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Head OfficeWhitworth Building, Morning Star Avenue,North Brunswick Street, Dublin 7Tel: 01 664 0600 Fax: 01 661 0466Email: [email protected] http: www.ino.ie

N U R S E S

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I N G F O R N U R S ES

Irish Nurses Organisation

Annual Report 2005


2

Annual Report 2005

Notice of Meeting 3

President’s Foreword 4

Executive Council 2004/2006 6

Introduction 7– Branch Officers/Section Officers/Nurse

Representatives– Organisational Developments– Special Delegate Conference– Executive Council– Galway Office Opens– Department of Health and Children– Nursing and Midwifery Legislation– Health Service Executive– Irish Congress of Trade Unions Issues– An Bord Altranais– National Council for the Professional Development

of Nursing and Midwifery– International Nurses’ Day– International Midwives’ Day– Staffing

Industrial Relations Review 15– Overview– Nursing and Midwifery Management Structures– Accident and Emergency Overcrowding– Sustaining Progress, Benchmarking and Pay– Benchmarking– PPARS– Care of the Elderly– Miscellaneous Claims– Nurse Representative Training– Summary – Another Busy Year– Regional Round Up – Industrial Relations Officers

Organisation and Social Policy 30– Social Policy Committee– Migrant Nurses– Immigration Bill– Leadership Initiatives for Females in Trade Unions

(LIFT)– ICTU Health Report– Whistleblowing– Conferences– Fitness to Practice

Professional Development Centre 33– Overview– Workshops 2005 and Statistics– Conferences– INO National Conference– Nurse/Midwifery Prescribing Project– Return to Nursing/Midwifery Practice Committee– Accreditation of Nursing and Midwifery Awards– National Committee Membership– External Bodies

– European Federation of Nurses Associations– International Report– Bem Me Quer

Online and Information Technology 42– INO Website– Nurse2Nurse– Library– Information Office

National Section Reports 45– Overview– Accident and Emergency Section– Assistant Directors of Nursing/Public Health

Nursing/Night Superintendents Section– Care of the Older Person Section– Clinical Nurse/Midwife Manager Section– Clinical Placement Co-Ordinators Section– Community General Nurses Section– Directors of Nursing/Midwifery/Public Health

Nursing Section– Interventional Radiology Section– Midwives Section – Nurse Tutors and Clinical Teachers Section– Occupational Health Nurses Section– Operating Department Nurses Section– Orthopaedic Nurses Section– Overseas Nurses Section– Practice Nurse Section– Public Health Nurse Section– Rehabilitation Nurses Section– RNID Section– School Nurses Section– Student Nurses Section– Surgical & Medical Day Care Section– Telephone Triage Nurses Section

Press and Media 57

Affiliations 61

For the Record 62– Benevolent Fund– Educational Loan Fund– Irish Nurses Rest Association– Publications– Government Departments/Other Bodies– Press and Media– Honorary Officers– INO Staff

Appendices 64I Branch Officers – Currently in OfficeII Section Officers – Currently in OfficeIII INO Secretariat – 2005IV Salary Scales Applicable from 1 December 2005V INO Private Nurses FeesVI Subsistence Rates

Contents


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Annual Report 2005

Notice of MeetingNotice is hereby given that the 87th Annual Delegate Conference of the Irish Nurses Organisation will be heldon Wednesday,Thursday and Friday 3, 4 and 5 May 2006, in the Slieve Russell Hotel, Ballyconnell, Co Cavan.

Wednesday, 3 May: 4.00pm to 6.30pm (private session)1 Registration

2 Invocation

3 Branch Roll Call

4 Appointment of Tellers

5 Adoption of Standing Orders and Standing Orders Committee Report No. 1

6 Minutes of Annual Delegate Conference 2005

7 Minutes of Special Delegate Conference 2005

8 Adoption of Annual Report 2005, incorporating reports from the Deputy General Secretary and Directors

9 Adoption of Accounts for period 1 January 2005 to 31 December 2005

10 Adoption of Budget 1 January 2007 to 31 December 2007 (to be taken with Motion No. 1 -Organisational)

11 Appointment of Auditors.

12 Discussion Document on use of INO Benevolent Fund

13 Debate on Motions Group 1 Organisational.

14 Presentation by Maev-Ann Wren – The Health Report

Thursday, 4 May: 9.00am to 6.00pm15 Roll Call

16 Adoption of Standing Orders Committee Report No. 2

17 Debate on Motions: Professional; Industrial; Social Policy; Educational

18 Keynote Address by Prof Allyson Pollock, School of Public Policy, University College, London, Health Service Systems – Privatisation

19 Debate on motions continued.

Friday, 5 May: 9.00am to 4.45pm20 Adoption of Standing Orders Committee Report No. 3

21 Debate on motions continued

22 Result of Executive Council Elections – Election of Officers in accordance with Rule 9 – President and Vice Presidents

23 Investiture of elected President

24 Address to Conference by Mary Harney TD, Tanaiste and Minister for Health and Children followed byPresidential Address by Madeline Spiers, RGN

25 Formal closure.

Liam Doran

General Secretary

Special events during Annual Delegate Conference 2006

• Presentation by Maev-Ann Wren – The Health Report

• Keynote Address by Prof Alison Pollock, School of Public Policy, University College, London,Health Service Systems – Privatisation – Thursday, 4 May at 3.00 pm

• Trade Exhibition on Thursday afternoon and Friday, 4 and 5 May

• Presentation of awards at Dinner on Thursday and Friday, 4 and 5 May

• Address by Mary Harney TD, Tanaiste and Minister for Health and Children at 3.00pm on Friday, 5 May

• Presidential Address by Madeline Spiers, RGN at 3.30pm on Friday, 5 May

• Gala Dinner on Friday, 5 May at 7.30pm for 8.00pm


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Annual Report 2005

Colleagues

It gives me great pleasure to presentto you the Annual Report of the IrishNurses Organisation for 2005. May Ibegin by thanking you all for yourcontinued support and dedication. Itis both rewarding, and challenging,to be President in these times and Iam aware that the voice of the INOmay often be the only platformwhere nurses and midwives have anopportunity to speak out and I am

happy that you do so. The ongoing challenge for us isto ensure we recognise and address your issues andconcerns.

I would like to thank Ann Martin, first Vice-President forher continued commitment to the professions ofnursing and midwifery and I would also like toacknowledge the commitment of Margo Flavin oursecond Vice-President. The Executive Council has alsoworked extremely hard during 2005 to promote theinterests of nurses/midwives and patient care and Iwould like to record my appreciation to them.

The Irish Nurses Organisation is greatly indebted toLiam Doran, our General Secretary, for his leadership,drive and passion. His understanding of the needs ofnurses and midwives in order to give a quality service,within a quality environment, is paramount to thesuccess of our union.

I would like to put on record my appreciation of DaveHughes our Deputy General Secretary, AnnetteKennedy, Director of Professional Development andClare Treacy, Director of Social Policy. Furthermore, Iwould like to commend the IROs, and the entireOrganisation’s staff, for their dedication, commitmentand hard work.

The health service reforms, which we embraced with acautious welcome in 2004, have not delivered thequality or quantum of service which we had hoped.The rolling out of new structures, incorporating a newvision was a lost opportunity to radically change thehealthcare landscape. The voice of nurses andmidwives, whilst critical to the new health service, isnot being heard at the higher echelons. The structuresare still hazy and reporting protocols are unbelievablybureaucratic. The continuing challenge to the INO is tocreate clear lines of communication between thosewho do the work and those who administer thesystem.

The reformed? Health Service Executive has noteffectively managed the clearly identified problems inthe health system. If anything, the HSE, and itsmultilayered senior management, has become asignificant obstacle to implementing that criticalreform programme. So we continue to have too fewacute hospital beds, inadequate community services,severe problems in A&E and an employment ceilingwhich impacts on front line staff.

On a more positive note nursing continues to be anattractive career to school leavers and it is hearteningthat almost 1,700 people began three degreeprogrammes last September.

The Organisation also welcomes the decision tocommence undergraduate degree programmes, inmidwifery, and an integrated children’s general nurseprogramme, later this year. These will complete theeducation revolution. The overriding challenge now,for this country, is to retain these skilled professionalswhen they qualify.

I am also very aware that the present cohort of nursesand midwives must be acknowledged and notdiscriminated against within the framework of theNational Qualifications Authority of Ireland (NQAI).This Authority, established under statute in 2001, hasdescribed its function as “a framework for thedevelopment, recognition and award of qualificationsin the State, based on standards of knowledge, skill orcompetence to be acquired by learners”.

The NQAI has stated that the framework will consist of10 levels. New honours graduates will be recognisedat level eight. The INO is determined that there must bea recognised value, in terms of awards/credits forexperiential learning, in-service updates, self-directedlearning and also for the many unaccredited courseswhich were provided to up skill nurses/midwives. Allnurses/midwives already work at degree level andmust, therefore, be recognised accordingly. Nothingelse is appropriate and we will strive to ensure apositive outcome, on this key issue, in 2006.

The many challenges, facing the health service andourselves, continue to dominate the workingenvironment. I had hoped that the new HSE wouldhave delivered a streamlined and effectivemanagement system but, to date, it is almostimpossible to navigate the new HSE structures. Asnurses/midwives we are very committed to embracinga coherent health system with the patient at the centreof the service but as key players, we are waiting for theengagement to start.

One of the most significant milestones in 2005 was theSpecial Delegate Conference and the decision todepart from the proposed second benchmarkingexercise. This conference determined that the INOwould pursue, directly with health employers, keyclaims including our demand for a 35-hour week, theremoval of the pay anomaly with social care workersand our claim for pay parity with other healthprofessionals. The INO will continue to activelyparticipate in social partnership talks as a potentialway of addressing the inadequacies and underfundingof our public health service but we will not participatein any pay negotiations which are simply not capableof addressing our key issues.

The special conference also endorsed thecommencement of phase 2 of the ‘Enough is Enough’campaign aimed at bringing an end to overcrowding in

President’s Foreword

Madeline Spiers


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Annual Report 2005

A&E Departments. At the end of the year this highprofile campaign had undoubtedly captured theimagination of the general public.

The Hygiene Audit, which we welcomed, confirmedthat over 90% of our hospitals are operating at sub-standard levels. Nurses and midwives are not requiredas part of their duties to clean hospitals. TheOrganisation has, however, stated that hospitalhygiene will only be improved by the provision ofadditional resources. This should include cleaningservices, working 24/7, and, most fundamentally, areduction in the bed occupancy rates, to theinternationally accepted norm of 85% down from thiscountry’s norm of 100%+ in many locations. MRSAinfection will also only be reduced when we addressthe endemic levels of overcrowding within our publichealth service.

During the year the Organisation was also activelyinvolved, at national level, on groups examining theEuropean Working Time Directive and the properutilisation of the grade of healthcare assistant. Ourapproach to these issues will be to ensure the fullpotential of nurses and midwives is realised through areconfiguration of skill mix and roles which must takeplace as part of reforming our health service.

It is therefore unfortunate that a new Nurses andMidwives Act, recommended in the Commission onNursing report 1998, is still not enacted. This legislationis critical to propel nurses and midwives to take onmore challenging roles, to develop their skills andrealise their potential. This legislation can unlock realopportunities in areas such as diagnosing, prescribingand clinical autonomy. On an optimistic note, I amconfident that this will be achieved in 2006

In 2005 we saw the election of Annette Kennedy asPresident of the European Federation of Nurses. This isa true recognition of Annette’s contribution tointernational nursing and a reflection of thisOrganisation's consistent networking, andunderstanding of, the importance, and, influence of

the European Union. We must also commend ourExecutive colleague Deirdre Daly, and the MidwiferySection on Deirdre’s election as President of theEuropean Midwives Association. This againdemonstrates Deirdre’s, and the INO’s, standingamongst her midwifery colleagues. This is the firsttime the INO has held the Presidency of both theseimportant bodies, simultaneously, and thus offers us areal opportunity to influence pan European policies inthe medium term.

I would like to take this opportunity to thank you all fortaking the time to meet me in your hospitals, branches,section meetings and communities. That invaluabledialogue gives truth and reality to the lived experienceof everyday life for nurses and midwives. This is yourOrganisation and it will be sustained and focused byyour support and vision.

I wish to thank all branch officers, section officers, andnurse representatives for their continued involvementand hard work on behalf of their colleagues andcommunities. The INO cannot function without yourcourage and commitment.

Finally, may I extend my sympathies to the family andfriends of members of the Organisation who died inthe past year. I would also like to extend mysympathies to any staff and their families who mayhave suffered bereavement during 2005.

I now commend this annual report to you whichreflects another very challenging and busy year for theIrish Nurses Organisation.

Madeline Spiers

President


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Annual Report 2005

Executive Council 2004/2006

Office BearersPresident: Madeline Spiers Senior Staff Nurse,Theatre, St Columcille’s Hospital,

Loughlinstown

1st Vice-President: Ann Martin Clinical Midwife Manager, University College Hospital, Galway

2nd Vice-President: Margo Flavin Clinical Nurse Manager, Waterford Regional Hospital

Clinical (16 seats)Raymond Boyle CPC Cavan General Hospital

Winifred Collier CNM2 Lusk Community Unit, Co Dublin

Sheila Dickson Staff Nurse St Columbanus Home, Killarney

Catherine Doyle CNM2 (CNS) St Vincent’s Centre, Lisnagry

Kay Garvey Clinical Nurse MIDOC, Mullingar

Teresa Hayes CNM2 Adelaide & Meath Hospital, Tallaght

Joe Hoolan Staff Nurse Midland Regional Hospital, Portlaoise

Ethel Leonard Acting CNM3 Portiuncula Hospital, Ballinasloe

Collette Lynksey Staff Nurse University College Hospital, Galway

Ursula Morgan Staff Nurse Roscommon County Hospital

Ursula Paine CNM1 Hospital of the Assumption, Thurles

Jo Tully Staff Nurse St James’s Hospital, Dublin

Mary Walsh Staff Nurse Sligo General Hospital

Administration (3 seats)Marie Gilligan Nurse Practice Development Cregg House, Sligo

Co-Ordinator (ADoN)

Joan McDermott Director of Nursing D’Alton Community Nursing Unit, Claremorris

Joan Tobin Assistant Director of Nursing Waterford Regional Hospital(Night Superintendent)

Education (2 seats)Deirdre Daly Principal Midwife Tutor Rotunda Hospital, Dublin

Gervaise Maher Former Director CNE Beaumont Hospital, Dublin

Student (1 reserved seat)Alan Batt Student Nurse South Infirmary/Victoria Hospital, Cork

The Executive Council of the INO along with several staff members, from back left: Clare Treacy; Raymond Boyle; Alan Batt; Joe Hoolan; Ursula Morgan; Mary Walsh; TeresaHayes; Joan McDermott; Ursula Paine; Catherine Doyle; Dorothy Mullarkey; and from front left: Gervaise Maher; Collette Lynskey; Kay Garvey; Sheila Dickson; Liam Doran;Madeline Spiers; Ann Martin; Joan Tobin; Winifred Collier; Ethel Leonard; and Marie Gilligan. Council members absent from picture: Margo Flavin, Jo Tully and Deirdre Daly


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Annual Report 2005

Introduction2005 will be recalled as the year thatthe struggle continued, ourdetermination remained resolute andthe Irish Nurses Organisation,because of our continuing campaignsfor a quality assured public healthservice, became the most visible, andeasily recognisable, Trade Union inthis country.

This Annual Report, which acts as ahistorical record of theOrganisation’s activities during

2005, will, in the following pages, amply demonstratethe energy, commitment and resolve of our members,activists and staff.

The following pages will chronicle the huge number ofactivities, issues, fora and successes that theOrganisation has been engaged in over the past 12months.

The first noteworthy development was the continuedgrowth of the Organisation, with, at the end of 2005,the membership reaching almost 33,000. This is yetanother historical high for the Organisation and isconclusive proof that we are now the undoubted voiceof nurses and midwives in this country.

This growth continues to bring with it challengesinsofar as we strive to listen, to our membership, anddevelop services which are sought after by all ourmembers from students up to senior nurse managers.We will continue to listen to you, the member, and Iimplore you again to always voice your views, directlyto us, so that, in turn, we can ensure the Organisation’senergies and resources are devoted to the areas mostrequired by our members on the ground.

I now ask you to read this Annual Report and to study,and appreciate, the dynamic, and energetic,Organisation of which you are a member.

Branch Officers/Section Officers/Nurse RepresentativesAll of this energy, commitment and growth is onlypossible because of the continued loyalty anddedication of our branch and section officers andnurse representatives. On behalf of the ExecutiveCouncil, and all our staff, I want to immediately placeon record our deep and sincere appreciation for all ofthe work done by these key activists.

I again salute all of you, for the work done, and callupon you to remain active and committed as we goforward into 2006.

Organisational Developments

86th Annual Delegate Conference

The Organisation held its 86th Annual Delegate

Conference, in Killarney, on 4, 5 and 6 May 2005.

The Conference, which was attended by 340 delegates,was again packed with debate, and discussion, on themotions submitted by our 41 branches and 24sections.

In particular this years’ Annual Conference covered thefollowing:

Address by Tanaiste and Minister for Healthand Children, Mary Harney TD

In her first address, as Minister for Health andChildren, to an INO Annual Delegate Conference, MsHarney, speaking without notes, stated hercommitment to developing a world class healthservice and also indicated her intention to activelyengage on such issues as skill mix, nursing/midwiferymanpower issues and the A&E overcrowding problem.

Her entrance to the conference hall was marked by asilent, and dignified, protest by some delegates aimedat highlighting the continued overcrowding, occurringin A&E departments, and the needs to address, withemergency funding, the issue of bed capacity.

The Tanaiste, at the close of her address, engaged in aquestions and answer session, with the delegates,which proved to be a lively affair with a strongexchange of views on both sides.

Presidential Address

Madeline Spiers, in her first address to conference asthe Organisation’s President, and replying to theTanaiste’s speech, gave a wide-ranging address whichtouched on all salient issues currently affecting nursesand midwives in this country.

The issues of overcrowding, nurse/midwife retention,the health reforms and the need for a quality assuredhealthcare system were all raised by Ms Spiers, whoreceived, at the end of her address, a standing ovationfrom the 400 delegates and observers present.

Keynote Address

Ann Doherty, on behalf of Kevin O’Kelly, Acting CEO ofthe Health Service Executive, also addressed theconference on Thursday 5 May. In her address MsDoherty sought to outline the current state ofdevelopment, of the Health Service Executive andwhat it was seeking to do as priority issues.

In replying to Ms Doherty’s address Madeline Spiers,INO President, expressed disappointment at the lack ofinclusion of nurses and midwives, in the reformprocess to date, and called upon the HSE to prioritisethis issue without delay.

Motions

The conference also debated over 70 motions,submitted by branches/sections and the Executive

Liam Doran,General Secretary, INO


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Annual Report 2005

Council and these gave direction to the Organisation’sagenda for the remainder of 2005.

In particular the conference debated an emergencymotion, on behalf of the Executive Council, whichstated that a ballot for industrial action would beinitiated if the threat to withhold a pay increase, due on1 June, was not paid to all nurses and midwives. Thedetails of this issue are covered in the IndustrialRelations Section of this report.

The conference agenda also included the followingnoteworthy events:

Gobnait O’Connell Award for Outstanding Service

Therese Gallagher, Letterkenny General Hospital, wasthe recipient of the 5th Gobnait O’Connell Award,which is presented annually, for outstanding service,by an activist, to the Organisation.

The award, which is presented in memory of ourdeceased former IRO and Ministerial Adviser, GobnaitO’Connell, was given to Therese in recognition of heryears of commitment, interest and activity, on behalfof the Organisation, to the Letterkenny branch.

