Il- Musbieh - Edition No 85

Il-Musbieœ MALTA NURSING AND MIDWIFERY JOURNAL

Malta Union of Midwives and Nurses

Numru 85 - Diċembru 2019

Seasons Greetings the heartbeat of healthcare

www.mumn.org Tel: 7714 1260 E-mail: mumn@maltanet.net

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contents

Ħarġa nru 85

Diċembru 2019 - Editorial & President’s message

pages 4-5

- From our diary

pages 20-21

- Please Just Stop

pages 36-37

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

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

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

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

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

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

Çirkulazzjoni: 4,000 kopja.

Ritratt tal-faççata: Joseph Aquilina.

Il-Musbieœ jiæi ppubblikat 4 darbiet f’sena.

Il-Musbieħ DIĊEMBRU 2019 Diÿinn u stampar: Union Print Co. -Ltd., Marsa

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Editorial

photo | images.hellogiggles.com

Sexual harassment According to a research by Men Against Violence and the Women’s Rights Foundation as part of a project dealing with sexual harassment at the workplace funded by the Malta Community Chest Fund, 80% have experienced or witnessed sexual harassment at work in Malta.

Sexual harassment is an unwelcome behaviour of a sexual nature or other sex-based conduct affecting the dignity of women and men at the workplace. Male and female employees may not always realise that their behaviour constitutes sexual harassment. They must recognise that what is acceptable to one person may not be acceptable to another and that such conduct can create an offensive working environment for the recipient.

Florence Nightingale tried to control male physicians and surgeons’ sexual harassment of her nurses in

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the 1800s. Her approach was one of prevention - each nurse had to be of high moral character, thereby implying that nurses were to blame for their own victimisation, which was the thinking of the time.

Sexual harassment takes many forms, from relatively mild sexual comments about appearance or dress that belittles or ridicules or is intimidatory, to actual sexual assault.

The following may be considered as a broad classification system in this regard: Sexual Physical conduct of a sexual nature; verbal conduct of a sexual nature; non-verbal conduct of sexual nature; and sexual blackmail.

The effects of sexual harassment on the victim are stress, fatigue, depression, weight loss or weight gain, sleep disturbance, headaches and PTSD. There is also decreased work performance as the victim focuses on dealing with harassment, increased absenteeism to avoid harassment, or due to illness from the stress, resulting in sick leave without pay, termination/dismissal due to retaliation from the harasser or due to

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decreased work performance resulting from harassment and loss of career.

Social Effects include humiliation by gossip, defamation of character, and extreme stress affecting relationships with significant others, peers, family and friends.

Article 29 of the Employment and Industrial Relations Act (Cap. 452) and Subsidiary Legislation 456.01 (Access to Goods and Services and their Supply (Equal Treatment) Regulations) legislate against harassment based on gender and sexual harassment. Apart from harassment based on gender and sexual harassment, harassment can also be based on race, ethnic background or gender identity, colour, religion or belief, sexual orientation or disability issues.

Effectively preventing sexual harassment requires transformational leadership.

It is not enough to use piecemeal approaches such as training, an effective policy, and zero tolerance, though important.

As nurses, we are the largest healthcare • continued on page 7

President’s message It has finally arrived, next year is the year of the Nurses and Midwives, the year 2020, a year specifically dedicated to us nurses and midwives. This year will highlight the great work performed by our two professions and allow the general public, the world population to appreciate the efforts of nurses and the midwifes around the globe. It is the year of opportunity where nurses and midwives will have more exposure and more occasions to stress to the public how fruitful the work, we provide to our patients is.

The year 2020 was dedicated to nurses and midwives because we will be celebrating the bicentenary of Florence Nightingale, 200 years since her birth. So, it is a commemoration anniversary of Florence Nightingale which led the WHO to dedicate the year 2020 for nurses and midwives.

Florence Nightingale whose legacy is embedded also in our history since Malta being a country forming part of the British Empire, was used to care the 25,000 soldiers during the Crimean war, earning the nickname of the Nurse Of The Mediterranean, which for us is a great honor.

As MUMN, we will be launching several activities both educational and cultural for our members. To have this year remembered, MUMN, will be honoring all nurses and midwives by having a postage stamp specifically dedicated to all nurses and midwives, the first time ever. I hope all nurses and midwives will appreciate this “once in a lifetime gesture” since these are very rare anniversaries indeed.

On another different aspect, MUMN is becoming stronger and bigger. Our premises in Mosta has become small and insufficient for our needs. There are not enough spaces for offices and there is only one meeting space. MUMN intends to enlarge its premises where more offices and more meeting areas could

be used for the benefits of all our members. MUMN is also planning to have a small hall as part of the premises, this will allow us to organize conferences or seminars of up to 150 persons in our own premises. The new premises will also have various meeting rooms so that all committees affiliated within MUMN can make use of these meetings rooms. MUMN has already located a building which is centrally located and will be accessible to all members. It is envisaged that if all goes well and contract is signed work will start next year on the new premises. The premises will also be close to a massive parking area. It is a very ambitious project, but it is time to have our own building and not just an apartment as we currently have.

This year will also be a challenging year. It would definitely be a turning point for the physiotherapists where MUMN is doing all its efforts from a legal aspect so that these health professionals will have a personal professional identity and not be part of the so-called Allied Health.

MUMN will also be finalizing the agreement of the social workers and hopefully MUMN will be starting the collective agreement of the physiotherapists, next year.

As regards to nurses and midwives, MUMN will be monitoring the open call which is supposed to be issued at the beginning of this year. MUMN

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will be pushing harder to address the nursing and midwifery shortage and MUMN has plans to address such shortage for the benefit of our members.

On a different note, MUMN members are strongly advised not to write incident reports before you contact an official of MUMN. There is no time barred to write an incident report even if the management might request such reports on the same day.

Such requests from management are to be ignored and always ask for advice before handing in any report, it is useless phoning MUMN after handing out the incident report to your superiors. A lot of mistakes are happening when handing in incident reports and some, if not all are preventable.

Well, everyone is looking forward for next year. In the Health Sector which sector is dynamic and continuously evolving, new issues and new problems will surely be encountered but together, as a union, we will be facing them and leave no stone unturned in order to help all our members.

Well, the festive season is with us and on behave of the MUMN council I would like to wish you all a blessed Christmas and a very prosperous New Year to you and your families.

Paul Pace MUMN President

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Kelmtejn

mis-Segretarju Ġenerali D

in ser tkun l-aœœar œaræa ta’ dan il-æurnal ‘Il-Musbieœ’ bœala karta stampata peress li minn Marzu li æej ’il quddiem, il-æurnal ser jibda jintbagœat b’mezzi elettroniçi. Irraæuni hija li ma’ kull œaræa li saret din is-sena, il-Union marret minn taœt ¢1200, iæifieri matul is-sena kollha, morna min taœt madwar ¢5000.

Bœala æurnal ser jibqa’ l-istess eÿatt bid-differenza li flok ser tirçevih bilposta ser ikun qed jasal gœandek permezz ta’ email.

Is-sitwazzjoni preÿenti fil-pajjiÿ mhiex waœda feliçi u nawguraw li fi ÿmien qasir jeræa’ jiæi kollox gœannormal fl-interess tal-membri kollha li aœna nirrappreÿentaw.

Nixteq ngœid ÿewæ kelmiet dwar it-talba tagœna fir-rigward tal-ammont ta’ siegœat li æew mogœtija lilna bœala kumpens tal-Festi Pubbliçi li kienu nqattgœu lilna fl-2006. L-MUMN qed targumenta li l-ammont ta’ siegœat irid ikun aktar minn 8 siegœat li qed jagœti l-Gvern u dan biex verament ikunu qed jirriflettu s-siegœat meœud lilna dak iÿ-ÿmien. Naturalment aœna napprezzaw li ngœataw lilna 8 siegœat però biex ÿgur tkun saret æustizzja kompluta hemm il-œtieæa li jingœataw aktar. Ilna sejrin b’din ittalba gœal madwar 18-il xahar u s’issa gœadu ma ntlaœaqx ftehim. Nixtiequ ninfurmawk li l-MUMN gœadha ma qatgœetx qalba li t-talba tagœha tiæi milqugœa u gœalhekk ser inkomplu ninsistu fuq din it-talba tagœna.

Is-sitwazzjoni tar-rikkonoxximent ewlieni tal-Physiotherapists kif ukoll l-awtorizzazzjoni sabiex l-MUMN

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tkun tista’ tinnegozja Ftehim Settorali gœall-Physiotherapists waœedhom qegœda tiæi indirizzata fil-Qorti sabiex fi ÿmien qasir inkunu nistgœu ngœidu li gœelibna dan l-ostaklu li gœalkemm mhux façli, jidher çar li s-sitwazzjoni qegœda favur tagœna.

Nixtieq inœabbar ukoll li l-Ftehim Settorali ædid tas-Social Workers œa ÿvolta tajba u favorevoli. Ser ikollna laqgœat oœra bil-gœan li nagœlqu dan il-kapitlu fi ÿmien ftit æimgœat oœra.

Bœal dejjem l-MUMN tlaqqa’ lillmembri nvoluti qabel tiffirma dan ilFtehim Settorali.

Dwar l-ECG Technicians nixtieq ninfurmak li l-MUMN qed timbarka f’laqgœat dwar il-compliment peress li l-aœœar wieœed li sar kien œafna snin ilu u wieœed ÿgur li japprezza kemm ÿdiedu s-servizzi minn dak iÿ-ÿmien ‘l hawn biex ma nsemmux li æie mibni sptar ædid u gœadna bl-istess compliment ta’ ÿmien l-isptar San Luqa.

Kontra qalbna nixtiequ ninfurmawkom li l-ispejjeÿ tal-Union qegœdin dejjem jgœolew. L-ekonomija tal-pajjiÿ huwa vera li sejra tajjeb iÿda magœha din iææib l-gœoli ta’ dak kollu li l-Union tixtri sabiex toffri servizz eççellenti kemm jekk huwa professional development taœt l-Institute for Health Care Professionals, is-servizzi purament ta’ Trade Union kif ukoll dawk l-gœajnuniet li noffri fuq baÿi soçjali. Gœalhekk nixtieq ninfurmak li l-membership fee ser togœla b’¢10 gœat-total ta’ ¢60 fejn minnhom intuk lura ¢30 li jissarfu fis-CPD Allowances. Barra minn hekk dan

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l-ammont jinkludi wkoll is-servizz ta’ avukat b’xejn fuq dawk il-kwistjonijiet marbuta mal-impjieg tiegœek.

