chu et al, 2019), there is less standardisation in what is undertaken at each institution. Medical CTFs are generally described as taking on bedside teaching and simulation, as well as curriculum-based activities (Chu et al, 2019).
THE FUTURE OF DIABETES MANAGEMENT IS
Il-Musbieħ - SETTEMBRU 2022 31 The new Dexcom G6 ® Continuous Glucose Monitoring (CGM) System is the first real-time diabetes management system approved with zero * fingersticks. CGM displays dynamic information about glucose direction and speed, giving users additional insight to help with diabetes management. In 5 clinical trials, Dexcom CGM use has proven to †: Lower IncreaseReduceHbA1c1,2riskofhypoglycaemia3,4thetimespent‘inrange’ 1,2 Improve quality of life and well-being 5
HERE DEXCOM G6 OFFERS YOU MORE PROTECTION, CONVENIENCE AND FLEXIBILITY THAN EVER BEFORE &AlertsalarmsOutstandingaccuracy610-daywearsensorfingersticksZero* *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.
“When people discover they have cancer, it would have already been on them for two years,” he said. He added that since a young age, children are thought that cancer is a silent killer as it does not show any sign of infection, unlike if one were to suffer from high blood pressure as effects such as headaches and dizziness are
It’s a sad place, but we try to create a family atmosphere at Oncology Centre - Charge Nurse
He added that apart from nurses and doctors, consultants, social workers and psychologists are all important to help prepare the patient “for this new stage in their Speakinglife”.about
Despite sometimes not being recognised properly for their hard work, some nurses are just happy knowing that they have taken good care of their patients and see them leave the hospital when Oncologyrecovered.charge
Speaking about his current role, Frendo said that his views on life in general have “Yourchanged.viewson life change when you work in the Oncology Department as
Nurses in this department are together with their patients from their very first appointment, and in some cases, depending on circumstances, they are also present when they take their last breath.
Il-Musbieħ - NUMRU 9632
Oneimmediate.ofthe
THE PATIENT’S EXPERIENCE
the patient’s reaction when they discover that the treatment is not working, Frendo says some of them cry, while others stare in the blank and are under shock, “that they do not understand two percent of the news they would have just heard, as after
“Sometimes it is the children of patients themselves who tell us not to inform their parents about their diagnosis, as they know how they would react. In such circumstances we have always managed to find the right words to break the news slowly, using phrases like ‘you have a start of malicious tissue growth, which we need to treat’, always helps,” said Ronnie.
Asked how young children patients are given the news, Frendo said that “they have to be treated differently than if it were an adult”. He added that normally children are told in words they understand such as “now the doctor will give you something for the pain and it will not hurt anymore”, as the news in full will make sense to their parents.
by Sabrina Zammit
Frendo said that in order to maximise their curability rate, people should go to a doctor as soon as they feel something is wrong with their body.
The patient’s journey starts with tests that lead to a diagnosis and this is where they are told what the situation is.
hardest news doctors and nurses have to break to patients is that of having to inform them that they have cancer. Ronnie adds that this would not be the only shock patients suffer, as the second one comes with having to tell them that they are going to be treated as palliative care patients.
VIEWS ON LIFE
“I am very happy working here,” he told The Malta Independent.
Ronnie said that since his childhood he had always wanted to be a nurse and he would confirm this every time a teacher would ask him what kind of career he wanted to pursue. Working with oncology patients, some of whom are terminally ill, is not easy.
“Although they would feel that their health is deteriorating, some of them would not be expecting it,” he said.
Nurses are an indispensable human resource in any hospital. It is safe to say that Malta has already had a taste of what such a nursing shortage could cause to its health department, as during the peak of the Covid19 pandemic nursing staff was stretched to the limit.
nurse Ronnie Frendo, 56, has been working in the oncology department for the past 32 years.
“If the cancer is in its first stage it is one thing but if it’s in its fourth than that’s another thing, as the more advanced the stage, the less effective is the cure,” he said.