PJ Madden/CJ Coleman Research Award

This award was won by Noreen Smith, Clinical NurseManager 1, Beaumont Hospital, for her study entitledPost Operative Telephone Service for Day CarePatients.

The award was presented jointly by Ms MadelineSpiers, President, and Ms Nancy Layton Cooke, fromCJ Coleman and Company Limited, London.

Special Delegate Conference –27 September 2005The Organisation also held a Special DelegateConference in Croke Park, Dublin, on Tuesday, 27

September to review, discuss and decide on thefollowing:

• The approach of the Organisation to the proposedsecond benchmarking exercise

• The need to commence phase 2 of the Enough isEnough A&E overcrowding campaign.

Second Benchmarking Exercise

The Special Delegate Conference, following a lengthyand dynamic debate, unanimously voted to accept amotion, in the name of the Executive Council, whichread as follows:

Conference records its utter dissatisfaction with theterms of reference as agreed between the PublicServices Committee of ICTU and the Department ofFinance.

In particular the failure to afford priority status toLabour Court recommendations 17805 and 17526 andto explicitly provide for equality proofing or completetransparency, will if, unchanged, render the exerciseincapable of addressing our long standing issues ofequal treatment for nurses and midwives with theirpeers in terms of pay, grading and hours of work.

Accordingly this Special Delegate Conferencemandates the Executive Council to reject the terms ofreference for the second benchmarking exercise and topursue independently all claims on behalf of nursesand midwives through direct claims on the healthemployers.

Following this decision, the Organisation immediatelyformulated eight claims, reflecting a range ofoutstanding issues of critical concern to ourmembership, and lodged them, before the end of theyear, directly with the health service employers underthe disputes resolution procedure for the healthservice.

The detail of these claims are covered in the IndustrialRelations Section of this report.

A&E ‘Enough is Enough’ Campaign Phase 2

The conference, again after a very thorough debate,also unanimously adopted a second motion,sponsored by the Executive Council, which read asfollows:

Conference

• Acknowledging the success of the ‘Enough isEnough’ campaign undertaken in the spring and earlysummer

• Recognising that the overcrowding in A&E continuesat unacceptable levels and that the Tanaiste’s 10-pointplan has not brought about the significantimprovement promised

endorses the commencement of the second phase of

INO President Madeline Spiers (right) presents Therese Gallagher, PRO for theLetterkenny Branch with the Gobnait O’Connell Award in recognition of her serviceand dedication to the INO.The award was established following the untimely deathof Gobnait O’Connell


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Annual Report 2005

the campaign which will involve:

• The mobilisation of the full trade union movementthrough a campaign organised by the ICTU

• The resistance to any attempt to place extra beds inalready overcrowded and understaffed in-patientwards/units in the interests of patient care andinfection control

• The nationwide lobbying of public representatives byINO branches and the correlation and publishing oftheir responses

• The co-ordination of a national postcard campaign,to be sent to the Tanaiste, in conjunction with patientsand their families, highlighting the reality of thesituation;

• The investigation of whether a patient’s human rightsare being violated when placed in an overcrowdedarea without privacy and dignity; and

any other measures deemed appropriate by theExecutive Council to ensure the elimination of thisblight on our public health service.

Once again, immediately after the conference, theOrganisation moved to enact this second phasethrough a high profile media campaign and anationwide postcard campaign, the details of whichare also covered in the Industrial Relations Section ofthis report.

Executive CouncilThe Executive Council of the Organisation, incompliance with rule, held 11 ordinary meetingsduring 2005.

The Executive Council, in order to conduct its businessefficiently and effectively, directs some of its businessto be conducted by four sub-committees as follows:

Finance and General Purpose Committee

This committee, which is required under rule, waschaired by the President, Madeline Spiers, and met on

11 occasions. It has six other members including thetwo Vice-Presidents.

Industrial CommitteeChaired by Margo Flavin, second Vice-President, andunder the guidance of Dave Hughes, Deputy GeneralSecretary, the Industrial Committee concentrated uponthe following issues:

• Motions forwarded to it by Annual Conference

• Formulation and lodging of major pay claims directlywith health employers following the INO’swithdrawal from the proposed second benchmarkingexercise

• Ongoing review of the overcrowding occurring inA&E departments

• Monitoring of all other IR issues including variousgrading and other claims.

Nursing and Midwifery Education andPractice Committee

Chaired by Ann Martin, first Vice-President, and underthe guidance of Annette Kennedy, Director ofProfessional Development, the work of the Nursingand Midwifery Education and Practice Committee isdetailed within the report from Annette Kennedy,Director of Professional Development.

However, in summary, the Committee had a veryheavy workload, during 2005, on a range ofprofessional/educational issues including drugprescribing, the role of the healthcare assistant, theEuropean Working Time Directive and the expansion ofthe role of the staff nurse/midwife.

Social Policy Committee

Co-chaired by Sheila Dickson and Raymond Boyle, andunder the guidance of Clare Treacy, Director ofOrganisation and Social Policy, the work of the SocialPolicy Committee is detailed elsewhere in this report.

Major Policy Issues In addition to the work of the committees, theExecutive Council, reflecting the decisions of annualconference, was also very actively involved in thefollowing:

European Working Time Directive

The Executive Council decided to ensure theOrganisation played a very active part, at local andnational level, in all discussions concerning theimplementation of the European Working TimeDirective.

In the context of nursing and midwifery, the INO hassix members on the National Nursing and Midwifery

INO delegates at the Special Delegate Conference at Croke Park unanimouslyrejected the terms of reference for the second benchmarking exercise


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Annual Report 2005

Expert Group – European Working Time Directive,which was established to ensure a proper andprogressive role, for nurses and midwives, arisingfrom the implementation of the working time directivewith regard to non-consultant hospital doctors(NCHDs).

In addition, the Organisation’s General Secretary, LiamDoran, was the Organisation’s nominee to the NationalImplementation Group – Medical, which wasestablished to oversee the implementation ofinitiatives which would lead to a reduction in workinghours for NCHDs.

The two committees, following a recommendationfrom Kieran Mulvey, CEO of the Labour RelationsCommission, also established a Conjoint Group,representative of both the Nursing/Midwifery andMedical National Committees who, it was agreed,would meet, on a regular basis, to reviewdevelopments which affected both nursing/midwiferyand medical grades.

At the end of the year, both of these national fora wereawaiting proposals, from nine pilot sites around thecountry, which would be implemented, by agreement,for a period of three months to assess theireffectiveness in addressing the working hour’s issue.

The nine locations were:

• Midwest Regional Hospital, Limerick

• University College Hospital, Galway

• University College Hospital, Cork

• Letterkenny General Hospital

• Mullingar General Hospital

• St James’s General Hospital

• Our Lady’s Hospital for Sick Children

• St Lomans Hospital, Mullingar

• National Maternity Hospital, Holles Street

Midwifery and Children’s Nursing –Undergraduate Degree Programme

Throughout the year the Executive Council alsoprioritised the issue of seeking the full implementationof the final report of the Midwifery and PaediatricEducation Expert Group which had been published inDecember 2004. This report, which was fully endorsedby the Organisation, recommended the following:

• The commencement of a four year undergraduatedirect entry midwifery programme

• The commencement of a four and a half year directentry children’s/general nursing integrated degreeprogramme

• The transfer of existing post registration midwiferyand children’s nursing programmes to the third levelsector.

Throughout 2005 the Executive Council maintainedpressure upon the Department of Health and Childrento confirm the implementation of this report with thenecessary funding.

In November 2005 the Organisation welcomed theannouncement, by Mary Harney TD, Tanaiste andMinister for Health and Children, that the governmenthad agreed to fund the commencement of the two newdirect entry programmes as detailed above.

However, no indication was given with regard tofunding the transfer of existing post-registrationeducation and, at the end of 2005, the Organisationwas continuing in discussions, with the Department ofHealth and Children, on this issue.

The Organisation also agreed to fully participate in theNational Implementation Group, established by theTanaiste, to oversee the commencement of the twonew degree programmes. This NationalImplementation Group was established under theindependent chair of Rosemary Ryan, formally Directorof Nursing in St James’s Hospital.

Registered Nurse Intellectual Disability –Expert Group

During 2005 the Executive Council expressed itsincreasing frustration with the lack of progress withregard to the completion of the work of this expertgroup which had originally been established in 2003.

The first report of the group had been rejected by INOmembers and, as a result, the group had beenreconvened to review a number of issues whichremained unsatisfactory including:

• The reporting relationship of the RNID

• The need to introduce CNS and ANP posts in the IDsector

• The question of delegation, to non-registeredprofessionals, in intellectual disability settings

• The role of the RNID in the education of the severeand profound individual.

Little progress was made, on these issues, during 2005and, at the end of the year, the Organisation hadformally written to the Health Service Executive –Employer’s Agency indicating its total dissatisfactionwith the management sides approach to this veryimportant issue.

MiscellaneousThe Executive Council was also deeply involved inmany other issues, during the year under review,


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Annual Report 2005

including the health service reforms, A&Eovercrowding, drug prescribing, skill mix/staffingissues and recruitment and retention, all of which aredetailed elsewhere in this report.

Galway Office OpensOn Tuesday, 15 November, the Organisation formallyopened its new full-time regional office in Galway City,which will service our membership in the Western andNorth-Western Regions.

The office, which is located at Westside BusinessCentre, 74 Old Seamus Quirke Road, Galway, will beopen full time and Kylie Matterson will act asAdministrative Officer. Noreen Muldoon, IRO for theWestern Region and Noel Treanor, IRO for the NorthWestern Region will also work out of, or be servicedby, the new Western Regional Office.

The opening of this office means that the Organisationnow has three regional offices in Cork, Limerick andGalway. The opening also marks the culmination ofmany years of tireless effort, by our activists in theWestern Region, who had consistently sought theoffice in order to further enhance the Organisation’sservices to our growing membership in the westernseaboard area.

The new office was jointly opened by Madeline Spiers,INO President, and Councillor Brian Walsh, Mayor ofthe City of Galway.

Minister for Health and ChildrenMary Harney TD, Tanaiste, continued as Minister forHealth and Children during 2005.

Apart from attending our annual delegate conference,Ms Harney also addressed our professionalconference which was held in October. In addition theOrganisation met with Ms Harney, both formally andinformally, during the year with the main focus of alldiscussions concentrating on:

• The continuing overcrowding occurring in A&Edepartments and the effectiveness of the Tanaiste’s 10point plan aimed at alleviating this overcrowding

• Measures to aid retention of nurses and midwives inthe Irish health service and, by extension, the nursingand midwifery manpower levels within the Irishhealth service

• Nursing and midwifery involvement within the healthservice reform programme.

Department of Health andChildrenDuring 2005, the Organisation continued to haveregular, and ongoing, contact with many officials, anddivisions of the Department of Health and Children.

During the year certain changes took place, withregard to personnel, in the Nursing Policy Unit and theOrganisation would like to take this opportunity toexpress its appreciation, and best wishes, toSimonetta Ryan, formally Principal Officer in theNursing and Midwifery Policy Unit, who wastransferred, in late 2005, to the Employment ControlDivision within the Department.

The Organisation would also like to welcome TonyMorris, who has been appointed as Principal Officer tothe Nursing/Midwifery Unit and we look forward toworking with him during 2006.

At the end of 2005 the Department of Health andChildren, was recruiting three new nurse/midwifeadvisers, to the Nursing/Midwifery Policy Unit, and wewant to take this opportunity to thank all the previousnurse/midwife advisers for their help and assistance atall times.

Nurses’ and Midwives’LegislationOne of the great disappointments, during 2005, wasthe failure of the Department, despite much pressure,to publish a new Nurses and Midwives Bill asoriginally recommended by the Commission onNursing in 1998. At the end of 2005, the Departmentrecommitted itself to definitely publish the Bill, whileallowing time for consultation on same, during 2006.

Irish Medicines Board Bill 2005

On a more positive note, it is appropriate to record thatMary Harney TD, Tanaiste and Minister for Health andChildren, committed herself, during 2005, to includediagnosing and prescribing rights, for nurses andmidwives, as part of the Irish Medicine’s Board Billwhich was published during the year under review.

The decision to include these rights, in this newlegislation, directly stems from the recommendationsof the nurse/midwifery prescribing project which wasestablished jointly by An Bord Altranais, and theNational Council for the Professional Development ofNursing and Midwifery, and which was published inNovember 2005.

The Tanaiste’s prompt and positive response, to thisreport, is recognised, and welcomed, by theOrganisation as it has the potential to realise a muchgreater role, for nurses and midwives in so many areasof the health sector, in a manner which improves thequality of patient care.

Health Service ExecutiveFollowing its formal establishment, on 1 January 2005,the Organisation commenced ongoing contacts withsenior management in the new Executive.


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Annual Report 2005

On 1 August 2005 Professor Brendan Drumm wasappointed as the first Chief Executive Officer of thenew HSE and the Organisation wished him everysuccess in his challenging post.

Issues discussed during the year, and covered in detailelsewhere in this report, include:

• A&E overcrowding

• Nurse/midwife involvement at senior managementlevel

• Bed capacity

• Primary Care Strategy

• Staffing levels.

At the end of 2005 it is necessary to record that a lackof clarity remained over the structures within the HSE,the division between the Department and the HSE, thelinkages between acute and other services andbetween the HSE and voluntary agencies.

Irish Congress of Trade Unions(ICTU)The General Secretary, Liam Doran and Clare Treacy,Director of Organisation and Social Policy, were re-elected to the ICTU Executive Council at the biennialconference, held in Belfast in July 2005.

Biennial Delegate Conference

Also at this Biennial Conference, the Organisation’stwo motions, which were as follows:

1. Funding of Health Services

Conference noting:

• The failure of the government to implement its ownNational Health and Primary Care Strategies withparticular regard to the provision of adequate bedcapacity and primary care services;

• The continuing severe levels of overcrowding in thecountry’s A&E Departments;

• The illegal levying of charges on vulnerable seniorcitizens;

calls upon the incoming Executive Council to ensure:

• Government commitment, and funding, within thepreviously stated timeframes, for the fullimplementation of its own Health Strategies;

• That all monies now due to senior citizens, in long-term care, is paid without delay and withoutnegatively affecting existing and planned healthservices;

• That additional earmarked funding is allocated toaddress the crisis of overcrowding in A&EDepartments.

2. Childcare

Conference, noting the abject failure of government toensure the provision of affordable childcare, to allworking parents, calls upon the incoming ExecutiveCouncil, in any talks on a new social programme, toensure the following:

• That the availability of both childcare places andcrèche facilities is greatly increased in both the publicand private sector;

• That a tax credit is introduced, in the 2006 Budget,which would apply to working parents who providereceipted childcare expenses;

• That an allowance be introduced, payable to a familymember undertaking childcare responsibilities, onbehalf of a working parent;

and that Congress would not agree to a new socialprogramme unless definite, and stated, commitmentsare given with regard to this critical social andeconomic issue.

were unanimously adopted by the 600 delegatesrepresenting almost 600,000 workers in this country.

Social Partnership

The Organisation, through its affiliation with, andmembership of, the ICTU Executive Council, was alsoactively involved, at the end of 2005, in the preliminarydiscussions leading to the possible commencement ofsocial partnership talks on a successor to SustainingProgress.

The INO, although indicating its non-involvement inany second benchmarking exercise as part of itsmembership of the Public Services Committee of theICTU, decided to continue to play an active role, in anysocial partnership discussions, in order to ensure theproblems of the health service formed a central aspectof any new programme.

ICTU Youth

2005 also saw the election of Edward Mathews, INOIndustrial Relations Officer, to the chair of the ICTUYouth Committee. Eddie was also elected President ofthe Youth Committee of the European Trade UnionConference.

ICTU Health Study

During 2005, and again in the context of socialpartnership negotiations, the Organisation, inpartnership with other health service unions, jointlyfunded an ICTU commissioned study, carried out by Dr Dale Tussing, from the USA and Maev-Ann Wren,Health Economist, entitled The Health Report, whichwas published in November 2005.

This report, which was warmly welcomed by the


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Annual Report 2005

Organisation, endorses many of the Organisation’sviews, with regard to the public health service, and willact as a foundation for all of the ICTU’s discussions, onthe health service, within the social partnershipnegotiations.

An Bord Altranais Throughout 2005, the Organisation continued to havea series of contacts, at many levels, with An BordAltranais in order to discuss a range of issues andmatters of concern.

In particular, during the year, the Organisation wasinvolved in the following:

PHN Rule Change

Arising from the Board’s decision, made withoutconsultation in late 2004, to seek changes to the rulesgoverning entry to the PHN register, the Organisationhad demanded a major review of this whole area.

In response, An Bord Altranais agreed to commence aconsultation exercise, which would be overseen by asteering committee, aimed at ascertaining the views ofall stake holders with regard to the appropriate skill-setrequired to be a public health nurse.

However at the first meeting of the steering groupissues arose with regard to the ability of the exercise tocomprehend the views of those who continue to seekmidwifery as an essential qualification.

As a result of this, the Organisation was forced towithdraw its cooperation, with the proposedconsultation exercise, and demand a full review of itsterms of reference by An Bord Altranais.

At the end of 2005, An Bord had indicated thatmidwifery could be raised, as part of a consultationexercise and, as a result, the Organisation, at the end

of the year, was indicating its willingness to participatein the consultation exercise.

The Role of the Healthcare Assistant

Arising from the work of the high level group, on thehealthcare assistant, discussion had been necessary,with An Bord Altranais, in order to ascertain absoluteclarity with regard to the delegation of tasks, bynurses/midwives, to healthcare assistants and any nonregistered professional.

In these discussions, An Bord Altranais had confirmedthat it was not appropriate for any employer to imposea mass delegation requirement, on any registerednurse, as it remained the sole remit, of the individualregistered nurse, to decide whether any task couldsafely be delegated to another non registeredprofessional.

Administration of Drugs by Non-NursingGrades

At the end of the year discussions were still ongoing,with An Bord Altranais, regarding the administration ofdrugs, by non registered professionals, particularly inthe intellectual disability sector.

The need for clarity on this matter arose fromproposed changes in policy, by some health serviceemployers, which would impose a daily requirementon nurses to delegate drug administration tasks tonon-registered care staff.

With regard to these ongoing discussions, it isnecessary to record the Organisation’sdisappointment, with An Bord Altranais, regarding itswillingness to openly engage, with the Organisation,on matters of concern to nurses/midwives in clinicalpractice.

In particular the Organisation still cannot accept thefailure of An Bord to comment upon, and involve itselfin, issues related to service delivery which, in theOrganisation’s view, undoubtedly impact uponnursing/midwifery practice.

National Council for theProfessional Development ofNursing and MidwiferyDuring 2005 the Organisation continued to have anumber of contacts with the National Council todiscuss various issues of concern. These included:

• The very slow pace, and small increase in, thenumber of specialist and practitioner posts nowbeing approved by the National Council

• The incorrect reporting relationship, stipulated by theNational Council, with regard to the Director of PublicHealth Nursing and senior management.

In 2005 the INO collaborated with the Irish Museum of Modern Art, which suppliedan art exhibition for INO headquarters.The artwork was selected from a body ofwork called “...and start to wear purple” created by older people from St Michael’sParish on Bluebell and Inchicore between 1991 and 1999. Pictured at the openingof the exhibition were (l-r): Liam Doran, INO General Secretary; Annette Kennedy,INO Director of Professional Development; Dublin Lord Mayor Catherine Byrne;and INO President, Madeline Spiers


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Annual Report 2005

At the end of the year the Organisation continued to beinvolved in a legal action which seeks to direct theNational Council to process applications, from publichealth nurses, for approval as clinical nursespecialists.

In addition this action also seeks that the HealthService Executive – Employer’s Agency would cease tointerfere with the National Council’s statutory role withregard to processing applications for nurse/midwifespecialist posts.

International Nurses DayThe INO, as an affiliate of the International Council ofNurses (ICN) participated in International Nurses Daywhich had, as its theme – Counterfeits Kill. NursesTarget Counterfeit Medicines.