Qed ikollna numru ta’ problemi fejn jirrigwardaw l-isptarijiet immexxija minn Steward Health Care. Jidher çar li hemm diÿgwid bejn Steward Health Care u l-Gvern f’dak li huwa kuntratt u l-interpretazzjoni tiegœu. Kemm kienet gœaqlija l-MUMN li ffirmat Ftehim mal-Gvern sabiex il-membri li jaœdmu fiÿ-ÿewæ sptarijiet ikollhom moœœhom mistrieœ li l-ewwel nett ser jibqgœu impjegati mas-servizz pubbliku, igawdu minn kull Ftehim li jiæi ffirmat u li l-Management irid ikellem lill-Union f’kaÿ li ser jibdel xi kundizzjonijiet tax-xogœol. Min-naœa l-oœra aœna diÿappuntati li mill-paroli kollu li ntqal dwar il-bini state of the art li ser ikollna, gœadna ma rajna xejn u jidher li mhux ser ikollna çaqlieq kif æib u laœaq.

Gœal llum ser ikolli nieqaf hawn gœax œadt spazju biÿÿejjed. Ma nistax nagœlaq dawn il-kelmtejn mingœajr ma’ nirringrazzja lill-Membri talKunsill gœall-gœajnuna tagœhom, l-Office Administrators li huma dejjem effiçjenti f’xogœlhom, l-Attivisti kollha li mingœajrhom ma nagœmlu xejn kif ukoll lilek tas-support tiegœek matul issena. Ma nistax inœalli barra li l-partner tiegœi Marisa u t-tifel Nicholas talpaçenzja li jieœdu bija.

Nixtieq nieœu wkoll din l-opportunità biex nawgura lilek u ’l dawk viçin tiegœek Milied Hieni mimli saœœa, barka u æid.

Colin Galea Segretarju Generali

Sexual harassment

• continued from page 4

A Nurse’s

Prayer Let me dedicate my life today, in the care of those who come my way.

Let me touch each one with healing hand, and the gentle art for which I stand.

And then tonight when the day is done, Let me rest in peace, If I’ve helped just one.

professional group; we are bright, know the healthcare environment and culture, and are best positioned to not only be the catalyst for change, but to be the changemakers.

Persons experiencing forms of sexual harassment who opt to lodge an informal complaint may approach the person concerned and attempt to resolve issues informally.

Where informal methods fail or when the complainant feels that informal procedure is not appropriate in the circumstances, employees are advised and encouraged to lodge a formal complaint.

In cases when both the complainant and the alleged perpetrator are members of staff the Sexual Harassment Incident Report Form is to be compiled. In cases when the complainant and/or the alleged perpetrator are third party members, the Incident Report Form is to be used.

The workers’ group from the International Labour Organisation (ILO) has called for a proposal for a new ILO standard (convention accompanied by a recommendation) on gender-based violence at work. Currently, the ILO has addressed sexual harassment primarily as a form of discrimination in the workplace.

The major ILO convention addressing sex discrimination is Discrimination (Employment and Occupation) Convention (No.111) which entered into force in 1960.

This convention does not explicitly mention sexual harassment, although a 2003 general observation states that “sexual harassment is a form of sex discrimination and should be addressed within the requirements of the convention.”

A person in Malta who contravenes the provisions relating to sexual harassment in the law is guilty of an offence and is liable on conviction to a fine not exceeding ¢2329.37 or to imprisonment for a period not exceeding six months, or to both such fine and imprisonment. In line with the GenderBased Violence and Domestic Violence Act, 2018, a person guilty of an offence of sexual harassment is liable to the punishment of imprisonment for a term from six months to two years or to a fine of not less than ¢5,000 and not more than ¢10,000, or to both such fine and imprisonment.

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A glimpse into the historical Capuchin assistance to the sick The question crops up spontaneously, especially when I come across people in one of the many long corridors of Mater Dei hospital. Or, whilst visiting the patients, their relatives and the hospital sta at the wards. Why do the Capuchins assist the sick? How did this come about? How come that, in many hospitals around the globe one would notice the Capuchin presence with our brothers and sisters the sick?

The Order of Friars Minor Capuchin (in Latin Ordo Fratrum Minorum Capuccinorum; its abbreviation is O.F.M.Cap) is an order which came as a reform of the Franciscan Order.

The Order saw its beginnings in 1520 when Matteo da Bascio, an Observant Franciscan friar from the Italian region

of Marche, claimed that he received an inspiration by God that the way of life lived by the friars of his times did not match at all with what their founder, Saint Francis of Assisi, had contemplated for his brothers. Thus, Matteo tried to go back to the original Franciscan way of life that was lived

by Francis and his brothers mainly that of solitude and penance.

Brother Matteo and his companions had to face persecutions from their superiors. In fact the latter tried to arrest them for having run away from their religious obligations. Knowing the great danger they were living in Brother Matteo and his brothers were offerred refuge by the Camaldolese monks. As an act of gratitude towards them these first Capuchins adopted the cappuccio, that is the hood which these Camaldolese monks wear as an order of hermits.

Furthermore they took over from them the practice of wearing a beard.

Thus, the Capuchins are called so due

photo | images.askmen.com

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to this aspect of their religious habit.

It was in 1528 when Brother Matteo got the pontifical approval from Pope Clement VII and was given an official permission to live as a hermit and be an itenerant preacher to the poor.

These permissions were extended for the future brothers too so as to restore the most literal observance possible of the Rule of Saint Francis.

The Capuchin Constitutions mirror the Capuchin charism of caring for the sick. Constitution number 108.3 says: After the example of Saint Francis, who had great compassion for the poor, and the founders of our Capuchin brotherhood, who helped those suffering from the plague, let us live alongside our brothers and sisters in need, especially the sick, eager to offer them wholehearted service as brothers. Whereas in Constitution number 149.2 we read the following: Let us promote the customary works of the apostolate such as popular missions, retreats, the sacramental

A glimpse into the historical Capuchin assistance to the sick confession of the faithful, the spiritual care of religious women, especially Franciscans, care of the sick and of prisoners, works of education and of social development. Constitution 153, 1-2 states: After the example of Saint Francis and the enduring tradition of the order, we willingly undertake the spiritual, and even bodily, care of the sick and infirm. Following Christ Who went through towns and villages healing every kind of sickness and infirmity as a sign of the arrival of the Kingdom of God, we fulfil the mission of the Church. Through her children, she is at one with people of every condition, especially the poor and afflicted, and willingly spends herself for them. Of particular interest concerning the Capuchin care of the sick is Constitution number 5.4 which says: Gathered together in Christ as a single distinctive family, we develop among ourselves relationships that are fraternally spontaneous, and gladly live among those who are poor, weak and infirm, sharing in their lives and maintaining our characteristic closeness to people.

Now let us let the Capuchin history speaks of itself regarding how the brothers lived their God-given brotherhood charism among the weak and the infirm throughout the ages.

The first historical example that naturally comes into my mind is that of Brother Matteo da Bascio himself.

Matteo distinguished himself in the early days of the Capuchin Order not only for preaching the Word of God but, and most importantly, for nursing the sick and the plague stricken. With

his three companions, the brothers Raffaele and Ludovico Fossombrone and Paola da Chioggia, Matteo dedicated himself to the service of the people stricken with the plague.

History goes that they nursed the sick and comforted the dying. And, when the number of the deceased practically escalated they also gave a helping hand in burying the dead.

In another incident when the Duke of Camerino died of the plague the four friars served the stricken citizens of Camerino by spiritually assisted them.

A colossal historical figure of the Capuchins working with the sick is certainly Fra Paolo Bellintanto da Salo. Paolo came from an ancient and wealthy family. The situation that instigated him to work hard among the plague stricken people was that while he was in the friary of Lodi the Podestà of Crema came to his place saying how the dead lay thick in Venice and there was no one to bury them.

Fra Paolo was so moved from the Podestà’s words that he wrote to the Visitor General of the friars in Milan.

He begged him “for the love of Christ, Who gave His life for mine” to be given permission to offer his services to the plague stricken in Venice. The saintly Archbishop of Milano, Saint Carlo Borromeo, who moved without fear among the stricken population, comforting the sick, ministering the sacraments and organizing every possible help, appealed to the superiors of the religious orders for chaplains in the hope of serving at the hospitals. The Capuchin General Visitor, Fra Giacomo da Milano,

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replied to the Archbishop’s plea. Fra Paolo wrote to him and made himself available to serve the sick. The latter was given permission at Milan not in Venice. On his way to Milan Fra Paolo had a bout of fever. In the meantime, some twenty Capuchins had started working at the hospitals. Some of them were placed at the San Dionigi Hospital in the City while the rest were put in the hospitals of Vittoria and Monza, always within the Milanese territory.

San Carlo led Fra Paolo to work at the Lazaretto, outside the walls of Milan. Here the sick were put in thousands. Out of the four Friars that were placed in the Lazaretto three of them were already dead whilst their places were filled by other friars who were waiting for the call to serve there.

Fra Paolo was appointed governor of the Lazaretto to stop any abuses and reforming the health service there.

His first step was to separate those kept under suspicion of being infected from those who were really sick. Then he organized the proper supplies while removing the dishonest trader.

Fra Paolo instituted a rather efficient medical service. He had managed to form the nurses and curb any abuses in the system. This zealous Capuchin managed to transform the moral tenure of the lazaretto. Such a comforting environment helped instilling peace and hope in the sick who were suffering. History records that during its one long year course the plague did not take as many lives as it did in many other cities. And this • continued on page 35

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Emergency nurses to get work insurance High-risk workers will be eligible for compensation for work-related injuries Nurses working in environments considered high-risk will soon be able to claim compensation for work-related injuries as the government is set to provide them with insurance coverage.

On Monday, the nurses’ union threatened to “block” emergency services unless its members at Mater Dei Hospital’s Emergency Department and Mount Carmel Hospital were given occupational insurance.

The union’s threat prompted Health Minister Chris Fearne to urgently put the issue on the table during a Cabinet meeting, during which it was agreed the nurses should be treated like other workers from different sectors who are also considered as operating in high-risk situations.

Some 120 nurses working at Mater Dei Hospital and Mount Carmel Hospital, including those dispatched from hospital on ambulances to handle medical emergencies, are expected to benefit from the insurance coverage.

The move comes in the wake of a series of incidents where nurses were assaulted by patients or their relatives. Just last week, a nurse was

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pushed down the stairs by a patient’s relative and another was assaulted.

Welcoming the decision, Malta Union of Midwives and Nurses (MUMN) head Paul Pace said the casualty nurses had long been waiting for such coverage as this would give them some additional peace of mind while carrying out their duties.

“Casualty nurses had long been waiting for insurance coverage” According to Mr Pace, the government has pledged to have all the insurance paperwork in place

by December 1. The union was also pleased to note that the issue was taken seriously by the Health Minister, he said.

Nurses have been asking for

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insurance for several years but the issue came to a head earlier this year after the government announced that its uniformed personnel would be covered by occupational insurance.

Under that scheme, members of the disciplined forces are eligible for compensation of up to ¢180,000 in case of death or injury while on duty.

When contacted, Mr Fearne said professional and technical staff do “sterling work with dedication and commitment” and, therefore, the “last thing they should expect is to be verbally or physically abused”.

“Unfortunately, however, incidents happen. To my mind, protecting the interests of our frontline staff who work in high-stress environments is the correct decision.

We are showing our gratitude and solidarity in a concrete way,” he said.