He said that once all treatments, such as radiation and chemotherapy, stop working on the patient, then they would have to break the news. It is at this stage that patients start to be considered for palliative care.
they start questioning the doctor”. He added that it is for this same reason, that normally these patients are asked to be accompanied.
In spite of having years of experience in the field, Frendo said that being present for such episodes, where the family is being informed about a relative’s cancer diagnosis, still affects him, especially when the patient is still young.
As an example, he said that if they witness a patient having a rough
Althoughthem.the
He said that nowadays “you don’t hear much about this happening anymore”, as windows in the facility are locked, with only the security personnel having a key. ❙
PATIENT’S MENTAL HEALTH
In circumstances where the patient has no one to visit them, the nurses are known to give such patients extra attention, such as asking them if they want anything from the hospital canteen since they cannot go themselves. Although this is a very simple act, being offered something other than hospital food, can help boost a patient’s Andmorale.when it comes to Christmastime competitions are held between wards at the Oncology Centre, where the best decorated one wins. Some of these decorations are handmade by patients themselves.
particular experiences which have left an imprint on him, Ronnie recounts how during his earlier years, when the Oncology Department was still at Sir Paul Boffa hospital, he had witnessed first-hand, the level of desperation some patients find themselves in emotionally, while being treated for cancer.
In explaining the effects of being a nurse working in the Oncology Department, Ronnie said that seeing so many people dying especially young ones, leaves its marks. Despite this, he said that it does not hinder the quality of service and care which nurses and doctors provide, as if needed they can also benefit from the psychological services already being offered on site.
Oncology Centre
Nurses try their best to make patients feel at home. “We try to joke between us and with patients without crossing any limits obviously and this has allowed us to create and maintain a family atmosphere,” he said.
option to sleep at the facility is always offered to patients who are in for very complicated and long treatments, Frendo said that he feels very satisfied, knowing that some of them do so willingly. He added that some patients have grown so comfortable with them that they even jokingly describe the experience as a “weekend break”.
Despite the years of experience having made him a tougher person, the sight of a patient passing away still saddens
Nurses are also provided with constant training opportunities in order to better their understanding of how they should respond to several situations. Although attendance is not forced, a large turnout number is always expected.
Il-Musbieħ - SETTEMBRU 33
EFFECTS OF THE NURSING JOB ON THE INDIVIDUAL
The first thing that the staff does to the patient is give them a “tour” of the facility together with an explanation of what they should expect. When giving these introductions, Frendo likes to add that “here there are people who love you and are going to take care of you”, as he noted that since nurses work in shifts, patients will be attended to by different nurses.
explained that nurses are instructed to inform the ward’s doctors when they find out that a patient wants to commit suicide, as they would need a referral to a psychologist.
there is no such thing as a guarantee on a long life,” he said.
Frendo said that constant training is a necessity for nurses and they cannot permit themselves to fall behind, especially when considering that the experienced ones have to act as mentors for the new recruits.
day because of unbearable pain, the nurses go out of their way and start a conversation with them to try and distract
This would be experienced on a deeper level emotionally if the patient in question would have been at the facility for a long time.
“We try to do our best in treating patients holistically,” he said.
Frendo said that during the first period of his career in the Oncology Department
it was very hard for him to process the death of a patient and he used to go in another room to cry.
Mentioninghim.
“It was not the first time that a patient jumped out of a window to their death,” he Frendosaid.
First fleet of cars MMDNAat
On patient’s mental health, Frendo said that new patients are always confused when they come in for their first treatment, and that is why a warm welcome is always needed.
The Safewards model has helped us diffuse multiple situations where flashpoints occurred but did not reach containment, however, causality is complex, with multiple overlapping and interacting factors involved. There is no single magical answer to the problems of conflict and containment because some incidents are outside the control of ward staff.