In highlighting the event, which took place on 12 May2005 the ICN stressed the following:

• Increase awareness of the existence andconsequences of counterfeit medicines

• Provide tools to identify counterfeit drugs and toreport any suspicious medicines

• Encourage nurses and other health professionals tolobby governments and regulatory authorities forattention to the existence and dangers of counterfeitand substandard medicines.

International Midwives DayThe INO, as part of its affiliation to the InternationalConfederation of Midwives (ICM), acknowledged the

International Midwives Day which took place on 4 May2005.

The theme for this important event was: Midwives andWomen – A Partnership for Health.

The Organisation, through our Midwives Section, fullyendorsed the theme of this day and recommitted itselfto work, in every way possible, to highlight theindependent, and pivotal, role of the midwife asadvocates for healthy women, healthy babies andhealthy nations.

StaffingThe following staffing changes took place during theyear under review:

• Kylie Matterson – Kylie was moved, to the GalwayOffice, and took up the post of administrative officer

• Mary Cradden – Mary was appointed to the post ofadministrative assistant

• Una McKevitt – Una commenced, part-time, in ourMembership Department

• Nora Donagh – Nora worked as a temporaryindustrial relations officer between May andSeptember 2005

• Clare Mahon – Clare worked as a temporaryindustrial relations officer between September 2004and April 2005

• Anna Malone – Anna completed her appointment aspart-time nurse representative (Limerick City).


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Annual Report 2005

Overview2005 was the year of health reform.The 1970 Health Act, which createdthe health board structure, wasrepealed and the new Health Act of2004 was to be enacted from 1 January 2005. The new Health Actwould see the eight regional HealthBoards and three Health Authoritiesin the Eastern Region abolished andreplaced by a single Health ServiceExecutive, which would takeresponsibility for the entire

nationwide delivery of health services, with a budgetof ¤11 billion devolved to the new executive fromgovernment. At the end of the year the Organisation’smembers may well have been left asking, whatreform? as there was no apparent difference in thescarcity of resources available to them in the deliveryof direct patient care and the spectre of ever increasingnumbers of patients lying on trolleys, awaitingadmission to accident and emergency departmentscontinued to grow and worsen throughout the year.

The year commenced with the new Health ServiceExecutive stumbling into existence following a rushedagreement with senior managers who had refused toco-operate with the transfer of powers in the HSE,unless and until their agenda had been satisfied. Thisvery successful industrial action, from the seniormanagers point of view, led to a situation which wasreported in the media as having given themguarantees with regard to continued employment upto their normal retirement age, a range of newpromotional positions at national level confined tothemselves and a severance package for the formerChief Executive Officers whose contracts had already,or were about to cease. The appointment of a ChiefExecutive to the new Health Service Executive hadfallen flat on its face and the selected candidateultimately declined the position and thus the newnational health service commenced its life with anacting Chief Executive who had been the governmentappointed Chairman of the Board of the Health ServiceExecutive and a retired banker.

The abolition of 11 health authority structures and itsconsequent elimination of many functions rancontrary to the guarantees which had been agreedwith regard to employment. Consequently nurses andmidwives, along with many others, were reduced toobserver status as they watched a myriad ofadministrative structures which seemed more drivenby the need to accommodate people with positionsthan real health reform. They witnessed the creation ofnew titles and positions, which appeared to duplicateposts which already existed and a special behindclosed doors arbitration and pay review, which yieldedmoney only to those most remote from direct patientcare. This was in stark contrast to staunch opposition ofthe very same Health Service Executive where any and

every claim made on behalf of nurses and midwivesand their outright inertia in dealing with ever growingdependency levels with a static or reducing number ofstaff in our hospitals and care of the elderly facilities.A new Chief Executive, Professor Brendan Drumm, apaediatric consultant, was ultimately appointed andtook up position as Chief Executive Officer of theHealth Service Executive in August and he broughtwith him a special high level management team, whichhad not been provided for in the health service reform,rolled out in the first eight months of the year, andwhich was apparently to be very influential in the realreform of the health service. The inertia and confusioncontinued throughout the year, Professor Drummannounced that 10 hospital networks planned by hispredecessors and to which eight of the 10 networkmanagers had already been appointed were to bereduced to four. Consistent with the rest of the healthservice reform programme the final position reachedon hospital networks is eight at the end of the year andthe organisational chart for the Health ServiceExecutive is notable for the conspicuous absence of aclinical directorate or any senior nursing or midwiferyposts at the top level of decision making in any of thenational directorates.

From the Organisation’s point of view, 2005 was a yearof campaigning and rejuvenation, which has seengrowing awareness among INO members of the needto stand up for the professions of nursing andmidwifery, and to make their voices heard asadvocates of their patients.

Throughout the year the Organisation campaigned forgreater and higher level involvement of nursing andmidwifery management in the Health ServiceExecutive. It mobilised public opinion and dominatedmedia attention in the spring and autumn of the year,highlighting the appalling crisis that is accident andemergency department overcrowding.

It relentlessly campaigned for the review of nursepatient ratios in all sectors and, in particular, care ofthe elderly and it sent a strong message to employersand government that it would not be bullied orthreatened by the withholding of pay increases on theissue of healthcare assistants or forced into abenchmarking exercise whose terms of reference arespecifically designed to prevent nurses addressing aserious anomaly with regard to their pay and theirhours of work.

Nursing and MidwiferyManagement StructuresThroughout the year the Organisation have met withthe Health Service Executive on a number of occasionsindicating the unacceptable attempts by laymanagement to relegate the reporting relationships ofDirectors of Nursing and Midwifery away from theagreed position of 1999. The INO’s interpretation of thenew structures is that Directors of Nursing and

Industrial Relations Review 2005

Dave Hughes, Deputy GeneralSecretary, INO


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Annual Report 2005

Midwifery in the former health board structure reportto network managers in the case of the acute hospitalnetworks and local health office managers in the caseof primary continuing and community care directors.No other reporting relationship is acceptable to theOrganisation and management grades have beenrepeatedly instructed to adhere to this position. TheOrganisation has also engaged in lobbying of both theBoard, CEO, and the senior management on the needfor the evolvement of nursing and midwifery at thehigher echelons of the decision making processes ofthe HSE and while at the end of the year no significantprogress had been made, there was no weakening inthis campaign.

Those engaged in promoting the new health servicestructure attempted to engage in their preoccupationwith the Nursing and Midwifery Planning andDevelopment Units and their over simplistic view thatas everything else was organised on the basis of fourregions, the existing eight units should be reduced tofour. The Organisation stood firm throughout the yearinsisting that the contracts of employment of those inthe units must be maintained until final agreement isreached and demanding retention of all the units,given that they are in themselves only a newinnovation in the promotion of quality and standardsof patient care, nurse education and professionaldevelopment. The Organisation will not allow anunjustified reduction in the resources available to theprofessions and will insist that any change ordevelopment in the field of nursing or midwifery isbased on sound promotion of enhanced quality patientcare, the promotion and protection of the professions.

Accident and EmergencyOvercrowding The year commenced with the newly appointedMinister for Health and Children, An Tánaiste, MaryHarney promoting a 10 point plan which she promisedwould, in a relatively short period of time, lead to theelimination of accident and emergency departmentovercrowding. It was clear almost from the start of theyear that the ¤70 million allocated for the plan wouldcome nowhere near providing a solution andunfortunately, at the end of the year the situation hadactually deteriorated. Attempts by the Health ServiceExecutive to portray it otherwise were rejected by theOrganisation and by the public in general.

The February meeting of the INO Executive Councilendorsed a plan to launch a campaign highlighting theongoing crisis under the title Enough is Enough. Thecampaign involved lunchtime protests in the hospitalswhere there was a continuing crisis and where thenumbers of people waiting on trolleys had beenconsistently high. The public were called to supportthese protests, which would be half an hour induration during lunchtime. The first protest wasplanned for 22 February.

However, in a direct meeting with Mary Harney TD,Tánaiste and Minister for Health and Children, takinginto account her statement that there would be asignificant reduction in the trolley count by the end ofMarch 2005, and that there would be no bar to fundinghome care packages and the provision of intermediateand high dependency beds, the Council agreed todefer the first protest to review the situation again atthe end of March. When there was no visibleimprovement at the end of March, the ExecutiveCouncil decided, at its March meeting, that it had nochoice but to proceed with the protests at selectedhospitals on Tuesdays and Thursdays throughout themonth of April.

The campaign was a rolling campaign involving oneDublin, and one provincial hospital each day, Cork andGalway being twinned with provincial hospitals for thedays on which they were engaged in the action. Thefocus of the protests was to build solidarity withpatients, to highlight the lack of bed capacity and theneed for better management within the hospitals.Special placards, leaflets, and t-shirts were preparedfor the campaign.

The campaign dominated the media for the entiremonth of April, live radio programmes were inundatedwith public complaints about the state of the healthservice and many commended the INO for what wasone of the most successful media campaigns by anytrade union in recent history.

In May, the Director of the National Hospitals Officewrote to the INO suggesting a new A&E Forum fromwithin the National Hospitals Office, involving all of thestaff and key management players in the system. INOaccepted the proposal and nominated the DeputyGeneral Secretary to be joint Chair of the Forum. TheForum replaced the LRC Nursing Forum and had twoadvantages over it. Firstly, it encompassed other staffgroups including representatives, IMO and IHCA, whohave both involvement and responsibility along withnurses in the area. Secondly, the National HospitalDirector was in a position to report directly to a Cabinetsub-committee, which had been formed specifically todeal with the question of accident and emergencyovercrowding. It was believed at the time that thiswould lead to some action on the issue. In the eventthe Forum had a sluggish start only holding its firstmeeting towards the end of September and even thenit was less than satisfactory in that the PrimaryContinuing and Community Care Directorate did notappear to take the Forum with the same level ofseriousness as its National Hospitals Office equivalent.They appointed an LHO manager as theirrepresentative, as opposed to their national director orassistant director. Trade unions on the Forum, led bythe INO, objected strenuously to this and while this didlead to the nomination of Assistant Director, it wasquite apparent by the end of the year that there was alack of consistency or real intent with regard to theapproach of PCCC to the Forum. This is particularlyproblematic given the focus put by the CEO and the


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Annual Report 2005

Minister on the need to improve services in that areain order to alleviate and reduce the demand side onthe acute sector. While the Forum was a usefulenhancement and a great opportunity to galvanisesupport from within the staff for the INO objectives inrelation to capacity and improved hospitalmanagement, the HSE continued it’s denial insisting,despite all the evidence to the contrary, that thesituation was improving. As the trolley count roseagain dramatically at the end of the year, the ExecutiveCouncil, at its December meeting, decided to proceedwith phase two of the Enough is Enough campaigncommencing in January 2006 with a postcarddepicting A&E overcrowding and the discomfortcaused by it and asking the question ‘How Long MustThis Keep Going On?’.

The postcards, it was agreed, would be distributedthrough staff in A&E departments to the general publicwho would be asked to put their message to theMinister on the postcards, which would be returned toINO by freepost and delivered on-mass to the Tanaisteat some point in early 2006.

Sustaining Progress,Benchmarking and PayThe final phase of the benchmarking agreement, one-quarter of the amount due to each of the grades was tobe paid from 1 June 2005. Along with this increaseSustaining Progress provided for a 1.5% increase andtwo phases remaining of that pay agreement, a further1.5% in December 2005 and the final 2.5% on 1 June2006. The benchmarking payment and the JuneSustaining Progress payment fell due forconsideration by the Performance Verification Group inMarch 2005 and none of the local agency reports or the

national report of the Health Service Executiveindicated any issue with regard to nurses andmidwives getting their entitlements.

Following the launch, at the end of March, of theEnough is Enough campaign an amendment wasmade to the HSE national PVG report suggesting thatthe INO had refused to co-operate with theintroduction of healthcare assistants in the Irish healthservice. Aside from the fact that this was blatantlyuntrue, the INO viewed it as a complete retaliation forthe public Enough is Enough campaign.

Through every available procedure the INOdemonstrated there had been full co-operation withhealthcare assistants and the piloting of their roleenhancement and that there was only one contentiousmodel with regard to their training which the HSEincorporated, without consultation or adequateagreement, on standards in relation to the delegationof vital signs to healthcare assistants. The issue hadbeen debated with the Professional DevelopmentCentre of the INO and documents were underconsideration. It had not been raised in any formal IRforum with the INO as an industrial relations issue, butsuddenly it emerged at the end of March as anamendment to the PVG report and was accompaniedby statements from the Minister and the HSEcondemning the INO.

As a media campaign the attempt did not work ordeflect public anger in relation to the A&Eovercrowding. From an industrial relations point ofview, however, it posed a serious problem to the INOin that the procedures were not being adhered to andyet the employer was seeking to prevent the paymentof two increases due on 1 June to nurses andmidwives. Every attempt to appeal for reason duringthe month of April and early May were met witharrogant resistance. The Executive Council, in its pre-conference meeting, decided that if the Health ServiceExecutive persisted in this unwarranted attack onnurses and midwives, the Organisation shouldrespond in the strongest possible manner by ballotingmembers for industrial action. In keeping with thedisputes procedure for the health services, theOrganisation notified the Health Service ExecutiveEmployers Agency of our intention to take industrialaction subject to the outcome of a national ballot ofmembers, which was immediately called.

The swift response by the INO to the unwarrantedthreat and the severity of that response drew nationalfocus to the prospect of a serious industrial dispute atthe start of the summer. The National ImplementationBody comprising the ICTU, IBEC and the Departmentof Finance convened a special meeting of the partiesand ultimately issued recommendations which led to aresolution of the dispute and the abandonment of theballot for industrial action.

The High Level Group proposals recorded that the INOhad no principled objection to the introduction ofhealthcare assistants or the training of them in relation

Immediately after the Special Delegate Conference, the Organisation moved toenact the second phase of the Enough is Enough campaign through a high profilemedia campaign and a nationwide postcard campaign


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Annual Report 2005

to appropriate patient care. It recommended that theOrganisation co-operate with the disputed trainingmodule subject to a health service High Level Groupcomprising representatives of nursing, healthcareassistants, An Bord Altranais and management,reviewing the recommendations of the report on theeffective utilisation of the skills of nurses andmidwives with regard to the topic and makingrecommendations for the orderly introduction ofhealthcare assistants into patient care under agreedprotocols approved by the regulatory body.

The National Implementation Body’s recommendationwas that this High Level Group should complete itswork by the end of September. Anne Carrigy, Directorof Nursing from the Mater Hospital was appointed asChair to the group. The group completed its workwithin the time allowed but by the end of the year thefinal report was still in the drafting stage with the INOexperiencing some difficulties having recordeddecisions of the High Level Group included in the finalreport.

The pay increases were paid with effect from 1 Juneand an important message had been registered withboth employers and government with regard to justhow far they could push the Organisation in spite ofthe highly restrictive pay agreement that is SustainingProgress.

BenchmarkingThe negotiations on the terms of reference forbenchmarking proceeded throughout the summer.The INO submitted a total of 14 amendments to thepreamble to and terms of reference of theBenchmarking Body mark two. Through the manymeetings, which considered these benchmarkingamendments, none of those proposed by INOsurvived. The twin objectives of the Organisation thatthe terms of reference would provide for priority to begiven to our claims with regard to the anomalybetween the pay of the childcare worker and registerednurse/midwife along with our requirement to achieve areduction in the working week were blocked beforethey were even presented to the employers.

Instead a wording was inserted into the terms ofreference which referred to the two relevant LabourCourt recommendations on these topics and the needfor them to be addressed along with all otherrecommendations relevant to the Benchmarking Body.In spite of the amendments not having been put to themanagement side by the ICTU delegation, INO, in thefinal meeting with the official side on thebenchmarking issue, put the priority amendmentdirectly to the official side and in spite of the fact thatit had been agreed within the health service, there wasa denial by the official side that any such priorityshould be afforded.

The Organisation was required by the Annual DelegateConference in May 2005 to hold a special conference

on pay and this was called for 27 September. Theconference decided to reject the terms of reference forthe Benchmarking Body and to instruct the ExecutiveCouncil to pursue the legitimate claims of nurses andmidwives directly with the Health Service Executiveand other health employers, under the agreedprocedure for the resolution of disputes in the healthservice.

Eight claims on behalf of nurses and midwives wereregistered with the Health Service Executive inDecember 2005. The Organisation informed theemployer that they were being processed inaccordance with the dispute resolution mechanism ofthe health services, which has an indicative time limitfor the processing of such claims of 26 weeks and anabsolute time limit of 34 weeks for the exhaustion ofall procedures.

The Organisation informed the Executive that this 34week period would expire on 2 July 2006 at which timethe INO would have honoured all of its commitmentsunder Sustaining Progress and, in its view, would befree to deal with these issues under any alternative payprocedure or directly with the employer.

PPARSThe INO welcomed the decision of the Health ServiceExecutive’s CEO to suspend the roll out of the PPARSproject pending an overall review of the cost involvedand the appropriateness of the system.

This was a welcome relief to the Organisation whichhad been embattled with numerous queries frommembers relating to serious problems and flaws in thePPARS system. The biggest flaw was that almost everyagreement reached at national level with theemployers with regard to protecting people’s termsand conditions of employment was ignored at locallevel and led to numerous local disputes with regard toprotecting those conditions. In addition to this, therewere major errors which led to people being bothoverpaid and underpaid and apparently an inflexibilitywithin the system which seemed to make it impossibleto correct these flaws.

The third category of problem related to increasedworkloads associated with the introduction of thesystem and a determined effort to delegateresponsibility to nurse managers for time recording,which had previously been a central function and waslikely to divert the attention of clinical nurse managersfrom their primary responsibilities. The suspension ofthe roll out of the system has provided some relief inthe year 2006 with regard to a project which the INOhave long come to view as incapable of dealing withthe complexities of payroll involved in a service asdiverse as the Irish health service. The Organisationhad argued that it was over ambitious and the cost ofit was grossly underestimated. A report subsequentlyissued by the Controller and Auditor General on theproject was highly critical of both the cost


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Annual Report 2005

effectiveness of the PPARS project but also on the lackgovernance in relation to it.

Care of the Elderly Staffing IssuesThe Organisation through the year were successful inconcluding independent reviews of staffing levels in anumber of care of the elderly facilities. However, theHSE, by the end of the year, had failed to implementalmost all of these reports and recommendations eventhough they had been agreed.

The Organisation are now raising the issue at allnational fora and are attempting to get seriousengagement from the PCCC to ensure safe staffinglevels in care of the elderly.

Miscellaneous ClaimsA number of claims were pursued on behalf ofindividual groups as follows:

Bed Managers

The CAPITA report providing for a revision and re-emphasis on bed management was not implementedby the Health Service Executive during 2005. Thisundoubtedly contributed to the continuing chaos ofA&E Departments and no real excuse was offered bymanagement for the failure to act on this agreedConsultant’s report. The question of the grading of bedmanagers was one of the impediments to the fullimplementation of the report as a dispute had arisenwith regard to CAPITA statement that the job should bevalued at that of administrative Grade 8 but paid onthe grade of assistant director. This was channelledthrough the Labour Court and led to three hearings ofthe Court on the issue.

Ultimately the Court issued recommendation 18123 inFebruary. The Court came down firmly in the INO’sfavour on the issue taking the view that if jobs werevalued based on the functions, which those appointedwere expected to perform, it would be totallyinappropriate to attach a salary to them which was lessthan that commensurate with the grading decided inrelation to them.

In short, this meant that although the bed manager hasa requirement to be a registered nurse, the pay andterms and conditions of the post should be that of theadministrative Grade 8 which is substantially higherthan the assistant director of nursing grade.