Details on the type of insurance coverage to be provided to the nurses have yet to be divulged.

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Times of Malta

Operations postponed as hospital nurses demand better ‘free’ meals Union also concerned about legal liability of nurses on ‘constant watch’ A number of operations at Mater Dei Hospital were postponed on Tuesday morning because of industrial action by nurses over meals.

A spokesman for Mater Dei said that up to eight operations had been postponed by 8am, as nurses were instructed not to accompany patients to operating theatres.

The nurses are following a directive by the Malta Union of Midwives and Nurses (MUMN) which is arguing that the quality of food they are provided while on duty should be improved.

“This is disproportionate action which certainly doesn’t put the interests of patients first,” Mater Dei CEO Ivan Falzon told Times of Malta.

While clarifying that emergency interventions and operations for serious conditions are not covered by the strike action, Mr Falzon said the action would impact many who have been waiting months for a date in the operating theatre.

He said all doctors and nurses are entitled to free meals from the canteen but the numbers of those making use of it in recent years had shot up to around 1,300 people. The nurses’ union is now demanding an allowance instead.

“Of course unions have every right to take action, but let’s first make sure the discussions are exhausted,” Mr Falzon said.

The issue has been simmering since June, when the MUMN first threatened to issue directives to all its members unless sweets, sweet beverages and carbohydrates are reintroduced for staff in Mater Dei hospital.

“MUMN would like to make it clear that Malta is not a dictatorship country where a person is obliged to eat only what the Health Promotion department deems fit,” it said at the time.

Moreover, the starter given to staff, which was never a large portion, was also removed, it said, adding the Health Promotion Department should not “impose” a special diet on union

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members.

MUMN president Paul Pace told Times of Malta on Tuesday that a meeting with the Health Department on Monday had ended in disagreement.

Concerns over legal liability of nurses The discussion had included the meal allowance and the legal liability of nurses employed on constant watch with patients.

The constant watch issue cropped up after a court found a nurse liable for damages after a patient choked on a piece of chicken and died. The union is insisting that enough nurses should be deployed for constant watch duties and they should not have to carry out constant watch along with other duties.

On the meals issue, Mr Pace said the food being offered to nurses was “crap” and the union was therefore calling for a small meals allowance, enough to buy a tuna roll and a bottle of water for a 12-hour shift.

He said various directives had been ordered. Surgeries were affected because nurses were told not to leave their wards.

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Ethics & Health Care…

Compassion Compassion, along with competence, commitment, confidence and conscience, were identified as the five Cs of caring in Sr Simone Roach’s theory “Caring the Human Mode of Being”. Sr Simone Roach was a nun and Canadian nurse theorist.

In 1992 she enlightened us with what she described the five Cs of caring, which she updated ten years later when she referred to them as the six Cs of caring; adding comportment to the caring approach. Additional Cs that have been added by other theorists include communication, culture and courage. The link with the six nursing values introduced in the preceding article is evident.

Compassion, is therefore, noted as a value of nursing and as one of the original five Cs of caring. Cummings & Bennett (2012) describe compassion as “…how care is given through relationships based on empathy, respect and dignity – it can be described as an intelligent kindness and is central to how people perceive their care.”

Compassion is often linked to witnessing the suffering of another and feeling compelled to alleviate that suffering to the best of one’s ability. This may lead some confusion to the term compassion being used interchangeably with empathy, sympathy and caring. However, it is important to acknowledge that

each term has its own meaning and emphasis. To be able to demonstrate compassion, suffering must be identified and addressed. van der Cingel (2011) identified seven dimensions required to address the complexity of compassion. These are attentiveness, listening, confronting, involvement, helping, presence and understanding. Roach emphasised that compassion is demonstrated when the nurse attempts to understand what the patient is experiencing (cited by Caranto, 2015). This supports the emphasis made by other nurse researchers that communication is essential when demonstrating compassion (Baillie, 2017).

In 2002, when Roach revisited the Cs of caring, she highlighted the importance of extending caring to the patient and the family. This could be in dealing with impending loss of a loved one where there might be questionable expectations, fears, regrets and grief (cited by Caranto, 2015). Nurses need to acknowledge the depth of how their presence, care and presence can support patients and relatives in order to provide

effective compassionate care. Some nurses may find this challenging, as there is a need to step out of their comfort zone.

As explained by Caranto (2015) the nurse’s key role is “to promote, maintain, or establish human connectedness for therapeutic outcomes”. Sherwood (2000) defined this by referring to recognising the suffering of another and enabling them to become stronger, grow and heal (cited in Caranto, 2015).

Demonstrating compassion is not about the skill set a nurse has or the application of appropriate behaviours. It is about being able to genuinely connect through an authentic presence that recognizes the vulnerability of another individual, and know that no matter what the clinical outcome maybe, that individual can still grow in the caring they receive when it is provided by a compassionate nurse. Simpson (2014 cited in Caranto, 2015) emphasised that “nobody in healthcare knows more about the power of compassion than nurses do.” This will be explored further in the next issue.

Marisa Vella

photo | thepsychologist.bps.org.uk

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

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How Nutrition can support your child’s health

M

alnutrition is very often underrated and like an iceberg, its threat remains hidden under its surface. It is widely perceived as a condition related with death, which happens for instance during catastrophic events like wars or natural disasters, but for the majority, malnutrition affects slowly and silently, by delaying child’s physical and brain development, causing permanent delays and decreasing the immune system activity. Indeed very often behind a frequent episode of infections, low growth rates, skin problems and poor cognitive development, there is a history of neglected malnutrition.

Malnutrition should not be confused with starvation and scarcity of food, but a complex combination of many factors such as: protein deficiency, fat or carbohydrates or even micronutrients deficiency like vitamin D, Calcium, Zinc and DHA and it can come in all sizes, people with malnutrition could be both underweight and overweight! Obviously the majority of cases affect the first group, and eventually may cause a condition called failure to thrive or even just a decrease in term of growth, that your Pediatrician or Pediatric Dietitian identify as a negative “deviation” on the growth chart. The second group does not show signs of stopping growing, but still may cause brain development and cognitive system delays.

Malnutrition should also be related to other acute or chronic diseases that may interfere with the nutritional intake, absorption or metabolism of food, like celiac disease, cystic fibrosis, inflammatory bowel diseases, cardiovascular problems, hyperthyroidism or cancer.

Take it in time!

As mentioned above, malnutrition causes permanent growth delays, it is therefore crucial to intervene immediately by correcting the issue. Your Pediatrician and Pediatric Dietitian will guide you through, so once again, be suspected if your children has got one of the symptoms related with it!

Resource Junior is a high energy 1.5 kcal/ml, ready to drink sip feed for children aged 1-10 years. It is a nutritionally complete and provide the right amount of protein, carbohydrates and fat. It also includes a blend of fat soluble and water soluble vitamins enough to satisfy your child’s requirements, can be used as a supplement or as solely source of nutrition when is needed. Moreover it has fibre inside, which are essential to prevent diarrhea, to maintain a normal intestinal function and microbiome. Available in two popular children’s flavours (strawberry and vanilla) to improve the palatability and compliance even for a long term.

This article has been brought to you by:

Mirko Cirolli

BSc (Hons.) Dietetics (Italy) MSc Human Nutrition (Rome, Italy) Business Developer Nestlé Infant Nutrition & Nestlé Health Science

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from our

diary the Courts of Malta to MUMN once again restored to of the Physiotherapists ns safeguard the will and decisio

A Turkish Union paid a visit to MUMN Offices to discuss the Trade Unionism in Malta in relation to an EU Project

One of the courses organised

by MUMN at its premises

mittee Once again the FNBF Group Com at the ony em Cer ual organised its Ann with ed our hon e wer We Presidential Palace. lta Ma of the presence of H.E. President

MUMN organised a very interest ing conference regarding health & safety issues and legal liabilities

H.E. President of Malta together with all the FNBF Members who received the Memento Nurses at Birkirkara Health Centre during a Health Promotion Campaign

The Pensioners Group Commit tee organised a colourful day in Goz o

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photo | Linda Kastrup/Ritzau Scanpix

Denmark struggles to recruit nurses despite government promising 1,000 more Although the government has promised to increase the number of nurses in Denmark, the challenge of recruiting requisite numbers is growing.

In 2018, then-opposition leader Mette Frederiksen promised that she would increase the number of nurses by 1,000 by 2021 nationally.

But the total number of nurses working within the Danish public health system has decreased by 473 ‘working years’ over the past 12 months, broadcaster DR reported on Monday.

The figures in the DR report come from the Danish Health Data Authority A ‘working year’ equates to the total working hours of one full-time staff member for one year.

Frederiksen’s Social Democratic party promised in its campaigning for the 2019 general election to hire 1,000 more nurses for the health system as soon as possible.

The proposal for next year’s budget sets aside 300 million kroner for hiring nurses – funded in part by raising the price of cigarettes.

Helle Dirksen, who is head of the Danish Nurses’ Organization told DR that the government already has catching up to do if it wants to fulfil the election promise.

“We are starting from less than zero. I assume that the missing nurses will be added to the 1,000 by which we are already short,” Dirksen said.

Those comments appear to be supported by Kjeld Møller Pedersen, a professor at the University of Southern Denmark’s Department of Public Health, who said that finding so many extra nurses represents a challenge for the government.

“It’s not as though there are 500 unemployed nurses. I think they are in demand in municipalities and in general practice,” Pedersen told DR. Minister for Health Magnus Heunicke admitted that Denmark faces a bigger challenge than

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expected in increasing the number of nurses working within the health service.

“The new figures show that, whilst we have been discussing this, things are moving in the wrong direction,” Heunicke told DR. The Zealand administrative health region is cited as having seen a particularly sharp loss of nurses, with 155 working years’ less workforce in the second quarter of 2019 compared to 2018’s third quarter.

That is due in part to a large number of redundancies last year, DR writes.

“If it’s possible to let so many nurses go, then it must also be possible to get the number to go in the other direction,” Heunicke told DR. The minister noted that financing for the new nurses was still under negotiation, with the budget still at the proposal stage.

- DIĊEMBRU 2019

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Il-Qorti tilqa’ l-mandat ta’ inibizzjoni mitlub mill-MUMN

I

l-Qorti laqgœet temporanjament it-talba tal-Union tal-Infermiera u l-Qwiebel (MUMN) u gœaldaqstant œaræet mandat ta’ inibizzjoni li jwaqqaf lill-Gvern milli jinnegozja mal-UŒM Voice of the Workers, gœall-ftehim settorjali gœan-nom talfiÿjoterapisti fis-servizz pubbliku.

Il-kwistjoni ddur madwar min gœandu d-dritt li jirrappreÿenta lill-fiÿjoterapisti blMUMN issostni li gœandha l-maææoranza tal-fiÿjoterapisti li huma membri tagœha.

Min-naœa l-oœra, il-Gvern u l-UŒM qed jinsistu li din tal-aœœar gœandha l-gœarfien uffiçjali tal-professjonijiet tas-saœœa oœrajn (Allied Health Professionals), li jinkludi lillfiÿjoterapisti.