• Know each other
• Discharge messages
• Positive words
Il-Musbieħ - NUMRU 934 CMYCYMYCMYMCK BL_ADV_A5_Pregnancy_Mag_21.pdf 1 19/01/2021 09:16
At Mount Carmel Hospital both staff and patients are bound by legal and managerial policies. The Mental Health Act is a law in itself and has to be rigorously adhered to. Standard Operating Policies are written and these must also be used as guidelines that need to be followed. These polices ensure that all wards follow the same procedures and comply with national guidance. The Safewards Model consists of ten simple and easy to follow interventions that can be practiced in any situation and at any time. These are:
allows the patient to feel more at ease in approaching us. During our training it was interesting to see some of the interventions such as soft words, reassurance and bad news mitigation because without us realising it, these are practiced constantly.
• Reassurance
• Talk down
• Calm down methods
❙
Sharon Maria Cuschieri - RMN MAPN Council Member
• Bad news mitigation
However, this new model introduces new concepts and new domains. Moreover, it helps in allowing the generation of a number of different interventions reduce the rates of conflict and containment, and so increase safety in our role.
continued from page 29
“Safewards, reducing Conflict & Containment in in-patient Psychiatric Setting”
• Soft words
As a psychiatric nurse in an acute admission ward, my collegues and I have had training on the Safewards Model and have applied a variety of the interventions to our ward. For instance, we created a calm down box, which basically contains items such as herbal teas, adult colouring books, stress balls, aromatherapy oils, colouring pens and so forth. We also practice positive words amongst ourselves as nurses, which helps to continuously remind us that our patients are individuals and not just a psychiatric case or number. Another intervention that proved to be effective is the ‘Get to know each other’, whereby we provided some information about ourselves such as our hobbies, likes and dislikes. This
• Mutual help meeting
conflict and that sometimes the use of containment can itself give rise to conflict rather than successfully prevent it. Furthermore, the model shows that staff can influence the rates of conflict and containment in their wards at every level. This can be done by reducing or eradicating the conflict originating factors and by preventing flashpoints and by halting the link between a flashpoint and conflict.
What we did in the first six months of the role, until August 2021, echoes what is found in the literature around medical CTFs. While at university, we have been involved in: Curriculum design; Module development; Academic assessor roles; Delivering teaching from the
Although this role is in its infancy, definite benefits of having CTF posts for nursing can be seen. The CTF role has long been successful in medicine, and it could be just as successful in nursing – from both a student perspective and for aspiring nurse academics who are looking to pursue a career in nurse education. This role allows such candidates to develop their teaching portfolio in practice and in an HEI, providing insight into, and experience of, developing and delivering a nurse
the role openly, and there was some supportive and constructive feedback from staff (Table 1).
OUR GOALS FOR THE ROLE
We worked hard to shape the role over the first six months and there are many goals. Forging stronger interdisciplinary links is at the forefront of plans over the coming months. This could mean working both in and outside of our HEI, and the benefit of teaching across disciplines such as social care, medicine, physiotherapy and occupational therapy could be invaluable. Students’ anecdotal feedback expressed a desire for this and it was mentioned in the staff evaluation forms. Establishing interdisciplinary links is already under way, but progress could be made to better prepare our future multidisciplinary workforce.
Muchcurriculum.ofthe
anecdotal feedback and that garnered through the evaluations echoes findings from the literature, demonstrating that practitioners who are relatively junior are often best placed to educate students and take on a more student-centred approach to education (Van Heerden et al, 2020; Woodfield and O’Sullivan, 2014).
Workcurriculum.inthe
based, and have taken place both in the trust and at the university’s simulation unit. They have been evaluated well by Boxstudents.1.
Simulated skills sessions offered: Nasogastric tube insertion; Catheterisation; Aseptic technique; Stoma care; ECG monitoring and basic interpretation; Tracheostomy care; Medicines management; Management of emergency situations; ABCDE assessment; ABCDE = airway, breathing, circulation, disability, exposure; ECG = electrocardiogram
Roles such as the CTF could be explored by HEIs to bridge the gap between practice providers and academic education to improve student nurse experiences, while forging stronger links between institutions. Given the current challenges in practice, this is becoming ever more important. ❙
Il-Musbieħ - SETTEMBRU 2022 35
Staff and students both responded positively about their experiences of the CTF role, with all students feeling the role was “required” at the same point in the previous year. Interestingly, staff responses to this question differed: 65% of staff agreed or strongly agreed with this statement.
in having relatively recent experience as a student nurse, as it provides an insight into the challenges students face; these benefits are highlighted in literature, such as that by Woodfield and O’Sullivan (2014).
