Il-fehmiet li jidhru f’dan il-æurnal mhux neçessarjament jirriflettu l-fehma jew il-policy tal-MUMN.
L-MUMN ma tistax tinÿamm responsabbli gœal xi œsara jew konsegwenzi oœra li jiæu kkawÿati meta tintuÿa informazzjoni minn dan il-æurnal.
L-ebda parti mill-æurnal ma tista’ tiæi riprodotta mingœajr il-permess bil-miktub tal-MUMN.
Çirkulazzjoni: 5,000 kopja.
Il-Musbieœ jiæi ppubblikat 4 darbiet f’sena.
Dan il-æurnal jitqassam b’xejn lill-membri kollha u lill-entitajiet oœra, li l-bord editorjali flimkien mad-direzzjoni tal-MUMN jiddeçiedi fuqhom.
Il-bord editorjali jiggarantixxi d-dritt tar-riservatezza fuq l-indirizzi ta’ kull min jirçievi dan il-æurnal. Kull bdil fl-indirizzi gœandu jiæi kkomunikat mas-Segretarja mill-aktar fis possibbli.
Front (top photo): MUMN Officials welcome Ms. Suwaida Bugeja, the winner of Miss Malta Universe who is a Staff Nurse at SVP. (bottom photo): MUMN will be participating in this year’s MedTech Event being held in Malta in November.
Euthanasia
Our objectives as nurses have always been to relieve pain, keep our patients comfortable and not end a life. As nurses, we have always been firm advocates of giving enough narcotics as it is necessary to lessen a person’s pain. We have always taken viable decisions to give enough narcotics to create a sleep state (induced coma), but not enough to stop the breathing. We constantly supported our dying patients by administering heavy-duty morphine and not “hasten” the painful process of dying. We as nurses, especially those from the palliative speciality, daily assist dying patients that are relieved from excruciating pain and adapt. Even their loved ones are relieved.
We have been through some interesting dialogues regarding Malta’s proposal on assisted voluntary euthanasia, which for the past months caused quite a stir. A two-month, public discussion on such a sensitive subject to understand whether the population would opt to terminate our patient’s life “in dignity” was simply not enough. We’re still at crossroads even when we come to terminology such as ‘assisted dying’, ‘assisted suicide’ and other legal pitfalls. This has caused some form of confusion.
As a principle MUMN has always been pro-life in all forms of life, but regarding this legislation it is respecting the decision of the patient. MUMN has insisted about the right to refuse participation clause (freedom of consciousness).
As nurses come from diverse backgrounds and hold a variety of opinions and beliefs on euthanasia, MUMN is respecting all views on this matter. It is also insisting that the preparation and administration of such euthanising drugs remains a matter of personal choice for each nurse to decide. Legislation should therefore include a right to conscientious objection.
In principle no health professional should make moral or religious judgements on behalf of a patient. Such professionals have their own human rights. Legislative provisions on conscientious objection to Voluntary Assisted Dying by health professionals in Malta must be clear, carefully balanced, and supported by comprehensive subsidiary guidance. Any policy to be introduced must not undermine medical ethics or places undue pressure on health professionals who are dedicated to preserving life.
MUMN has also stressed that euthanasia should never be used at the expense of palliative care. An expanded community-based palliative
care is very much required at present. Relatives wishing to care for their loved ones at home should be fully supported with the provision of a 24-hour carer, a special bed and all the necessary medications without bureaucratic hurdles. Palliative care, already inundated, and with obvious deficiencies, must be expanded, without staggering variations, easily available in the community and with a 24/7 outpatient and respite service.
Palliative care remains the most humane and ethical approach to end-of-life treatment. The recent launch of Malta’s National Palliative Care Strategy 20252035 should therefore be respected and implemented to the full.
Let’s make sure that any policy to be introduced does not impact on our palliative care services. Let us also embrace a strategy which was developed for the National Mental Health Services, under the auspices of the Ministry for Health and Active Ageing, regarding the Joint Action ImpleMENTAL on the Implementation of Best Practices in the areas of Mental Health and Suicide Prevention.
Our take-out analysis on this matter is: ‘Is euthanasia an act of generosity towards our patients? However wellmeaning, who are we to assist to end a life? Should we continue to normalise dying during palliative care or alienate dying through euthanasia?
Dear Colleagues,
Allow me to update you with some of the recent developments that MUMN has in hand on your behalf:-
Meal and Shoe Allowances Update
Recently, MUMN has taken important steps regarding the shoe and meal allowances, both of which are entitlements for our members. These allowances were introduced to replace the old tender system, which previously provided meals and shoes directly to nurses and midwives.
Thanks to MUMN, the meal allowance is now available to all MUMN members (according to the policy), while the shoe allowance applies specifically to nurses and midwives.
Meal Allowance
• The meal allowance was introduced in 2019 after a series of industrial actions due to the poor quality of food served in hospitals — including an infamous incident where a mouse was found in a plate.
• Since 2018, the cost of living has increased significantly, but the meal allowance has not been updated to reflect these changes. MUMN is pushing for an increase.
• When the allowance was introduced, the Health Minister of the time dismantled the dining facilities at MDH, Mt. Carmel, and Gozo General Hospital. These spaces were converted into hospital beds due to underinvestment in the health sector.
• Nurses and midwives thus paid a high price: not only did the promised MDH gym never materialize, but long-standing dining areas, present since St. Luke’s days, were lost. This caused great frustration among staff.
• MUMN insists that the policy on meal allowances must be updated. Members working overtime should also receive the allowance, as they previously had access to meals in hospital dining areas
Shoe Allowance
• The shoe allowance arose because the CPSU repeatedly failed in its obligations:
• It did not issue the correct tenders for footwear.
• For the last three years, it even failed to issue any tender at all.
• This failure highlights CPSU’s incompetence and abdication of responsibility towards nurses and midwives.
Taxation and Receipts
• MUMN strongly insists that both allowances must be tax-free, as they are work-related entitlements.
• Nurses and midwives should not be required to submit shoe receipts It is obvious that professionals do not come to work in flip-flops — appropriate footwear is already purchased by staff.
MUMN has been assured by Ms. Mahoney that the necessary costings
Nurse’s Daily Prayer
Dear Lord,
for both allowances are being finalized. Once ready, MUMN will be consulted.
Encouragingly, it appears that the shoe and meal allowances will not result in an industrial dispute, and costings are expected to be released soon. These will then be shared with all MUMN members.
In Summary
• Meal allowance and shoe allowance must be increased and updated.
• Shoe allowance must be free from unnecessary bureaucracy.
• Both allowances must be tax-free
• MUMN will keep members updated once costings are available or if patience will run out.
Regards, Paul Pace President
As I begin this day, Grant me strength to care, Compassion to heal, And patience for every challenge I face.
Help my hands to be gentle, My words to be kind, And my heart to be open, Even when I feel tired or overwhelmed.
Let me see the person behind each diagnosis, The story behind every wound, And remind me that even small acts Can bring great comfort.
Protect my patients, Guide my decisions, And walk beside me
As I do this sacred work. Amen.
mis-Segretarju Æenerali
Kif inthom œbieb? L-istaæun tas-Sajf kwaÿi gœadda. Nisperaw li sibtu œin biex tgawdu wkoll dan l-istaæun.
Matul dawn l-aœœar tliet xhur konna attivi fuq bosta fronti. Daœlu lmenti mill-isptar Mater Dei dwar nuqqas ta’ reæistrar tat-TOIL fis-sistema tadDakar. Dak kollu li beda œiereæ kien qed jiæi mnaqqas imma d-dœul le, bilkonsegwenza li setgœu ntilfu xi siegœat. L-awtoritajiet responsabbli minn din is-sezzjoni, infurmawna li sal-aœœar ta’ Awissu kellu jibda l-proçess tar-reæistrar. Jidher li hekk seœœ gœalkemm gœadna qed nimmoniterjaw il-proçess gœax gœad baqa’ postijiet li gœadu ma seœœx kollu. Is-sistema ma tantx tagœmel sens. Persuna waœda responsabbli minn fattur wieœed u kif din l-iskrivana ma tirrapurtax gœax-xogœol, jaqa’ kollox u ma jsir xejn gœax œadd ma jaf jagœmel xogœlha!
Kwistjoni oœra li tolqot lil eluf ta’ membri kienet dwar l-uniformi. Il-materjal jidher li huwa sostanzjalment eœxen minn dik li gœandna llum. Ressaqna l-ilment lil min huwa kkonçernat però s’issa gœad m’hemmx soluzzjoni aççettabbli. Punt ieœor kien dwar iÿ-ÿraben peress li ilna tlett snin ma nirçievu par ÿarbun. Intlaœaq ftiehem li ser jingœata voucher però gœad irridu naraw jekk hux ser jingœata pagament ta’ tlett snin u kif dan l-istess pagament ser jingœata.
Æejna avviçinati mill-organizzaturi talMedTech Event biex inœajjru lil membri tagœna jipparteçipaw fl-event prestiæjuÿa tagœhom li ser issir f’Novembru fl-MCC. Din hija konferenza b’differenza. Tidher interressanti immens speçjalment gœal dawk li jinterreshom l-iÿvilupp diæitali u kif dan jgœin fil-qasam tas-saœœa. Din hija event li ta’ minn jattendi biex l-ewwel nett jara b’gœajnejh liema ÿvilupp hemm fil-pipeline gœall-qasam tas-Saœœa u l-Anzjanità Attiva u t-tieni naraw kif il-pazjenti, il-professjonisti u l-ambjent in æenerali ser jiæi mgœejjuna biex inkunu aœjar.
Dan ix-xahar æew imwaqqfa ÿewæ Group Committees æodda. Wieœed flisptar Mater Dei u l-ieœor fl-isptar Monte Karmeli. Dawn ser iservu biex jiÿdied ilkuntatt bejn il-union u l-membri. Aktar tard ser joœoræu d-dettalji kollha biex min ikollu bÿonn ikun jista’ jagœmel kuntatt magœhom. Qed jiæi annalizzat fejn hemm aktar il-œtieæa li jiæu mwaqqfa aktar Group Committees æodda.
Il-preparazzjonijiet sabiex jiæi inawgurat il-Muÿew fil-bini tal-MUMN, kompla gœaddej. Ir-rispons huwa nkorraææanti œafna. Jidher li l-œolma ta’ œafna ser issir realtà. Minn hawn nixtieq nieœu l-opportunità sabiex l-ewwel nett nirringrazzja lil benefatturi kollha u t-tieni, kull min irid ikun parti minn din l-istorja inkreddibli, gœandu jagœmel kuntatt magœna. Ÿgur li œadd mhux ser jissobih li gœamel donazzjoni, anzi se nkunu kollha kburin li rnexxielna mhux biss infakkru l-istorja gœal llum imma wkoll gœal æenerazzjonijiet li æejjien.
Nixtieq ukoll nieœu din l-opportunità sabiex nawgura kull suççess linNurses u l-Midwives il-æodda kif ukoll professjonisti æodda oœra bœal Phlebotomists, Social Workers etc. Nilqawhom b’idejna miftuœa fil-familja tagœna u nwegœduhom li nkunu ta’ sostenn gœalihom fejn ikun jinœtieæ.
