Nurses told not to accept patients if beds unavailable
The Malta Union of Midwives and Nurses has issued what is has described as 'instructions' to members, including not to accept patients in certain wards unless beds are available.
Union president Paul Pace told a news conference this afternoon that nurses in five surgical wards, in three orthopedic wards, two urology wards, the ENT section, the ophthalmic ward, fairyland, gynae and daycare, were being asked not to accept new patients unless beds were available.
He said that should patients be sent to these wards when no beds were available they would be returned to the customer care unit. He advised patients to call this unit to check if there were beds available before turning up for their appointment and not to turn up at all if there were none.
Nurses, Mr Pace said, should not take patients to operating theatre unless consent forms were signed, for legal reasons.
He added that nurses should refuse to change dressings for patients who were not in-patients. Dressings should be changed at health centres. This instruction, he said, did not apply to Fairyland.
Nurses were instructed not to do clerical work unless this was a nursing duty and to refuse to carry out blood tests ordered by private doctors at wards.
Ophthalmic wards should not accept emergency cases because these should be taken care of by the Ophthalmic Unit at the Emergency Department.
Day cases would not be seen in Ophthalmic unless there were enough nurses.
Mr Pace said that theatre nurses would not accept patients taken on a stretcher rather than on a bed.
In the recovery area, the ratio of nurses to patients should be two anaesthetic nurses for every three patients. But these were one nurse for every five patients. Unless ratios were respected, patients would be refused and would remain in the operating theatre.
Nurses were also being instructed to refuse responsibility as a surgeon's first assistance since they were not trained for this.
Mr Pace said these were instructions, not directives, because they related to practices which should be followed but were not.
He said the MUMN felt that health and safety practices were not being respected and the instructions which were being given were for the benefit and safety of both patients and nurses.
The migration to Mater Dei, he pointed out, had reduced the number of beds to the detriment of patients.
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Nadia Cassar
May 6th 2009, 15:26
I work in the medical field.
I totally agree with Mr. R. Gatt. The doctor/nurse to patient ratio is very bad. Our health professionals are being exhausted and stressed with the terrible work load.
Our Health Centres are running with less than the 'skeleton staff' when it comes to doctors and other medical staff. All this whilst a good number of patients turn up before their appointment date aggressively insisting that they want to be seen by a doctor or nurse there and then.
To whom it may concern:
What better incentives should we offer to our medical staff to keep them working in Malta instead of overseas?
What about starting by controlling the patient flow to our Hospital Casualty Unit and to our Health Centres?
The following was suggested by a medical professional in a particular Health Centre:
How about doing one secure entrance for any of our Health Centres? That is, the patients are not allowed in the Health Centre unless the receptionists accept them in. With security guards stand by. And any patients who do not respect their appointment dates and other rules will not be admitted.
Such measures will drastically reduce abuse.
eric saliba
May 5th 2009, 08:22
@ michael seychell. i pity your feeble efforts to prop up this weak govt that we have.
only last week we all saw minister tonio fenech saying to chiara on tv that if she wins the eurovision contest he'll find the money to finance the show next year.
how about finding the money to buy more beds for mater dei?
i am sure you agree michael that health is much more important than a song contest!!
debono lawrence
May 5th 2009, 08:16
How can the Ophtalmic urgent cases be seen at the Accident and Emergency dept, if the Ophtamic room in Area 3 is always closed due to shortage of staff ?
why the MUMN have instructed nurses working in the wards not to accept patients if there are no beds availabe in their respective wards, but the MUMN did not include the Accident and Emergency staff to do so aswell. Area 2 and Area 3 at the A & E are constantly being used as wards both for medical and surgical cases, and patients being left for many hours on stetchers rather than on beds.
nursing staff at the A & E are also members of this Union, so please do take note of us aswell, as we are over stress both by the management problems and even by the MUMN's actions.
d. borg
May 5th 2009, 08:03
Ma tahsibx li qed tessagera naqra issa Sur Pace? Hawn qed nitkellmu fuq nies morda li l-Bambin biss jaf kemm diga jkunu inkwetati u mdejjqin, dawn l-affarijiet ikun jonqoshom. Il-kelma vokazzjoni ma saret tghodd xejn ghal dawn in-nies?