Theworkshops.skillsworkshops aimed to increase student confidence and competence in clinical skills, many of which were in deficit due to the effects of the Covid19 pandemic. The workshops have developed from students’ feedback, often in collaboration with specialist nurses, with skills being offered, as set out in Box 1. Sessions have been student focused, rather than outcome
“The clinical teaching fellow role has long been successful in medicine, and it is a pathway that could be just as successful in nursing”
All staff and students strongly agreed that there had been a positive impact on student experiences and the role had contributed positively to the Department of Health Sciences. It is encouraging to see that, although many staff did not foresee the role as being a ‘requirement’, they now feel it is a favourable addition to the department. As well as quantitative figures gained from the evaluation forms, written feedback was provided by many, highlighting key themes from both students and staff. Students praised
THE FUTURE OF CTFS
continued from page 30
STAFF AND EVALUATIONSTUDENT
The first six months of this post were heavily focused on shaping and creating a vision for the role – evaluations played a key part in this. Students and staff at the university were sent an online evaluation form to complete. It consisted of a combination of free text and closed Likert-scale questions, with responses ranging from strongly disagree (1) to strongly agree (5).
trust has focused mostly on student experiences, with regular walk-arounds, focus groups, forging links with the medical school, and the development of clinical skills
Introduction of clinical teaching fellows
There was a reasonable response rate, with 52 students from all stages and fields of practice, as well as 20 staff members out of 37 staff with whom we worked most closely, completing the evaluation. This gave a response rate of 54% among staff. Of the staff members, 70% (n=14) were teaching staff and 30% (n=6) were support staff.
The WHO/ILO report also looks at the factors that are driving the sector’s gender pay gaps. Differences in age, education, working time and the difference in the participation of men and women in the public or private sectors only address part of the problem. The reasons why women are less paid than men with similar labour market profiles in the health and care sector across the world remains, to a large extent, unexplained by labour market factors, the report says.
‘The lack of flexible working policies and practices is another barrier to career progression for women, a large proportion of whom are seeking familyfriendly, flexible work, which also tends to be underpaid.
Il-Musbieħ - NUMRU 9636 Press ComunicadoCommuniquéInformationdepressedeprensa
at the factors that are driving the in age, education, working time and and only The
ICN CEO Howard Catton raised ICN’s concern that the ILO definitions of nursing do not reflect the realities of nursing practice and the differences between nursing “Inroles.this
Geneva, Switzerland; 14 July 2022 –– The International Council of Nurses (ICN) has highlighted two recently released reports on pay and gender, which show that nurses, who are predominantly female, are underpaid for their services, earning on average 24% less than men. ICN has been calling out the historical, chronic and healthworkdemandsbeingofundervaluingdeep-rootedandunderfundingfeminizedwork,withnursingaprimeexample.ICNequalpayforequalwithinnursingandthesector.
‘ICN calls for health systems around
In response to the findings of the two reports, Dr Pamela Cipriano, ICN President said: “Nursing, a 90% female profession, has been historically underpaid. Caring professions like nursing are often regarded as ‘women’s work’ and therefore are undervalued and underpaid or even unpaid. Fair pay is critical to recruiting and retaining the nursing profession, especially now that working conditions are increasingly difficult due to the COVID-19 pandemic.
The World Health Organization (WHO) and the International Labour Organization (ILO) yesterday released an analysis of the most comprehensive global evidence on gender pay inequalities in the health and care sector in the time of COVID19. The report, The gender pay gap in the health and care sector: a global analysis in the time of COVID19, which uses representative survey data from wage employees from countries in all geographic regions and income groups across the world, found that women in the health and care sector face a larger gender pay gap than in other economic factors, earning on average 24 percent less than their male peers. The findings highlight that women are underpaid for their labour market attributes when compared to men.