Is-seminars tal-Well Being gœalqu sena. Kien ilu œafna jinœass il-bÿonn li n-Nurses u l-Midwives jitilqu minn fuq il-post tax-xogœol u jattendu gœal dawn il-laqgœat fejn ikunu jistgœu jitkellmu b’mod liberu x’qed iœossu, minn xiex gœaddew u kif esperjenzi ta’ fuq ilpost tax-xogœol qed jaffettwawhom. Il-lecturers involuti œejjew rapport kull wieœed u æie preÿentat lill-Ministeru
biex jiæu indirizzati l-problemi eÿistenti. Huwa œafna importanti li tattendu gœal dawn is-seminars bi œæarna u nipparteçipaw.
Il-preparamenti gœall-konferenza edukattiva tal-Midwives li qed norganizzaw b’kollaborazzjoni ma’ l-European Midwives Association waslu fil-final tagœhom. Kulœadd qed iœares ’il quddiem gœal din il-konferenza ta’ presitiæju. Ser tkun il-vetrina talMidwifery f’pajjiÿna kif ukoll dik Ewropea gœaliex il-parteçipazzjoni tal-Midwives mill-Ewropa hija xi œaæa straordinarja. Min gœadu ma bbukkjax ikun aœjar li jagœmel dan malajr gœaliex il-postijiet li baqa’ huma ftit. Nirringrazzja lillPresident tal-Parlament Ewropew Roberta Metsola u lill-Ministru tas-Saœœa u l-Anzjanità Attiva Jo Etienne Abela li aççettat li jindirizzaw lil dawk preÿenti.
Punt ieœor li l-MUMN qed tinsisti fuqu huwa r-reviÿjoni tal-Food Allowance. Gœaddew 8 snin mill-aœœar li æie rivedut u gœalhekk wasal iÿ-ÿmien li jiÿdied kif ukoll li jinbidlu çertu kriterji eÿistenti
ICN joins 48 million health professionals calling for inclusion of health care in global plastics treaty
Geneva, Switzerland, 07 August 2025 - As negotiations to finalize a major global treaty to end plastic pollution begin this week, the International Council of Nurses has joined with Health Care Without Harm and major health groups to demand strong commitments to limit plastic use and protect all people from plastic-related health harms, with special considerations rather than exemptions for the health sector, in an open letter.
Previous drafts of the Intergovernmental Negotiating Committee (INC) treaty exempt the health care industry from resolutions to reduce plastic waste and promote sustainability across product life cycles, including waste disposal. As the open letter states, this blanket exemption is counterproductive and would only limit innovation and sustainable practice in health care, which should instead lead the way in protecting human and planetary health. The World Health Organization (WHO) also supports removal of the full-scale exemption for health care and has instead called for health care to be afforded special consideration in the treaty, to enable the sector to develop and promote effective, affordable alternatives that prioritize
patient safety as well as sustainability.
ICN President Dr José Luis Cobos Serrano commented: “As outlined in ICN’s recent Position Statement and Topic Brief, climate change is the single greatest health threat facing humanity, with profound implications for human health and well-being.
‘Every day, nurses witness the harms caused by plastic overuse and pollution to both human and planetary health. Many of the chemicals in plastics contribute to issues including respiratory problems and chronic illnesses, with vulnerable populations especially at risk, and unsustainable plastic use and pollution is a major contributor to wider environmental degradation.
‘For these reasons, ICN is coming together with Health Care without Harm and other leading health groups to call for a strong treaty that fully recognizes the health harms of plastic pollution and commits to decisive measures to reduce unnecessary plastic use and move towards more sustainable solutions, including in the health sector, with special consideration for this sector’s needs. The health sector must lead by example, not exemption, by promoting a just and viable transition
to environmentally-friendly practices.
‘Nurses are the world’s largest health care profession, they deeply understand the connections between climate and health, they are highly trusted in their communities, and they are already accelerating climate-focused solutions in health care. It is time to elevate nurses’ voices in global environmental policy and support them as leaders in creating a sustainable health sector and a sustainable world.”
ICN CEO Howard Catton, reaffirmed that health care is a key part of the solution to plastic pollution and other environmental harms, adding:
“The health sector has both the responsibility and opportunity to take the lead on sustainability. Nurses are deeply committed to values of social and environmental justice and to addressing the climate crisis. That’s why ICN has joined with the other signatories of this letter to advocate for no blanket exemption of health care in the treaty on plastic pollution and instead call for the treaty to include special consideration of the health sector. Protecting human health must go hand in hand with protecting the health of our planet.”
Graffiti Storiçi f’Lazzarett
It-Tielet Parti
Kitba ta’ Joe Camilleri, C.N.
Fil-œaræa ta’ qabel komplejna nittrattaw il-Lazzarett ta’ Manoel Island u l-personalitajiet li ÿaruh. Tkellimna wkoll dwar l-gœassa stretta li kienet issir fih u l-madwar u l-œaddiema li servew fih. Bdejna wkoll nittrattaw is-suææett tal-graffiti nnifishom li hemm imœaÿÿes fil-bini tiegœu u llum nidœlu f’aktar dettall tagœhom.
Ismijiet imnaqqxa
Rigward l-ismijiet mibruxa nsibu ta’ bosta persuni kemm Maltin u anke barranin u dawn setgœu kienu morda, sempliçement viÿitaturi, skjavi, baœœara ta’ galeri jew vapuri, kaptani jew suldati li kienu b’servizz hemmhekk. Ismijiet notevoli li darba œaÿÿew graffiti nsibu ‘l dak ta’ Newman, dak li wara kien sar Kardinal fejn kien anke kiteb fir-rakkonti tiegœu meta wasal Malta lejliet il-Milied “a wretched day” u “Christmas Without Christ, Malta, December 25, 1832” waqt li l-poeta Lord Byron naqqax ismu wkoll, imma llum sfortunatament dan ma jinstabx iÿjed minœabba li laœaq ittiekel jew inqer.
Fost ftit mill-ismijiet li ma nafux minn huma nsibu “E.Tomey”, “F.Warner”, “F.Jaques”, “Doddy Jhony”, “P.Coppini”, “Gary Holmes” u “FR. Vincenti Corso” fejn dan tal-aœœar seta’ kien æej minn Corsica. Graffiti partikolari mpinæija æewwa piramida hija “H. Bergh New York” fejn dan kien gœamel tour flEwropa u barra li kien diplomatiku kien anke attivist ewlieni kontra l-krudeltá talannimali u t-tfal fl-Amerika.
Graffiti oœra turi “J. F. Donovan” li maÿ-ÿmien serva ta’ Visiting Officer talQuarantine Law tal-1893 u jidher li kien anke Health Officer u Supretendent notevoli li kiteb dwar il-ædim fil-Jamaica. Donovan kien kiteb fil-BMJ u l-Jamaica Gazette.
Hemm graffiti turi “E. S. Calman 1837” fejn dan Erasmus kien membru lajk ta’ The London Society for Promoting Christianity amongst the Jews fejn hu serva ta’ supretendent ta’ kulleææ, u anke almoner u steward æewwa sptar f’Æerusalemm.
Insibu wkoll graffiti bl-isem u l-annu ta’ “*manuele Nani 1790” gœal Emanuele
Nani li skont Schiavone kien millBelt Valletta fejn dan kien muÿiçista magœruf li ta’ 16-il sena qatta’ xagœrejn f’Livorno, fl-Italja u meta æie lura kien vjolinista æewwa l-Katidral tal-Imdina. Hu kien jiæi mfaœœar bœala n-‘Nani divino’ jew l-‘illustre Nani’. Bejn l-1821 u l-1822 sar id-direttur orkestrali tatTeatro Comunale Provvisorio u fl-1823 irritorna Malta fejn æie appuntat direttur tal-Orkestra fit-Teatro Brittannia æewwa l-Belt Valletta u kien ukoll laœaq direttur tal-Orkestra tat-Teatru Manoel.
Graffiti oœra turi sempliçement “Carmelo Gauci Guardian 1231, 1866” fejn dan kien ikun gœassa f’Lazzarett u n-numru 1231 kien ikun in-numru tas-servizz. Insibu “MIChELE CAMILLERI dETTO BLETTI 1892” u allura dan œaÿÿeÿ billaqam tiegœu b’kollox, jiæifieri dak ta ‘Bletti’.
Hemm graffiti turi “A.S.Dunlop, CAPTAIN R.A, DEC 1897” li skont The London Gazette ta’ Diçembru 1897, il-War Office f’Pall Mall kien laœœqu gœall-Brigade Major tar-Royal Artillery f’Novembru tal-1897, jiæifieri xahar wara li œaÿÿeÿ f’Manoel Island.
Insibu “Bridger 1903” fejn dan kien Wilfred Percival Bridger li twieled fl20 ta’ Jannar 1885, ingaææa fl-army u ingœaqad ma’ The Royal Sussex Regiment fejn is-2nd Battalion æie Malta u qatta’ 12-il xahar hawnhekk. Meta faqqgœet l-Ewwel Gwerra reæa’ ngaææa mar-Royal Sussex imma sabu li gœandu t-tuberkolosi. Huwa miet ta’ 33 sena.
Hemm ukoll “W.F.A.Colman” fejn dan kien William Frederick Adams Colman li twieled fl-1826 fi Plymouth. Hu ingœaqad mal-commissioned Ensign
Insibu “A. Girard” fejn dan kien ilBrigadier Generali Alfred Conrad Girard, mill-U.S.A. Dan kien qed jivvjaææa l-Ewropa, iÿur diversi sptarijiet u ippubblika rapporti dwar l-antiseptic surgery u wara Atlas dwar il-Clinical Microscopy. Kien ukoll Chief Surgeon u librar ta’ dipartiment mediku.
Insibu l-isem ta’ “Camilla Nahum” imdawwar f’ÿewæ friegœi tar-rand. Gœalkemm ma nafux min hi dilpersuna interessanti hu li dal-kunjom kien jeÿisti f’Malta gœall-œabta tal1850, partikolarment il-Belt Valletta fejn çertu Nissin Nahum kien sensar ta’ oriæini Lhudija. Insibu wkoll “G.Tayar” fejn dan il-kunjom hu predominanti Fl-Ewropa gewwa t-Turkija u gœandu wkoll konnessjonijiet Lhudin.
80th Regiment of Foot u serva flAwstralja, u anke sofra gœarqa b’vapur fil-Bay of Bengal u salva fuq gÿira mdawwar bil-kannibali! Huwa serva wkoll fil-gwerra ta’ Sutlej, fil-battalji ta’ Moodkee, Ferozeshuhur u Sobraon. Meta laœaq Maææur serva wkoll fl-Indja u Malta, sakemm irtira fl-1878 u miet ta’ 56 sena.