Matthew Anthony
May 4th 2009, 22:50
Nixtieq inkun naf x'ghandhom xi jghidu l-MEPs u dawk li qed jikontesstaw ghal MEPs fuq dan ir-rigward, ghax donnu s-sahha ma tantx qedgha fl' Agenda taghhom.
@Gauci Gorga
Prosit tat-taghrif tieghek. Il-link vera nformattiv.
@ ghal dawk li qalu li dawn l-istruzzjonijiet inghataw biex in-nurses joqghodu jitghazznu jew biex jigi attakat il gvern: jien inheggighom sabiex jidhlu jghamlu 4 snin kors l'Universita u jkunu parti minn din il-professjoni. Jekk jaghmlu dan forsi l-problema tissolva ghax id-divizzjoni tas-sahha jkollha aktar nurses ghad-dispozzizjoni taghha. J'Alla mbghad dawk li jidhlu jaghmlu parti min din il-professjoni ma jitilqux wara ftit jiem ghax l'istress li ggorr maghha din il-professjoni jkun insapportabli.
Michael Seychell
May 4th 2009, 21:10
A question - Are the recent and present Industrial Actions a concerted effort to destabilise the Maltes Government and its economy in this worst global recession - presently coupled with the swine flu and its negative effects?
PS - Since Mr Pace of the MUMN worked hand in hand with the Nationalist Party in government in the past, I believe him that the actions taken presently are "Instructions" and not the deadly Industrial Action called Work to Rule !
R Gatt
May 4th 2009, 20:24
To those grumbling about lack of beds and mocking the "state of art" crap ad nausea ... are you aware of the ratio of doctor hours to patients? Well, I'm not, and you are not either. What I do know of is the exaggerated amount of hours doctors at Mater Dei are working due to the lack of doctors, this being an average of 90 hour weeks, which can even exceed 100. I don’t quite see the use of more beds until the issue of human resources is better managed.
Are you aware that from last year's new doctor intake, at least half went abroad, most of which left immediately?
So again, tell me ... what is the point of having more beds if we don’t have enough doctors? (Probably we don’t have enough nurses either, but I am not aware).
A.Cutajar
May 4th 2009, 20:23
Like all other health care professionals nurses/midwives have their professional code of conduct. One basic obligation of every nurse is to avoid unsafe practice on her account, and must act to identify to minimise the risk to patients and clients (NMC, United Kingdom 2002). There are situations in which nurses are expected to make supreme efforts to cope with poor conditions related to the environment of care. It is not wise for health care professionals to struggle on, in silence, bearinmg the burden of understaffing, overcrowding and taking shortr cuts with hazardous practices. Such a level of functioning leaves both staff and patients vulnerable by making the nurses' workload personally intolerable and professionally dangerous. Thus, well done MUMN for taking actions and urging your members to act in order to protect patients and clients from risk. If I was part of MUMN council I would have urged my members to report these incidents to senior personnel with enough authority and urge my members to keep the management responsible/liable for these situations.
P.S.I'm not a member of MUMN as I'm not a nurse/midwife.
Nadia Cassar
May 4th 2009, 20:17
The migration to Mater Dei Hospital was surely done for the best.
However, it is a pity that such a grand hospital contains even less beds than our old hospital, when so much emphasis was always being done about the overflow of patients in corridors at St. Luke's Hospital.
Another concern is: What is going to happen to those patients geniunely needing emergency treatment in casualty who later will need to be admitted to one of these wards(when no beds are available)?
Gauci Gorga
May 4th 2009, 20:03
The instructions given to nurses by their union were after all given in order to ensure patients' safety. As far as I know a few days ago the media informed us that Malta ranked low when compared with other EU counterparts as regards patients right and safety. Patient safety should be number 1 on the agenda, and a culture of patient safety should be implemented throughout the entire health care system. This is well esatblished in the Luxembourg Decleration (2005). As a potential patient I have a right to expect that every effort will be made to ensure my safety as user of all health service. The health care sector is a high-risk area because adverse events, arising from treatment rather than disease, can lead to adverse events and patient suffering. Investment in patient safety has the potential to generate savings in expenditure coupled with an obvious benefit to patients .So I thank MUMN for the necessary precautions taken. However I urge other NGOs who believe that the patient has a right for safety health care services to follow MUMN example.
www.cpme.be
Jeremy J Camilleri
May 4th 2009, 19:24
Teachers can't strike because it affects Pupils....