New reports reveal nurses are underpaid, undervalued and face larger gender pay gap than other sectors
includes the predominantly female profession of nursing.
‘ICN calls for health systems around the world to invest in nursing and evaluate the gendered pay models toward the nursing profession as a historically female profession. Women and other gender minorities need equal pay for equal work within nursing and the health sector.“
world remains, to a large extent, factors, the report says.
recent report, only Advanced Practice Nurses are classified as professional nurses; all other nurses are classified as technical workers. This is a classic example of the undervaluing of the overwhelmingly female nursing profession and has resulted in countries reporting data about the composition of their nursing workforce which our members believe misrepresent, often significantly, the actual number of nurses practising in different roles. ICN has raised this issue with the ILO as it has serious consequences for national policy making and workforce ‘Weplanning.strongly believe it is important to review the definitions and provide further guidance to countries to ensure that the nursing workforce recruitment,
Women in Global Health also launched a report on gender and pay on 7 July, Subsidizing Global Health: Women’s Unpaid Work in Health Systems, which revealed that more than six million women worldwide are subsidising health systems with their unpaid or underpaid labour. This
Globally, around 75% of women aged 18 years and over have experienced sexual harassment. Sexual harassment involves sexualised forms of unwanted or unwelcome behaviour, which violates the dignity of an individual and creates a humiliating environment. Although both women and men may be subject to sexual harassment, victims are predominantly women, and perpetrators are predominantly men.
ICN denounces undervaluing and underfunding of nursing and highlights limitations in ILO definitions of a nurse
Il-Musbieħ - SETTEMBRU 2022 37
recently reported on the alarming rise in the number of nurses taking strike action across the world in direct response to governments’ failure to tackle the root causes of our fragile, severely weakened, and in some cases collapsing healthcare systems. The ICN/ CGFNS’s International Centre for Nurse Migration report, Sustain and Retain in 2022 and Beyond, emphasized how nurses are exiting the profession in great numbers since the COVID-19 pandemic put increased stress on the nursing workforce. If only an additional 4% of global nursing workforce exits due to the pandemic, this could cause over one million nurses to leave the profession. This combined with a pre-pandemic shortage of six million nurses, and an ageing nursing population, means the global nursing shortage could be as high as 13 million. ICN has called workforce shortages “the current greatest threat to global Announcinghealth”.
Moreover, research shows that about a third of women who have faced sexual harassment in the EU experienced it at work. Sexual harassment in the workplace is a form of discrimination that hinders gender equality, creates a hostile work environment, and adversely impacts the well-being of workers.
reading the ICN reports: Ageing Well? Policies to Support Older Nurses at Work, The Global Nursing Shortage and Nurse Retention, Mass Trauma experienced by the Global Nursing Workforce as well as Sustain and Retain in 2022 and Beyond. ❙
The National Commission for the Promotion of Equality (NCPE) is empowered by Chapter 456 of the Laws of Malta to investigate complaints of alleged sexual harassment in the workplace and to provide the necessary assistance and information in the compilation of a complaint. Complaints can be lodged using the form available on the NCPE’s website.
retention and future planning is based on a more precise understanding of the size and composition of the nursing ICNworkforce.”has
the release of the report, WHO stated “Closing the gender pay gap and ensuring gender parity in the world of work is fundamental for economies and societies to thrive. Ensuring the full and equal inclusion of women and girls in all spheres of society and across the world should be a key pillar in all economic recovery plans following the economic and social disruptions caused by the COVID-19
In this context, the NCPE works to raise awareness on sexual harassment in the workplace. The NCPE is disseminating the attached poster to different stakeholders to reach out to more potential victims and/or perpetrators of sexual harassment. ❙
ICNpandemic.”recommends
- NUMRU 96 A4 ADVERT_V6.indd
It was a time of great stress. Negotiating with health leaders to protect the workforce and support the NHS, while simultaneously returning to clinical work in intensive care to help my old hospital. Incredibly, after years of tremendous pressures, teams across the NHS and social care stepped up to deliver in the most exceptional circumstances. It was truly amazing to behold.