Hemm ukoll “A.W.Baldwin EX Smyrna” fejn dan kien Lieutenant u Assistant Chief Ordnance Officer tan-New Zealand Army Ordnance Department gœal-œabta tal-1923. EX Smyrna qed talludi gœaÿ-ÿmien ta bejn l-1919 u l-1922 lejn l-aœœar tal-Imperu Ottoman u fl-aœœar tal-Gwerra Griega-Torka wara l-Gwerra l-Kbira. Il-belt ta’ Smyrna kienet œuææiega waœda wara li arsonisti
kienu œarqu kull ma sabu. Numru ta’ refuæjatu u suææetti Brittanici kienu æew deportati Malta permezz tal-HMHS Maine u oœrajn. U la qed insemmu l-Smyrna, fl-ewwel sular tal-barracks æewwa l-Forti insibu mnaqqax:
Carmine Buttigieg
Maria Buttigieg
Paul Buttigieg
Famiglia
Refugiata
Di Smirne
17 Settembre 1929
Insibu wkoll “Lino de Clemente tragato de la Ano de 1788 ” imnaqqax sabiœ mal-bitœa imponenti f’Lazzarett. Lino de Clemente kien figura ewlenija fost dawk li æabu l-indipendeza ta’ Venezwela minn Spanja. Huwa kien ingœaqad man-Navy Spanjola fejn fl-1786 ingœaqad malvapur Conde de Regla fejn din gœamlet traæitti fil-Mediterran u baqa’ fuqu sal1788. Wieœed irid jimmaæina dan ilConde de Regla soræut f’Marsamxett, xini imponenti tal-qlugœ b’112-il kanun, tlett decks fejn dan kien anke serva filgwerer Napoleoniçi.
Insibu l-isem imnaqqax “EDMUND CALVERT 1852” fejn dan kien æej minn
familja li kellhom interessi fl-antikwitá u kien jiæi wkoll minn familja Ingliÿa tal-Levant li gœexu f’Malta meta kienet baÿi navali. Huwa twieled f’Malta fl1825 imma hawnhekk ma kienux sejrin tajjeb u fl-1829 imxew gœad-Dardanelli. Edmond Calvert kien aæent Brittaniku gœaliex l-Ingilterra kienet isserraœ œafna fuq familji mil-Levant gœall-intelligence u tkixxif. Huwa serva wkoll ta’ konslu gœall-Kostantinopli u Rodi. Insibu wkoll li dan Calvert fl-1883 ta b’donazzjoni lill-British Museum ta’ Londra xi scarabs
(antikwitá Eæizzjana) misjuba f’Malta stess (sic).
Gœalkemm mhux graffiti, hemm isem miktub fuq bieb antik tal-injam æewwa l-parti tal-Palazz l-antik fejn naqraw “Lt. Andrews”. Dan kien l-Ispiÿjar John Andrews li æie Malta fit-12 ta’ Jannar 1857 minn Gibiltá u spiçça fl-1866.
Kuntratti
Kif semmejna qabel, hemm graffiti li huma forma ta’ atti notarili bœal kif hemm miktub: “Maître Marchand de Marseille à la [deman]de de Mme la Comtesse de Sale 31 août 1733”, imnaqqax sabiœ donnu bi stensil fejn iæib kuntratt tal-familja De Sales, familja nobbli minn Savoia li kienu jiæu minn San Franæisk de Sales, Isqof ta’ Æinevra.
Lingwi
Jidher li barra l-lingwa Maltija f’Lazzarett tœazzu kliem u simboli ta’ œafna nazzjonijiet fosthom bl-Gœarbi, biçÇiniÿ, bil-Æappuniÿ, bil-Pakistan, blIngliÿ, bit-Taljan, bl-iSpanjoli, bil-Françiÿ, biç-Çipriott u saœansitra bil-Latin.
ikompli f’paæna 11
AI in Nursing
A Local Solution to a Global Shortage?
Nurses are the backbone of healthcare. Yet across the world - and here in Malta - the profession is under pressure. Chronic staff shortages, administrative overload, and an aging population are putting immense strain on already-stretched healthcare systems. Could artificial intelligence (AI) be part of the answer?
As global systems race to integrate smarter technologies into clinical practice, Malta is also facing a critical question: How can we harness AI to ease the burden on nurses while ensuring the human element of care remains intact?
Easing the Strain: AI’s Promise for Malta’s Healthcare System
Malta, like much of Europe, is grappling with a dual challenge: an aging population and a shortage of healthcare workers, particularly nurses. According to local reports, recruitment and retention remain key issues, driven by both workload and burnout. AI, if applied thoughtfully, could help bridge the gap.
AI tools that automate repetitive and timeconsuming administrative tasks, such as CareYaya’s documentation and scheduling assistance platform, are already making waves abroad. Similar innovations could be trialed or adapted in Malta’s hospitals and clinics to free up nurses from paperwork, allowing them to focus on patient care.
NHS England’s AI Lab, for instance, is testing tools that generate clinical notes in real time, transcribe patient conversations, and flag deteriorating patients—all with the goal of reducing clinician fatigue. These are the types of tools that could reduce stress levels and improve care quality if implemented locally.
Learning
from Japan:
Robots and Elderly Care
Japan, where nearly 30% of the population is over 65, has long been considered a bellwether for aging societies. There, humanoid robots like “Pepper,” and other AIpowered assistants are being deployed in elder care homes to support nurses, provide companionship to seniors, and even help with mobility and monitoring.
cially for non-clinical tasks like lifting, transport, and patient reminders—areas that often cause physical strain for human caregivers.
The question isn’t whether robots will replace humans, but how they can support them. As highlighted in a survey by McKinsey (2024), nurses overwhelmingly want AI tools that enhance— rather than replace—their ability to care. This is where Japan’s model offers useful parallels: robots acting as support systems, not stand-ins.
Innovation vs. Job Security: Finding the Balance
Embracing AI in nursing isn’t just a matter of logistics; it’s a matter of ethics and policy. The WHO’s 2021 guidance on AI in health emphasizes that any implementation must be people-centered, inclusive, and rights-based. The European Union’s AI Act echoes this, mandating transparency, risk classification, and accountability in health-related AI systems.
For Malta, this means building trust among healthcare workers. Nurses must be involved in discussions around deployment. There must be clear communication that AI tools are there to support, not substitute, their roles. In a system already short on staff, introducing tools that improve working conditions could be a winwin if paired with education and upskilling initiatives.
Looking Ahead: What AI in Nursing Could Mean for Malta
could help nurses do what they came into the profession to do: care.
But the path forward requires thoughtful integration. As we weigh the benefits of automation against the irreplaceable value of human touch, one thing is clear: the conversation must continue.
AI offers Malta a rare opportunity: to not only relieve the burden on its healthcare workforce but also to modernize the way care is delivered. Whether it’s by reducing time spent on documentation, supporting the elderly with robotics, or using predictive analytics to triage patients faster, AI
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While Malta’s demographics are less extreme, the island is not immune to similar pressures. Introducing robotics in long-term care settings could supplement the existing workforce, espe-
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Talb, Slaleb u Qaddisin
Slaleb hemm bil-bosta u dawn jistgœu æew imnaqqxa gœal xi œadd li miet, bid-data u l-isem, jew jista’ jkun marbut ma xi œalf. Partikolarment hemm Salib Marjan fejn is-salib jingœaqad mal-ittra M li jfisser il-konnessjoni intima ta’ Marija f’riælejn is-Salib. Simboli Marjani kienu popolari speçjalment bl-ittri “A.M” f’xulxin, li jirriflettu d-devozzjoni dejjiema lejn Marija Santissima. Jinstab ukoll basso riljew ta’ qaddis bil-Bambin Æesú f’idejh ta’ dak li jidher li hu San Æuÿepp. Dan il-qaddis minn dejjem
Bnadar u pajjiÿi
kien meqjum œafna fil-Knisja u barra li hu interçessur, huwa qaddis patrun ta’ œafna popli u pajjiÿi.
Tifimha wkoll li l-vjaææaturi kienu jœaÿÿu t-talb mal-œajt, gœax dawn barra li setgœu kienu jew Kattoliçi ferventi jew Kristjani, riedu jirringrazzjaw lil Alla, lill-Madonna u ‘l Qaddisin minœabba li waslu qawwijin u sœaœ minn xi vjaææ iebes, minn pajjiÿ impestat u forsi œelsuha minn xi mxija, u possibilment mill-mewt innifisha. Uhud mit-talb huwa bil-Latin gœalhekk insibu “S. Maria Ora Pro Nobis AB” li tfisser S.Marija Itlob Gœalina.
Bla dubju sibt is-Salib tal-Kavallieri minqux kemm-il darba. Dan is-salib huwa propjament ta’ The Most Venerable Order of the Hospital of Saint John of Jerusalem, magœruf aktar bœala l-Ordni ta’ San Gwann.
Graffiti bil-kaligrafija Gœarbija titkellem dwar ‘Arkan’ jew il-Pilastri li fl-Islam ifissru x-Shahada, is-Salah, is-Sawm, iz-Zakat and l-Hajj (Alla wieœed biss, it-Talb, is-Sawm (fir-Ramadan), l-gœoti ta’ Karitá, u il-Pellegrinaææ lejn Mekka). Tajjeb nimmaæinaw numru mhux zgœir ta’ Musulmani f’Lazzarett isallu 5 darbiet mal-æurnata, iœarsu lejn Mekka, jiæifieri n-naœa tal-Belt. Il-Musulmani mejta bil-mard kienu jindifnu gœalihom f’wieœed mill-œames çimiterji f’Manoel Island stess.
Insibu wkoll 3 œutiet mgœaqqdin flimkien, simbolu uÿat b’mod sigriet li jissimbolizza t-Trinitá Mqaddsa.
Il-Union Jack tœaÿÿet f’œafna postijiet li ovvjament tirrifletti l-kolonja, innumru kbir ta’ personel fis-Servizz, vjaææaturi mill-Ingilterra, u dawk li kellhom xi simpatija lejhom, inkluÿ Maltin.
Insibu “L.REGIS” fejn Edward, ir-re, ta permess biex il-belt ta’ Lyme taddotta
l-kelma bil-Latin ‘Regis’ li tfisser ‘tarRe’. B’hekk din il-belt wegœdet li li tibni l-vapuri tal-gwerra u tiæbor it-taxxi.
Insibu “Vive La France” u wieœed jistaqsi min seta’ kien dak li kellu gœal qalbu ‘l Françiÿi ta’ Bonaparti wara li l-Ordni kien tilef ‘il Malta fl-1998. Il-Françiÿi f’Lazzarett kienu daœœlu regolamenti æodda, tneœœew oœrajn qodma, imma s-servizz tal-kwarantina
tahthom qatt ma kien laxk.
Insibu l-inizjali “JC ” flimkien mal‘minæel u l-martell’, simbolu bikri tal-komuniÿmu li kien jirrapreÿenta is-solidarjetá proletarjana bejn ilœaddiem tal-agrikoltura u dawk industrijali waqt ir-Rivoluzzjoni Russa (wara l-Gwerra l-Kbira).
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Graffiti Storiçi
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Insignias Reæimentali, Irjali u Simboli
Fost dawn it-tip ta’ graffiti nsibu l-Insignia Rjali “E. R.” gœal Elizabeth Regina; “R” gœal Rex li bil-Latin tfisser Re; l-iswastika tan-Nazi Æermaniÿa; ilWhite Ensign tar-Royal Navy; L-ankra tar-Royal Navy ; u l-arma tal-Bugle talKOYLI jew il-King’s Own Yorkshire Light
Infantry fejn il-105th kien sar it-Tieni Battaljun tagœhom u serva fl-Irlanda, l-Indja u f’Malta lejn l-aœœar tas-seklu dsatax u l-bidu tas-seklu gœoxrin.
Insibu l-ittri “K.O.M.R” li kienu l-Kings’ Own Malta Regiment li twaqqaf fl-1801 sal-1972 u l-kanun fuq karru, insinja ta’ The Royal Regiment of Artillery talBritish Army li æie stabbilit fl-1716. Insibu wkoll “A.W.OLDS R.A.O.C.