Wara li laqgœet proviÿorjament it-talba, il-Qorti mistennija tisma’ l-kaÿ f’iktar dettall minn nhar it-Tlieta li æej.

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AVAILABLE IN ALL PHARMACIES - NUMRU 85

2. Avoiding contact with eyes, ears and mouth.

3. Let it act for 3 minutes, to assure antiseptic absorption.

4.

5. Do not apply any other product. skin and hair are clean.

www.prohealth.com.mt medicaldevices@prohealth.com.mt 23385000 | 79081282

Press Information Communiqué de presse Comunicado de prensa

ICN: “Mental health is a human right - end discrimination now” ICN calls for investment in nursing as an essential prerequisite for high-quality mental health services Geneva, Switzerland, 10 October 2019 – World Mental Health Day (10.10.2019) is observed each year to raise awareness of mental health issues affecting 1 billion people across the world. Despite effective strategies for managing and preventing mental disorders, many people do not seek help because of limited access to care and the stigma attached.

World Mental Health Day is an opportunity to highlight the invaluable role of registered nurses in promoting mental health, preventing mental illness and providing personcentred mental health care. Nurses are the largest professional group working in mental health.

Mental illness affects people of all ages, genders, socioeconomic levels and in every corner of the globe. And yet, around the world, mental health services are often plagued by stigma and discrimination and, as a result, end up underfunded and inaccessible to people who are in dire need.

This year’s focus on suicide prevention is especially welcome because of the high number of suicides across the globe. The World Health Organization estimates that as many as 800,000 people take their own lives each year - one every 40 seconds - a truly staggering and alarming statistic.

ICN Chief Executive Officer Howard Catton said: ‘Health is a human right and that right should apply equally to physical and mental health problems. Mental health services have historically been

poorly funded and given a low priority, which means that the one in four of the population who will experience a mental health issue either have to wait far too long for help, treatment and support, or do not get any help at all.

‘The impact of not getting proper, timely treatment puts enormous pressure on individuals, their families and friends, and can quickly lead to people facing a number of issues, including social isolation, problems at work, and financial difficulties. People with mental illness often have limited or no access to housing, education or employment.

‘This lack of mental health services is a form of discrimination that can result in violations of people’s basic human rights, and it must end.

We all need to talk more about mental health, and governments must invest more in services and the nurses that make them run smoothly. Nurses act as patient advocates and play an essential role in preventing and eliminating abuse and poor treatment of people with mental illness.’

ICN is concerned about the pervasiveness of the stigma and discrimination associated with mental illness and its negative consequences on the wellbeing of patients, families and society in general. The focus for the future development of mental health services should be on fully integrated services that are embedded in local communities to provide the best care as close to home as possible.

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photo | financialtribune.com

Note to Editors People with mental health problems are three times more likely to develop debilitating noncommunicable diseases such as diabetes, heart disease and stroke.

The impact of mental illness on the social and economic wellbeing of individuals, families, and societies is large, underestimated, and often ignored. If untreated, mental illness undermines health capital, and hence human capital development, since they, unlike many of the high-burden diseases, have an early age of onset and are highly prevalent in the workingage population. In OECD countries mental illness affects an estimated 20 per cent of the working-age population at any given time.

According to the world Bank the global economy loses about $1 trillion every year in productivity due to depression and anxiety.

It is estimated that the world spends 2% of the global health budget on mental health. It is believed that if investment was made into treatment interventions at the community level, there would be significant economic returns.

The benefit-to-cost ratios for depression equated to approximately two and a half times and for anxiety disorders up to three times the benefit.

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Aħna li għexna l-80’s

L-Ewwel Parti

Minn studenti sa tal-post…

L-iskop ta’ din is-sensiela ta’ artikli huwa biex nuri x’bidliet seħħew matul is-snin fir-rigward tannursing u l-isptarijiet f’dik il-ħabta. Mhux se nkun qed nikteb biss esperjenzi tiegħi personali iżda wkoll memorji kollettivi li kultant tħeġġeġ ftit nostalġija jew tbissima.

Se nkun qed nuÿa lingwaææ li nuÿaw aœna ta’ kuljum u mingœajr tidwir ta’ kliem. Il-æenerazzjoni tallum assolutament ma tistax tifhem çertu kunçetti ta’ kif gœexna dak iÿ-ÿmien gœax l-affarijiet huma differenti œafna minn tal-lum u gœalhekk importanti li nfakkruhom f’kuntest storiku. Li wieœed ifakkar il-passat huwa mportanti gœaliex wieœed jista’ jifhem aœjar il-problemi li jaffetwaw il-professjoni illum u forsi nirrangawhom; In-Nursing dejjem kien, gœadu u jibqa’ dak li hu: servizz vokazzjonali u totali lejn il-marid.

Forsi t-teknoloæija u l-fissazzjoni fiddokumentazzjoni li œadu rankatura b’saœœitha mit-tmeninijiet il-quddiem nessewna ftit mill-kunçett tal-bedside nursing. Li hu zæur hu li l-80s ma kienx ÿmien il-œaæar, l-anqas. San Luqa kellu Intensive Care u CCU tajbin œafna u t-teknoloæija bdiet titjieb bl-introduzzjoni ta’ monitors æodda, infusion pumps æodda u anke mediçina ædida. It-tmeninijiet kienu interessanti anke gœall-fatt li kien ÿmien ta’ prova gœall-æenerazzjoni ta’ N.Os li ma kienux il-famuÿi Sorijiet (sorijiet tal-Karita’) li jmexxu s-swali u anke minœabba ÿ-ÿieda fl-SRNs fuq l-SENs. Dan ifisser li s-sistema ta’ tmexxija tal-wards kienet inbidlet xi ftit: minn sistema ta’ dixxiplina kwaÿi militari gœal-tmexxija aktar moderna, aktar lajka (gœalkemm xorta kien hemm xi wœud li kienu jmexxu b’ dixxiplina kbira). Bœal-dejjem, l-N.

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Os fis-swali kienu l-fulkru tal-isptar.

N.O. tajjeb kien ifisser sala tajba. Kien gœad kellhom çertu poteri u ma kien jindaœlilhom œadd. Œafna kellhom xi laqam, inkluÿ il-Matron, uÿanza aktar popolari gœal-dak il-œabta li ntirtet minn qabel. Ma kontx tagœmlilhom il-bÿieq fuq imnihirhom u l-esperjenza li kellhom kienet vasta u utli. Ittmeninijiet ra wkoll l-introduzzjoni tal-First Line Management, taœriæ neçessarju gœal-min kien imexxi swali, kliniçi eçç. Minn naœa l-oœra il-kunçett tal-professjonalizmu kien gœadu fl-infanzja tiegœu imma lejn l-aœœar tiegœu rajna xaqq dawl bl-introduzzjoni tal-Baçellerat u l-introduzzjoni tal-istudji Terzjarji finNursing.

Gœan-nofs tat-tmeninijiet il-jobs u l-opportunitajiet akkademiçi kienu pjuttost limitati f’pajjiÿna u li taœdem ‘mal-gvern’ kienet u baqgœet xi œaæa attrajenti. Kien il-perjodu meta l-gvern kien qed iœajjar numru mdaqqas ta’ ÿgœaÿagœ biex jagœmlu l-eÿamijiet gœan-Nursing jew tidœol skont kemm kellek GCEs. F’deçennu kienu daœlu ‘il fuq minn 400 gœall-kors tal-SRN u b’kollox kellek workforce ta’ ‘il fuq minn 600 SRN jaœdmu fis-servizz.

Kien ÿmien ta’ reçessjoni u minœabba l-qagœad kien ikollok jew taœdem mal-gvern jew f’xi fabbrika. Filfatt filbidu tat-tmeninijiet Il-qagœad kien

- NUMRU 85

ilaœœaq ftit inqas mit-12%, gœalœabta tal-’83 il-GDP kien niÿel, filwaqt li t-tkabbir kien niÿel 1%. Lejn l-aœœar tat-tmenijiet reæa’ rkupra b’5%. Il-life expectancy f’dak id-deçennu kienet ta’ 70 sena fl-1980 u telgœet gœal-76 sal-aœœar tiegœu.

Fil-kaÿ tiegœi dik il-œabta kont indeçiÿ dwar il-futur tiegœi u f’tebqa t’gœajn, wara li œabib tiegœi qalli li se japplika biex jagœmel l-eÿami, tlajt mieghu x’imkien il-Belt u applikajt bœalu. Dan wara li kont gœadni kif spiççajt minn kors ieœor terzjarju flinæinerija.

Insomma, entrance examination wara intgœaÿilna biex nibdew il-kors, gœamilna l-‘Medical’ fejn tabib anzjan jarak is-Sanita’ u jgœidlek ‘isgœol’ u sibna ruœna in-Nursing School ta’ Gwardamangia li kien parti ntegrali minn San Luqa. F’dik is-sena partikolari (1984) konna dœalna madwar 90 ruœ bejn Pupil Nurses u Student Nurses.

Wieœed kors ta’ sentejn u l-ieœor tlieta. Waqt l-interview tabib staqsieni: ‘Gœalfejn minn kors fl-inæinerija æewwa t-Technical dœalt gœall-kors tal-SRN?, u jien innoçentament weæibtu: ‘Œeqq biex jekk ikollkom xi magna tal-XRay bil-œsara, nsewwiehilkom!’. Gœalnaqra ma kienx se jibgœatni nixxejjer!

Konna mmorru x-xogœol b’ tal• ikompli f’paæna 29

All your medical equipment needs under one roof!

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Il-Musbieħ - DIĊEMBRU 2019 Tel: 21 222 044 Email: info@unicare.com.mt

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Precise, gentle, easy: the latest generation of blood pressure monitors

It all comes down to the precision If you want to monitor your blood pressure, you need a device with the best possible accuracy, and which is easy to use. Thanks to their intelligent specifications, Veroval® blood pressure monitors prevent measurement errors, for example, by helping you check correct cuff position – which is essential for a correct result.

Gentle measurement is also provided by Comfort Air Technology.

It determines expected blood pressure already when the cuff is being inflated and therefore only inflates as much as is individually needed. Another great feature: all your measured values can be saved, processed and shared with other Veroval® devices, such as the scales or the activity tracker using the Veroval® medi.connect software.

Veroval® Premium blood pressure monitor For those who want to measure accurately and gently, then a Veroval® Premium blood pressure monitor is the right choice. All monitors are clinically tested, simple to operate and offer high measurement accuracy for patients who measure regularly.

Upper arm blood pressure monitor The VEROVAL® Duo Control blood pressure monitor measures correctly, even in the case of cardiac arrhythmias and is medically precise measurement thanks to the DUO SENSOR technology.