The Health Service Executive Employer’s Agency(HSEEA) sat on this recommendation until the middleof the year and then, without any further discussion,issued a circular to employers changing twofundamental aspects with regard to bed managers.Firstly, they sought to remove the requirement that abed manager was required to be a nurse and secondly,

they were now insisting that those already appointedto the role of bed manager would be required tocompete in order to achieve the new grading. INO sawthis as a clear attempt to depart from the originalagreement and to fill the post with people other thannurses. Consequently the matter has now, at the endof the year, been referred back to the Labour Court forfinal clarification.

Out of Hours Nurse Managers

The out of hours nurse managers who haveresponsibility for whole sites pursued a claim forparity of pay and grading with colleague nightsuperintendents who are graded at assistant directorlevel. The processing of this claim was protracted withthe HSEEA procrastinating through postponing,adjourning and making themselves unavailable for thenext stage of each process. Ultimately the matterstruggled to the Labour Court on Friday 23 Septemberfor a full hearing.

The HSEEA caused great confusion at the hearingsuggesting that the claim was ill-defined and that iteffectively covered CNM1, CNM2 and CNM3s. TheCourt, because of the confusion, wrote to both sidesasking them to attempt to define the claim and resolveit if possible. This led to a direct meeting with the HSE-EA which failed to further define or resolve the issue.

In spite of the efforts of the Organisation and a furtherconciliation conference some months later, at the endof the year the out of hours nurse managers were stillawaiting a date for a final Labour Court hearing. Theexperience of the out of hours nurse managers andother nurse managers in pursuing claims for theirentitlements has been appalling.

The approach taken by the HSEEA appears to be toreject any claim, regardless of its merits, that comesfrom nurses and, in the process, to insult the mostsenior members of the profession. They createconfusion and try to divide the nurse workforceplaying one set of nurse managers off against theother and have generally poisoned the atmospherewith the INO in relation to pursuing such claims.

It is expected that the Labour Court will see throughthis fruitless strategy and deal with the legitimateanomalies that are being presented by nursemanagers and which are created from within healthservice management itself.

Radiology Nursing Location Allowance

One of the most disappointing claims pursued atnational level was that on behalf of radiology nurseswho sought the extension of the location allowance totheir area.

Again the HSEEA procrastinated in the extreme on thiscase and, even though in the initial process theyclearly indicated that they were prepared to make anoffer, ultimately made none at all.


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Annual Report 2005

Unfortunately, the Labour Court were not persuaded inspite of the difficult conditions of working in radiologydepartments that a location allowance should apply.Nurses in radiology departments were bitterlydisappointed by the outcome of this case and haverejected the recommendation and are reviewing theiroptions.

Hospital Banding

The hospital banding agreement of 1996 has been thesubject of a number of claims for a revision of thebanding for particular hospitals.

All of the claims are based on the expanding needs ofthe services and the fact that the criteria set down forthe various bands have been exceeded in the case ofthose hospitals that are claiming. In a minority of othercases comparisons are being made to hospitals ofsimilar size but slightly different activity where specialcases have been made.

Following failure to reach agreement through directdiscussions with the employers on this issue, thematter was referred to the LRC for assistance in theautumn of the year. Again, procrastination on the partof the HSEEA has meant that the actual conciliationconference on this issue was not scheduled until a dateearly in the new year.

A number of other claims were processed at local levelwith success on behalf of nurses and midwives andare featured in the regional reports of the IROs.

Nurse Representative TrainingThe Organisation provided nine basic training coursesfor elected nurse representatives on a nationwidebasis throughout the year. In addition an advancedcourse was held for experienced activists in April 2005in Dublin and two courses for INO representatives onpartnership committees were held in June andSeptember. Approximately 175 nurse representativesattended these training courses.

There were two training courses for full-time officialsof the Organisation which are designed to keep themup to speed with case law, changes in industrialrelations practice and law and improvement of skills.

Summary – Another Busy YearThis report is an overview of the industrial relationsclimate throughout the year 2005. By its nature itcannot comprehend all of the various diverse activitieswhich the INO have been involved in on an industrialrelations and human resource level throughout theyear. The Organisation is privileged to have a largenumber of dedicated elected local activists whorepresent their colleagues on a day to day basis in theevery day issues that are industrial relations. Theincreasing importance of the role of the localrepresentative is coming more and more into focus as

we move into a new era of partnership and change.

While the introduction of many laws and entitlementshave changed the focus of work from the point of viewof full time officials requiring the pursuance ofindividual claims for rights and entitlements, the roleof the local nurse representative in being thespokesperson and the advocate for the profession andtheir colleagues at local level is becoming increasinglymore important.

The INO has many strengths, it attempts to providebest possible quality service in terms of representingour members and is in the top league of Irish tradeunions in terms of the provision of industrial relationstraining.

At the same time our Professional DevelopmentCentre provides a service which is unique among Irishtrade union organisations. All of this, however, is onlypossible because the INO is a living, vibrant andeffective Organisation at local level and for that thecredit must go to the many elected representatives atthe various different levels throughout theOrganisation.

2005 was another year in which those representativesexcelled all previous expectations with regard to theireffectiveness in promoting the Organisation and theinterests of nurses and midwives.

Regional Round-Up (IROs)HSE – Eastern Region – East Coast Area Philip McAnenly

Incremental Credit: Nurses who haveexperience as a clinical nursemanagers reckoned for incrementalcredit on assimilating to the PHN scale.This has resulted in INO members

benefiting by more than e8,000 per annum.

Dominican Sisters, Sion Hill: INO members in theemploy of the Dominican Sisters, Sion Hill benefitedfrom favourable redundancy terms of six weeks peryear of service with no ceiling on the award. INOmembers in the employ of the Jewish Home of Irelandbenefited from having similar benefits extended tothem when the Jewish Home closed in 2005.

Beacon Clinic: Beacon Clinic agreed to pay two INOmembers a significant award following disputes whichwere referred to third parties for adjudication.

St Margaret’s/Maryville, Donnybrook: Ten INOmembers have benefited substantially followingnegotiations which will result in each nurse accessingpublic sector rates of employment. Most members willbenefit by almost e10,000 per year with retrospectiveeffect to 1998.

Hume Street Hospital: INO members are considering arange of attractive options negotiated by the INO


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Annual Report 2005

following plans to relocate dermatology services to StVincent’s University Hospital.

HSE – East Coast Area: Agreement reached to conductindependent staffing reviews in St Columcille’sHospital, OPD and Dalkey Community Centre for theElderly. Several outstanding promotional posts willnow also be filled.

Nursing Homes: A number of members havesuccessfully recovered monies owed but withheld byemployers, particularly after deciding to move to thepublic health service. Amounts negotiated rangedfrom e4,300-e9,500.

St Vincent’s University Hospital: Members interestsprotected in moves from Clonskeagh Hospital andwithin hospital to new buildings. One memberreceived almost e40,000 in settlement followingallegation of bullying by other staff. One memberawarded e3,000 following claim for monies due underDepartment of Health and Children’s Circular 109/99.

Leopardstown Park Hospital: Following ongoingrepresentations over 30 closed beds were re-opened.Attempts to deny long-serving staff from accessingadditional hours was prevented following INOintervention.

National Maternity Hospital, Holles Street: Onemember has been upgraded to CNM2 thus givinge12,000 per annum following the referral of herdispute to the Rights Commissioner services.

National Treatment Purchase Fund: The Labour Courtawarded an INO member e5,000 following claim forunfair dismissal.

HSE –Eastern Region – Northern Area Edward Mathews

Student nurses: Students have playeda prominent role in the work of theOrganisation within the area this year.Initially students took to the streets inprotest in both Connolly and Beaumont

hospitals due to a refusal by management to pay travelallowances during their clinical placements. Thestudents were successful in their campaign and hadthose allowances paid retrospectively to them.Students came to the fore again late in 2005 over theissue of vaccinations. The Organisation is activelyengaging with Connolly Hospital, Beaumont Hospitaland Dublin City University in order to address thisissue prior to 2006 intake.

Beaumont Hospital: Beaumont Hospital, as a busyBand 1 tertiary referral centre, has provided manychallenges for the Organisation during 2005. Ourmembers in the coronary care unit of this service werefaced with significant difficulties earlier this year, thestaffing levels and skills mix within the unit presentedparticular challenges to our members in ensuring the

provision of safe service to patients. Through thecollective action of our members and representationfrom the Organisation, remedial steps were takenwithin the hospital, additional training has beenprovided and enhanced management structures areserving to ameliorate some of the concerns of ourmembership.

The x-ray department of the hospital was the focus ofour attention on two occasions this year. Firstly, ourmembers brought to our attention the level of on-callcommitment they are required to provide in order toensure that very serious interventional procedureswhich take place within the department can go aheadout of normal working hours. The Organisationintervened and has secured, for our members, anenhanced on-call arrangement vis-à-vis what hadexisted previously in order that our members’commitment to the provision of an out of hoursservice, with very limited manpower, will berecognised through the payment of appropriate ratesof pay. The second occasion on which this departmentcame to our attention was when managementattempted to alter the working hours of our members.The current working hours within this department hasbeen long established for over 15 years, through theintervention of the Organisation our members’ termsand conditions of employment have been secured intothe future.

The Organisation was also active in the area ofinfection control within the hospital. In mid-2005 theservice advertised the head of the infection controlnursing resource as a CNM3 post. We immediatelysought that this be upgraded to an assistant director ofnursing, given the hospital-wide remit with which thisperson is charged.

While the management team initially rejected ourproposal, we have through sustained representation,both from the industrial staff and, indeed, our localrepresentatives, secured agreement for theappointment of an assistant director of nursing withresponsibility for infection control. This post is to beadvertised at the beginning of 2006.

A&E Departments: The A&E departments within theHSE Northern Area have been particularly busy during2005, this is symptomatic of the on-going crisis whichpervades all A&E departments. Within BeaumontHospital there have been occasions, during 2005,where the staff in the department, and, indeed, thedepartment itself, have reached breaking point.

While we have by no means solved the problem withinthe department, we have, we think, ensured thatmanagement on no occasion can forget that theworking conditions suffered by our members and theconditions suffered by patients are intolerable andmust not continue into the future.

Community nursing: The main focus of theOrganisation’s activity in terms of community nursinghas been the issue surrounding the antiquated and


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Annual Report 2005

dangerous conditions of Ballymun Health Centre. Wehave been successful in gaining commitments withregard to the commencement of work and our latestinformation indicates that it will be ready foroccupation in March 2006.

Orthopaedic Hospital, Clontarf: The OrthopaedicHospital in Clontarf has come to our attention on twoseparate occasions this year. An issue arose regardingthe inability of fixed term workers to access premiumpay, the resolution of which had the potential to causea loss of earnings for existing members of staff withinthe service. The Organisation was successful at aLabour Relations Commission conciliation conferencein accessing compensation for existing staff withregard to loss of premium earnings and in ensuringthat newer fixed term staff will have, in accordancewith their rights under law, equal access to premiumpayments.

There was also an attempt by management to reducethe amount of annual leave accruing to our membersworking on night duty. However through the astuteintervention of our representatives in theOrganisation, we were able to point out clearly tomanagement that additional annual leave awardedwas in compensation of additional hours workedwithin the service, for which our members are not paidon an on-going basis. We were successful in accessinga ‘red circled’ arrangement for existing members whocontinue to receive the additional annual leave, and toensure that new members entering the service willreceive full payment for any additional hours worked.

Notwithstanding our activities in the area of collectiverepresentation of our members, the Organisation,within the HSE Northern Area, has been extremelybusy in progressing individual issues of concern to ourmembers. Examples of some of our activities whichhave resulted in successful outcomes for our membersinclude:

• Regrading of managerial posts

• The backdating of an advanced nurse practitionerpost due to a failure by management to adequatelyconvert student ANP to a substantive ANP

• The successful representation of members who wereon long term sick leave and the achievement ofsuccessful reintegration to the workplace withoutloss of payment following extended leave

• The representation of a considerable number ofmembers in relation to allegations of bullying, both interms of representing complainants and respondents

• The successful accessing of study leave on behalf ofmembers

• Provision of advice to both our representatives andmembers which has allowed them on numerousoccasions to achieve successful resolutions to issuesof concern which have emerged within theiremployment.

HSE – Eastern Region – South West Area Phil Ní SheaghdhaSt James’s Hospital, Our Lady’sHospital for Sick Children,Peamount Hospital, Our Lady’sHospice, Harolds Cross,Cheeverstown House Ltd,Moore Abbey

St James’s Hospital:• Release of nurse rep for INO duties for one day a

week on site in St James’s Hospital achieved in 2005.

• Student nurses held a sit in and pickets during 2005to highlight their disquiet regarding their treatment atthis hospital, particularly in relation to travelallowance and cost of immunisations. Bothcampaigns were successful and students have to becommended for participating in these actions.

• Staffing levels remain the main issue of concern forINO members and the INO continue to pursue withmanagement.

• A&E relocated to new department. Local agreementreached regarding compensation for same.

Our Lady’s Hospital for Sick Children: Agreementsecured relating to regrading of CNM1s to CNM2s inthe ICU department of this hospital. The INO isparticipating in the local implementation group of theEuropean Working Time Directive.

Hospice Harold’s Cross: Three members representedwho pursued a case against their manager underdignity at work policy. An independent investigationfound that the allegations made were well founded.

HSE – South Western Area: Allegations were madeagainst an INO member under trust in care and ourmember subsequently suspended for prolongedperiod.

The INO represented the member to an independentinvestigator which found that there was no substanceto the allegations and our member returned to workand was compensated for loss of earnings.Community general nurses represented in relation topoint on scale and retrospection to 2004 achievedfollowing INO intervention.

Naas Hospital: INO members represented regardingopposition to new practice of returning nursing stafffor pay purposes at ward level which was presented asbeing part of the introduction of PPARS.

It was established that this was not necessary forcompliance with PPARS, and furthermore PPARS notimplemented at this site. A&E overcrowding remains alive issue at this hospital. The INO continues torepresent on this at local and national level.


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Annual Report 2005

HSE – Midland RegionKevin O’Connor

Midland Regional Hospital, Portlaoise

Theatre: The dispute in theatre, withregard to achieving a third nurse oncall, is ongoing. Negotiations havetaken place between INO and hospitalmanagement regarding this dispute.

The case has been referred to a Rights Commissionerbut no date has been set as yet.

A&E: An increasing trend in the number of people ontrolleys is evident. Management have refused tocancel elective surgery to free up the day ward for theescalation procedure. The Tanaiste and Minister forHealth and Children recently announced sanction forthe completion of the unfinished A&E department.While this development is welcome, there is noprovision for any extra beds in Portlaoise and this canonly lead to increased numbers on trolleys in thefuture when the new A&E department is open.

The outstanding claim for disturbance during thereconstruction of the A&E department has not beenbrought to closure. The INO has written to the HSE –Midland region advising them that negotiations withregard to the new A&E department will have tocommence. The issue of unfilled CNM shift leaderposts remains outstanding. It has been referred to theLabour Court and a date is awaited.

Midland Regional Hospital, Tullamore: The process ofthe transfer of services to the new hospital hascommenced. Terms of reference for the steeringcommittee and for the setting up of unit teams withinthe hospital have been agreed.

The handover of the hospital from the building to theHSE will be affected in December 2005, and thecommissioning of the hospital is planned to becompleted by December 2006. The transfer teams havenow been set up within each area of speciality and INOhave nominated members to these variouscommittees.

Midland Regional Hospital, Mullingar: Issues whichremain outstanding at MRH Mullingar include:

• Theatre – lack of proper changing facilities/health andsafety

• SCUBU unit – commissioning

• Paediatrics – upgrade

• Wards – staff shortages/lack of changing facilities.

St Francis Private Hospital, Mullingar: During 2005 adispute arose in the hospital with regard to thefollowing issues:

• Employment of an operating department practitionerin the role of a nurse in the theatre department

• Proposed introduction of a computerised time andattendance management system

• Non-payment of benchmarking in 2005

• Non-payment of nurses’ annual increments

• Refusal to appoint CNM1s in all areas.

St Mary’s Care Centre, Mullingar: A number of issuesarose in this facility during the course of 2005. Despitemeetings with hospital management no progress hasbeen made to date. The matter has now been put intodispute and members working under protest. Theissues of concern are as follows:

• Failure to control vermin within the hospital

• Acute staff shortages

• No night duty supervision

• Overcrowding in wards

• Lack of proper manual handling devices

• Inadequate space in bathrooms and toilets for safemanual handling of patients

• Failure to provide both resident and staff smokingareas

• Failure to provide adequate security at night

• Failure to display or make available a safetystatement

• Failure to allow protected time for the elected safetyrep to carry out the functions of a safety representative

• Failure to provide adequate numbers of changingrooms for staff

• Failure to rectify faults in the fire alarm system.

Coombe Women’s Hospital: A staff rostering/partnership committee was established in the latterpart of 2005. This committee has already produced astaff survey form with regard to the needs ofstaffing/staff rostering. In house workshops formidwives were also held with regard to roster changeimplications and the findings of the survey were to bepublished by early December. The INO has beenapproached by hospital management with a view toexploratory talks on staff recruitment and retentionand these talks are imminent.

AMNCH Tallaght

A&E Department: Crisis continues unabated with largenumbers on trolleys each day. Management areoperating their escalation policy and admissions anddischarge procedures efficiently but bed capacity stillremains the fundamental problem. Plans for the acutemedical assessment unit have not advanced anyfurther due to funding not being approved.

Renal Dialysis Unit: Proposal put forward by hospitalmanagement to introduce night duty shift in the renaldialysis unit. This proposal purported to be an interimmeasure to allow the service expand to meetincreased demands being placed on it and also todrive an agenda that if the service expands to 24-hourservice then it will make a case to build a larger unit in


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Annual Report 2005

time. Management’s proposal was to commence nightduty shift without extra staff being allocated to unit.Their proposal was to reduce the number of stationsoperating during the day to create the night service.According to staff calculations this would becomeunworkable after three weeks in operation. A claim hasbeen laid with management for proper staffing of anight duty shift in light of the above.

HSE – Mid-West Region Mary Fogarty

Ennis General Hospital: The INOattempted to engage withmanagement in January overinadequate staffing levels. INOmembers commenced ‘Working underProtest’ as engagement was obstructed

by management objecting to the use of the grievanceprocedure. This dispute was subject to a hearing at theLabour Relations Commission and a subsequentreferral to the National Joint Council.

The decision of the NJC was in favour of the INO. Thesubstantive matter of inadequate staffing levels iscurrently the subject of an internal review with theassistance of Gillian Conway from the Nursing andMidwifery Planning and Development Unit.

The A&E department at Ennis General Hospitalremained under constant pressure in 2005 withpatients awaiting admission on a daily basis in boththe department and the surgical day ward.

Temporary nurses at Ennis General Hospital raisedserious concerns regarding the ‘on-call’ aspect of theiremployment contracts in October following a decisionby the hospital to offer overseas nurses two yearcontract of 39 hours each week.

The INO achieved 39 hour contracts for all temporarynurses following representations to human resources,also assurance was given that no threat existed to thejob security of temporary nurses at the hospital in thelong term.

Mid West Regional Hospital: Throughout 2005 the INOhad difficulty at this hospital in obtaining realengagement from hospital management on a range ofindividual and collective issues.

Implementation in full of the national theatre on callagreement was the cause of much dispute throughoutthe year. In conjunction with this conflict, a partnershipapproach which had commenced in 2004 to addresstheatre members’ grievances, inclusive of rosters,made little progress in reaching a consensus outcome.

All of these issues have been referred to the LabourRelations Commission and to an independent externalreview. The inaccurate media expose of the difficultiesin this theatre department led members to pass aunanimous vote of no confidence in the seniormanagement team.

The A&E department experienced its worst year ofovercrowding, with a peak of 32 patients on trolleysrecently. Inadequate recruitment of staff to ensure theopening of an overflow unit compounded theovercrowding in the latter part of 2005.