1919” li tfisser li dan kien fir-Royal Army Ordnance Corps jiæifieri dak il-Corps li kien ikun responsabbli gœall-armamanti u l-munizzjon.
Insibu wkoll il-Broad Arrow jew ilCrow’s Foot, dik li bil-Malti nsibuha Sieq it-Tiæieæa jew Sieq ir-Reæina, li kien jimmarka propjetá tal-militar.
Marka interessanti hija persuna b’bandiera f’idejh qed imexxi ÿiemel mir-riedni. M’aœniex çerti jekk dan jirrapreÿentax xi wieœed mit-13-il Cavalry Mounted Regiments tal-British Army li kienu anke f’Malta.
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Refererenzi
Gidney, Rev. W. T., M.A., (1908) The History of the London Society for promoting Christianity amongst the Jews, London Schiavone, Michael (15 March 2024), Biographies, Community, Emanuele Nani, Times of Malta https://deathandservice.co.uk/tag/malta/ https://www.hotelalexandra.co.uk/ https://jcollinsmedals.co.uk/single-campaign-medals-pre1902/ https://vassallohistory.wordpress.com/naval-hospitals-inmalta/ https://www.maltatoday.com.mt/news/
national/111495/1921_how_we_were_100_years_ago https://vassallohistory.wordpress.com/military-hospitals-inmalta/ https://www.um.edu.mt/library/oar/ bitstream/123456789/37927/1/1.pdf https://www.um.edu.mt/library/oar/ bitstream/123456789/81974/1/JMPS13%282%29A1.pdf https://mt.usembassy.gov/policy-history/ https://rnzaoc.com/2017/08/29/nzaoc-july-1922-to-june1923/ Dawn ta’ fuq kienu kollha aççessati fis-7, 15 u 28 ta’ Jannar, 2025
Claudia Calleja - August 2, 2025 - Times of Malta
Half of pregnant women at mental health clinic report partner abuse
Of the 85 women who took part in the survey, 40 women said they had experienced psychological, verbal, physical or sexual abuse by their partner
Nearly half of pregnant women treated at Mater Dei Hospital’s perinatal mental health clinic experienced intimate partner violence during pregnancy, a study has found.
Of the 85 women who took part in the survey, 40 women - or 47 per cent - said they had experienced psychological, verbal, physical or sexual abuse by their partner. Most reported more than one form of abuse.
The abuse ranged from financial threats and insults about their pregnancy to being dragged, hit and kicked in the stomach.
Verbal and psychological abuse were the most common. A third of respondents said their partner made them feel bad about themselves during pregnancy, while 24 per cent were humiliated in front of others. A quarter said their partner deliberately tried to scare or intimade them.
Many described controlling behaviour: nearly a quarter said their partner became angry when they spoke to other man, while a fifth said they were monitored closely and restricted from access to finance. Others were restricted from seeing friends or family or required permission to seek healthcare. Nine women reported that their partner had threatened to hurt either them or someone they care about.
The most reported physical abuse included being pushed, shoved or having their hair pulled (12 per cent of respondents).
Five mothers reported that they were kicked, dragged or beaten; four mothers said they were punched during pregnancy - in two cases in the abdomen. Two women reported being chocked or burnt. One woman said she had been threatened with a weapon. Eleven women said they had been slapped or had objects thrown at them.
Nine women (11 per cent) said they were forced into sex or agreed to sexual activity out of fear of their partner’s reaction.
The study, Intimate Partner Violence and Perinatal Mental Health Disorders, was published in the Malta Medical Journal. Researchers Edith Agius, Andee Agius, Claire Zerafa, Ethel Felice and Neville Calleja conducted the study among patients attending the clinic between February and May 2021.
The clinic provides specialist care for women dealing with mental health issues during pregnancy or in the first year after birth. Women who were younger, unmarried, economically dependent on their partners or with lower levels of education were at greater risk of abuse.
“This study confirms that mothers suffering from an antenatal or postpartum depression and/or anxiety disorder are at a higher risk of experiencing intimate partner abuse during pregnancy. More needs to be done to identify pregnant mothers at risk of abuse at an early stage and offer the necessary interventions,” the study authors noted.
They pointed out that the data was gathered during COVID-19, when abuse levels were generally higher.
All participants were aged over 18, with the most aged between 31 and 35.
Four expectant mothers said they had been punched during pregnancy - two in the abdomen
Ethics & Health Care
by Marisa Galea Vella
Pyjama Paralysis
Pyjama paralysis is when patients spend much of their stay in their hospital gowns or pyjamas and in bed, which can have a significant impact on their physical and mental health. Immobility during hospitalisation is endemic. It can result in significant risk of physiological deconditioning. This triggers functional decline and even hospital-acquired disability.
Nurses, together with the multidisciplinary team have a responsibility to preserve patient function and promote patient dignity and autonomy. This can be achieved by encouraging and motivating patients to get out of bed, dress in personal day wear clothing and move around as much as possible. Initiatives that are function-focused can mitigate functional decline and deconditioning.
Functional decline and deconditioning can lead to other issues such as increased risk of falls and development of pressure sores. Other effects include weakness, muscle loss, incontinence, constipation and malnutrition as well as increased risk of developing an infection or thrombosis. There is also a negative impact on mental wellbeing resulting from greater dependence and loss of confidence.
The End PJ Paralysis movement is a patient-centred approach that aims to increase patient dignity, improve patient centred care and prevent functional decline due to low patient activity levels in hospital. The initiative aims to get patients up and out of bed and into their own clothes, reducing hospital stays and improving outcomes. The UK embarked on a national campaign
that encourages patients to get up, get dressed, and get moving during their hospital admission to avoid unwanted effects of laying bed for a long time. Canada has also committed to similar initiatives. End PJ Paralysis is now an international concept aimed at getting patients to get out of their pyjamas and dress in their own clothes during their hospital stay. This encourages patients to get up and move about.
There is no doubt that deconditioning causes harm. It is crucial that patients are supported in maintaining their independence, mental wellbeing and dignity. The evidence demonstrates that where End PJ Paralysis is implemented a positive impact has been seen in patient outcomes, notably patient mobility, length of hospital stay as well as confidence to follow up with their care plan on discharge.
Despite the knowledge and awareness amongst healthcare professionals on the importance of activity and promoting function, patients spend an excessive amount of time in bed or armchair in their pyjamas or hospital gown during their hospital stay. The literature suggests that this is the result of mounting pressures in clinical areas and a shortage of nurses. The limited availability of allied health professionals, particularly occupational therapists and
physiotherapists and their assistants is also noted as a contributing factor.
The following suggestions are recommended by the End PJ Paralysis movement for implementation on hospital wards. Patient should be encouraged to change from their pyjamas to comfortable loose fitting clothing; patients should be advised on how they can increase their movement by changing positions in bed frequently and alternate with sitting on the armchair, at the dining room table or TV room and taking short walks around the ward; patients should be instructed on simple exercises that can be done according to their ability and condition; patients should be supported to get out of bed when they have something to eat; patients should receive guidance regarding appropriate foot wear for safety and stability; the multi-disciplinary team should ensure that the required support is provided when needed to promote these functions. Relatives and loved ones should be involved too in this too.
Promoting the End PJ Paralysis campaign is paramount from a clinical perspective, but also from an ethical and professional perspective. It promotes active care and improves the overall quality of patient care.
by Louise Bugeja Vella, Midwife, Advanced EFT Practitioner
The Healing Pause Introducing EFT to Healthcare Professionals
On the 27th June 2025, about 130 healthcare professionals - primarily nurses, midwives, and allied health workers - gathered for a halfday seminar titled “The Healing Pause,” organised by the Institute for Healthcare Professionals within MUMN.
The aim was to explore how Emotional Freedom Techniques (EFT), also known as “tapping,” can be used to regulate stress, restore calm, and gently process the invisible emotional burden carried by many in the caring profession.
As an advanced EFT practitioner, I was asked to lead this seminar, bringing together evidence-based science and embodied practice in a setting that was both professional and deeply human. Most participants had never heard of EFT before, and their interest, openness, and feedback affirmed what I have seen many times in practice: those who care for others are often seeking safe, effective, and grounded ways to care for themselves.
What is EFT?
EFT, or Emotional Freedom Techniques, is a mind-body approach that combines gentle tapping on specific acupressure points (mostly on the face, head, and
upper body) with verbalised statements focused on emotions or beliefs. EFT is used to reduce the intensity of emotional stress, shift limiting thoughts, and help regulate the nervous system. The process is simple, but surprisingly effective, and can be used either for personal self-care or with the support of a trained practitioner.
EFT research has grown steadily over the past two decades. A meta-analysis by Clond (2016) found EFT to significantly reduce anxiety symptoms¥. Randomised controlled trials by Church et al. (2012) reported measurable decreases in cortisol (the body’s primary stress hormone) and improvements in PTSD and depression¥. Feinstein’s (2012) review highlighted EFT as an evidence-based technique with wide applications for emotional health¥. Importantly, a study by Church and Brooks (2010) found that EFT improved emotional wellbeing specifically in healthcare workers. Additional research by Stapleton et al. (2016) demonstrated its usefulness for managing pain and reducing food cravings.
EFT is now gaining international recognition. It has been included in PTSD clinical guidelines in Australia, accepted into the South Korean medical system, and recommended
by UNESCO for use with children and families during crises. In the UK, the NHS is offering EFT training for staff, and in 2024, Kaiser Permanente began providing EFT resources to patients, signifying increasing trust in its clinical and practical value.
The Seminar Experience
The Healing Pause was structured in four parts:
1. Why it Matters – Understanding stress and the need to pause
2. Focusing on Self-Care – Exploring how healthcare workers can protect their own wellbeing
3. Understanding EFT – Learning about the basic technique and how it works.
4. Using EFT to Calm and Heal –Guided group practice
Participants explored the impact of stress on the autonomic nervous system, the effects of prolonged cortisol elevation, and the subtler cost of compassion fatigue. Then we turned theory into experience. Despite the size of the group, nearly everyone took part in the guided tapping sessions to ease symptoms like “constricted breathing” and general stress.
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Many expressed that they felt calmer, lighter, or more grounded afterwards. Several participants stated that more healthcare workers need to learn about EFT, and that these sessions should be repeated periodically - some preferring smaller group workshops, others expressing interest in one-toone support, and some even wanting to share the technique with patients and family.
Participant Feedback
Some comments from the feedback form:
• “No medications are involved and it can be done anywhere.”
• “It was an escape from daily stress, an opportunity to give myself a mental break.”
• “It helps to destress and for mental wellbeing.”
• “Reminded me of the importance of pausing.”
• “I believe in the power of my mind and body.”
• “Easy to understand.”
• “The session was interactive. Wouldn’t change anything.”
• “To do it more often.”
• “More time for practice and handson.”
• “I would opt for a one-to-one learning experience.”
• “It was a reminder that care workers like us are required to implement self-care to decrease burnout and ultimately deliver better care to patients.”
• “Wished all my team was here.”
• “Intentionally de-escalating stress. I loved it.”
• “Immediate positive effect from tapping.”
This kind of response is not unusual. EFT can help diffuse emotional reactivity in the moment, and contribute to lasting change. While it is a powerful tool for self-care, complex or long-standing issues are best addressed with the support of a trained practitioner.
What can EFT help with?