Features: • Fully automatic upper arm blood pressure and pulse measurement • 2 measurement methods: Korotkoff microphone measurement and Oscillometric measurement • Detects and displays cardiac arrhythmias • Facilitates correct measurements thanks to the Secure fit patented cuff, control of correct cuff position and rest indicator • Large illuminated display for easy reading of measured values • Indicates too high or too low ambient temperature • Simple analysis of measured values using a traffic-light system • Easy data administration and storage with the Veroval® medi. connect software

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• Data can be shared between all Veroval® devices such as the scale and activity armband • USB cable and 4x 1,5 V AA batteries DUO SENSOR technology The innovative DUO SENSOR technology combines two professional measuring methods: the Oscillometric technology and the Korotkoff technology. Whereas most of the automatic blood pressure monitors on the market only function using the Oscillometric technology, which evaluates arterial pulse waves, the DUO SENSOR technology additionally measures using the very precise Korotkoff method, where a microphone is used to record heart sounds. Doctors also use the Korotkoff technology to measure blood pressure, since this is very reliable (gold standard) and also provides correct readings in patients with cardiac arrhythmias.

Comfort Air Technology The Veroval® Duo Control upper arm blood pressure monitor with Comfort Air Technology allows gentle measurement. Unlike many automatic blood pressure monitors with pre-programmed cuff inflation pressure, the Comfort Air Technology determines an approximate systolic blood pressure of the patient during each measurement and adds 30 mmHg for the measurement accuracy.

This allows for more comfortable upper arm measurements.

Certified high precision: European Society of Hypertension validated ESH-IP2 2010 The proven high measurement quality of the Veroval® Duo Control upper arm blood pressure has been approved by the European Society of Hypertension (ESH).

Quality seal of the German Hypertension League - Deutschen Hochdruckliga (DHL) Veroval® Duo Control has met all specifications required for the quality seal of the German Hypertension League.

Quality seal of the Britisch Hypertension Society (BHS) Veroval® Duo Control is clinically validated by the British Hypertension Society.

For further information visit: www.veroval.info 5 Il-Musbieħ - NUMRU 8 Veroval® is distributed in Malta by Alfred Gera & Sons Ltd. Tel: 21446205

Aħna li għexna l-80’s

• ikompli minn paæna 26 linja, tilgœin u neÿlin it-telgœa’ ta’ Gwardamangia jew Tal-Pieta’ u ftit kienu dawk li kellhom karozza second hand jew mutur. Il-parking kien limitat u œafna minna konna nipparkjaw barra u nispiççaw b’xi œæieæa mkissra u jisirqulna xi stereo.

In-Nursing School kienet f’post çentrali u viçin ta’ San Luqa fejn bdejna nistudjaw. Kellna klassijiet kbar, arjuÿi u b’gallariji jagœtu fuq l-Imsida u fuq Tal-Pieta’. Qattajna issiegœat fihom, nistudjaw, niççaççraw u nagœmlu l-eÿamijiet. Il-Lippincott’s studjajnih minn quddiem sa wara u xi wœud mit-tutors kienu jtuna n-‘notes’. Œmerijiet gœamilna bosta. Kienet dinja li gœada pjuttist ‘sempliçi’: dinja mingœajr mobile phones f’idejna u dinja li t-teknoloæija tal-computer kienet fil-bidu vera tagœha. Kien feeling ta’ œajja li ma torbtokx: li stajt tfittex fil-kotba, li timraœ fil-libreriji (gœalkemm fl-iSchool for Nurses kien gœad ma kellniex waœda) u mhux imkaxxal fuq Google; li ççempel minn telephone booth meta trid int u mhux meta jridek œaddieœor; li tixtri u taqra gazzetta u li tagœti kaÿ x’hinuma jgœidu sœabek u mhux tibbrawsja fuq facebook. Il-gossip kien minn dejjem, ma kienx fis-social media imma wiçç imb wiçç (jew minn wara d-dahar).

Kienet mentalita’ oœra. Fl-iskola kien hemm id-dixxiplina speçjalment meta kien ikollok lil-Sister Federica, Principal Nurse Tutor li b’œarsa biss kienet issammrek. Kellna anke tutors tajbin, kollha SRNs b’esperjenza kbira fisswali. Xi wœud kienu jgœallmu b’mod li jibqa’ ttimbrat æo moœœok, oœrajn kienu jiddependu fuq it-text book u jaqraw il-ktieb fil-klassi. Ma nistax ma msemmix tutors li nibqgœu niftakru, bœal-Sister Mary, Donia Baldacchino, Ms. Camilleri, Mr. Rimmer, George Muscat, Ms. Sloane, Sister Alberta, Tony Cordina u anke Ms. Magri flimkien ma’ visiting lecturers, uœud mill-qasam mediku. L-iskola konna nitgœallmu l-Anatomija, il-Fisjologija, Health u l-Igene, il-First Aid u n-Nursing. Il-kurrikulu kien jikkonsisti fuq mudell mediku u mhux dak tanNursing. Konna bdejna nisimgœu bilfamuÿa Roper (gœal Nancy Roper), Logan and Tierney model of nursing li kien gœadu kif kien rivedud fl-1985 fejn kien mudell tan-nursing ibbaÿat fuq l-AL (activities of living). Inçident kurjuÿ li niftakar dak iz-zmien fl-Ischool for Nurses huwa meta bdiet iddur petizzjoni biex in-nurses iræiel ikunu jistgœu jagœmlu l-kors gœall-midwives.

Xi œaga li ma niÿlitx tajjeb œafna ma’ xi wœud li kellhom influwenza fil-qasam tal-qwiebel! Naœseb iktar kienet saret apposta b’xi ftit inkejja ÿejda.

Il-Musbieħ

L-iSchool for Nurses min-naħa tal-Pieta’ L-atmosfera fil-pajjiÿ kienet waœda turbulanti, taœraq politikament u kull minn ikun se jibda’ jifforma xi assoçjazzjoni, union jew organu li jaqbeÿ gœal-xi kawÿa kien jiæi ttimbrat u affaçjat b’ostilita’ minœabba li kien jidher li ‘qed jaœdem kontra l-gvern’.

Avveniment partikolari li seœœ fl-1984 kien meta xi studenti tat-3rd year li kienu segwew strajk leæittimu ta’ æurnata b’appoææ gœall-istrajk talUnion tal-Gœalliema (MUT), barra li kienu æew sospenduti, il-finals kellhom jagœmluhom xi xahrejn wara. Id-diskors fuq il-politika bejnietna ÿ-ÿgœaÿagœ kien wieœed pjuttost qawwi u saœansitra kien hemm affiljazzjoni attiva fil-partiti.

Donnu ÿ-ÿgœaÿagœ tal-lum qajlu ‘jifhmu’ x’hinu jiæri madwarhom jew jimpurthom mill-politika partiææjana (œlief gœall-avvenimenti riçenti). Kien ÿmien fejn in-Nurses u l-Midwives ma kellhomx house union gœalkemm kien hemm attentati fis-sebgœinijiet biex titwaqqaf il-Malta Union of Nurses.

X’uœud minn Nurses kienu affiljati jew mal-UHM jew mal-GWU, gœalkemm il-UHM kienet aktar rapreÿentattiva • ikompli f’paæna 30

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Aħna li għexna l-80’s • ikompli minn paæna 29 gœal-dil-klassi ta’ œaddiema. In-nurses ma kienux rappreÿentati biÿÿejjed, u gœal-ÿmien twil ‘sofrew’ fis-silenzju, b’konsegwenza li l-kundizzjonijiet taxxogœol ma kienux xi eççellenti. Sa dik il-œabta kienu rari l-okkazjonijiet meta n-nurses aÿÿardaw jipprotestaw gœaldrittijiethom. Il-big brother syndrome kien prevalenti mhux œaÿin. Fl-1984 kien gœadu kif œareg il-film ‘1984’ fis-swali taç-çinema u gœaldaqstant kien suææett topiku mhux œaÿin!

Il-midwives kienu l-unika settur li kellhom il-Union tagœhom u li filfatt gœenet biex tiæi mwaqqfa l-Union tagœna tal-lum. Anke aœna l-istudenti ppruvajna nwaqqfu assocjazzjoni biex naqbÿu gœad-drittijiet tagœna, imma minœabba id-diviÿjoni politika æew maœluqa ÿewæ organi skont jekk intix ‘aœmar’ jew ‘blu’. Darba minnhom waqt rally fl-auditorium taliskola tal-iStudent Nurses Association inqala’ xi diÿgwid u saœansitra æew xi ‘mastrudaxxa’ ta’ St. Luke’s biex ‘jagœmlu gœalina’. Il-Ministru tas-Saœœa ta’ dak iÿ-ÿmien kien gœad kellu poteri sostanzjali fuq id-deçizjonijiet rigward is-saœœa u ma ninsewx li kien gœadna kif spiççajna mill-burraxxka tal-istrajk tat-tobba. Kien anke ÿmien meta kont tkellem lil-Ministru jew tmur is-Sanita’ ‘meta kien ikollok bÿonn xi œaæa’.

Nepotiÿmu fl-aqwa tiegœu. Xi nurses ‘minn kull naœa’ kienu magœrufa gœall-affiljazzjonijiet politiçi tagœhom u kultant kien ikollok bÿonn tkellem lilhom qabel, speçjalment gœal xi promotion. Kien zmien fejn xi nurses kienu ddiÿappuntati u mweægœin ferm minœabba dal-fattur. Kien gœadu ÿmien it-transfers politiçi, kultant b’kattiverija, fejn ‘il-Manikomju’ kien ‘tal-kastig’ u gœalhekk kellek numru ta’ nurses li ma jaqblux mal-gvern talæurnata li jintbgœatu hemm kontra qalbhom jew imorru hemm u ‘ma jagœmlu xejn’. Dan kien jagœmel gœajb gœall-professjoni tagœna. Dik ilœabta ma kienx hemm house union jew assoçjazzjoni li ‘taqbeÿ gœannurses’ u kien ikollok tbaxxi rasek gœalkollox. Uœud minn dawn gœaddew minn ÿminijiet diffiçli psikologiçi u oœrajn addattaw tant li ma kienx façli taqlagœhom minn fejn intbgœatu kontra qalbhom. In-nurses ta’ dak iÿ-ÿmien kienu nurses resiljenti fejn anke œadmu f’sitwazzjonijiet diffiçli

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ferm speçjalment meta kienu huma li jieœdu deçiÿjonijiet gœall-pazjenti jew meta kellhom ikunu nterpreti ma pazjenti li ma jafux l-Ingliÿ. Œafna nurses œadmu kemm felœu fis-silenzju, obdew kemm felœu u baqgœu jaspiraw li xi darba jitjiebu l-affarijiet. In-nurse ta’ dak id-deçennu kien nurse li ma kellux biÿÿejjed empowerment, anzi kien nurse sottomess.