Milford Care Centre: The INO achieved the introductionof the senior staff nurse pay scale with effect fromJanuary 2006. This agreement was reached in July withthe management of Milford Care Centre after twolengthy conciliation conferences under the auspices ofthe Labour Relations Commission.

Included in the agreement were the introduction ofsubsistence for the home care team and a nominalpayment of ¤21 per week of night duty in lieu of a mealbreak.

St Munchin’s Maternity Hospital: Inadequate securitybetween the hours of 10.00pm and 8.00am at thishospital had been highlighted by members onnumerous occasions. However, in December, with acollective approach by the INO that unless animmediate security presence was evident at nighttime, the only alternative was to highlight in the mediathe vulnerability of patients, babies and midwives inthe hospital. Management immediately reviewedsecurity arrangements and placed a security guard atthe hospital entrance between 10.00pm and 6.00am.

North Eastern Health Board,Mater Hospital, Mater PrivateHospital, Bon Secours Hospitaland St Michael’s House, BallymunTony Fitzpatrick

Monaghan General Hospital:Disturbance claim for building work hasbeen referred to Labour Court. Loss of

theatre on call referred to the Labour Court.

Cavan General Hospital: The Labour Court inrecommendation 18289 has recommended “that in allof the circumstances that the unions claim should beconceded” with regard to the provision of clericalsupport to nursing staff in each of the following wards:ICU/CCU; paediatric ward; A&E; theatre; medical 2;surgical 2; day ward and endoscopy.

The Labour Court supports the recommendation in theCommission on Nursing report in Chapter 7 that award sister or nursing officer should receive adequatesupport to ensure that both functions are effectivelypreformed in the interests of the delivery of anefficient, effective and high quality health service.

Holiday premium payments for temporary staff: TheINO has referred this matter to the Labour RelationsCommission. However, prior to a hearing beingarranged, management within the HSE North East,conceded to the INO’s claim seeking that 30 membersof staff will receive their holiday premium paymentsretrospectively.


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Annual Report 2005

St Michael’s House: Upgrade of out of hours nursemanagers – the INO secured the upgrading of out ofhours nurse managers in 2005. However, somematters remain outstanding including retrospection tothe date of claim.

The Mater Hospital: Mater management requested ameeting with the Irish Nurses Organisation to discussthe implementation of a policy they had developedwith regard to the placing of additional beds oninpatient wards. The meeting took place and theOrganisation outlined its view that this proposal wasdraconian, and a backward step with regard toprogressing and improving conditions in the A&Edepartment. The INO has sought agreement that noextra beds are placed on wards on foot of the openingof the transit unit.

Car parking: This remains a contentious issue amongour members, as it appears proposals are now comingforward from the Mater Hospital management, thatstaff will have to park in the grounds of GrangegormanHospital, in order to allow construction work tocommence on the new Temple Street/Mater Hospitalsite, between the Mater Private and the Mater Public.Ann Cody is representing the INO in discussions.

St Oliver Plunkett, Dundalk: The Rights Commissionerhas recommended in favour of a claim, put forward bythe Irish Nurses Organisation, that our part-timeworkers in St Oliver Plunkett’s were being treated lessfavourably than their full time comparators. The issuein dispute was the non payment of time and one sixthto our members working the twilight shift of 5.00pm-10.00pm in St Oliver Plunkett’s.

The Rights Commissioner stated that the INO hadmade the more persuasive case, and stated that thenational guidelines which state you must work aneight hour shift in order to receive the time of one sixthare outdated. The Commissioner also clearly statedthat you are entitled to the protection of the Actreferred to above, and the members are entitled totheir time and one sixth. The HSE North East haveappealed the recommendation to the Labour Court.

St Mary’s, Drumcar: A case involved a staff nurse at StMary’s Drumcar, who was not allowed to carry forwardannual leave that she had accrued while absent underthe revised serious physical assault scheme. The nursehad been absent from February 2004 to April 2005. StMary’s said that the member was entitled to receiveannual leave for the four month period in 2005. As shehad not returned to work in 2004, she would have toforfeit the leave accrued over the 10 month period in2004. The Commissioner recommended that themember should carry forward to 2005 the legalminimum annual leave entitlement accrued during herabsence under the serious physical assault scheme.She recommended that this leave be granted andtaken by the end of 2005. She said the leave accruedduring the four months of 2005 should be granted infull and taken by 20 June 2006.

This recommendation demonstrates that staff whoaccrue annual leave while absent under the revisedphysical assault scheme, are permitted to take thatentitlement on return to work, even if it is in the nextleave year.

Bon Secours: Annual leave entitlement for night staffhas been referred to Labour Court.

HSE – North Western RegionNoel Treanor

Aras Carolan, Mohill: The best exampleof collective solidarity took place inAras Carolan, Mohill. Staffingcompliments were amongst the worstin the area, if not the country, and theLabour Court in 2004 had ruled in

favour of the employer, rejecting a staffing review.

However at the end of 2005, it can be reported thatstaffing levels have nearly doubled and there are nowtwo nurses minimum out of hours. This was followinga working under protest and a successful mediacampaign, allied to activists raising the issue ofstaffing directly with the Tanaiste at the ADC inKillarney. There is still more to do for Mohill, butcongratulations are in order to the commitment of theactivists and members here.

Letterkenny General Hospital: Further collectivesolidarity was shown in Letterkenny in an attempt toaddress the bed crisis there. A very successful publicdemonstration was held in February, with a lesssuccessful public meeting in March, attendedprincipally by staff and local interest groups andpoliticians.

The public of Donegal, with some notable exceptions,have not been as eager as we had hoped in takingownership of this issue, although it must be noted thatthere are specific pressure groups in existence.

A small light at the end of the tunnel appeared inDecember when Professor Drumm, on a visit to thehospital, conceded that greater capacity may well beone of the solutions to the crisis in Letterkenny.However, the proof of good faith on the part of the HSEwill be when the required additional beds are in place.

St John’s Hospital, Sligo: The members at St John’sHospital, Sligo, ever to the forefront when protectingand pursuing their rights and entitlements, called theHSE – North West Area under a breach of sustainingprogress. Where previously employees on reducedworking hours would have received annual leave foradditional hours worked at a flat rate, this waswithdrawn by the employer.

Following local discussion, agreement was reachedand is now applied to the whole region, in that nurseswho work additional hours under 39 hours now accrueboth annual leave and superannuable benefits for thisservice.


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Annual Report 2005

Third Party Referrals: It was a fairly successful year atthe third parties. Particular successes include theprovision of concession days to community RGNs inthe region. Most notable however was the recognitionat a Rights Commissioner hearing that the acting upallowance should be paid to two job sharing memberswhen they acted up on an aggregate for a week ormore. The principle that the allowance follows the postand not the person was not appealed by the HSE andthe INO is now seeking that this is applied universally.

However, the main issue affecting membersthroughout the year has been the consistent difficultyin recruitment and retention of nurses, combined witha deliberate policy of slowing down appointments.Many meetings have been held, but one canreasonably assume that the nursing staffing difficultieswill be worse again in 2006 unless there is a significantchange in the HSE and Department of Health andChildren.

HSE – Southern Region Michael Dineen/Patsy Doyle

Bon Secours Hospital,Cork: The INOnegotiated enhancedmaternity benefit for

staff availing of same. Previously this was set at 80% ofone’s basic pay. This is now to be increased to 90%following the intervention of the INO from 1 January,2006. Awaiting a Rights Commissioner hearing inrelation to the application of the maternity benefit andsick pay scheme.

Bon Secours Hospital, Tralee, Co. Kerry: Agreementreached with management to ensure the presence ofCMN1 posts in all wards throughout Bon Secours inTralee. Agreement on the part of management toreview the sick pay and maternity schemes inoperation. The enhanced benefits negotiated in Cork interms of the maternity scheme to apply to staff in theBons, Tralee.

Mercy University Hospital: Successfully negotiatedenhanced staffing levels for a refurbished CCU/ICUwithin the Mercy University Hospital. Eventuallysucceeded in having all retrospective elements of thetheatre on call applied to our members to whomenhanced terms apply. Referral of time in lieu issues tothe Labour Relations Commission and the RightsCommissioner service.

Kerry General Hospital: The situation that prevailedwithin Kerry General Hospital was indicative of thedifficult climate in which this Organisation operated inseeking to pursue any claims within the public service.Any claims for additional staffing were ignored bygeneral management culminating in a referral to theLabour Relations Commission and a ballot forindustrial action which is underway as of January2006.

As an Organisation, I believe that we are seriouslychallenged in seeking to protect the registration of ourmembers within Kerry General Hospital as the climatethat prevails seriously jeopardises their ability topractice safely on a daily basis.

One would have to have concerns that this issomething that has potential to manifest itselfthroughout the pubic service as any claims we mayhave for additional staffing resources are falling ondeaf ears, regardless of the legitimacy of our claim.

South Infirmary/Victoria University Hospital: Theinvolvement/participation of the Organisation withinthe South Infirmary/Victoria University Hospital hasseriously increased over the past 12 months. This hasculminated in a number of referrals to the LabourRelations Commission in relation to the SouthInfirmary/Victoria University Hospital which wouldhave been unheard previously.

St Columbanus Home, Killarney, Co. Kerry: Issue inrelation to staffing referred to the Labour RelationsCommission.

Listowel Community Hospital, Co. Kerry: Difficulty inrelation to the calculation of bank holidays whilst onannual leave has been referred to the Labour RelationsCommission.

St Patrick’s Hospital, Marymount: The issue regardingthe calculation of annual leave premium has beenreferred to the Labour Relations Commission. Awaitingthe outcome of a Rights Commissioner hearing inrelation to the application of the voluntary hospital’ssuperannuation scheme.

Brothers of Charity: Significant industrial relationsdifficulties have been experienced with themanagement throughout the Brothers of Charityservices resulting in a referral of a number of issues tothe Labour Relations Commission. We are also seekingthe intervention of the Labour Relations Commissionin an advisory capacity.

St Joseph’s Foundation, Charleville, Co. Cork: We havemade significant strides in recruiting nurses within StJoseph’s Foundation who had not previously beenmembers of this Organisation. They have an extensivelist of claims in relation to conditions of employment.A number of these have been progressed satisfactorilywhilst a considerable number await an outcome.

Caherciveen Community Hospital, Co. Kerry: Claim foradditional staffing has been the subject of twoconciliation conferences and will potentially go to theLabour Court for a determination.

Serious Physical Scheme: Application of the scheme atvarious intellectual disability services is provingproblematic. Meeting and correspondence with theHSEEA outlining meaningful clarification has beenforthcoming.

Our members working within the ID services areseriously compromised through the management’s


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Annual Report 2005

failure to appropriately apply the scheme andunfortunately they seek to hide behind the impartialadjudicators identified within the scheme in justifyingtheir appropriate application of the policy.

Cork University Hospital:• New A&E opened following protracted negotiations

on 18 April 2005. Rapid transit admissions wardopened on 4 July 2005. This is a multi-million eurodepartment which we had hoped would alleviate thenecessity for patients to wait several days for a bed.Full participation in Enough is Enough campaignphase one and two.

• Labour Relations Commission intervention in August2005 on management’s abject failure to implement anurse led soft tissue clinic at the weekend andprovision of CNS in the minor injuries unit.

• Successful transfer of processing instrumentationfrom orthopaedic theatre to HSSD.

• Finish time for OPD defined as 5.30pm (finishing timehad run over on most evenings up to as late as8.45pm to chaperone patients waiting for beds).

• Rights Commissioner settlement for part-time nurseswho applied for leave to attend a course. Hospitalattempted to apply pro-rata leave – awaiting ameeting with HSE (SA) to maximise members’ rights.

• Management attempted to propose a levy of e2 perday charge for parking – outright rejection lodged.

• Groundwork achieved on restructuring of ITU to dealwith increased dependency and complexity in patientgroup. An external facilitator has been appointedwho has made very helpful recommendations.

Health Service Executive Southern Area: Sponsorshipfor student PHNs 2005/06. All 18 panellists aligned toUCC from 26 September 2005 and in receipt of fullsponsorship. Formation work undertaken torepeatedly challenge the priority and fairness ininterview and appointments process for nurses in theboard.

Millstreet Community Hospital: Handover timeconfirmed and backdated to January 2005 formembers.

Mount Carmel Hospital, Clonakilty: Additional nursinghours in block two. Streamlining of medication roundsfrom four to three per day. Increased attendant coverin Alzheimers Unit following Labour RelationsCommission intervention to address the shortfall instaffing following the opening of the Alzheimer’s Unitin November 2004.

Unified Maternity Service: Director of Midwiferyappointed to lead up the amalgamation of St Finbarr’s(Maternity) and Erinville Hospitals in Spring 2007.Successful challenge by midwife members to apremature and ill conceived referral to the PVG whichthreatened their December pay increase.

Public Health Nurses: The Cork Fire Department have

condemned a health centre in North Cork and the HSE– Southern Area have been ordered to improve thebuilding which will benefit our members’ workingconditions. Damage to PHN’s car covered by HSE –Southern Area.

Bantry General Hospital: Improvement in premiacalculations, ie. 24 hour clock conceded. Managementsub structure reviewed to include a CNM2 inendoscopy.

St Finbarr’s Services for the Elderly: Claim for staffingreview lodged.

PPARS: Relief that ‘pause’ period prevails as theimplementation of the system would only have servedto alienate the membership.

Integration of Care Assistants:This is a profound issueand we look forward to working towards cohesion andeffective delegation to this new grade particularly incare of the elderly facilities.

HSE – South East Region Liz Curran

2005 was a year largely characterisedby difficulties progressing claimsowing to the changing structures of theHealth Service Executive, and resultingindecision on the part of HSE – South

East management regarding their authority to concedeclaims. However, some service issues wereprogressed to the satisfaction of members, and a largenumber of claims on behalf of individual memberswere conceded.

South Tipperary General Hospital:• First application of the injury at work agreement in

the South East secured for a member.

• Agreement regarding implementation of the LabourCourt recommendation regarding disturbance payfor our members eventually secured. Localagreement reached regarding the process to beemployed to repay the time owed to each of ourmembers in relation to additional annual leaveaccrued. Agreement was also reached to allow eachmember take this accrued leave as time off in lieu orby way of monetary payment or a combination of theabove.

St Brigid’s Hospital, Carrick-on-Suir:The long overdueindependent staffing review got underway by BettyBrady. Her report and recommendations are expectedshortly.

GP Practice, Clonmel: A claim for breach of theprovision of the Protection of Employees (Fixed-TermWorkers) Act 2003 in respect of an INO member saw apayment of ¤2,000 being paid to the member and apersonal apology issued by the practice.

St Patrick’s Hospital, Cashel: Implementation of the


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independent staffing review has still not beencompleted. We are awaiting a date for a conciliationconference on this issue.

Our Lady’s Hospital, Cashel: The INO are still awaitingnews of funding being made available fordevelopments on the site prior to rejoining talks withmanagement regarding the amalgamation of serviceswith St Joseph’s Hospital, Clonmel.

St Luke’s Hospital, Kilkenny: A number of upgradingsof existing posts achieved. Negotiations regardingadditional staffing for a number of areas of the hospitalare being progressed.

Kilcreene Orthopaedic Hospital: The claim for anadditional CNM1 post in theatre recovery wasconceded. The implementation of the agreed seniornursing management structure in the hospital (by wayof the appointment of a second ADON) has beenconceded in principle.

Waterford Regional Hospital:• A number of individual issues were resolved, many

more are being progressed.

• An LRC conciliation conference regarding lateopening for theatre recovery saw a secondtemporary agreement reached. This agreement to bereviewed after one year.

• Maternity Unit: The payment of an allowance, basedon the theatre co-ordinator allowance, to the mostsenior nurse on duty in the labour ward at night wassecured. Agreement on this was reached in June withretrospection payable to each eligible member datingback to 17 January 2005. Additional care assistantinput for the unit was also secured, together withimproved portering arrangements.

• Neonatal Unit: Revised pay arrangements agreed fornurses on night duty who, owing to service need,work frequent night duty and are therefore unable torecoup premiums on day. Some issues remainregarding the pro-rata payments for job-sharing andpart-time staff and are the subject of ongoingnegotiations.

Waterford Association for Mentally Handicapped: INOsecured the payment of the location allowance for ourmembers, with one year’s retrospective payment.

Brothers of Charity, Belmont Park: Various issues,including ongoing negotiations regarding the use ofseclusion, are being progressed.

Wexford General Hospital: Lunchtime A&E protest inApril was very well attended and received the fullsupport of all staff. The A&E department continuesovercrowded on a daily basis. Nursing staff workingunder tremendous pressure in the unit.

Claims have been lodged for additional nursing staffon both day and night duty. An additional careassistant on night duty and designated security for

A&E have been conceded but, to date, no additionalnursing staff have been allocated.

St John’s Hospital, Enniscorthy: Labour RelationsCommission conciliation conference on staffing levelsand relocation payments made no progress. The issuewill now progress to a full hearing of the Labour Court.

Ely Hospital, Wexford: Negotiations have commencedregarding conversion to a Monday to Friday service,with our members currently considering the offermade by management for compensation for loss ofpremiums.

HSE – South East:• A number of staffing claims have been lodged and

are the subject of ongoing negotiations.

• In community care a number of claims for upgradingof PHN posts are being progressed through the LRC.

• Community RGN members – a number of claims forimproved pay arrangements and working conditionshave been lodged and are the subject of ongoingnegotiations. In Waterford, with INO assistance,community RGNs secured back payment of annualleave owed from their time working as temporarynurses.

HSE – Western RegionNoreen Muldoon

Palliative Care Services, Galway –Bullying: The INO represented two ofour members, one from the HSEWestern Area and one from the GalwayHospice Foundation, who madeallegations of bullying against theconsultant in palliative medicine.

Following a very protracted investigation, taking overthree years to complete, their allegations of bullyingwere upheld in April 2005.

As a direct result our members have suffered andcontinue to suffer inordinate amounts of stress andbullying related symptoms.

One member, a clinical nurse specialist in palliativecare, employed in Portiuncula Hospital by the HSE, hasbeen the subject of a Labour Court hearing, as a resultof the then Western Health Board’s failure toinvestigate the allegations of bullying made by her. Atthat hearing the INO sought to have her leaveclassified as ‘special’ leave as opposed to sick leave.The Labour Court granted this and now almost fouryears later our member continues to be paid on specialleave. Negotiations are ongoing regarding her returnto work in a safe environment.

Our member employed in the Galway HospiceFoundation, took intermittent time off and alsosuffered the consequence of bullying. She continues towork there.

The report concluded that our members (and another


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person who is not a nurse) experienced bullying by theconsultant:

“These were not momentary lapses of sang-froid; theywere the result of a regime of bullying. The evidence ofthe complainants was compelling with regard to theconclusion, as to the existence of this regime”.

The consultant was subsequently issued with a writtenwarning in accordance with the Consultants CommonContract Appendix IV.

Further allegations of bullying: Prior to the issuing ofthe report into the allegations of bullying, furtherallegations of bullying were made against theconsultant in palliative care medicine, by 22 of the INOmembers in the Galway Hospice Foundation. Theallegations were very similar and worse in someinstances to those already investigated.

Following the outcome of the initial investigation, itwas agreed amongst all stakeholders to try afacilitation process. This was agreed and the INO had apivotal role to play in reaching agreement. Thefollowing has now been agreed:

• The consultant in palliative care medicine will nolonger work in the Galway Hospice Foundation

• The consultant will no longer be the RegionalDirector of Palliative Care

• Two new consultant palliative care consultants willbe appointed

• A new regional palliative care manager will beappointed

• Nursing staff, working at the Galway HospiceFoundation will have access to all educationalprogrammes provided by the HSE – Western Area

• A joint management forum to include INOrepresentation is to be established

• A once off training and personal support fund is to beallocated to the nursing staff that brought thecomplaints. Details to be agreed by management, themediator and the INO.

