The Medical Association of Malta yesterday warned of industrial action over the agreement between the Government and the nurses’ union to allow specialised nurses to administer certain medicine in emergency cases.
We doctors end up picking the pieces because we have to deal with the patient at the end of the day
MAM president Martin Balzan criticised the agreement, which, he said, did not conform to the Health Care Professions Act and the Medicines Act, which stipulated who could diagnose and treat patients.
Dr Balzan was speaking eight days after Health Minister Joe Cassar announced that specialised nurses would be able to administer some medicines without a doctor’s prescription when patients were being rushed to hospital.
Although the Government had spoken to some consultants at the Emergency Department, MAM had not been consulted about the issue, Dr Balzan said yesterday. This was one of the main reasons why the association would be ordering industrial action on October 14.
Asked about the nature of the action, Dr Balzan said he could not disclose what had been decided not to alarm people. “We’re not implementing the directives immediately because we want to stimulate a process of discussion,” he said.
Dr Balzan said that the agreement between the Government and the nurses’ union laid down that nurses who administered medicine had to be specialised. But there was no register, authority, courses, qualifications or examinations regularising the specialisation of nurses, he pointed out, adding that a three-year full time paramedic course existed abroad for ambulance workers.
“The specialised nurse qualification is fictitious because there is no regulatory authority to establish the qualifications and set the training programme, institutes, tutors and trainees,” he said.
Some 50 nurses with a three-year experience and no training had already been appointed as specialised nurses, he added, and MAM had written to the Public Service Commission asking it to stop the call for specialist nurse positions and revoke all appointments.
Dr Balzan said he suspected that the agreement had been reached to enable nurses to go up a scale, noting that union warnings about ambulance working conditions and the state of the vehicles had ceased when the agreement was reached.
MAM, he said, was open for discussion about nurses administering certain medicine, such as drip, oxygen or insulin, but this had to be done in line with the law and following the best possible training.
Dr Balzan said that according to “sources”, the “verbal” agreement covered six types of medicine, including adrenaline, which could even lead to heart failure or death if misused. “And we (doctors) end up picking the pieces because we have to deal with the patient at the end of the day,” he said.
In its reaction, the Malta Union of Midwives and Nurses insisted that nurses and midwives were as professional as doctors and no one would prevent the union’s members from carrying out their duty.
MUMN said that nurses administering medicines had specialised abroad and the agreement did not break any law.
It added that if the agreement reached with the Government was not respected and nurses and midwives would not be in a position to save peoples’ lives, MUMN would have no other option but to direct its professionals not to accompany ambulances. In this case, it said, doctors could go on ambulances themselves.
During the discussion process that led to the agreement, doctors working in the Emergency Department offered to be included in the nurses’ training and the policy regulating the agreement was signed by the department’s chairperson himself, the union said.