Ma rridux ninsew is-sabiœ ukoll: iddiscos fil-Milied u okkaÿjonijiet oœra li kienu jsiru. Konna nÿejnu l-auditorium u saœansitra ntellgœu concerts b’ xi kant, plays u muÿika. Fil-famuÿ canteen konna nieœdu l-breakfast bilbajda moqlija tqattar iÿ-ÿejt, wara ta’ bil-lejl, u fil-break ta’ filghodu kien ikollna l-œobÿ imqatta’ frisk biÿ-ÿejt u l-kunserva fuq tilari daqshiex u œalib tal-MMU. Il-koki u l-fattigi konna nafuhom kollha b’isimhom u jekk kont tkun œabib ma’ xi wieœed minnhom kont takkwista xi bajda ÿejda!

Meta dœalna n-Nursing School, mill-kamra tas-Sur Salv, issuplixxewna b’ gagaga bajda (il-lab coat), par ÿarbun kannella (tal-medjuevu) u kalzetti kanella, u gœamilna l-badge li teœel bil-labra, u lin-nisa tawhom il-libsa l-bajda, iç-çintorin l-abjad (imbagœad kien jingœata wieœed blu), il-kappa tad-drapp, il-kappun navy blue, kalzetti bojod u ÿarbun abjad.

Kienet uniformi li tidentifika œafna ma dak li jagœmilna ‘nurses’, speçjalment in-nisa. Kienet kwazi xena ‘romantika’ tara l-uniformi tan-nisa bil-kappa u l-kappun mixjin flimkien deœlin gœaxxogœol. L-uniformi tagœna l-iræiel filfatt kienet bœal-dik tat-tobba u dixxiplini oœra; æagaga sempliçi. Ilœaqna wkoll xi 3 SRNs iræiel, gœalkemm aœna ma kellniex, uniformijiet blispalletti li ma kienux gœadhom jiæu milbusa. L-uniformi kienet (u gœada) tirrapreÿenta l-iæene, l-ismartness u saœansitra l-istatus tagœna. Interessanti li fi œdan il-General Stores, li kien barra mil-isptar kif taqsam it-triq minn San Luqa, kellu grupp ta’ œajjata li prattikament kienu jœitu kollox huma.

Kellna l-‘placements’ fis-swali ta’ San Luqa u Karen Grech, imsejœa ukoll il-‘Block’, twil 4 æimgœat kull post, forma ta’ apprendistat u konna naœdmu wkoll it-Theatres u l-Casualty max-shifts fir-rosters (SRN u SEN) u l-esperjenza li dabbarna kienet enormi. L-ewwel darba li mort San Luqa gœal-placement intlift fil-

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basement u kellha tkun fattiga biex turini minn fejn ngœaddi. Kif tlajt fisSala kont ma SRN mara biex nibda’ naœsel il-pazjenti u l-ewwel œaga li qaltli kienet: ‘Neœœi jdejk mill-but’.

Konna naœdmu siegœat twal, shifts ta’ l-gœases (12-il siegœa), tas-sitta u ta’ bil-lejl dejjem ma l-istess shift. Skont il-min tinzerta fix-shift kien jibgœatek xi ftit kmieni. L-istudenti Gœawdxin kellhom preferenza biex jitilqu kmieni, speçjalment meta r-riœ ikun xi forza 6 jew 7 u mhux l-ewwel darba li ma œadimx il-vapur. Mal-æurnata konna ninzertaw naœdmu ma’ 2 shifts waqt li f’ta’ billejl max-shift tagœna biss.

Konna nagœmlu kollox. Litteralment kollox: Œasil tal-morda, nassistu fid-dressings, immexxu l-pazjenti, inbattlu u nittestjaw l-awrini, inqassmu u nnaddfu l-patelli, inbattlu l-NG tubes, nibdlu l-loÿor, nippreparaw il-pazjenti gœat-theatres, nitimgœu u nisqu, nippreparaw u nqassmu t-te’ u l-breakfast, ngœasru l-laring, niæbru u nixxuttaw il-platti, innaddfu l-l-iÿgambelli u s-sollijiet tat-twieqi, ngœoddu l-laundry, nnaddfu s-sluice, inæorru s-sodod, nippreparaw il-feeds gœat-trabi, niæru bil-konsulti u anke ngœoddu l-konsenja. Gœadni niftakar nipprova nnaddaf sputum mug talistainless steel. Ma kienx xogœol façli speçjalment meta l-ingwanti kienu f’ammonti limitati. Saœansitra anke l-ippurgar konna nbiddlu mingœajr ingwanti. Konna anke nduru bil‘ktieb tad-dieta’ u naraw minn hu diabetic jew le. Kien ukoll ÿmien dwar l-importanza ta’ kif ‘tagœmel is-sodda’, bil-‘corners’ fil-ænub u l-importanza tal-bedspread. Æiri bil-qadi kien hemm kemm trid u ma rridux ninsew li l-Health Assistants kienu gœadhom fil-bidu tagœhom, allura konna ‘nibilgœu kollox aœna’. Xi wœud millpazjenti kienu jiddubitaw u jsaqsuna x’aœna propja: Studenti jew Health Assistants? Kien ÿmien li ma tmerix u li tgœid ‘Sinjor si’ biss. Œafna pazjenti kienu gœadhom jgœajtulna ‘servjenti’ u dan mhux b’disrispett imma gœax il-kelma æejja mill-antik. Il-qadi kien gœall-kullimkien: XRays bil-pazjenti u filing gœand Freddie, il-Medical Records gœand Frankie, gœand isSur Messina, l-Ispiÿerija gœand is-Sur Serge, il-Patoloæija bis-samples taddemm u ta’ kollox, is-CSSD bid-drums, gœand Temi tal-istores u mitt post ieœor. Swali oœra kienu jqabbduna

naqalgœu il-purtieri, inÿejnu gœal-Jum il-Œelsien u fir-Repubblika, inpinæu u nÿejnu fil-Milied (li kienet xi œaæa sabieœa) u nnaddfu t-treatment room. Partikolarment bil-lejl konna niæu mqabbda niftœu minn tulhom il-gareÿ u t-tajjar u nqasqsuhom b’imqass kbir gœad-daqs taddressings biex ‘jissajru’ s-CSSD. Pero’ qabel inqassqsuhom dan in-nurse partikolari kien jitwi r-rollijiet gœaddaqs ta’ mitraœ u jieœu ‘r-rest’ fuqu! Xi wœud mix-xogœol li konna nitqabbdu nagœmlu kienu elenkati fil-list of duties tagœna bil-miktub pero’ oœrajn le. Kien hemm anke NOs li jabbuÿaw bina biex nagœmlu l-qadi tagœhom personali, ta’ xi pazjenti, ta’ konsulent partikolari jew ta’ ‘xi baÿuÿlu’. Xi NOs fis-swali tan-nisa kienu anke juÿaw tattiçi ta’ bullying jew juru disprezz speçjalment lejn studenti nisa. U mhux NOs biss imma anke head of shifts kienu jibbuljaw. L-gœajjat minn naœa gœall-oœra tas-sala ta’ ‘student/ studenta’ biex iqabbduna xi œaæa gœadu jidwi f’widnejja. Mhux l-N.O.s kollha kienu hekk anzi xi wœud kienu bil-kontra: kienu jieœdu grazzja ma xi wœud (forsi gœax-gustuÿi) u jagœmlu l-preferenzi. In æenerali dak iÿ-ÿmien kien jinœass li n-numru ta’ studenti fis-swali kien jgœin mhux ftit filcompliment tal-ward. ‘Another pair of hands’ kienu jgœidu. Ÿgur li ma kienx ÿmien ta’ ‘reflective practice’ jew ‘evidence based learning’. Meta kont il-Casualty konna niæu mqabbda nagœtu ‘it-treatment’ (injections I.M) lill-pazjenti fi djarhom u kien ikollna dawra bl-ambulanza mhux œaÿin. Niftakar nidœol fi djar u nibqa’ mpressjonat b’residenzi substandard li konna niltaqgœu magœhom. Xi wœud kien gœad kellhom il-lavaman (fuq trepied) biex inkunu nistgœu naœslu jdejna bis-sapuna mill-buqar u nixxuttawhom fix-xugam. Saœansitra tfal konna ntaqqbu u naœseb li din kienet irresponsabilita’ kbira li tqabbad student biex ittiha. Œdimna n-Nursery tal-Post-Natal fl-isptar Karen Grech u nistqarr li kienet waœda mill-isbaœ esperjenzi tiegœi personali. Bilkemm ma kontx œadt il-qagœda, nisqu, inbiddlu l-œrieqi, u nagœmlu t-‘tops and tails’. Forsi gœax l-arloææ paternali tiegœi beda’ jtektek! Œdimna wkoll isPsychiatric Unit u kont nimpressjona ruœi bl-ECT, li kultant kienet tidher prassi krudila.

L-ECT Dwar is-suggett tal-konsenja ta’ min wieœed jispjegha fil-qosor: baÿikament kull œaæa li kien hemm filward riedet tkun imniÿÿla f’reæistru: loÿor, investi, kikkri, plattini eçç u jekk jonqos xi œaæa trid tirrispondi. Allura meta kienu jonqsu per eÿempju l-loÿor kienu jinqatgœu oœra minn wieœed sœiœ u meta jonqsu l-kikkri kienu jitniÿÿlu ma biççiet ta’ kikkri oœra taççakkuf imkissrin. Ritwal fejn kulœadd kien moœœu biex jgœodd u jœabbal rasu kif se jæibha ÿewæ. Niftakar anke N.Os. ‘jixtru’ pusati (frieket, skieken u mgœaref) mill-Monti tal-Belt biex ‘ipaçu’ u jaqblu mal-konsenja. Darba f’ reæistru tal-konsenja, xi œadd li ried jikteb ‘passatur’ bl-Ingliÿ niÿÿel: ’pasta in water out’! Kien anke ÿmien li jekk kienet taqa’ xi œaga mal-art kont taqbad xkupa u mopp u tnaddaf.

M’hemmx nejk. Kien ukoll ÿmien li trid taqdef kemm tiflaœ biex titgœallem, issaqsi kemm tiflaœ u tkun hands on.

Konna wkoll nieœdu t-TPRs, l-intake u l-outputs, nagœmlu l-HGTs u niççartjaw kollox. Kienet kwaÿi ossessjoni li tieœu it-temperatura lil-kulœadd, dœalt biex dœalt. Bott imdaqqas mimli methylated spirit fuq dressing trolley zgœir u ÿÿid jew tnaqqas grad jekk il-‘œæieæa’ gœamiltix taœt l-abt jew fil-warrani. Id-dokumentazzjoni u charting kien anqas laboruz jew mandatorju. Kien charting sempliçi speçjalment n-Nursing Report b’xi swali jniÿÿlu biss: ‘Comft. Day’ jew ‘Comft. Night’! Waqt il-ward rounds konna nkunu dejjem preÿenti u minn

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hemm tgœallimna œafna wkoll. Irrounds kienu gœadhom kwaÿi ritwal pjuttost sinifikanti fejn il-preÿenza tal-‘Professur’ u l-entourage, flimkien ‘mas-Soru’ jew l-‘N.O.’ kienet œaæa mportanti. Kulhadd qisu purçissjoni, qraba kollha barra, il-bieb tal-8-bedded jingœalaq, minn hu barra barra min u æewwa æewwa, pazjenti xummiema, l-art maœsula, kwiet perfett, radios u televisions mitfijin, trolley daqshiex bl‘istejjer’, l-‘N.O.’ bil-‘ktieb tad-dieta’ u l-‘ward round book’ u ammont imdaqqas ta’ medical students li llum laœqu Konsulenti u waslu biex jirtiraw!