The day-to-day reality of nursing on busy hospital wards and in communities hit me hard.
Working successfully for a union – perhaps more so than any other organisation – depends on the strength and energy of the people around. I’ve been fortunate to benefit from the wisdom and enthusiasm of Unison nurses like Gamu Nyasoro, Joy O’ Gorman, Annette Heslop, Natalie Elliot, Mick McKeown, May Parsons, April Montoya, Victor Tapah and so many
is power in a union. Together we can win many more victories. There’s always more to be done. I’m sad that, as I leave Unison, there’s still a fight for the pay we deserve and the safe staffing levels we need.
by Stuart Tuckwood
Nurses need strong unions and nursing leaders more than ever
I’m proud of the role we played through the pandemic, a time of national crisis. I was often told how we all needed to pull together for the national effort. But health and care workers needed answers and support. Students wanted to know if they would receive financial support if they had to extend their courses. Nurses wondered if they would get proper sick pay for self-isolating and who would protect their PINs when they made emergency decisions.
The role at Unison has allowed me to stand up and speak out for nurses on professional issues – to be their voice in the room when decisions are made on vaccines or preceptorships
When the opportunity arose to work for Unison nationally in 2019, I was torn. I loved my role as a rapid response nurse – thinking on my feet and working in an effective NHS team to manage deteriorating patients and respond to Butemergencies.IfeltI
Togethermore.
I became a nurse because I enjoyed caring for people. I loved the satisfaction of working with people every day and helping them; seeing them develop, enjoy new experiences and make the most of their lives.
My career began as austerity was imposed on the UK and cuts to the NHS and social care kicked in. While I loved the opportunities nursing gave me, it often felt like I was just surviving; barely getting through each shift and grabbing some rest in between. All around me, experienced nurses began steadily to retire or leave as pressures grew – while our pay and our time with patients didn’t.
“If we’re to protect the NHS and our nursing roles, we need strong voices and unions, and I wanted to be part of that” As a steward for Unison in my hospital, I supported colleagues when they needed the union. We protested against government spending cuts and attacks on our pensions.
or education. It’s required building solid relationships with key leaders in healthcare and nursing; and collaborative working to solve challenging issues.
Then there was Covid-19. I attended the Chief Nursing Officer for England’s Summit where worried officials briefed us on the tsunami of cases that could overwhelm the NHS. Simon Stevens announced that students would be ‘deployed’ to support nursing teams.
Theremore.
we’ve won stronger safeguards for overseas nurses, secured financial support for students during the Covid-19 pandemic, influenced the development of better preceptorships for new starters, helped to reform nursing and midwifery education, demanded support for NHS nurses to reduce carbon emissions, and so much
There was much to learn quickly and so much to do. The NHS was teetering through the winter of 2019-20 with the worst target results on record. Staff across health and care services were crying out for change and asking their unions for support.
Those same teams have since been betrayed by a government that’s broken its promise to give them what they need; restraining their pay and refusing to even negotiate in good faith with unions. When your shift isn’t staffed properly and you’re exhausted and underpaid, it can be difficult to see the value of your union. But I’ve seen first hand the real differences and improvements that we can make. I’m proud of the work I’ve done to get Unison nurses active in our campaigns and our efforts to tackle deep-rooted, systemic problems, like pay and staffing.
Many nurses might not consider working for a union but leading this work is a great opportunity to learn and develop professionally, and to support your colleagues. Nurses need strong unions and nursing leaders more than ever. And maybe they need you. ❙
couldn’t turn down the chance to support my nursing and NHS colleagues nationally. If we’re to protect the NHS and our nursing roles, we need strong voices and unions, and I wanted to be part of that.
Stuart Tuckwood is former national officer for nursing, Unison
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