This is seen by all stakeholders as a positive wayforward for palliative care in the West of Ireland,allowing our members to work with dignity andrespect.

Criteria for promotional grades: The INO weresuccessful in preventing the introduction of a

management qualification being essential, onapplication for any promotional post in GalwayRegional Hospitals, including CNM1, CNM2 andCNM3. The INO argued that this requirement woulddisqualify a huge percentage of staff nurses fromapplying for a promotional post and wasunacceptable. Many of these nurses would haveadditional nursing qualifications.

Our contention being that should a managementqualification be essential, the successful applicantshould be facilitated to undertake this on successfulappointment, following interview. The INO referredthis issue to the Labour Relations Commission.However agreement was reached, prior to the hearing,that this requirement would not be essential and nowit is ‘desirable’ to have a management qualification onapplication for a promotional post in nursing atGalway Regional Hospitals.

Interestingly, on researching this issue, the INOdiscovered that it is not an essential requirement tohave a management qualification for any non-nursingmanagement position, prior to appointment, in anyarea of the HSE.

Mileage: Our members are entitled to the samemileage, as all other staff, whilst attending educationalcourses, following intervention of the INO. Ourmembers were being paid 13c per mile, whilst othergrades of staff were being paid the public service rate.

PHN Transfers: Following intense negotiations with theINO a transfer policy was agreed. Heretofore, all PHNswishing to transfer from one area to another, withinthe same community care area, had to apply and beinterviewed in a formal setting. This has now ceasedfollowing the introduction of the transfer policy.

Anti-Natal Educator, Mayo General Hospital:Following the intervention of the INO and referral tothe Rights Commissioner service the position of anti-natal educator in the maternity unit of Mayo GeneralHospital has been upgraded from CMM1 to CMM2.Our job-sharing members applied for the position andwere appointed from the date of the RightsCommissioner hearing.

Galway Regional Hospitals: A member, who suffersfrom a disability was ‘put off sick’ as a result of beingunable to continue working on a ward. Followingintervention by the INO, she is now placed as a co-ordinator of a new service.


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Annual Report 2005

2005 was an extremely busy year,particularly in the area of fitness topractice. We also saw a number ofnew developments in the area ofsocial policy, in particular the area ofmigrant nurses, childcare, whistle-blowing, and the publication of anICTU reform document on healthcare in Ireland.

Social PolicyCommittee

The Social Policy Committee is a sub-committee ofExecutive Council, and includes Raymond Boyle (co-chairperson), Jo Tully, Kay Garvey, Ursula Morgan andSheila Dickson (co-chairperson).

The committee meets on a monthly basis togetherwith Clare Treacy, the Director of Organisation andSocial Policy. The committee and the directorparticipated in a number of activities throughout theyear, including contributions to various reports,participation on a number of committee’s, andattendance at national and international conferences.

Migrant nurses

The INO, together with other unions and ICTU haveworked hard on the ground to champion the rights ofmigrant workers, and have achieved good results bothin tangible terms and in giving the issues ofexploitation a higher profile. Nevertheless, a numberof cases highlighted by the INO have clearly indicatedthat some employers and recruitment agencies exploitworkers and tougher measures need to be taken toensure protection of migrant nurses workers andmidwives.

As part of the INO work on behalf of migrant workers,the INO were joint partners in relation to research onmigrant women workers in rural areas in Ireland. Thisresearch was funded by the Equality Authority, andconducted by Dr Jane Pillinger, Social PolicyResearcher. The Overseas Nurses Section, and thesocial policy committee worked together with Dr Pillinger, and assisted with detailed analysis andresearch of migrant nurses working in a number ofsettings outside of Dublin. A full report has yet to bepublished. However, it is clear that areas of genderspecific exploitation and discrimination were identifiedin a number of private healthcare settings.

The report identifies the positive effect of the INO insupporting migrant women’s workers and specificallyidentifies the positive contribution of the OverseasNurses Section.

Immigration Bill

The INO welcomes the opportunity to contribute to thegovernment’s discussion document on immigration

and residency in Ireland. Our submission highlightedissues of specific concerns for nurses and their family,and we also made comments on more general issues,around the prevention of racism and exploitation ofworkers and other migrants. A number of proposalswere made. Specifically it was proposed that theprocedure be reviewed in relation to work visas, witheither visas being issued for a longer duration or thatthe renewal process should be automatic, unless thereare changes that would require the applicant topresent themselves to the department.

In relation to work permits, the INO sought protectionfor workers who report exploitation by recruitmentagencies, and for the government to take a more pro-active role in the vetting of such agencies, and theirpractices. It was also proposed that work permitswould be issued directly to each employee. Althoughthe vast majority of migrant nurses in Ireland workunder the visa system, an increasing number of nursesare recruited into the private sector, under the workpermit system. Currently a work permit is the propertyof the employer, not the employee.

The INO also asked for a more transparent and userfriendly system to be introduced which would allowthe spouse of a nurse to be given a permit to work,prior to having achieved an offer of employment. Thiswas identified by the Overseas Nurses Section, as anextremely important area for us to pursue.

In addition to this, the INO made a number ofadditional recommendations in relation to humanrights, and family reunification. It is clear that the Irishhealth system is dependent on migrant nurses andmidwives. It is absolutely vital that these nurses/midwives are free from exploitation and importantlythat their experience in Ireland is a positiveexperience, and encourages nurses/midwives toremain in this jurisdiction.

Throughout 2005 the INO continued to work closerwith the Immigrant Council of Ireland (ICI) who havebeen extremely helpful in advising our members inrelation to specific migration, visa and citizenshiprights. The ICI provides a very useful informationservice to overseas nurses and can be accessed via theINO website.

Leadership Initiatives for Females in TradeUnions (LIFT)

The Irish Congress of Trade Unions (ICTU) receivedsubstantial funding to carry out an extensive two yearproject in relation to women in trade unions,specifically identifying women in leadership roles intrade unions. The LIFT development is a partnershipbetween ICTU, the Institute of Public Administration,and the National Centre for Partnership andPerformance.

Clare Treacy, Director of Organisation and Social Policyrepresents the INO on the Steering Committee. The

Organisation and Social Policy

Clare Treacy,Director of Organisationand Social Policy, INO


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Annual Report 2005

work of this extremely important project is influencedby the fact that women who compromise 45% of unionmembership are grossly under represented at decisionmaking levels in all unions – with only 26% of electedofficers being female. The project hopes to assist tradeunions in developing skills to address the underrepresentation of women at all levels of themovement, ultimately hoping to make a real impact ongender equality, and engaging women at every level ofthe union.

Since the project commenced a number of membersof the INO have been interviewed in relation to theiractivity within the INO, including identification ofperceived barriers to their progress. In addition to this,senior officials of a number of trade unions, includingthe President and General Secretary of the INO haveactively participated in this research project to date.

It should be noted that in June 2005 at the biennialdelegate conference of ICTU, a significant rule changewas adopted which has now led to the doubling of thenumber of women represented on Congress ExecutiveCouncil. Currently the two vice presidents of ICTU arewomen. In promoting the inclusion of women in seniorand decision making levels within trade unions, themovement seeks to benefit from their value addedcontribution in terms of relevancy to members need.

Further information about this project can be found onwww.lift.ie.

ICTU Health Report

The much anticipated and very detailed health reportcommissioned by ICTU Executive was completed inNovember 2005. The authors Dale Tussing and Maev-Ann Wren have completed a report that challengesmany of the government held views on health and theprovision of healthcare. In particular it challenges thecontention that Ireland has one of the highest rates ofnurses per capita in the OECD.

Specifically in relation to nursing numbers the authorsof this report argue that the OECD assumptions arebased on a comparable head count of nurses inrelation to population and does not take into accountthe part-time nature of nursing, that is so prevalent inIreland. In Ireland there were approximately 40,700nurses in the Irish public sector in 2004. However,because of the part-time working these nurses filled34,300 whole time equivalent posts.

The report also questions the assumption thatincreased number of healthcare assistants willsignificantly reduce the need for nurses in the Irishhealthcare workforce, identifying that this conceptignores the many other functions which nursesperform in Ireland.

They go on to recommend that the Department ofHealth and Children should commission and publish aspecialist study on the type of work typicallyundertaken by nurses in countries at a comparable

level of development to Ireland in order to assess thefeasibility, safety and efficiency of this policy. Theauthors recommend that healthcare assistants shouldhave mandatory training, and nurse supervision.

In addition to these recommendations the 285 pagereport includes several recommendations on manyaspects of the provision of healthcare in Ireland,including; hospital bed capacity, primary care, A&E,hospital acquired infections, financing of medical care,access to public hospital care, health service staffingincluding; medical and consultant numbers,accountability and administration.

The INO enthusiastically welcomed this report, andbelieves that if this report is fully embraced by thetrade union movement, then it will be extremelysignificant and influential in relation to the attitude andviews of Congress.

This ICTU health report is strongly recommended tomembers as essential reading, and is due to bepublished in March 2006.

Whistleblowing

A Position Paper on the Protection of Nurses andMidwives upon Disclosure of Practices of Concern inthe Workplace was presented to, and adopted by, theAnnual Delegate Conference in May 2005. This positionpaper was formulated following a motion at theprevious conference, and in an environment where anincreasing number of nurses and midwives werecontacting the INO expressing concern that they wouldbe victimised if they raised a matter of concern in theworkplace.

In the past number of years there have been a numberof well reported tragic incidents where investigationshave revealed that employees had serious concernsbut were too frightened to speak out. It is not just thefear of reprisal that gags these individuals, but often itis the organisational culture.

Some organisations discourage openness, withmanagers turning a deaf ear, or accusing staff ofdisloyalty. The INO believe it is important for nursesand midwives practising in Ireland to have a system inplace which offers protection to all employees.

It is our preference that disclosure in the workplaceshould be protected by whistleblowing legislation,however, in the absence of that legislation the INO hascommenced discussions with the HSE in an effort toseek a formal agreement in relation to workplacedisclosure. Copies of the INO position paper areavailable via the INO headquarters.

Conferences

Throughout the year a number of conferences wereattended by Clare Treacy and a committee memberfrom the Social Policy Committee. Specifically, akeynote address was given by Clare Treacy to a


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nursing and midwifery practice seminar, organised bythe North Western Health Board. The presentation wason the Role of Trade Unions in Advancing Equality inNursing and Midwifery Practice.

We also attended a conference on elder abuse, titledHidden Truths and Silent Cries. Kay Garvey and Jo Tullyrepresented the social policy committee at aconference in Poland on European Health Funding.This conference was organised by the European TradeUnion Congress, in the context of increasing anxiety atthe reforms in healthcare emerging across Europe.The purpose of the conference was to initiate a processof awareness amongst healthcare workers, and to gaina European perspective on the delivery of healthcare.

The National Anti-Poverty Strategy on Healthcontinued to meet with the INO/ICTU beingrepresented by Clare Treacy. This committee is due toreport in 2006.

The director, Clare Treacy, was invited to attend aUNISON conference of health workers, and made apresentation in relation to equality legislation in theRepublic of Ireland. This was an extremely importantconference in relation to ongoing development ofrelations between the INO and unions in NorthernIreland.

The INO continues to be represented on the NationalWomen’s Council (NWCI), the Irish Congress of TradeUnions Women’s Committee (ICTU), the newlydeveloped LIFT project and the National Anti-PovertyStrategy (NAPS).

Fitness to PracticeThe number of nurses and midwives reported tofitness to practice on the grounds of allegedprofessional misconduct, and/or alleged unfitness toengage due to physical or mental disability continuesto increase.

During 2005 there were 19 new complaints. It wasfound that there was no case to answer in six of thesecomplaints, four have been referred to the Fitness toPractice Committee for a full hearing under Section 38of the Nurses Act 1985. We are awaiting a response inrelation to the other nine matters.

In addition to this three nurses were referred to the

High Court under Section 44 of the Nurses Act. This isan extremely draconian measure, and can only beused by An Bord Altranais if it genuinely is of the viewthat the public interest is at risk if the nurse continuesto practice.

In this situation An Bord makes an application to thePresident of the High Court for a temporary removal ofthe nurse from the Register of Nurses, whilst awaitinga full hearing before the fitness to practice committeeof An Bord Altranais.

There were four hearings under Section 38 whichrelated to matters reported in previous years. Thisresulted in members being censored and conditionsattached to their practice. No nurse represented by theINO was removed from the register in 2005.

As the number of complaints against nurses andmidwives continue to grow, it is important thatnurses/midwives are aware of what actions should betaken in the event that they are subject of a complaint.All nurses/midwives should be aware that any personcan issue a complaint against a nurse, and An BordAltranais is obliged to investigate this in accordancewith the Nurses Act 1985.

It can be an extremely frightening experience to be thesubject of a complaint, however, it is important that allnurses/midwives act promptly upon receipt of such acomplaint, and seek advice immediately from theirindustrial relations officer, or directly from the Directorof Organisation and Social Policy.

It is absolutely vital that a nurse/midwife does notreply to the initial complaint without first seekingadvice.

We have noted an increasing number of complaintsfrom patients and relatives which at times have beenidentified as vexatious. However, the process stillremains the same, and the matter has to go to thefitness to practice committee for consideration.

As part of on-going education, an educationprogramme on fitness to practice was delivered at allnurse representative training courses. In addition tothis, the Director of Organisation and Social Policy,together with O’Connor’s Solicitors, has developed aday long programme which is targeted atnurse/midwife managers to ensure that theyunderstand the complex area of fitness to practice.


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Annual Report 2005

OverviewThe Professional DevelopmentCentre provides information, libraryfacilities and web based resourcesthrough the INO and N2N website.The centre continues to expand anddevelop, always being focused onthe ongoing professional needs ofnurses and midwives within thechanging climate of health delivery,patient dependency and medicaladvancement. Our new headquarters

in the Whitworth Building provides members with stateof the art facilities in terms of meeting rooms, educationand training rooms, conference and library facilities aswell as the most up-to-date IT and video conferencingfacilities.

Branch meetings, section meetings, adhoc meetings,workshops and conferences for up to 80 people cannow be held in our new headquarters. The PDC is veryproud of its achievements with over 12,215 nurses andmidwives attending one of 700 educationprogrammes provided over the last eight years.

Workshops 2005

Workshops No of Attendanceworkshops

Internal (held in PDC) 55 775

External (held outside PDC) 11 210

External customised programmes 14 275

Internal customised 4 55

Total 84 1,215

The PDC continues to develop new workshops andprogrammes for members both in house andnationally according to demand. Requests forcustomised programmes to meet specific needs hasincreased. Several of these were held within thehospitals and health areas and some were provided inthe Professional Development Centre.

Workshops covered topics in all areas of nursing andmidwifery practice and management. The mostpopular areas continue to be clinical skills, interviewskills and management, particularly human resourcemanagement.

Focus on Residential Care and Older People

During 2005 a number of issues were highlighted inthe media and by members regarding care of olderpersons in residential facilities. The PDC, recognisingthe need for professional development in this areadesigned a series of workshops specifically focusingon current issues in the nursing care of older personswhich includes such topics as:

• The gift of a life: communication skills and intimacymaintenance with older adults in residential care

• Standard setting and clinical audit for older people inresidential care

• The role of the nurse in ethical decision making

• Principles of best practice in the use of restraint forolder people

• Medication management for older people

• Taking the pressure off!!!: pressure ulcer preventionand treatment plan workshop

• Nursing within the legislative frameworks in olderperson care

• Accreditation in residential care of older people

• Elder abuse in focus

• Nutritional needs of older people in residential care.

Due to the success and high demand of the firstprogramme, it will now be run on a regular basis.

Second Management DevelopmentProgramme for Public Health Nurses – HSE Western Region

(13 September 2004 to 21 February 2005). 15 publichealth nurses registered.

Aims

This programme is designed to help public healthnurses develop their skills in self management, peoplemanagement and reflective practice. It focuses on thePHN’s pivotal role in the community health team andprovides an opportunity to examine practical stepsthat may be taken to improve the delivery of service tothe local community.

Objectives

By the end of the programme participants will be ableto:

• Take positive steps towards managing a lifestylebalance which best suits personal well being and jobperformance

• Plan work activities and time management to reducestress

• Set clear job performance targets which satisfySMART criteria

• Provide leadership to the community health team

• Apply team building techniques to their own team

• Plan service provision based on team consensus

• Understand their own influencing styles and howbest to utilise these in negotiating with others

• Appreciate the importance of accountability in theprovision of community health services

• Apply reflective practice techniques to professionaldevelopment

• Apply the Golden Rules of People Management.

Professional Development Centre

Annette Kennedy, Director of ProfessionalDevelopment, INO


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Annual Report 2005

Evaluation

Once again the overall evaluation was one of success.The participants felt they gained confidence in dealingwith issues and workplace practices. The grouppresented the following projects to management as anintegral part of the programme: 1. Flexitime; 2.Continence – Supplies – Distribution; 3. ReflectivePractice; 4. Ineffective Calls To Clients – and weresubsequently invited to present at the HSE WesternRegion Education Day.

Management Development Programme forDirectors and Assistant Directors of Nursingand Midwifery – Negotiations & ConflictResolution – Employment Challenges

(23 February to 18 May 2005)

A total of 26 participants registered on the programmeand the attendance was 98%. The overall feedback wasthat the programme provided excellent informationrelevant to their position and allowed opportunity fornetworking, reflection and self-analysis on theirperformance.

The outcomes surpassed their expectations and theparticipants recommended the programme to berepeated for other colleagues.

HOHNEU – Harmonising Occupational HealthNursing in the European Union

There are 25 EU-member states in the Federation ofOccupational Health Nurses. There is a wide variationof standards of occupational health nurse education incountries within the EU with no diploma/degree/masters in occupational health nursing.

Discussions commenced with FOHNEU and SheffieldUniversity in 1997 regarding the development of aprogramme for Danish nurses to bring them to a levelthat would enable them to access the UKCC OHNdegree programme. Since then collaboration hascontinued and the first group of Danish nursescompleted in June 1999 with then subsequent groupscompleting in September 2001 and October 2003.

Due to the success of the programme the Federation ofOccupational Health Nurses within the EU (FOHNEU)became interested in developing this collaboration toassist occupational health nurses in Europe to gain thedegree qualification. With this in mind a steering groupwas set up consisting of:

• England – Sheffield University

• Denmark

• Ireland (Irish Nurses Organisation )

• Slovenia

• Jagiellonian University, Krakow, Poland.

A proposal was submitted to the Leonardo daVinciCommunity Action Programme for funding andfollowing some further proposals and discussion,

partial funding was given to produce a web-baseddistance learning programme for occupational healthnurses within EU, to provide further education,professional development for countries with norecognised occupational health nurse educationalprogrammes and to provide tools to allowoccupational health nurses to achieve degree/masterslevel.

Meetings To-Date:

• 18 November 2004 – Partners Meeting, Dublin

• 14 and 15 April 2005 – Partners Meeting, Slovenia

• 6 and 7 October 2005 – HOHNEU Meeting, Sheffield.

Work currently in progress

Ireland has been assigned the writing of the module‘Work Place Surveillance’, the content of which willcover occupational health and external environment,social/lifestyle, community health, stakeholders –occupational health nurses, ethics and accountability,OH hazards/ill health, health risk assess, fitness towork, return to work, sickness and absencemanagement, rehab and work ability and adaptation,health surveillance, health and safety legal, H7S,vulnerable groups, risk assessment, relevantlegislation.

A web site has been set up and the completedprogramme is to be ready to launch at FOHNEUCongress in London in 2007.

The MSc in Nursing (Distance Learning)

INO/RCN/Manchester University – This distancelearning programme continues to be popular andcomprises of six modules at Masters level. On averagebetween eight to 18 people attend each module.