Lecturers can't strike because it affects students.
Nurses can't strike because it affects patients....
Dockers can't strike....it affects economy.....
ST Electronics workers can't strike...it would make them redundant......
And on and on....
Do you ever realise how ridiculous you all sound? You folks just think that the employer should have a free hand...
The right for any Union to resort to industrial action is embedded in our laws....Live with it....
Gianni Xuereb
May 4th 2009, 19:23
@J.Tonna:
I am not happy with the situation at all. I'm forking out the money (taxes) how can I be happy? Yes it's the government to blame for the situation. 18 years in the making, it had enough time to plan, to realise that the number of beds planned for the new hospital are not enough. St. Luke's was a big problem already. Do you remember the beds in the corridors ? How can you expect the problem to disappear with a new hospital with less beds than St. Luke's ? I had relative who was dying of cancer and waited over 8 hours in the emergency waiting room to be seen. I had to sit on the floor because no chairs were available. Some bright guy thought a dozen chairs would be enough.
Remember: it's the staff that makes a good hospital, not the bricks!
Paul Barrett
May 4th 2009, 19:14
This "suggestion" looks more like a "work to rule guide" which will make everything that others are trying to achieve in reducing waiting time and waiting lists totally useless and really is not very helpful to anyone.
Efforts in trying to get things to work better with what we have would be very much more beneficial to everyone.
j.caruana
May 4th 2009, 19:10
pls MUMN do not come up with further ideas because we (final nursing students) are stressed more than enough...please do not make the matters worse
Morover, humans remain humans. Both patients and nurses and nursing students are humans...so, i believe it is a very difficult decision to take
carmel
May 4th 2009, 19:09
dont start blaming the nurses or the mumn bed state was reduced by around 200 beds social cases are still there we are still without a paramedic team for ambulances hence draining the e&a dept from nurses who are still working long shifts the problems that were at st lukes are still there and crises management rules the day litegation is now common it is easy to critisise have a heart and appreciate the work done by the medical and nursing staff at mater dei extra beds are out of the question theatre lists will suffer
J.Tonna
May 4th 2009, 18:29
Some of you seem to be happy with the situation. L'aqwa li kontra l-gvern! Let's hope that you will not be a 'patient' when no bed is available.
Gianni Xuereb
May 4th 2009, 17:43
The building might be state of the art. The apparatus too. Heck, after we forked out 300,000,000 (leaving a big hole in the public finances) and 18 years in the making, what do you expect ? The service leaves much to be desired, short of staff, underpaid staff and arrogant managment. The patients are becoming overdemanding year by year. Their expectations are sky high and their patience is little to nothing (blame all the election pump and propoganda). The patients, especially the ones who wait 8 hours to be seen at the casualty department, have all the right to complain. I used to work there, and left for good. I took the right decision and will NEVER look back. God help my friends who still work there.
C. Scerri
May 4th 2009, 17:25
Does Mr Pace know that a good number of cases are day case i.e. minor surgery that does not require beds? And what about the urgent cases? Also - in some cases dressings are required to be changed in the ward as the doctor/surgeon requires to assist them.
edmond baldacchino
May 4th 2009, 17:23
this is what they call STATE OF THE ART......
Carmel Saliba
May 4th 2009, 17:08
The Origin of this State of Art building wasn't for a General Hospital. This is the real reason about the shortage of beds. It is true that it was enlarged but the bed state is less than that of St Luke's Hospital. Even the shortage of doctors and nurses are not given the NEEDED attention. To have more doctors the University need to consider that the needed requisites Chemistry and Biology be enough at grade C or better and even the Intermediate should also be acceptable at Grade C or better. To have more nurses the course should be opened to at least 250 each year for at least three years and then consider again. Not to forget that each year there are nurses leaving their profession when they retire. If the number of students is not reached it should once again consider the minimum wage to attract more student to follow the nursing courses.