Ma rridux ninsew li ward ma kelliex aktar minn ÿewg Konsulenti sakemm bdew jilœqu aktar u dar-ritwal beda’ jitlef l-importanza tiegœu. Il-pazjent kien jindirizza ‘lill-professur’ permezz ta’ ‘sinjur’, xi œaæa li kienet turi anke r-rispett lejn l-awtorita’ medika. Kien gœadu ÿ-ÿmien ‘id-doctor’s orders’ u kienet l-uÿanza li tgœolli l-flokk ta’ taœt gœall-professur biex jisma’ sider il-marid u jekk hemm bÿonn tgœattilu œalqu meta jgœidlu jisgœol jew jieœu n-nifs.

Il-God complex dejjem kien jeÿisti fl-isptarijiet fejn xi wœud kienu jaœsbu li huma xi allat, zgœar jew kbar. Kien hemm ukoll professuri, konsulenti, supretendenti, civil servants u principali tajbin œafna, li gœamlu œafna æid u æabu tibdiliet kbar. Xtaqt insemmi xi ismijiet ta’ nies li baqgœu jissemmew sal-æurnata tallum imma nibÿa’ li jekk inœalli ‘l xi œadd barra jieœu gœalih xi œadd.

Ikompli f’œarga oœra.

Joe Camilleri

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I’m a nurse, and here’s how to attract more of us to the NHS Molly Case

Instead of making claims about 50,000 new recruits, politicians should ask frontline staff where the funding should go.

O

ne of my worst shifts was during a particularly frosty winter some years back. I was a relatively newly qualified nurse but experienced enough to work on a high dependency unit at a large acute trust.

On arrival, at the ward the day shift let us nightshift workers know there was going to be a rejig that night: oncology services were desperately short-handed and the trust could no longer rely on agency workers to plug the gaps due to the funding deficit.

We were told that no extra staff were being called on and that we were to help out. The night shift stretched out worryingly before us, with each of us wondering who would pull the short straw to cover the oncology ward with life-threateningly unwell patients. That night the straw was mine: I later came to file the experience in my memory as a “never again” moment. I wouldn’t let it happen again, if I could help it.

Why do NHS staff boo Johnson?

Because he and his party are not listening to the people who hold the answers It was luck that got me through that shift, luck that a patient didn’t

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seriously deteriorate, and luck that I was working with an incredibly capable colleague who (as NHS staff always do) picked up the slack of missing a fully qualified extra nurse to tend to patients requiring cancer treatment, antibiotics, wound dressings and basic assistance. Since I was not trained in chemotherapy administration, and eight carefully prepped, minutely calculated infusions were required before 9 o’clock that night, we divvied out tasks within our skill set to try to keep patients as safe as we could. If there had been enough staff across the hospital we wouldn’t have had such difficulties.

And so I am fed up with watching male politicians tuck their ties into their shirts on arrival at the next unsuspecting hospital. Perhaps if Boris Johnson had been with me on that frosty night he would have seen how crucial having a fully staffed NHS is to patient safety. I truly believe that if all parties took the advice of vocal frontline staff, voters would be better informed and so able to understand possible solutions for the health service at this general election.

Why do NHS staff boo Johnson when he arrives at

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hospitals? Because he and his party are not listening to the people who have the answers. The people who have been working long hours in an NHS debilitated by living with an unmanaged, long-term condition for the past 10 years. Our prime minister will not even grant us the courtesy of informing us ahead of his attendance, allowing us the time to put questions to him.

Johnson has stated that his party are “putting more money into the NHS than ever before”. But the money simply doesn’t matter if it is not going to the right places. And where should that be?

Most importantly, our workforce.

Good, kind, hardworking people now have to pay to train to be a nurse.

For many this is simply not feasible.

Since the Tory government removed the nursing bursary we have seen a tremendous drop in university applications to train – a 31% decrease between 2016 and 2018.

I already had a degree – and debt – when I decided to become a nurse, but was well-supported to train with the nursing bursary. This course is not the same as other degrees: student nurses are working the same long

“I am fed up with watching male politicians tuck their ties into their shirts on arrival at the next unsuspecting hospital.”

shifts as registered colleagues on the wards, in the community, in addition to attending classes at university, and therefore are not able to get part-time jobs to help fund the degree. This cut to the bursary is coupled with already well-established chronic understaffing – a nursing shortfall of approximately 40,000 staff. Again, basic maths: no staff equals no NHS. Or as we’ve seen, cold nights where patients are put at risk because of a lack of staff.

The impact of understaffing on current health service employees is profound. The rate of staff leaving the NHS has tripled in the past seven years: the stress imposed on our nurses and doctors, who simply want to look after people but can’t because of dangerously inadequate staffing levels, is a fundamental reason why we are not retaining them. Added to that there’s the government’s “hostile environment”. We should stop deporting our doctors and instead guarantee settled status for the incredibly skilled EU workforce that keeps the health service running.

Another reason why healthcare professionals have taken to booing the prime minister out the door?

Our social care system is intrinsically

tied to the health of the NHS – and yet its funding has been stripped.

Austerity cuts to community services, GP practices, ambulance staff, community nurses, mental health and drug and alcohol misuse services has left nowhere for people to go but to A&E. There, frontline staff see more unrealistic targets asked of them. Lower A&E waiting times are demanded despite a staggering rise in need. Keeping patients safe without the correct number of trained nurses on the wards – it doesn’t add up.

On Sunday the Conservative manifesto emerged with a grand promise of 50,000 more nurses: it was a claim too good to be true – further examination shows this to be yet another lie, and lying to the good, hardworking people of the NHS is shameful. Johnson’s 50,000 target includes 19,000 nurses already employed by the NHS and will fall short of the numbers needed.

Laughably, the Conservatives want to persuade nurses to stay within the NHS. Meanwhile, despite talk of a Tory U-turn, the NHS bursary is not being brought back. A maintenance grant is

Il-Musbieħ

being offered but tuition fees remain – this is still a huge and costly barrier to those wanting to train.

Conservatives and Labour are vowing to spend billions to improve care. Labour has pledged £5.5bn more a year to end lengthening delays for treatment, tackle the staffing crisis, restore bursaries for student nurses, improve mental healthcare and facilities, but Chris Hopson, CEO of NHS Providers has warned about a surge in false promises. Before we can even begin to think about the incredible medical technology soon to be at our fingertips, we need a sustainable, long-term solution to urgently address the NHS’s deteriorating condition.

This must start with the workforce, and it needs to address our social care deficit – changing how we look after all members of our society long before they reach the hospital gates.

• Molly Case is a nurse and author of How to Treat People: A Nurse At Work https://www.theguardian.com/ commentisfree/2019/nov/26/ more-nurses-nhs-50000-frontlinefunding - img-1

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Press Information Communiqué de presse Comunicado de prensa

International Council of Nurses calls for ethical recruitment process to address critical shortage of nurses

G

eneva, Switzerland, 21 November 2019 – The International Council of Nurses (ICN) calls on governments to monitor and publish data on nurse migration and adhere to World Health Organization (WHO) standards for ethical international recruitment.

As the world faces a potentially catastrophic shortage of nurses over the next decade, ICN has published a position statement on international career mobility and ethical nurse recruitment.

ICN Chief Executive Officer Howard Catton said: “The World Health Organization is predicting a

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global shortage of nine million nurses and midwives by 2030 and we can already see the terrible effects of a lack of nurses in many countries around the world.

Imbalances in funding between rich and poor countries means there is an increased risk of unscrupulous international recruitment that fails to adhere to ethical principles and leaves vulnerable health systems stripped of their most valuable asset, qualified nurses.

It is crucial that all countries train and retain more of their own nurses and implement ethical recruitment

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practices when they employ nurses from overseas.

Career mobility is important for many nurses: it enables them to further their professional development, maximise their skills and qualifications, and fulfil their personal career goals. And the quid pro quo of this is that they provide nursing care in countries where there are shortages of appropriately skilled nursing personnel.

But there have been many cases of internationally educated nurses being poorly treated by their employers, and some countries that can ill-afford to lose their nurses have been left with insufficient numbers because of aggressive recruitment from overseas.”

In 2006, ICN and CGFNS International Inc established the International Centre on Nurse Migration (ICNM) to develop, promote and disseminate research, policy and information on global nurse migration and human resources in nursing. This resource centre features news, resources and publications aimed at policy makers, planners and practitioners.

The ICN position statement calls on governments and employers to address their workforce shortages by training and educating enough nurses to meet their own country’s health needs, and to adopt appropriate policies when taking nurses from other countries.

Mr Catton said the WHO’s goal of Universal Health Coverage will only be achieved if governments provide a sustainable nursing workforce that is properly educated and remunerated for the work that nurses do, adding: “Any international recruitment should adhere to WHO’s global code of practice on international recruitment and follow ICN’s guidance concerning nurses’ welfare and employment rights, and the requirements of the countries that are supplying nurses to the rest of the world.”

A glimpse into the historical Capuchin assistance to the sick • continued from page 9 was thanks to the wise judgement and constant energy not only of the Milanese Archbishop, San Carlo Borromeo, but also of the heroic activity of the Capuchin hero, Fra Paolo Bellintanto da Salo.

Another reference to the Capuchin assistance of the sick is that concerning the famous friar Fra Bernardino Ochino Da Siena, the Vicar-General of the Order. Chronicles tell us that when he was preaching daily during Advent or Lent, Fra Bernardino fasted scrupulously and travelled on foot. When staying in the houses of the rich he renounced the comfortable bed, slept on hard mattress or on the floor, at table he just took one dish while showing the greatest compassion for the poor. In his letter to the Compagnia di San Domenico at Siena Fra Bernardo greatly exhorted its members to visit the city hospitals. He wrote to them that “these sick men are only waited on by hirelings who are without love and give them no word of comfort, so that their souls are often more sick than their bodies”. It amazing how the early Capuchin preaching revolved around the care of the sick.

The Capuchins knew what they were preaching about because they shared [and are still sharing] their lives with the sick. As certainly they are doing, with their characteristic silent and heroic way, still today.

I would like to end this quick

historical glance at the Capuchin assistance with the sick by offering this prayer which, the great Capuchin mystic, Saint Pio of Pietrelcina, the founder of the private hospital Casa Sollievo della Sofferenza (Home for Relief of the Suffering), used to pray.

Stay with me, Lord, for it is necessary to have You present so that I do not forget You. You know how easily I abandon You. Stay with me, Lord, because I am weak and I need Your strength, that I may not fall so often.

Stay with me, Lord, for You are my life, and without You, I am without fervor.

Stay with me, Lord, for You are my light, and without You, I am in darkness.