EFT has been used with all ages and strata to support:
• Stress and anxiety
• Burnout and overwhelm
• Sleep problems
• Grief and trauma
• Self-doubt and performance stress
• Procrastination
• Food cravings
• Fears, phobia, and OCD
• Chronic pain and somatic symptoms
• Supporting behaviour change and personal growth
EFT is flexible enough to use before a challenging shift, after a tough conversation, or as part of a long-term healing journey.
Practitioner Support and continued work
As a healthcare professional myself, I can fully understand and empathise with the challenging situations experienced. While many people can learn to use EFT as a self-care tool, yet
some emotions and experiences may require sensitive guidance.
As an Advanced EFT Practitioner, I offer small group workshops for shared exploration, and one-to-one sessions for those wanting to address deeper patterns. My approach is traumainformed, nervous-system aware, and combines science with presence and compassion.
Final Reflections
At the heart of this work lies a simple truth: the more resourceful we are internally, the more resilient we can be in the face of external pressure. EFT offers a pathway to return to that internal calm, not by numbing nor avoiding, but by processing and integrating.
The Healing Pause was a beginning, a space for pause, reflection, and empowerment. For those on the frontlines of care, it is vital to have accessible, effective tools to sustain not just professional functioning, but personal wellbeing.
We often say that you cannot pour from an empty cup. EFT helps to fill that cup, not with quick fixes, but with real embodied calm.
For more information, upcoming sessions, or to enquire about individual work, feel free to get in touch at:
Alone in the waiting room: When family fades from view
It happens more often than we’d like to admit. An elderly resident in our care needs to be taken to hospital. We make the call to the next of kin. Sometimes we get no answer. Other times, the answer is clear: “I can’t make it today.”
And so we go. One of our carers sets aside their day to accompany that person. Not because it’s in their contract. But because no one else is coming.
This is not a one-off situation. It’s becoming a pattern. And while we’re used to offering physical care, we are less equipped to fill the growing emotional gaps left behind when family members gradually, and often unintentionally, disappear from the picture.
We don’t speak about this enough - this quiet form of neglect. Its’ not malicious. There are no bruises. There’s just absence. And silence.
The truth is that elder neglect doesn’t always look like abuse. Sometimes, it looks like no one showing up. It looks like residents facing hospital corridors alone. It looks like decisions being made without the voices of those who know and love them best. It looks like care workers becoming companions by default, not by design.
This isn’t about blame. Families today face enormous pressures - from jobs, travel, young children, strained dynamics, or unresolved history. We know it’s not always easy to be present. But that doesn’t make presence any less vital.
In our homes, we see the difference it makes. Residents who receive regular visits tend to eat better, communicate more, and remain more connected to who they are. Those who don’tgradually fold into themselves. It’s no just sad. It’s a quiet erosion of dignity.
We believe it’s time to talk about this - honestly, openly, and with care.
Because this issue doesn’t only weigh on the emotional wellbeing of our residents. It also strains the systemsocially, financially, and ethically. Carers cannot be in two places at once. And yet we are increasingly asked to send them away from care homes to act as family stand-ins.
Which brings us to the proposal we are considering. If a family member formally opts out of accompanying a resident during external appointments - which remains a legal responsibility - a carer will step in but this cannot continue.
At present, when a family member is unable to accompany a resident to a medical appointment, a carer is often assigned to step in. However, we believe this practice needs to change. Moving forward, we are proposing a system in which family members take primary responsibility for attending such appointments, with carers stepping in only in exceptional circumstances - specifically when a resident has no relatives or close friends available to accompany them. It is after all the legal responsibility of the next of kin to continue to be present in the lives of the elderly person.
We hope that by talking about
this openly, we can prompt reflection - and change. Families matter. Even a short visit, a phone call, a hand on the shoulder during a hospital checkup - these moments ripple out far beyond what we see. This World Elder Abuse Awareness Day, let’s widen our understanding of neglect. Let’s talk about absence. Let’s talk about what it means to be truly present. Because care begins with connection. And no one should face their most vulnerable moments alone.
Julia Aquilina is Policy Executive, The Malta Chamber of Commerce, Enterprise and Industry.
Safe Staffing Levels Nursing Action - a WHO-led project funded by the European Commission
ICN charts a bold vision and calls for urgent investment in nursing to secure the future of care
Helsinki, Finland – Against a backdrop of escalating global health challenges, the ruling council of the International Council of Nurses (ICN) has issued a powerful call for urgent action to address the nursing workforce crisis. Backed by compelling evidence from several new reports, the Helsinki Communique outlines core challenges along with strategic solutions and reiterates that support for nursing is not a cost: it is a wise investment in the future of health care.
ICN’s governing body, the Council of National Nursing Association Representatives (CNR) held its biennial meeting in Helsinki, Finland, 6–8 June, just ahead of the ICN Congress. This historic gathering marks a significant milestone as ICN has now grown to encompass 140 different National Nursing Associations (NNAs), strengthening the collective voice of the world’s nurses.
The CNR, composed of member association leaders, came together to tackle core issues affecting the workforce, including grave shortages, inadequate working conditions and compensation, rising attacks on health workers and facilities in conflict areas and other risks to nurses’ safety and wellbeing, and inequitable workforce distribution which is exacerbated by unethical recruitment of nurses from the world’s most fragile regions.
In the Helsinki Communique that resulted from the meeting, the Council affirmed the central role of nurses, the world’s largest health care profession, in leading health care transformations, tackling complex challenges from climate change to conflicts, and achieving global health goals, including Universal Health Coverage (UHC).
The Communique presents compelling evidence from multiple sources, including the 2025 State of the World’s Nursing (SOWN) report and ICN’s survey of NNA Presidents, highlighting the critical need to invest in nursing to
improve health outcomes, strengthen economies, and build more resilient societies. The Helsinki Communique sets out the steps needed to “reimagine how health care systems value, nurture and retain their nurses and ensure that nurses’ physical and mental health is protected”, including:
• Fair wages and decent working conditions
• A strengthened WHO Global Code of Practice for International Recruitment
• Support for pathways towards leadership and advanced practice
• Improved nursing education and professional development
• Strengthened regulation reflecting ICN Definition of Nursing
The CNR representatives also approved a resolution strongly condemning all attacks on health care personnel, patients and facilities and calling for full compliance with international humanitarian law that protects health workers in conflict.
ICN President Dr Pamela Cipriano, who chaired the meeting, remarked:
“Our discussions at this CNR have once more shown the strength and unity of the world’s nurses, who are committed to building a sustainable future for nursing and for health care. However, our association leaders are telling us that despite the extraordinary achievements of nurses in their regions and throughout the world, the nursing workforce continues to be overworked, undervalued, and underprotected. We are seeing continued failures to care for nurses and to harness their power and influence as leaders and advanced practitioners.
‘We cannot deliver high-quality care for all without sufficient nurses — which is why we are calling on governments and health system leaders to make the smart, strategic choice and invest in a strong, sustainable nursing workforce.
‘We know that nurses are uniquely positioned to address the health challenges of the future, whether by delivering primary and preventive care
in communities or by responding to climate emergencies, pandemics, and disasters. That is why it is so important to enable nurses as the health care leaders the world so desperately needs for thriving and healthy communities, populations, and economies. We urge all governments and decisionmakers commit to the policy actions outlined in the Communique and ICN’s Charter for Change.”
In parallel to the CNR meeting, ICN hosted its Student Assembly which brought together over 250 student and early career nurses from around 70 countries under the banner “The Power of Student Nurses to Change the Landscape of Nursing”.
The Assembly highlighted issues affecting new and student nurses, including mental health, financial stressors, and transition to practice, and discussed critical global health topics from nurse migration and nursing in conflict zones to women’s and LGBTQIA+ health equity. The event focused on empowering new nurses as future leaders ready to meet the most pressing health issues of tomorrow by transforming the delivery of care, leading health systems and organizations, and shaping policy.
ICN’s CEO Howard Catton addressed the Assembly, emphasizing the importance of ICN’s new Student and Early Career Nurses (SECN) Alliance. He said: “The Alliance is a platform that brings the insights and influence of students and early career nurses to global health policy at all levels. It makes the voices and views of the next generation of nurses heard loud and clear and empowers them to cocreate the future of health care.
‘For ICN and its member associations to continue to flourish, we must nurture the next generation of nurse leaders. As ICN celebrates reaching 140 NNA members worldwide, we support today’s students and early career nurses as the bold changemakers who will lead these associations and represent their regions in the decades to come.”
MUMN looks forward to every opportunity to market the nursing profession especially amongst youths – William & Geoffrey during a Career Fair.
MUMN Officials discussing Nursing Policies during the Country RepresentativesNationalMeeting in Helsinki prior to the ICN Conference.
MUMN will be for the first time be participating in the MedTech Event being held in Malta –Paul, Marisa & Neville are being podcasted in an interview prior the event at the Sigma studios.
Deputy General Secretary William Grech was invited to participate in a post course seminar regarding our attitude towards foreign employees being organised by the NCPE Malta
The Institute of Health Care Professionals continues to organise the monthly seminars at MUMN Offices.
Voluntary Assisted Death…
What does this mean for the nursing profession in Malta?
Part
1 - by Dr
Adrienne Grech, PhD
This writing represents my personal, professional perspective as a nurse with expertise in ethics. While I draw upon established research and international evidence to inform my position and discussion, the views expressed here are my own and do not necessarily represent the official stance of any institution with which I am affiliated. This writing was developed as a contribution to Malta’s important national discussion on voluntary assisted dying (VAD), reflecting my commitment to advancing ethical discourse within the nursing profession and healthcare more broadly.
Executive Summary
This article discusses the ethical, professional, and practical implications of Malta’s proposed voluntary assisted dying (VAD) legislation from the perspective of the nursing profession. Nurses are often the first to engage with patients considering end-of-life options, making their involvement in VAD critical and complex. The current debate about VAD has not reached a consensus, thus this article considers the impact of the legislation on the nursing profession and provides counterarguments for common concerns currently brought up in public debates. This article advocates for the development of nursing-specific guidelines including
conscientious objection, professional education, and institutional support systems to navigate VAD. It calls for ethical discourse, respect for diverse views, and robust legislation and policy that safeguards both patients and professionals. The recommendations presented aim to ensure that VAD implementation in Malta is ethically grounded, professionally sound, and inclusive of the nursing voice.
Introduction The Government of Malta’s initiative to propose legislative changes regarding VAD represents a significant development within Maltese Society. The legislative change responds not only to current societal shifts in perspectives on death and advances in life-prolonging medical technologies but fundamentally addresses the state’s role in respecting autonomy at the end of life. Voluntary assisted dying is a complex, sensitive and polarising topic and it is well acknowledged that people have differing values and beliefs.
However, even though a lack of consensus exists about this topic, such a consensus is not necessary to respond effectively to the needs of patients. The implementation of such a legislation will be utilised by a minority of individuals who are terminally ill and voluntarily decide to opt for assisted dying. Within the literature the perspectives of nurses about VAD are mixed. Some nurses are supportive of such legislative changes in view of extreme uncontrollable pain, unbearable suffering or distress, and the individual’s right to die. Others
argue against such a legislation in view of religious beliefs, moral ambiguity and poor palliative care services. These debates and perspectives are required to support a sound debate about VAD which integrate clinical realities and moral reasoning.