Certificate in Health Service Management(Distance Learning)

INO/University of Limerick – The long standingDistance Learning programme continues to be assuccessful as ever. During the academic year of 2004-2005 a total of 28 students undertook and successfullycompleted the Certificate in Health ServicesManagement INO/University of Limerick DistanceLearning Programme. The programme was availableboth in Dublin and in Limerick.

Diploma/Degree in Health ServicesManagement (Distance Learning)

INO/University of Limerick – The 2004-2005 cohort ofstudents undertaking the Diploma in Health ServicesManagement was 23. The opportunity now exists forstudents to progress from the diploma programme(which takes two years) to the BA in Health ServicesManagement. Students are delighted to be affordedthis opportunity.

This degree is a four year programme aimed at themanagerial competencies required by nursing and


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midwifery managers and requires attendance atcollege one day every three weeks. Currently 54students are currently undertaking the degree in healthservices management.

Room Hire

Several organisations hired our conference facilitiesover the past six months, they include the following;ESBi, Partnership Rep Training Group and Irish HeartFoundation.

ConferencesIreland’s Annual Joint INO/RCM Midwifery Conferencewas held Wednesday 19 October 2005 in the ArmaghCity Hotel, Armagh. The theme of the Conference wasMeaningful Midwifery or Processing Pregnancy, 102INO delegates and 82 RCM delegates attended.

The joint planning INO/RCM conference planningcommittee put together an excellent programmemaintaining the high standards of continuouseducation that has been set over the years.

The papers and presenters were very relevant totoday’s service provision and the excellent calibre ofthe speakers met the expectations of the delegates.

Midwives and student midwives participated in theposter display which has become an integral part ofthe conference and demonstrated the enthusiasm andinnovation that is amongst midwives and studentmidwives.

Delegates voted on the posters and this year’s winningposter was presented by Aoife Kelly, Carolyn Brennan,Antonio Cabas, Claire Conway, Clare Flynn, CatrionaFurey, Sonya Gorman, Maria Higgins, Sarah Hopkins,Michelle McAuley, Tracey Mc Partlon, Irene Mulhall,Claire O’Loughlin and Yvonne O’Neill, all studentmidwives at the Coombe Women’s Hospital, Dublin.

The title of their poster was Blossoming Midwives –Meaningful Midwifery. The poster is now on display inthe INO library, making up an invocative ‘Poster Walk’.

Operating Department Nurses Annual Conference washeld on Friday 11 and Saturday 12 November 2005, inthe Kilkenny Ormonde Hotel, Kilkenny Town. Thetheme of the conference was Pathway to Progress.

A total of 211 delegates pre-booked into the conferencebut additional delegates arrived on both days. Onceagain, the conference planning committee deliveredan excellent conference maintaining the establishedhigh standard that has previously been reached.

This year there was a new dimension to the conferencewith an innovative Managers’ Forum taking place onthe Friday morning which was very successful with 25-30 managers attending the workshop that wasspecially aimed at their needs.

The overall evaluation of the conference was excellent,with the poster competition and the Fannin Healthcare

Award proving to be a very important integral part ofthe conference.

This year’s winner of the poster competition wasElizabeth Hennessy, CNM2, Mater MisericordiaeUniversity Hospital, Dublin and the title of Elizabeth’sposter was Walking Selected Day-Case SurgeryPatients to Theatre.

The winner of the 2005 Fannin Healthcare Award wasLinda Clarke, peri-operative clinical facilitator,Operating Department, St Vincent’s UniversityHospital, Elm Park, Dublin and the title of Linda’sproposal/initiative is The Development of aPreoperative Patient Education Tool Relating to thePerioperative Experience.

The Klinidrape EORNA Peri-Operative NursingFoundation Award went to Catherine Tierney, clinicalfacilitator, Mid-western Regional Hospital, Dooradoyle,Limerick. Catherine’s research proposal is: Peri-operative Nurses’ Experiences of Cadaver OrganDonation, A Phenomenological Study

The Operating Department Nurses Section wasdelighted that once again a member of the Section haswon the prestigious award and Catherine willrepresent Ireland at the EORNA Congress in May 2006.The Klinidrape Award has been run three times andIreland has won it twice.

The Joint INO/OHNAI Occupational Health NursesAnnual Conference was held on Friday, 25 November2005 in the Tullamore Court Hotel, Tullamore, Co Offaly.The theme was Challenge and Change.

A total of 120 OHN delegates attended the conference,which delivered a high quality programme ofcontinuous education for the occupational healthnurses.

The conference, whilst providing ongoing professionaldevelopment, also provides a valuable opportunity fornetworking for occupational health nurses, many ofwhom feel isolated in their particular positions.

At the opening of the Operating Department Nurses Section Annual Conference inKilkenny, with GAA president-elect Nicky Brennan cutting the ribbon were (frontrow only (l-r): Mary Power, INO section development officer; Eileen Wheelan, asstDON, Mater Hospital; Liz Waters,Theatre Dept, Naas; Terese Cummins and TheresaHerity,Theatre Dept, Mater; Caroline HIggins,Theatre Dept, St Vincent's


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Annual Report 2005

The conference always attracts a great interest fromcompanies providing sponsorship for the occupationalhealth nurses and this year was no exception with 26companies attending.

INO National Conference The INO’s national conference held in Mullingar inOctober was attended by 130 delegates from staffnurse through to director of nursing grade.

There were two international speakers, journalistSuzanne Gordon and Chief Nursing Executive ofOttawa Hospital, Ginette Rodger, as well as twonational speakers, Tanaiste and Minister for Health andChildren, Mary Harney and Professor Brendan Drumm,Chief Executive Officer of the Health Service Executive.

Suzanne Gordon spoke on her vast experiences asjournalist for the past 30 years and introduced her newbook entitled, Nursing Against the Odds 2005. In heraddress she reinforced how healthcare cost cuttingand hospital restructuring undermine the workingconditions necessary for the retention of nurses andmidwives and the delivery of quality care.

Ginette Rodger, Vice-President of Professional Practiceand Chief Nursing Executive at the Ottawa Hospital isresponsible for over 3,500 nurses. Ms Rodger spokeabout redesigning the professional practiceenvironment for today and tomorrow.

A number of masterclasses were also held whichincluded advance nurse practices, the Europeaninfluence on nursing and midwifery in Ireland,community nursing in transition, delegation andsupervision, influencing policy influencing change andnurse/midwife led services.

Professor Drumm addressed INO delegates for the firsttime and said that everyone working within thehealthcare system, including nurses and midwivesmust be prepared to accept change if a world classhealth system is to be achieved.

He engaged in a Questions and Answers session at theend of the conference.

National Report

Nurse/Midwifery Prescribing ProjectThe final report of the ‘Review of Nurses and Midwivesin the Prescribing and Administration of MedicinalProducts’, a three year project established by An BordAltranais and the National Council for the ProfessionalDevelopment of Nursing and Midwifery was launchedin November 2005. The INO welcomed this report andis committed to the introduction of nursing andmidwifery prescribing from the perspective of over thecounter (OTC) medications under protocol andindependent prescribing.

The INO was a member of the three year projectsteering committee and is currently involved in thenext phase of this project which is the development ofan educational framework for all nurses and midwivesto facilitate nurse/midwifery prescribing. Mary Power,Section Development Officer is the representative onthe prescribing project.

The INO has been actively involved in seeking to havethe proposed Nurses and Midwives Act tabled as soonas possible and is also seeking to have the Medicine’sAct implemented.

Return to Nursing/Midwifery PracticeCommittee

The Return to Practice Project commenced in August2004 and was led by the NMPDU in the HSE – EasternRegion, on behalf of all the NMPDUs. Annette Kennedyrepresented the INO on the steering committee.

The NMPDUs had identified the need to look at Returnto Practice programmes, to ensure equity in thestandard of such programmes and access to them. TheHealth Services National Partnership Forum’s researchwhich was directed by Annette Kennedy, AnExamination of Return to Nursing and MidwiferyProgrammes within the Republic of Ireland was usedby the committee to inform their work.

The purpose of the project was to encouragenurses/midwives who had previously left to return topractice, to evaluate all aspects of Return to Nursingand Midwifery Practice (RTNMP) programmes and todevelop common national principles for delivery ofsuch programmes in the future, in line withcompetencies developed by An Bord Altranais. Thiswould ensure equity of provision and access fornurses wishing to return to practice in any area.

An action plan was developed and completed withsuccess. This included agreement on remuneration, aframework for advertising, targeting An Bord Altranais’inactive register and the development of aninformation pack.

Healthcare Assistants Research The INO commissioned the Smurfit Business School toundertake an attitude survey on the role of healthcare

INO delegates at the National Conference in Mullingar welcomed the HealthMinister’s comments on the advent of nurse prescribing in 2006. HSE chief ProfBrendan Drumm addressed INO delegates for the first time at the conference


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Annual Report 2005

assistants. The researchers endeavoured to get areasonable cross section of all disciplines, ie. general,midwifery, learning disability, community and elderlycare both in urban and rural areas and to interview allgrades in nursing and midwifery as well as healthcareassistants.

This report was presented at Annual DelegateConference 2005 after which a debate ensued amongstall guest speakers and the delegates. This research alsoinformed the INO representatives for their work on theHealthcare Assistant High Level Group whichcompleted its deliberations in October 2005.

National Council on Ageing and Older PersonResearch: ‘Quality of Life of Older People in Public,Private and Voluntary Long Stay Care in Ireland’

Sheila Dickson, Executive Council member, was theINO’s representative on the steering committee of thisresearch. The chair of the Older Person Section,Rosemary Nolan was also on the committeerepresenting the INO.

The research report was completed and shows thedifferences in staffing levels and skill mix throughoutthe country and in the different settings; ie. public andprivate.

It also highlights the lack of choice of individuals inrelation to long term care, ie. location, accommodation,privacy and activities and the lack of appropriatefacilities for Alzheimer patients and that long termfacilities are generally viewed as places to die not tolive.

The report is awaiting ratification by the Executive ofthe National Council on Ageing and Older Person andwill be published in 2006.

Accreditation of Nursing and MidwiferyAwards – National Qualifications Authority ofIreland

Ensuring that all nurses and midwives are accreditedat the same level under the National Framework ofQualifications is a priority for the INO.

The INO has been actively pursuing the NQAI and AnBord Altranais to have nurses and midwives awardedlevel eight on the NQAI Framework which consists of10 levels, each level setting out a range of standards ofknowledge, skills and competence.

All nurses and midwives are accountable for thestandard and competence with which they deliver careirrespective of qualification award.

As detailed in An Bord Altranais’ Code of Practice 2000“The nurse or midwife must take measures to developand maintain the competence necessary forprofessional practice”.

This statement puts an onus on each nurse andmidwife to continuously update their knowledge and

skills in order to remain competent. The INO maintainsthat nurses and midwives by virtue of their uniquerequirements in fulfilling their responsibility must beevaluated accordingly:

• They are regulated under the Nurses Act

• They have a duty of care

• They have to fulfil the requirements and standards ofthe regulatory body, An Bord Altranais, forregistration

• They have to comply with EU Directives

• It is incumbent on each registered nurse/midwifeirrespective of qualification award, ie. certificate/diploma/degree to provide the same standard ofprofessional care to patients.

An Bord Altranais has undertaken a project inassociation with the NQAI and national stakeholderswhich will develop a framework that seeks to addressthe complexity of nursing and midwifery awards byrecognising competencies and outcomes, what aperson with an award knows, can do and understandsrather than the time spent on the programme.

The INO maintains that this framework mustacknowledge that nurses and midwives have had tomaintain their competence, knowledge and skills inline with increasing technological and medicaladvances, patient acuity, changes in nursing andmidwifery practice and patient needs andconsequently should have an NQAI award at leveleight.

National CommitteeMembership• An Bord Altranais Five Points of Entry Steering

Committee (Annette Kennedy)

• HSE High Level Group on Healthcare Assistants

• HSE European Working Time Directive – Nursing andMidwifery Sub-Group

• HSE Nursing and Midwifery Staffing Levels SteeringCommittee

• HSE Return to Nursing and Midwifery PracticeSteering Committee

• Review of Nurses and Midwives in the Prescribingand Administration of Medicinal Products SteeringCommittee (Mary Power, Section DevelopmentOfficer).

External BodiesMaynooth NUI – Governing Authority

Annette Kennedy was nominated by ICTU to theGoverning Authority of Maynooth National Universityof Ireland in October 2005 and will sit on the board forfive years.


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Annual Report 2005

Meningitis Foundation – Information Booklet

The INO has been liaising with the MeningitisFoundation for a number of years and assisted thefoundation in promoting their work.

The foundation has produced a number of veryvaluable publications for health professionals to assistin the early recognition, diagnosis and prevention ofmeningitis and septicaemia which has a highmorbidity and mortality factor and affects manychildren throughout Ireland.

A booklet entitled Vital Signs, Vital Issues: Recognitionand Prevention of Meningitis and Septicaemia. Helpfor Community Practitioners was developed inresponse to requests from community nurses,midwives and healthcare practitioners for informationin the recognition of meningitis and septicaemia andwith talking to parents about vaccination.

Nurses, midwives and healthcare practitioners saidthat they were regularly faced with misplaced anxietyand suspicion about vaccines, and needed informationto deal with this.

The resulting booklet, which INO members contributedto and is to be disseminated in early 2006, will addressthese concerns.

European Report

Presidential Elections

During 2005 the Organisation enjoyed the election oftwo of our senior people to the post of President inboth the European Federation of Nurses (EFN) and theEuropean Midwives Association (EMA). AnnetteKennedy, Director of Professional Development, waselected President of EFN for the two year period 2005-2007. In addition Deirdre Daly, member of ourExecutive Council and Principal Midwife Teacher in theSchool of Midwifery, Rotunda Hospital, Dublin, waselected President of EMA. While the details of theseelections can be found elsewhere the elections

themselves confirm the esteem in which our seniorpeople, and the Organisation as a whole, is heldinternationally.

European Federation of Nurses Associations(EFN) formally (PCN)

At PCN’s General Assembly in October 2004, membersagreed on a new Constitution which was required byBelgian law but which also allowed for changes to bemade in relation to membership and function.

The General Assembly also decided that a namechange, which more appropriately reflected theorganisation, was necessary as ‘The StandingCommittee of Nurses of the EU’ and the acronym PCNdid not translate into a meaningful name.

The committee will be entitled ‘European Federation ofNurse Associations (EFN)’ as and from the ratificationof the Constitution in European law.

The new Constitution will also allow for associatecountries currently outside the European Union tobecome full members following the fulfilment ofcertain criteria.

The organisation has also purchased a new premiseswhich is close to the European Parliament in Brusselsand will allow for greater flexibility in terms ofmeetings, lobby work and research.

EFN Presidency

On 23 September 2005 in Greece, Annette Kennedywas elected by an overwhelming majority of Europeancolleagues to the office of President of the EuropeanFederation of Nurses Associations (EFN).

EFN represents 30 countries from the wider Europeand over six million nurses. It is a great honour for theINO and for Irish nurses.

Manifesto for European Federation of NursesAssociations:

• To provide a platform where all European nursingorganisations can work together to bring a unitedfront to the European Union, European Parliament,Council of Europe and MEPs

• To focus on European and national issues whichdirectly affect the nursing profession and patient careoutcomes

• To ensure the visibility of nursing and to have a voicein defence of the need for well educated experiencedpeople in nursing who have more authority, betterworkloads and a culture that is supportive ofretaining nurses

• To provide leadership and vision

• To secure a committed General Assembly in theEuropean Federation of Nurses Associations.

The aim of the European Federation of NursesAssociations (EFN) is to strengthen the status and

INO director of professional development, Annette Kennedy (left) who was electedPresident of the European Federation of Nurses Associations (EFN) is pictured withDeirdre Daly, Principal Midwives Teacher at the Rotunda Hospital, Dublin who waselected President of the European Midwives Association


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Annual Report 2005

practice of the profession of nursing and the interestsof nurses in the EU and Europe.

Annette Kennedy is very passionate about her newrole and argues that no one in the health serviceknows more about patient care than nurses andmidwives.

Annette maintains that it is nurses and midwives whohold the most information about patients, about theirhistory, healthcare needs, their worries, their family,their support in the community and their socialcircumstances.

The EFN committee is imperative at a European levelas it allows nurses to contribute to EU health policyand the delivery of patient/client care and EUDirectives in relation to health, education,environment and service provision, which will directlyor indirectly affect how nurses work and deliverservices in member states.

Activities of European Federation of NursesAssociations

In 2005, the European Federation of NursesAssociations gave its input to several documentslaunched by the European Institutions which includedthe following:

• Sharps injuries

• Directive on Mutual Recognition of ProfessionalQualifications

• Services Directive

• High Level Reflection Group which looked atworkforce issues, care of the older person andleadership.

Other areas which EFN is involved in lobbying theEuropean Commission, Parliament and Council ofEurope are:

• Care for Older Persons

• Mobility of Nurses and Workforce Planning

• Euthanasia

• Pensions

• Patient Safety

• Reuse of Medical Devices

• Environment and Health

• Bologna Agreement (Third level education).

Further information on European Federation of NursesAssociations and position statements can be found onits website www.efn.be.

EU Open Health Forum:The Services Directive

As President of the European Federation of NursesAssociations, Annette Kennedy was invited by theEuropean Commission’s Directorate General Healthand Consumer Protection to speak at its annual OpenHealth Forum.

Ms Kennedy took part in a workshop debate thatfocused on health services in Europe and the impact ofthe proposed EU Services Directive.

The role of the workshop, co-organised by Health FirstEurope and European Health ManagementAssociation, was to identify some of the issues inEurope’s challenge to balance the equation to deliverhigh quality, safe healthcare to all its citizens with duerespect for equity of access and within the confines tosustainable financing.

The Services Directive in its current form also posesserious problems for working conditions, collectiveagreements and health and safety regulators as thereis not equity of standards of working conditions acrossthe EU.

Workgroup of European Nurse Researchers (WENR)

The Irish Nurses Organisation hosted the annualmeeting of the Workgroup for European NurseResearchers from 30 June to 1 July 2005. Seventeencountries from all around Europe attended the two daymeeting.

Anne-Marie Ryan, Chief Education Officer of An BordAltranais facilitated a strategy workshop for the groupin which the focus was on applying for EU researchfunding, 7th Framework (which has a fund of threequarters of a billion euro for research).

European Forum of Nursing and MidwiferyAssociations WHO (EFNMA WHO)

EFNMA WHO held its 9th Annual Meeting in March2005 in Copenhagen and Madeline Spiers, INOPresident was elected to the Steering Committee. TheForum was attended by representatives and observersof nursing and midwifery associations from 26 WHOEuropean member states.

Other member countries elected to the SteeringCommittee include representatives from the UK, theNetherlands, Norway and Denmark. This is a greathonour for the INO and enables Ireland to influenceimportant European nursing issues.

The main focal point of this annual meeting of theForum was Maternity, Child and Adolescent Healthwith focus on Obesity, a key priority area of the WHORegional Office for Europe.

To help the less well off nursing associations toparticipate at EFNMA WHO meetings, the Forumsupports the twinning of countries so that thedeveloped countries finance the travel expenses of thepoorer countries.

The INO sponsors the Belarus Nurses Association aswell as the Association of Health Care Professionals inNursing, Bulgaria. Both organisations have expressedtheir thanks and gratitude to the INO for theirgenerosity.


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Annual Report 2005

International Report

ICN Positive Practice Environment Report

The International Centre on Nurse Migration hosted aconference on 20-21 February 2006 in London whichexplored models of good practice for the internationalnurse.

It was a unique opportunity for policy makers, first linehealthcare managers, human resource managers andnurses to learn from international and nationalinnovators while sharing their concerns andexperiences.

In November 2005 Annette Kennedy was asked by ICNon behalf of the international centre on nursemigration to write a paper entitled Creating PositivePractice Environments for the International Nurse thatwas to be launched at this conference.