Stay with me, Lord, to show me Your will.

Stay with me, Lord, so that I hear Your voice and follow You. Stay with me, Lord, for I desire to love You very much, and always be in Your company.

Stay with me, Lord, if You wish me to be faithful to You. Stay with me, Lord, for as poor as my soul is, I want it to be a place of consolation for You, a nest of love.

Stay with me, Jesus, for it is getting late and the day is coming to a close, and life passes; death, judgment, eternity approaches. It is necessary to renew my strength, so that I will not stop along the way and for that, I need You.

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It is getting late and death approaches, I fear the darkness, the temptations, the dryness, the cross, the sorrows.

O how I need You, my Jesus, in this night of exile!

Stay with me tonight, Jesus, in life with all its dangers. I need You. Let me recognize You as Your disciples did at the breaking of the bread, so that the Eucharistic Communion be the Light which disperses the darkness, the force which sustains me, the unique joy of my heart.

Stay with me, Lord, because at the hour of my death, I want to remain united to You, if not by communion, at least by grace and love.

Stay with me, Jesus, I do not ask for divine consolation, because I do not merit it, but the gift of Your Presence, oh yes, I ask this of You! Stay with me, Lord, for it is You alone I look for, Your Love, Your Grace, Your Will, Your Heart, Your Spirit, because I love You and ask no other reward but to love You more and more.

With a firm love, I will love You with all my heart while on earth and continue to love You perfectly during all eternity. Amen.

Yes! Indeed! The Capuchin presence with the sick means the Lord Jesus’ closeness, strength, life, light, voice, company, consolation, communion, grace and reward to our brothers and sisters the sick.

Fr Mario Attard OFM Cap

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Please Just Stop A Nurse Spills the Most Annoying and Disgusting Things People Do in Hospitals When I graduated from nursing school, I had a shiny vision of what my role in the healthcare field would look like. I spent four years memorizing medication reactions, practicing clinical skills, and studying to be the best nurse that I could be. I passed my boards with flying colors, and I landed a sought-after position as a new grad in a busy emergency department. I felt prepared and ready to make a difference in the lives of my patients.

I didn’t go into nursing for glamour, money, peace, or quiet. Despite all of the ethical, emotional, and physical issues that come with being a nurse, I have the opportunity to make someone’s worst day a bit brighter, and those moments make what I do worth it. As a nurse, I have the ability to hold someone’s hand when they receive a terminal prognosis, to make a child laugh with some horrible dance moves fueled by the Moana soundtrack, to hug family members after we get a pulse back, and to watch stroke symptoms reverse after I give a life-saving medicine.

As a nurse, I am also verbally assaulted, physically abused, overworked, and underpaid.

I’ve accepted these facts to be the payoff for functioning on the front lines of a patientcentered workplace.

I start each shift smiling and optimistic, but it’s rare that my hope endures for a full 12-hour shift. I spend my days running around to ensure that each patient has the best experience, to anticipate problems before they arise, to address issues as they unravel, to appropriately triage patients, and to save lives. In my pursuit, I am often met with rudeness, condescending comments, and disappointment from patients that I hope is due to miscommunication and unrealistic expectations of the systems that the hospital has in place. I wish you all of the health in the world and hope to never have to care for you at the hospital, but if you find yourself as a patient, try to keep these things in mind to make the most of your experience:

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- NUMRU 85

photo | img.medscape.com

Please Just Stop Understand the triage process Despite popular belief, showing up to an emergency department is not a “first come, first serve” process. The primary goal of triage is to quickly obtain enough information to identify the patient in the waiting room that physically cannot wait to be seen by a doctor. It’s also important to keep in mind that the sickest person might not appear to be the sickest by the untrained eye. There are a plethora of factors that can make a person “highrisk” such as having a previously existing medical condition, unstable vital signs, or a certain presentation of symptoms.

Please understand that we are doing our best to efficiently decide who needs to get to hospital resources most quickly. It’s a terrifying responsibility, and as nurses, it is not something we take lightly! Keep this in mind when you wonder why “that person came in after me and is being called back first.”

Acquaint yourself with how to properly use the call light I have very conflicting feelings about call lights. When used properly, I believe that they can be a great tool for a patient to reach me. When overused or used improperly, they quickly become the bane of my existence. Here are great examples of when to use your call light: when you don’t know what’s going on during your visit and would like an update, when you have to use the restroom and need assistance walking, or when you have a change in your condition that you want to make the medical team aware of. I respond to all call lights as soon as I physically can, even when I’m with another patient, due to the fear that my patient is literally dying.

Call light fatigue sets in for nurses when our phones are ringing, we leave a task with a patient that we’re concerned about, and we run to the alarming call light to find that a patient wants a second turkey sandwich. As with all technology, use it, don’t abuse it!

Keep your shoes on It seems logical enough, but you’d be surprised at how many patients walk the hospital halls with bare feet. Out of all of the bodily fluids, trauma, and broken bones that I see in the emergency department, nothing makes me cringe more than watching someone shuffle barefoot in the hallway. Not only is it a safety concern to not wear non-skid socks or shoes

while walking, but it’s downright gross.

Sure, that floor looks clean because our environmental services representatives do their best to scrub and wax away the germs of yesterday, but I’ve seen enough blood, vomit, stool, and urine on hospital floors to know that my work shoes will never leave the hospital. Additionally, I don’t want to picture your skin cells getting trapped in the treads of my sneakers.

Put your phone away If you come to a hospital to seek care, it seems intuitive that you would give your healthcare team your full attention. It always baffles me that in the small amount of time we have together to get patients back to their usual state of wellness, we are met by people who are glued to their phones and half-listening to the questions that we’re asking. I fully acknowledge that if you’re in the hospital, you have to update your friends and family on your condition, but there is plenty of downtime in a medical visit to do so. If you’re trying to communicate how you’re feeling to your medical team, that round of Candy Crush can wait.

Remember that the hospital is not a hotel At the hospital, there are plenty of things that you can ask for to make your experience more comfortable. We offer warm blankets, pillows, socks, sleep masks, dimmed lights, snacks (if you’re cleared to eat), and an endless supply of hospital ice chips. I’ll go above and beyond to make you feel right at home, but please remember to keep your expectations reasonable.

Kindly refrain from complaining about our selection of food, the softness of our blankets, the sizing of your gown, or how fluorescent the lights are. As a hospital, we only have so much money, and safety, infection control, and clinical-related resources take priority over comfort. We do our best to make it work.

Refrain from calling your nurse “nurse” As a nurse, there’s nothing more irritating than hearing a patient yell “NURSE!” to get my attention. Don’t get me wrong, I worked tirelessly to achieve the R.N. credentials after my name, and I’m proud of what I do. But just as

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• continued on page 38

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Please Just Stop • continued from page 37 it’s strange for a grown adult to call a teacher “teacher,” being called nurse simply sounds weird and wrong. Get to know my name, show me some respect, and let’s be friends!

Use the pain scale appropriately In medicine, we attempt to objectify the subjective experience of pain so that we can determine the severity of it, explore if it aligns with the clinical presentation of an illness, and track if our interventions help it to improve. Typically, hospitals use a scale of zero to 10 to monitor pain levels with zero being no pain and 10 being “the worst pain you could possibly imagine.” Everyone’s “three” is different based on their previous pain experiences, and your 10 may be quite different than my 10. However, if you self-report 10/10 pain while texting, chomping on Cheetos, and sippin’ on some Mountain Dew to get a certain type of attention, it makes it difficult for me to properly assess you. Saying that your pain is a “four” does not mean that you won’t get pain medicine. It just helps us to accurately decide what diagnostic testing we need to obtain, if our treatments make you better, or if your condition is declining during your visit.

Understand what NPO means NPO is the term we use in the hospital to signify that someone cannot eat or drink until further notice. NPO quite literally stands for nil per os in Latin which translates to “nothing by mouth.” It’s always safe to treat yourself as NPO until you get clearance from your nurse or doctor based on your plan of care. In the mind of the medical team, every case could potentially be surgical until proven otherwise.

If your abdominal pain proves to be due to appendicitis and you need an emergency appendectomy, we don’t want to delay a surgical procedure because you were snacking on some Chipotle while waiting for your ultrasound results. As with any surgery, you should avoid food or drink for a certain number of hours beforehand

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to reduce the risk of aspirating stomach contents into your lungs during anesthesia or sedation. We’re not trying to be mean; we’re trying to keep you safe and to get you to the operating room as soon as possible if you need it. We promise we won’t let you starve. If we are concerned about your fluid or glucose status, we’ll pop an IV in and start some fluids.

Yes, I have done this before As a nurse, I have been trained to exhaustion on placing IVs, performing EKGs, administering medications, and bringing the highest level of care to your bedside. Despite fully explaining my moves before I make them, I am constantly being questioned on my abilities as a nurse. If a family member distrustfully hovers over me while I place a patient’s IV or a patient requests someone else to perform the task before I’ve even attempted it, it will put me on edge. I’ve placed five IVs a day for the past three years, and I’m pretty great at it. If I’m not comfortable with something or it’s my first time performing a task, I’ll be transparent, I’ll give you options, and I’ll ask for help.

Don’t assume that I’m not smart enough to be a doctor I think that patients and their families mean well when they question “you’re so smart, why didn’t go to school to be a doctor?” Let’s get this straight: nursing wasn’t a backup choice. I had the grades and the drive to get into medical school, but being a doctor simply did not interest me.

When I was deciding what career I wanted to develop in, I was attracted to the fact that nurses have the most face-to-face time with patients and that the career is so versatile. I chose the nursing profession based on my attributes and goals as a person and as a professional. If I didn’t love it, I wouldn’t be here.

Remember that I only have two hands At any given time, I am juggling multiple tasks at once. I typically have three to four patient rooms at a time, and my mind is constantly sorting through the

- NUMRU 85

chaos to determine what needs to be done now and what can wait. I work tirelessly to multitask so that I can approach a patient’s care in the most efficient way I can. That being said, I am only one person, and I am human.

There are plenty of times where patients take the rather interesting approach of barking out tasks more quickly than I can complete them, and I have to remind them that I only have two hands. If I had six hands, it would be weird as hell, but I would more clearly understand why some people have such strong confidence in my ability to perform six tasks at once.

I promise you, as evidenced by the sweat beads on my forehead, my two hands and I are moving as quickly as we can. Please be patient.

Be kind As a nurse, I am on the front lines of patient care, and this is the part of nursing that attracted me to the field. I love that I have the ability to ease a patient’s worries, meet their needs, and develop a connection that will help make someone’s rough day better. At the same time, being on the front lines makes me a convenient punching bag when things aren’t going well during a patient encounter.

I have always been one to own up to my mistakes and will take full accountability for my actions, but it is difficult to accept condescending language and rudeness for aspects of a patient’s visit that are out of my control. I put my heart and soul into making a patient’s experience as great as possible, so I take it personally when a patient verbally abuses me if they don’t get their way. Please remember that I am a human, and that I’m doing my best. A smile and a “thank you” go a long way.

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