Justification
The position outlined in this article rests on three fundamental justifications for Malta’s voluntary assisted dying legislation. First, the legislation provides a mechanism to reduce unbearable suffering in cases where no prospect of improvement exists. Despite advances in palliative care and pain management, some individuals continue to experience intolerable suffering beyond pain, that cannot be adequately addressed through existing interventions. The availability of voluntary assisted dying offers a compassionate response to these situations. The possibility to end your life in a manner which you feel is dignified promotes autonomous decision-making, even in death.
Secondly, the knowledge that availability of voluntary assisted dying is available could also be beneficial for a portion of society who may never utilise these services. This awareness provides reassurance and peace of mind, potentially enhancing
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St. Charbel and the family spirit among patients, families, relatives and hospital staff
One of my favourite saints is the Maronite Lebanese saint, St Charbel. As I was delving deeper about his life and, most of all, about his writings, I could sense that he is, in fact, a great resource for pastoral care.
The more I live and work with the patients, families, relatives and hospital staff at Sir Anthony Mamo Oncology Centre the more I am realising how St Charbel and his life transforming message is badly needed. Obviously St Charbel gives us Christ himself, who alone is the Way, the Truth and the Life which takes us to the Father in Heaven. Since St Charbel was united with Jesus it was not him who lived by, as St Paul tells us in his Letter to the Galatians, it was Christ who lived and acted, and still acts, through his powerful intercession.
Who was St Charbel? Jousef Antoun Makhlouf was born in the village of Bekaa Kafra, North Lebanon. The youngest of five children, he was baptized into the Maronite Rite of the Catholic Church. The Makhlouf family lived in the highest mountain village in Lebanon and were peasant farmers. His father, who died when Jousef was only three, was a mule driver. After his father’s death, his mother remarried; his stepfather later was ordained a priest where he ministered at the local parish. It is the long-standing tradition within the Maronite Catholic Church that married men may become priests.
From a young age, Jousef lived a holy and devout life. Two of his uncles were hermits, and Jousef was inspired by their example. As a youth, he tended the cattle and often spent long periods of prayer in the wilderness while his cattle grazed. He was especially devoted to the Blessed Virgin Mary and set up a shrine to her in a nearby cave. From an early age, he knew God was calling him to the priesthood and the monastic life, especially as a hermit.
In 1851, at the age of twenty-three, Jousef left his family once for all and entered the Monastery of Our Lady in Mayfouq, of the Maronite Catholic Church. His mother later wrote to him saying, If you weren’t to be a good religious, I would say to you: Come back home. But I know now that the Lord wants you in His service. And in my pain at being separated from you, I say to him, resigned: May He bless you, my child. As a newly professed monk, Jousef took the name Sharbel, after Saint
Charbel the Martyr, a second-century military officer who was martyred in Antioch during a persecution by the Roman Emperor Marcus Aurelius.
As a monk, Brother Sharbel longed to be a hermit and made the request to his superiors many times. For the first twenty-four years of his religious life, his superiors required that he live in community with the other monks. He was first transferred to the Monastery of Saint Maroun in Annaya where he professed his vows, was then sent to the Monastery of Saints Cyprian and Justina where he studied theology and philosophy, was ordained a priest in 1859 at the age of thirty-one, and returned to the Monastery of Saint Maroun where he remained for the next sixteen years.
Even if some monks lived as hermits, that vocation was reserved for those who proved themselves capable of such solitude and asceticism. In 1875, at the age of forty-seven, Father Sharbel was given permission to enter the Hermitage of Saints Peter and Paul to live as a hermit after a miraculous event took place. Some of his fellow monks decided to play a prank on him, filling his oil lamp with water. When he returned to his cell, he took his waterfilled lamp, lit it, and it burned. When the superiors heard about this, they inspected the lamp and found it to be filled with water. Unable to explain the miracle, the superiors saw it as a sign of his sanctity and agreed to permit him to become a hermit, according to his desire. He was sent to the Hermitage of Saints Peter and Paul where he spent the next twenty-three years in solitude, embracing a strict regime of daily prayer, manual work, and severe asceticism. In 1898, at the age of seventy, Brother Sharbel suffered a stroke while offering Mass and died eight days later on Christmas Eve. He was buried in the ground without a coffin, according to the custom of his order.
Albeit Saint Sharbel lived a life of extraordinary holiness, it wasn’t until after his death that his holiness became well known beyond the walls of the monasteries. After his burial, light was seen shining forth from his grave. This phenomenon drew the attention of many villagers who braved the cold and snow to see this mysterious light. After four months, permission was granted by the Church authorities to exhume his body. To the wonderment of all, his body was found to be completely
incorrupt. His skin and joints were like one who was sleeping, soft and flexible. He was cleaned of the dirt and mud from his gravesite and placed in a coffin in the monastery chapel. Then something else began to happen. Blood and sweat appeared to be coming forth from his pores, soaking his habit. It was so pronounced that his clothing needed to be changed twice a week. Finally, in 1927, his body was carefully examined by two physicians from Beiurut, placed in another coffin, and sealed in a tomb inside the monastery wall.
A little more than two decades later, a blood-like liquid was seen coming from the corner of the wall behind which Sharbel was buried. In the 1950’s, his tomb was opened three times. One of those times was broadcast on television and attended by high-ranking state officials, religious officials, medical doctors and scientists. In 1965 his body was found, once again, to be incorrupt and exuding the same blood and sweat. Finally, in 1976, the year before his canonization, his body was found to have finally decayed, only the bones remaining. Interestingly, the decay of Sharbel’s body coincided with the early days of the devastating civil war that broke out in Lebanon in 1975. In 1976, the Damour massacre took place. Palestinians attacked the Maronite Christian town. Many of Damour’s residents were killed in battle, massacred, or forced to flee.
Ever since Sharbel’s burial, those who have visited his grave have attributed many miracles to his intercession. This was especially the case in the 1950’s when he was found incorrupt after fifty years. At that time, the monks started to keep track of miraculous cures that were attributed to Father Sharbel’s intercession. Within two years, they had a list of more than twelve thousand reported cures. Devotion to him and his incorrupt body spread rapidly. The devotion, coupled with reports of numerous miracles, led to a new evangelization across Lebanon.
In the book How to protect your family from the devil, according to St. Charbel Makhlouf, written by Philip Kosloski, we find a very interesting advice given by the saint on the family: Guard your families and keep them from the schemes of the evil one through the presence of God in them. Protect and keep them through prayer and dialog, through mutual understanding and forgiveness, through honesty and
faithfulness, and most importantly, through listening. Listen to one another with your ears, eyes, hearts, mouths and the palms of your hands, and keep the roaring of the noise of the world away from your homes because it is like raging storms and violent waves; once it enters the home, it will sweep away everything and disperse everyone. Preserve the warmth of the family, because the warmth of the whole world cannot make up for it.
Certainly the devil tries its utmost to destroy the family. The family is the hub of love, peace, affection, commitment, education and is nourished and kept together by communion. As we know from our experiences of being and living in a family, love is shown through small acts of great care and compassion. Where love is there is also forgiveness, mutual understanding, patience and care without end.
If that family spirit is so needed in our families who, unfortunately, are also suffering from the waves of egoism, individualism, arrogance, anger and what not, how much more these important virtues are needed within the hospital setting. From my experience at the Sir Anthony Mamo Oncology Centre, the more this family spirit is shared the more one feels being cared for, feels better and, in the case of families, relatives and staff, can deliver more.
The devil is not only committed to destroy families but also our hospitals and places where care is given. He tries and works overtime to disseminate the seed of disunity, jealousy, suspicion, gossip, and all sorts of vices conducive to division. Care is strong when we are united together. But when resentment, labelling and competition starts creeping in it is the patient as well as his and her supportive system who start to suffer. Not just that but also staff members who are committed to give their utmost at work start loosing their focus and the enthusiasm once had.
That is why in our Oncology Centre we are trying our best to increase, or rather, let the Lord Jesus increase this beautiful spirit of protection, dialog, understanding, forgiveness, honesty, faithfulness and listening by prayer. Our Center is really blessed by the Masses, blessings and prayers done practically in its every bit of space. As many people tell me: We feel peace at this place.
Peace does not fall from the sky. Although it is true that peace comes from God, as God himself is peace, however it is the direct effect of prayer. St Teresa of Calcutta teaches us this very important lesson. She has a prayer which, according to some, can be dubbed as her “business card:” Hence it goes: The fruit of silence is prayer; the fruit of prayer is faith; the fruit of faith is love; the fruit of love is service; the fruit of service is peace.
Interestingly enough silence brings prayer and prayer leads to service, which, as its ending result, brings peace. In other words, peace is to be found in both prayer and service. Moreover, prayer is capable of bringing and guarding that family spirit of prayer and dialog, ... mutual understanding and forgiveness, ... honesty and faithfulness, and most importantly, ... listening. Prayer remains the backbone of all the pastoral service given at the Sir Anthony Mamo Oncology Centre. It is prayer which helps us to listen, dialogue and accompany one another. It is prayer which helps us live and relate warmly with one another. After all, when the medical treatment stops working it is only the warmth of the family spirit which can keep us going in that living hope which is our lifeline. When care, attention, compassion, understanding is shown amongst us it is the patient who will greatly benefit from that. Not only but the patient himself and herself can respond to us in ways that increase that family within us, his and her medical, pastoral and emotional care givers. In a nutshell, care breads more care and compassion breads more compassion. As life shows us, everyone is in great need of them.
Saint Sharbel, you were called into the solitary life of a monk and then a hermit, and you responded, help us keeping our eyes upon Christ. He who transformed your humble soul into a glorious beacon of light for the world to see may also help us, through your powerful intercession, to work for and maintain that family spirit amongst us. Please pray for us, that we will receive the grace to build healthy and caring relationships amongst us, each according to the vocation God has given, in our spiritual home, Sir Anthony Mamo Oncology Centre, keep responding with the same generosity and commitment that you manifested in your earthly life. Saint Sharbel, pray for us. Jesus, I trust in You. Amen.
Fr Mario Attard OFM Cap
Changing the narrative on suicide
The 10th of September marks a significant event on the calendar: World Suicide Prevention Day
World Suicide Prevention Day serves as a solemn reminder of our shared responsibility to engage in meaningful conversations, advocate for better mental health services, and support those at risk. This initiative, originated by the International Association for Suicide Prevention (IASP), aims at raising global awareness surrounding suicide prevention.
It is estimated that around 720,000 people worldwide die by suicide yearly. Despite this, many are less aware of the large number of individuals who attempt suicide. According to the World Health Organisation (WHO), for every suicide death, around 20 more attempts occur worldwide. Local statistics reveal a similar scenario, with an average of 700 reported attempts and 25-35 suicide deaths yearly.
It is too often that we hear of a beloved friend’s or patient’s passing by suicide, oftentimes not realising its profound impact until much after the event. Literature worldwide reveals the widespread impact of just one suicide death, specifying that each will leave an impact upon approximately 135 individuals, with 1 in 10 remaining deeply affected (Griffin et al., 2022; Hybholt et al., 2022). Such an effect has been shown to increase the rates for suicide ideations and attempts in those bereaved by suicide, highlighting a circular pattern that ought to be addressed without hesitation.
Suicide prevention has, hence, become a significant resolve on an international, national, and perhaps for us healthcare professionals, on a personal level too. Undeniably, stigma surrounding suicide, and mental health in general, remains prominent, negatively impacting the way these are perceived and spoken about. For this reason, IASP chose the title ‘Changing the Narrative on Suicide’ as the theme for the years 2024-2026. Throughout these years, the association aspires to motivate individuals, organisations and communities to speak openly and honestly about suicide, so as to transform cultures into becoming more understanding and supportive of individuals who are struggling in life.
It is time that we acknowledge that on truly listening to what the person
suicidal thoughts and behaviours are signs of immense psychological pain and distress, and talking about them does not enhance their incidence or occurrence. As healthcare professionals, we need to work towards a cultural change whereby talking about suicide becomes part of our daily narrative, ensuring that patients receiving care are monitored and assessed adequately for suicide risk.
One might enquire on the best way to break the silence on suicide and start a conversation with someone who might be struggling with these thoughts. In this regard, research focuses on various methods and interpersonal skills one must focus on when conversing about suicide. The most salient will be discussed below:
Choose a safe space
Find a calm and private environment, where the person feels safe to speak. Avoid rushing through the conversation. People may struggle to open up about their feelings, and may require reassurance that the other individual is really invested in listening to them.
Maintain a safe, respectful and compassionate demeanour
Resist the urge to pass comments or give personal opinions. This might come across as a form of judgement, which might hinder the level of safety and trust in the interpersonal relationship. Focus
has to say, validating their emotions and using prompts to connect further. Avoid using sensational language, but use context that reflects acceptance and destigmatisation. Do not be afraid to ask direct questions on their intent, such as whether they have been planning how and when they intend to die. It is a myth that talking about these and other specific details will plant ideas in the individual’s mind. Rather, these questions pose significance in determining the risk of someone dying by suicide.
Use sensitive language
Use language that promotes dignity and reduces stigma. Avoid phrases like “committed suicide,” which may carry connotations of crime or sin. Instead, say “died by suicide”.
Check on the individual
If you are aware of someone who is struggling, make sure you check in on the person regularly. Whilst talking about suicide is important, maintaining frequent contact makes the person feel supported and cared for, aiding in alleviating the sense of meaninglessness and distress.
Encourage professional support
Always ensure that each conversation is accompanied by details of available crisis
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hotlines, helplines and organisations. Keep the person’s situation in mind, ensuring they are directed to the professional support that best reflects their needs.
Access training opportunities and education
Attend training sessions on suicide prevention and awareness to increase your confidence in identifying and supporting individuals having suicidal thoughts and behaviours. Furthermore, encourage relatives, friends and colleagues to engage in such training, or facilitate training opportunities for others. These training initiatives are widespread, and can be delivered in person or online.
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individuals’ capacity to cope with terminal diagnoses and endure suffering, knowing that an alternative exists should their situation become unbearable.
Third, the legislation empowers competent individuals to maintain control over their own lives and death. This principle of autonomy, which refers to the right to make informed decisions about end-of-life care, is central to ethical-decision making. Respecting such autonomy represents a fundamental aspect of upholding human dignity. The preservation of personal agency during life’s final phase demonstrates respect for individual values and preferences.
Response to common concerns
Contemporary westernised healthcare has increasingly adopted a treatmentfocused paradigm that prioritises prolonging life whenever possible, at times even unnecessarily.
This approach, while well-intentioned, often disregards patients’ quality of life and personal wishes regarding their suffering. Such a perspective should not serve as the governing principle for healthcare, given our understanding
Changing the narrative on suicide
Participate in awareness campaigns Engage in mental health and suicide awareness campaigns organised by several organisations locally and internationally. Make use of social media to spread messages of hope. This helps to decrease stigma and encourage help-seeking behaviour.
Encourage the use of Suicide Safety Plans Suicide Safety Plans equip individuals with the right tools to protect themselves from harm when struggling with suicide thoughts.
(More details on suicide safety plans can be found in ‘Il-Musbieh’s’ edition no.100.)
While suicide remains a significant global concern, it is preventable. With timely support, compassionate conversations, and community efforts, recovery is
possible. Every life saved reflects the strength of collective action and human connection. As we commemorate World Suicide Prevention Day, let us commit to speaking openly, listening deeply, and acting decisively. Whether you’re a professional or a friend, your role in someone’s life can make all the difference.
Janice Agius is a Registered Mental Health Nurse and the MAPN Secretary
For further info go to https://www.mapnmalta.net/ Support helplines:
National Mental Health Services Helpline 1579; Richmond Foundation Helpline 1770; Loneliness Helpline 1772; Appogg Support line 179 Online Support Services: Kellimni.com; OLLI.chat
Voluntary Assisted Death
that numerous illnesses and conditions exist for which treatment remains impossible. Several counterarguments against assisted dying legislation have gained prominence in Malta’s public discourse.
The most prevalent concern centres on the perceived need to prioritise investment in palliative care over assisted dying legislation. This argument presents a false dichotomy, as these approaches are not mutually exclusive. Evidence from international contexts demonstrates no correlation between legalising assisted dying and reduced investment in palliative care, decreased demand for palliative services, or increased requests for assisted dying in lieu of palliation.
While acknowledging that Malta’s current palliative care system faces limitations, the palliative care strategy published recently indicates an increased commitment to improving these services. However, it is pivotal that such strategies move beyond documents and offices, and are implemented effectively in practice, monitored and regularly reviewed. This concurrent development supports the complementary nature of both approaches rather than supporting an either-or framework. In addition to concerns about palliative care investment, further concerns address a potential for a “slippery slope” effect
following the legalisation of assisted dying. However, these arguments rely primarily on speculative judgments and lack empirical foundation. Countries with established assisted dying legislation do not support concerns about disproportionate use among vulnerable populations or increased suicide rates. In the US, individuals seeking assisted dying are often relatively privileged persons who maintain the capacity to exert control over their lives.
Moral objections to assisted dying often centre around the idea that it devalues life. This is not true, we can agree that suffering is evil. Individuals themselves can find meaning in suffering and they will be free to find such meaning, such as staying around for their loved ones, but they will not be required to endure it, if they themselves cannot find meaning in that suffering.
With this argument, the devaluing perspective lies in denying people’s agency and their ability to shape their lives and choose a dignified death if they so choose. This implies that critics of assisted dying value autonomy but only for certain purposes, such as only for purposes that these critics deem to be fitting for human life. In this context, the preservation of human life.
continued in next issue
Musbieœ - Letter to Members from ICN
Dear MUMN President,
The Florence Nightingale Museum in London is currently developing an exhibition exploring nurses’ impact on hospital and health care facilities design entitled Healing Spaces.
The exhibition will open in November 2025 and will expand on the Museum’s permanent collection by exploring Nightingale’s influence on health care design and bring it up to the modern day by highlighting current pioneers in the field. The exhibition will be onsite for 12 months and will explore Nightingale’s influences, her environmental theories and designs as well as case studies of current practice from nurses, designers, architects, and students. There will also be a design station and hands on content to help inspire the next generation of health care professionals.
The Museum has been delighted by the number of sponsors and supporters already on board but would like to
include more case studies from outside the UK and USA and have reached out to ICN for our help. If you know of any examples or case studies demonstrating how nurses have significantly influenced modern hospital or healthcare design, then the Museum would love to hear from you.
If you would like to learn more or if you have an idea for a case study, please reach out directly to Laura Sharpe, Museum Manager, at laura@florencenightingale.co.uk by mid-September.
You will be aware that at ICN we have recently published new policy statements on both planetary health and climate change and have been
highlighting the critical roles nurses play in the design of healthcare facilities and systems in order to promote holistic approaches to healthcare delivery, healing and health for all. Please do also copy and send to me any submissions that you might submit as this is also an important issue that we are thinking of at ICN in relation to the future sustainability of health systems around the world.
Thank you for your assistance in bringing the global voice of nursing to this exhibition.
Best regards,
Howard Catton CEO | International Council of Nurses
The International Council of Nurses (ICN) is a federation of more than 140 national nurses associations representing the millions of nurses worldwide. Operated by nurses and leading nursing internationally, ICN works to ensure quality nursing care for all and sound health policies globally.
Corinne Scicluna - June 21, 2025 - Times of Malta
How people are dying today
The debate about assisted death can’t be held in isolation but alongside real reform in how people are cared for at the end of life
Much has been said recently - on television, social media and in this very newspaper - about the right to choose assisted death. As someone who believes deeply in human rights and the right to choose, I understand why this conversation resonates with many.
However, before we move toward such a complex and deeply personal legal reform, I believe we must also take a hard look at something more immediate: how people are dying in Malta today.
Some argue we do not need to choose between the debate on assisted death and the goal of a good, dignified death - so I ask, let us pursue both and give each the importance it deserves. But if we are to have meaningful discussions about choice, then we must start by listening to those already in our hospitals - patients, relatives and all those involved in care, most importantly nurses, who are with the patients 24 hours a day.
I recently experienced this first-hand with the passing of someone dear to me. Despite having clearly expressed her wishes, she was subjected to repeated tests and scans that she neither wanted nor needed. I had to step in to advocate for her and ensure her wishes were respected. Sadly, this wasn’t a one-off incident. It happened repeatedly, often on every shift.
Time and again, junior doctors, who are on-call and who had never met her on spoken with us, were left to make critical decisions about her care. Many lacked experience, not only in medicine but in the human realities of end-of-life care. And, yet, they were expected to decide whether to increase pain relief to make her more comfortable.
This is not fair to them, nor to the patients and families involved. Although this was exhausting for her family and mostly for her, unfortunately not everyone has this knowledge or confidence. And they shouldn’t need to.
“Many junior doctors lack experience not only in medicine but in the human realities of end-of-life care”
I say this not just from personal experience but also from my perspective as a nurse and lecturer at the university. One major issue we must address is the fragmentation in how we train our healthcare professionals. We still teach doctors, nurses and allied health staff separately and this reinforces outdated hierarchies.
We need interdisciplinary teaching and learning, from the earliest stages of education. There is strong evidence that this helps future professionals work collaboratively and compassionately - especially in emotionally complex situations like end-of-life care.
Despite all this, I have seen many professionals do their utmost, often in impossible conditions. One nurse
quietly asked me: “Please try and help us change the system. Patients - and we - are suffering.” Another shared: “This is part of our burnout. We are not heard.”
These are not attacks on their medical colleagues but, rather, a plea for a system where decisions are shared and responsibility is not shouldered alone. If we moved toward a truly person-centred approach, involving patients, families, nurses, doctors, physiotherapists and others as equal partners in care, perhaps doctors too would feel less isolated when facing difficult decisions.
This is what I hope we work toward in 2025 and beyond. A Malta where no patient has to plead for dignity in their final days. A system where all professionals, and patients themselves, are heard. And, yes - where the conversation about assisted death happens, not in isolation, but alongside real reform in how people are cared for at the end of life.
Corinne Scicluna is a senior lecturer at the University of Malta.
We must address the fragmentation in how we train our healthcare professionals. File photo: Chris Sant Fournier
by William Grech
Manual of Special Leaves
The Public Service Management Code (PSMC) is the principal framework governing the conditions of employment for public officers in Malta. It outlines the rights, obligations, and entitlements of public service employees, including various forms of leave.
The Manual of Special Leaves is an annex to the PSMC that provides detailed guidance on non-standard leave entitlements beyond regular vacation or sick leave. It reflects the Public Service’s commitment to flexibility, work-life balance, and public value by enabling employees to engage in activities such as professional development, voluntary service, political participation, religious vocations, international work, and cooperative entrepreneurship— without permanently leaving their government employment.
The manual is designed to balance the operational needs of the public administration with the individual aspirations and responsibilities of public employees. It is structured into seven main categories of leave, each with its own criteria, duration, and approval mechanisms. The Manual of Special Leaves categorises special leave provisions for public employees into seven main areas:
1. Paid Leave approved by Directors
2. Unpaid Leave approved by Directors
3. Paid or Unpaid Leave approved by Permanent Secretaries
4. Paid or Unpaid Leave on grounds of public policy (PRD within PSD)
5. Unpaid Leave to take up temporary EU employment
6. Paid Leave approved by Other Authorities
7. Cooperative Schemes
1. Paid Leave Approved by Directors
• Pre-Retirement Leave: Officers may convert unused full-pay sick leave (1 day for every 4 unused) into preretirement leave, up to a maximum of 3 months.
• Injury Leave: Granted if the injury occurs within the workplace, during
duty, or due to an occupational disease, excluding cases of negligence.
• Quarantine Leave: Granted with full pay when mandated by the Superintendent of Public Health, for the full duration of absence.
• Jury Leave: Applies to all public officers, including part-time and temporary, for the entire duration of jury service.
• Local Council Meetings: Elected Local Councillors are entitled to paid leave to attend official meetings.
• Twinning Ceremonies: One councillor per local council may receive up to 3 working days of paid leave to attend official twinning ceremonies abroad.
2. Unpaid Leave Approved by Directors
• New Recruits: May be granted up to 3 days of unpaid leave in their first 6 months under exceptional circumstances.
• Special Reasons: Up to 3 months of unpaid leave within 12 months for family or personal reasons, available to full- and part-time employees.
• Settling Abroad: Up to 1 year of unpaid leave to settle in another country, for employees with at least 1 year of service.
• Fishing/Agriculture: Officers may take up to 3 months unpaid leave for seasonal fishing or agricultural work.
• Vocation: One year unpaid leave to explore joining a religious order.
• Missionary/Voluntary Work: Unpaid leave up to 8 years, renewable annually and used continuously or intermittently.
• Private Sector Employment: Officers with one year of service can take unpaid leave from 3 months to 5 years (renewable yearly, max 4 renewals) to try private employment.
2. Paid or Unpaid Leave Approved by Permanent Secretaries
• Duty Leave: Granted with full pay for official duties or international conferences. Limited to the required time, including travel.
• International Organisations: Officers with at least 1 year of service may take unpaid leave to work with organisations like WHO, UN, FAO. Initially granted for 1 year and renewable annually.
• Electoral Leave: Unpaid leave to contest National Parliament, Local Council, or EU Parliament elections under Directive 5.
• Private Sector Employment: Officers not on performance agreements may take unpaid leave (3 months–5 years, renewable up to 4 times) to work in the private sector.
4. Leave on Grounds of Public Policy (PRD within PSD)
• Trade Union Release: Full-pay release for officers in scale 6 or below to perform union duties, based on union membership.
• Voluntary Organisations: Paid leave for public employees to work with VOs aligned with government policy, enhancing HR capacity.
• Committee of Regions (COR): Scale below 5 officers with 1+ year of service may be released (max 8 years) to work with COR, one officer at a time.
• Development Work Abroad: Up to 8 years of paid leave for full-time officers working in ODA-recipient countries. Contracted officers must revert to their substantive grade.
• MEP Assistants: Officers in scale 7 or lower may take one-year renewable unpaid leave to work as assistants to Malta’s MEPs. One officer per MEP.
• Political Party Roles: Officers in scale 6 or lower may take renewable
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unpaid leave to work in a party’s core administration or as assistants to party leaders in Parliament (one officer per leader).
5. Unpaid Leave to Work with EU Institutions
• Not on grounds of Public Policy: Personal Reasons: Officers with 1+ year of service may take up to 3 years unpaid leave (or less if service is shorter).
• On grounds of Public Policy: Cabinet or Equivalent Roles: Up to 5 years, renewable if post changes, A16–A13 Posts: For duration of term of office, A12–A9 Posts: Up to 5 years or 10 years (if officer has 10+ years of service), whichever is shorter.
6. Paid Leave Approved by Other Authorities
• Flexi Training Scheme: For nationallevel athletes, granted for 12 months, renewable. Officers retain their status but receive only basic salary, with pro-rata allowances. Sunday/public holiday allowances and injury leave are not granted.
• International Sports Activities: Paid leave for officials participating in national/international competitions or training camps. Flexi Training beneficiaries are also eligible.
• Cultural Leave: Up to 10 working days (or 80 hours for shift workers) per year for officers performing or participating in cultural events abroad, organised by governments or endorsed by Malta’s Ministry for Culture.
• Union Seminars: Officers in scale 6 or below may get 5 paid days per year to attend union-organised seminars. More days require vacation or unpaid leave.
• EU-Funded Seminars: Trade union officials may be granted paid leave to attend EU-funded events abroad. Other events require unpaid or vacation leave.
7. Cooperative Schemes
• New Cooperative Scheme: Employees in scales 8 to 20 may form registered cooperatives (min. 5 members). They retain full salary
and public service rights and may earn from profits. They remain bound by public service rules. The Cooperatives Scheme Unit provides managerial and financial support.
• Old Cooperatives Scheme:
• Scheme A: Officers may take unpaid leave to set up a cooperative targeting public/local tenders. They retain the right to return to public service if the cooperative ends.
• Scheme B: Officers can form a cooperative in collaboration with their directorate, retaining salary and rights, and earning profit shares. Requires approval from the Permanent Secretary. Directors may allocate work, agree on profit-
Policy Brief
Manual of Special Leaves
sharing, and oversee contracts. A joint bank account must be created for cooperative finances. The Board of Cooperatives monitors compliance.
This manual reflects a modern, responsive, and inclusive public administration approach, enabling the public workforce to contribute to national and international causes while preserving their public service status and responsibilities. For more detailed information you can easily access this manual online on: https://publicservice. gov.mt/Media/PSMC%20Documents/ Manual_on_Special_Leaves_9.pdf
William Grech
Nursing Student Mentorship Nursing Action - a WHO-led project funded by the European Commission
Advancing Nursing, Shaping Healthcare: IDEA College’s M.Sc. in Advancing Nursing Science
Healthcare is undergoing rapid transformation. Rising patient expectations, demographic shifts, technological disruption, and evolving models of care have made nursing more vital than ever. Nurses and midwives are not just delivering frontline care—they are increasingly expected to drive change, influence policy, and contribute to the evidence base of healthcare practice.
For those who aspire to be at the forefront of this evolution, the M.Sc. in Advancing Nursing Science at IDEA College offers a unique opportunity. Designed specifically for registered nurses and midwives, this postgraduate degree combines academic rigour with practical application, preparing graduates to become leaders, innovators, and educators in nursing both in Malta and abroad.
A Programme Rooted in Practice, Aligned with Global Standards
tion of nurses.
• Collaborate Across Systems: Develop interprofessional skills that enable collaboration with other healthcare professionals in addressing complex health challenges.
Who Should Apply?
This programme is aimed at registered nurses and midwives who are seeking to expand their impact. It is ideal for those wishing to advance into roles such as:
• Advanced Practice Nurse or Specialist Nurse – providing expert care in complex clinical settings.
• Nurse Leader or Manager – guiding teams, managing healthcare units, and implementing organisational change.
The M.Sc. in Advancing Nursing Science goes beyond a traditional nursing qualification. It is grounded in the realities of Malta’s healthcare system while drawing on international benchmarks for advanced practice nursing. This dual focus ensures that graduates are equipped not only to address local challenges—such as workforce pressures, ageing populations, and integration of new technologies—but also to contribute to the global dialogue on nursing leadership and professional development.
What sets this programme apart is its integration of practice, policy, and research. Students are encouraged to critically assess healthcare delivery, develop evidence-based interventions, and translate their findings into meaningful improvements for patients and communities. By the end of the programme, graduates are positioned to step confidently into roles that shape the future of nursing practice.
Key Learning Outcomes
• Advance Clinical Practice: Strengthen decision-making and clinical reasoning through evidence-based approaches.
• Lead with Confidence: Gain advanced leadership and management skills to inspire nursing teams and healthcare organisations.
• Influence Policy and Governance: Critically analyse healthcare policy, ethics, and governance frameworks, ensuring that the nursing voice is represented in decision-making.
and research into daily practice. Malta is no exception. The M.Sc. in Advancing Nursing Science is more than a qualification—it is a strategic investment in developing the next generation of nurse leaders who will safeguard the resilience of healthcare systems.
Graduates will not only be able to enhance their own careers but will also contribute to strengthening Malta’s healthcare system, ensuring it remains responsive to the needs of patients and communities. In doing so, they will join a growing international movement of nurses advancing the profession as a scientific discipline.
Building a Postgraduate Ecosystem for Healthcare Professionals
• Nurse Educator or Mentor – shaping the future workforce through teaching and supervision.
• Researcher or Policy Advocate – producing knowledge and influencing the frameworks that govern healthcare delivery.
In short, this degree is for those who want to move from delivering care to shaping how care is delivered.
Why Choose IDEA College?
• Practical, Impact-Driven Learning: Courses are designed with immediate applicability, using case studies from Maltese healthcare and European practice.
• Flexible Study Options: Part-time evening classes allow nurses to pursue postgraduate study while maintaining their professional roles.
• Faculty with Expertise Across Practice and Academia: Students benefit from the guidance of lecturers who have contributed not only to patient care but also to healthcare policy, management, and nursing research.
• MQF Level 7 Accreditation: Fully recognised within Malta and across Europe, ensuring graduates are wellpositioned for international career opportunities.
• 20% Scholarship for MUMN Members: An exclusive benefit for members of the Malta Union of Midwives and Nurses, reducing tuition fees and supporting ongoing professional development.
A Strategic Investment in the Future of Nursing
IDEA College recognises that nursing and healthcare leadership are multifaceted. That is why, alongside the M.Sc. in Advancing Nursing Science, the College has developed a suite of postgraduate programmes tailored to the needs of today’s healthcare workforce:
• M.Sc. in Public Health – equipping professionals to design and deliver population-level health strategies, with a focus on epidemiology, prevention, and policy.
• M.Sc. in Healthcare Management and Leadership – preparing professionals for senior roles in administration, governance, and organisational leadership.
• M.Sc. in Elderly Care Management –addressing the urgent demand for expertise in gerontology and long-term care as populations age.
Together, these programmes form a postgraduate ecosystem of healthcare excellence, enabling professionals to specialise, diversify, and collaborate across different fields of practice. For MUMN members, each course comes with a 20% scholarship, reaffirming IDEA College’s commitment to supporting nurses and midwives in advancing their careers.
Take the Next Step
• Contribute to Research and Education: Acquire advanced research skills to generate new knowledge, publish findings, and mentor the next genera-
The global nursing workforce is facing unprecedented challenges: workforce shortages, increasing demand for advanced care, and the need for professionals who can integrate technology
The nursing profession has always been at the heart of healthcare. Now more than ever, it needs leaders who can navigate complexity, generate knowledge, and advocate for patients on every level — from bedside to boardroom. The M.Sc. in Advancing Nursing Science at IDEA College provides the foundation for this next step.
For more information, visit https:// mt.ideaeducation.com or contact your Student Recruitment Advisor on WhatsApp at 2317 4632.