Liz Adams was commissioned to write the paper inpartnership with Annette. The paper can be accessedvia the website: www.intlnursemigration.org

ICN Credentialing Meeting, Madrid

In November 2005, Annette Kennedy representedIreland at ICN’s annual credentialing meeting whichtook place in Madrid. Several topics were discussed atthis meeting which was also attended by Denmark, UK,Spain, US, Canada, New Zealand, Australia, Japan,Taiwan and Jamaica. Topics discussed included:

• Accreditation

• CN/MS and AN/MP

• Legislation

• Workforce Issues

• Staffing Levels

• Skill Mix

• Non professional grades.

ICN Bank of Experts

ICN approached Annette Kennedy to submit a list ofnominations of nurse experts from Ireland in a numberof specific nursing areas for their database of nurseexperts.

The International Council of Nurses’ Bank of NurseExperts was established in 1997 to ensure ICN accessto the most current information, opinion and advice onissues it deals with regularly. The Bank has provedinvaluable in this regard and also enables ICN toobtain input that reflects geographic and culturalperspectives and to have a cadre of informed nursesthey can refer to when necessary.

Experts are asked from time to time to share theirexperience and assist ICN with advice, writtencomments, help identify trends and to participate in adhoc groups, represent ICN at meetings etc.

Ms Kennedy contacted all universities in Ireland tomake nominations and forwarded nominee’s details toICN. There was a great response from nurses and thereis also agreement from these experts to be nominatedto WENR Bank of Experts.

23rd ICN Quadrennial Congress,Taiwan May 2005

In 2005 ICN’s 23rd Quadrennial Congress took placeand included the 7th International RegulationConference and the Council of NationalRepresentatives meetings.

More than 3,500 nurses from 131 countries and everyregion of the world gathered in Taiwan, to participate inthe International Council of Nurses (ICN) 23rdQuadrennial Congress from 21-27 May 2005.

The scientific programme boasted more than 1,500presentations, including:

• Main sessions

• Symposia

• workshops,

• Special interest sessions

• Posters.

Dr Hiriko Minami of Japan was elected president andher presidency will last until 2009. Japan will host thenext CNR meeting in 2007.

The main focus of the Council of NationalRepresentatives was on the nursing workforce, theglobal shortage of nurses and the aggressiverecruitment of nurses from Asia and Africa bydeveloped countries, with poignant illustrations ofdeveloping countries being depleted of nurses, theirmost valuable asset.

Of those nurses not recruited to developed countriesapproximately 40% may die from AIDS. Studies nowshow that sub-Saharan Africa as a whole could lose20% of all its health professionals before this virus iscontrolled.

The report is entitled The Global Shortage ofRegistered Nurses: An Overview of Issues and Actionsand includes seven papers:

• Regulation, roles and competency development

• Nursing Workforce Planning: Mapping the Policy Trail

• What Makes a Good Employer?

• Nurse Retention and Recruitment: Developing aMotivated Workforce

• International Migration of Nurses: Trends and PolicyImplications

• Overview of the Nursing Workforce in Latin America

• The Nursing Workforce in sub-Saharan Africa.

Full reports can be accessed on the web atwww.icn.ch/global


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Annual Report 2005

ICN now has seven networks which include nursepractitioners/advanced practice nursing, nursepoliticians, research, leadership for change, regulation,socio economics, remote and rural and HIV AIDSnetworks.

Highlights of the conference included a motivatingspeech by Stephen Lewis, UN Special Envoy forHIV/AIDs in Africa, who was one of two people toreceive ICN’s Health and Human Rights Award at thequadrennial conference.

Margretta (Gretta) Madden Styles, former ICNPresident and President of the Florence NightingaleInternational Foundation received ICN’s Health andHuman Rights Award. It was with sadness that the INOlearned of Gretta’s death in November 2005. She wasa great ambassador for nursing and contributedgreatly to nursing work over her lifetime.

One of the key presentations was a debate on thevalue and future of legislated nurse/patient ratios inwhich the INO President Madeline Spiers participatedand Annette Kennedy, Director of ProfessionalDevelopment presented on Motivations of an AgeingWorkforce at the conference.

All speeches and further information on the ICNQuadrennial Congress can be obtained on thecongress website at the following address:www.icn.ch/congress2005/highlights.htm

ICN Position Statements

The International Council of Nurses issued a numberof position statements in 2005 which included thescope of nursing practice, protection of the title nurse,breastfeeding and breast milk substitutes, medicalwaste, female genital mutilation.

Further information on these new position statementsand all other ICN position statements can bedownloaded from www.icn.ch./policy.htm

Bem Me Quer In December 2004, the INO was contacted by a smallorganisation called Bem-Me-Quer (meaning life) which

was set up by Sr Helen Regan who is a St Louis Sisterfrom Co Mayo.

This is a small non governmental organisation whichlooks after the poor and destitute people who live inthe shanty towns towards the North West Region ofSao Paulo. Sao Paulo is the third largest city in theworld and has a population of over 15 million.

A very high percentage of these people have AIDs orare HIV positive and many parents die leaving childrenorphaned and homeless with little or no provisionsmade by the state.

It is in this region that this organisation has made adifference helping people to repair and build houses,providing counselling, support, education and adviceabout HIV and AIDS.

The first priority for Bem Me Quer is to provide foodand shelter to the people living in these shanty towns.The second priority is education for the children andself help employment for parents. The organisation’sprojects include

• ‘Drop-in’ centres

• Counselling and support

• Providing food baskets for families in need

• Building houses and huts

• Employment courses

• Public awareness campaigns.

Donations go directly to helping the people helpthemselves, no funds are spent on administration orfund raising. Fundraising is done only by friends andfamily.

The Executive Council of the INO decided that thiswould be a worthwhile project to donate e10,000 fromthe INO’s ‘Overseas Aid’ fund and requested that thisfunding specifically be given to support the repair andbuilding of houses for people who are HIV positive orhave AIDS.

The organisation was requested to provide the INOwith a six monthly update as to how the contributionwas being used.

One of the families in Sao Paulo assisted by Bem-Me-Quer Bem-Me-Quer provides support, education and advice about HIV and AIDs


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Annual Report 2005

Online and Information TechnologyINO websiteThe INO website, now in its ninth year has continuedto prove to be a great success, both at home andabroad. The website was in 10th place in the worldvoting of labour websites which is the first Irish unionwebsite to be placed in the top 10 for a Labour Websiteof the Year competition.

The INO website is updated on a daily basis with thelatest news and happenings in the world of Irishnursing and healthcare.

Campaigns such as Enough is Enough are constantlyhighlighted and promoted extensively via our website.Our trolley watch figures are heavily accessed by themedia. Members who visit the website at www.ino.ieare provided with a broad range of information aboutall of the INO services.

An analysis of statistics for www.ino.ie for 2005 foundthat there have been almost 4.5 million visits in 2005.The INO website is referenced in over 9,000 internetpages globally.

Of the visitors to the INO website 40% are from outsideIreland with UK, USA and Australian visitors leading.Even in the absence of major industrial issuesinvolving the Organisation the traffic to the websitehas still risen compared with 2004 and 2005.

Nurse2Nurse (N2N)www.nurse2nurse.ie (N2N) is the website/one-stop shopfor up to date education and research information fornurses/midwives in Ireland. N2N content iscomprehensive, credible, convenient and current.

INO members are provided with the opportunity tosearch for information from work, home or from anylocation the nurse/midwife has Internet access.

www.nurse2nurse.ie has received acclamation frommany individual nurses/organisations for its userfriendliness, presentation of up-to-date information andits options for accessing a host of nursing/midwiferyrelated information, N2N is the only website of its kind inEurope.

N2N was given a new look during 2005. Version 2 waslaunched in August 2005, after months of work by thelibrary staff in developing our own thesaurus andsubject heading list, N2N now has a comprehensivesearch engine making searching and using the siteeasier and more streamlined.

The MIDIRS (Midwives Information and ResourceService) database was also added to N2N during 2005and is heavily used by all our midwife members.

• The total number of visits to N2N January to December2005 = 1.5 million.

• New registrations on N2N are steady with about 200nurses joining monthly. The total user population

varies between 10,000 in summer with up to 15,000during winter months.

@Nurse.ie – updated email – with newfeatures

INO members are moving ahead of all otherprofessionals with their own professional email [email protected] and @midwife.ie. With the launch of the newlook N2N, the email system was also updated nowallowing members to see their email Inbox once theyhave logged into N2N.

In August 2005 a new student email service went livegiving our student members their [email protected] email address along with access to ahost of new features including the possibility to uploaddocuments and access these documents wherever orwhenever they have internet access.

This innovative step gives every student, nurse andmidwife in the country the opportunity to have [email protected], @nurse.ie or @midwife.ie emailaddress via www.nurse2nurse.ie.

As of December 2005 there are over 1,000 active emailusers. The numbers of emails passing through thesystem increased during October-December 2005 withover 100,000 emails processed. With new and excitingpersonal information management features it is hopedthat the year 2006 will see a massive growth in theusage of email services.

LibraryThe Library and Information Service continued to bedeveloped during the past 12 months. The move to ournew building and library continues to create many newopportunities and challenges for the library staff.

The extra space in our new library has given us theopportunity to temporarily house part of An BordAltranais’s journal and thesis collection.

As can be seen from the figures below, there has beenan increase in the number of queries and peoplevisiting the library, both members and non members.

The library holds a very comprehensive range ofnursing, healthcare and industrial relations materialincluding:

• 55 journal titles

• 59 e-journals

• 5,500 books, reports and official publications

• Directories

• Newsletters

• Online databases.

Services offered by the INO library during 2005included:


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Annual Report 2005

Journal Collection

The library provides access to a comprehensivejournal collection with subscriptions to all the corenursing/medical and industrial relations journals alongwith online access for all members to our electronicjournals collection, which is increasing annually.

Computerised Services

The library provides access to a host of onlinereference databases:

• Cumulative Index to Nursing and Allied Health(CINAHL)

• Medline (Clinical)

• The British Nursing Index

• Cochrane Library (evidence-based research, somefull text)

• MIDIRS (Midwives Information and Resource Service).

Book Collection

The library has a comprehensive collection of booksand reports on nursing, allied health, industrialrelations and related areas.

The move to our new library has given us muchneeded extra space and it has been possible to addmany new publications to the collection.

The library staff are at present in the process ofupgrading the library catalogue system which willallow all staff and members to view and search thelibrary catalogue.

The library continues to support the Office for HealthManagement’s e-learning project ‘Online NurseManager’s Competency Assessment Tool and PersonalDevelopment Pack’ for front, middle and top levelnursing management, by holding a comprehensivecollection of books/videos on the all areas ofmanagement.

All of the material referenced for this course isavailable for nurses using the competency assessmenttools at the INO library.

Photocopying and Document Supply

While articles may be photocopied in the library, apostal photocopying service is also provided. Alldocuments required by members not held in the INOlibrary are available to members via the IrishHealthcare Journal Holdings Co-operative, the NursingUnion of Journals (UK) or British Library DocumentSupply Centre.

The numbers of inter-library loans has increasedduring 2005, which is partly due to us housing An BordAltranais’ journal collection.

A continuing phenomena for the library in the past 12

months has been the increase in the number of articleswhich nurses themselves are downloading from thefull text material available online thereby cutting downon the number of articles which the nurse has to ordervia the library.

Literature Searches

In serving our geographically dispersed membership,hundreds of literature searches are undertaken bylibrary staff, for nurses and midwives who mayotherwise not have the possibility of acquiring theinformation they require to complete their studies.

Due to the online access to the nursing and medicaldatabases, the number of literature searches carriedout by the library staff has decreased.

There has been an increase in the number of queries,which are received from INO staff and ExecutiveCouncil members.

Current Awareness Services

The Current Awareness Bulletin containing contentspages of all the journals received into the libraryduring the previous month continues to be compiledmonthly and circulated among the staff and memberswho subscribe to this service.

Other resources, such as the daily newspapers, journalarticles and websites are scanned on a regular basis inorder to keep staff and members up-to-date on currentevents and information. With an increase in theamount of full text information available on theInternet scanning websites has become increasinglyimportant.

User Education

A number of workshops were held during the year onInformation and Library Skills. The programmeincluded: planning literature searches, journalliterature, references and referencing, practicalsessions in the library.

There were also a number of weekend courses onIntroduction to Research for Nurses and Midwives.This programme included the research process,methods of referencing, library skills andcomputerised information retrieval.

The library also facilitates tours of the library and itsservices to groups of nursing students. User educationis offered on an ongoing basis to all nurses andmidwives who visit the library.

Statistics January-December 2005

While we did have some concerns moving to a newlocation as to whether nurses/midwives would comein person to use our new library. This concern has beenalleviated. Nurses/midwives are getting to know wherewe are based with the numbers visiting the library on


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Annual Report 2005

a daily basis increasing significantly.

Nurses/midwives are visiting us from the variousDublin hospitals, universities as well as nurses/midwives travelling from the country to visit thelibrary.

The Library and Information Service has seen anincrease in the use of its services during the past year.The following statistics have been recorded fromJanuary 2005 to December 2005.

Information OfficeDuring the year 2005, the staff of the information officecontinued in their efforts to develop and deliver acomprehensive industrial relations research andinformation service to both members and staff of theINO. Information was collected from a wide variety ofsources and disseminated to the various groups withinthe Organisation.

Throughout the year information office staff respondedto a significant number of requests for information andadvice on a broad range of topics including, pay,workplace issues, employment legislation and mattersof concern to members. The information office continuedto utilise a wide range of mechanisms to communicateinformation directly to INO staff and members.

These included the production of explanatory leaflets onemployment legislation and employment rights,publication of information bulletins and booklets, theprovision of a rights and entitlements section on the INOwebsite, and the production of articles for inclusion inthe INO journal, the World of Irish Nursing andMidwifery. In addition, the staff of the information officecontinued to support the training activities of theOrganisation.

Explanatory Leaflets

During 2005, the Information Office continued to updateand expand its extensive range of explanatory leafletson employment legislation and employment rights. Theleaflets are updated to take account of developments inboth employment legislation and conditions ofemployment of nurses.

The office produced a new leaflet to provide informationon an employee’s entitlements following an injury at

work, or where an employee contracts a diseasebecause of the type of work they do.

A leaflet on the effects of work-sharing on social welfareentitlements was also produced, as was an informationsheet on entitlements to cost neutral early retirement forpublic servants.

INO Diary 2006

The INO 2006 diary was distributed to Executive Councilmembers, branch officers, section officers, nurserepresentatives and staff.

The diary contains up-to-date information on members'rights and entitlements at work, useful names andaddresses, and details of the full range of services andbenefits provided for INO members.

INO Desk Calendar 2006

The INO 2006 desk calendar was distributed to eachmember along with the December issue of the World ofIrish Nursing and Midwifery. As in previous years,additional calendars were also distributed to branchofficers, nurse representatives and section officers fordisplay on nurse stations and other visible areas in theirplaces of work.

In addition to providing the latest information on keypieces of employment legislation and nurses/midwives’rights and entitlements at work, the calendar alsocontains contact details of INO regional offices. Thecalendar continues to be very popular with staff andmembers alike.

Practice Nurse Booklet

The Information Guide for Practice Nurses providesdetails of the up-to-date pay and conditions ofemployment of practice nurses as recommended by theINO. Details of the INO’s professional indemnityinsurance cover and guidelines in the event of a claimare also contained in the booklet.

Training

The staff of the information office continued to supportthe INO’s training activities, providing training ininformation skills and employment legislation to bothINO staff and nurse/branch representatives.

INO Website – Rights and EntitlementsSection

The rights and entitlements section of the INO websitecontinues to be an important information resource forINO members and activists.

It is compiled and maintained by the information officeand is regularly updated to take account ofdevelopments in employment legislation and nurses’pay and conditions of employment.

Inter-library loans queries 1,935

Queries relating to Nurse2Nurse, 3,690information requests, and photocopying requests received by telephone/post/fax/email

Nurses and midwives visiting the library 585


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Annual Report 2005

OverviewMembers working in specialistareas of nursing and midwiferycan link up with colleagues whohave similar professionalinterests through their nationalsections. These special interestgroups of members are from agiven field of practice; specificnursing or midwifery grade ororganised to pursue social/cultural issues. The nationalsections hold meetings at regular

intervals to facilitate the networking betweenmembers, sharing of knowledge and expertise,bringing forward joint work, campaigning on issues ofconcern and pursue national claims relevant to all theirsections membership.

Currently there are 24 active sections within theOrganisation with a small number of sub-sections,aligned to their parent section and national networkgroups. We are delighted to advise of the formation ofthe following new national groups:

The Osteoporosis Nurses National Network has set upa national group in April 2005 and they are open to allmembers who are interested in all aspects of thisspecialism and who are engaged in the delivery of thisspecialist service. Much work has been conducted thisyear with regard to the Statutory Instrument 478 andtheir objectives for the forthcoming year includeestablishing standards for nurses working in bonedensitometry, provision of dedicated osteoporosis andbone health education modules, and ultimately tosupport the clinical development of this specialism.

Out of Hours Clinical Nurses formed their subsectionlinked to the Telephone Triage Section and theirobjectives are to promote the role of the clinical nursein the out of hours service, to develop and strivetowards uniformity of role and responsibility, and toenhance educational opportunity for the group.

The Retired Nurses and Midwives Section wasestablished in March 2005 and is dedicated toproviding opportunities for retired members to pursueretirement in a visionary and positive way and topromote the continued wellbeing of retired nurses andmidwives through informative, social and culturalinitiatives. It is the aim of this new section to maintainand develop friendship, to retain an interest in thenursing and midwifery profession and to continue tocontribute to the Organisation.

Finally, nurse members working within the arena ofStudent Health in Institutes of Technologies are in theprocess of amalgamating with their colleagues whowork in a similar role in the Universities.

A number of the national sections conducted

workshops and seminars for their section membersduring 2005. They included:

• Directors of Nursing – January

• A&E – February

• Operating Nurses study day – June

• Rehab Workshop – June

• Telephone Triage Conference – September

• Midwives – October

• Care of the Older Person – November

• Operating Room Nurses – November

• Occupational Health Nurses – November.

The maintenance of effective communication betweenand within the national special interest groupscontinues and has been enhanced by ongoingdevelopment of the section’s web pages and thedissemination of a dedicated newsletter on all sectionactivities twice annually. The Section page within TheWorld of Irish Nursing and Midwifery magazine growsfrom strength to strength with many contributionsfrom the national section officers relating to theiractivities and continues to attract enormous attention.

The midwives section are now also publishing theirown newsletter which is aimed at keeping themidwifery members up to date on all relevant issues ofboth a national and international nature.

A very successful nursing student recruitmentcampaign was conducted over September andOctober during which we attracted 1,033 nursingstudents into the Irish Nurses Organisation. We alsohave a very dynamic and hard working team ofnursing student officers and representatives who arecommitted to progressing issues both nationally andinternationally relevant to the nurse and midwife ofthe future.

A number of publications were developed bydedicated workgroups, some of which were cross-sectional and they include:

• Position paper with regard to The Introduction ofAccreditation Standards for Residential Care Services

• A detailed submission was made to the HealthService Executive relating to Best Health for Children– Revisited

• Submission to the National Taskforce on SuddenCardiac Death

• Guidance document on the process steps towardsaccessing an Advanced Nurse Practitioner Positionwithin the Community Care Service is nearingcompletion.

Both online and postal surveys were conductedamong a number of sections relevant to their

National Section Reports

Mary Power,Section Development Officer,INO


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Annual Report 2005

specialism during 2005 and theyinclude:

• A&E incident audit report(ongoing)

• Online student nursingquestionnaire (ongoing)

• Care of the older person facilities

• GP practice nurses conditions ofservice

• Osteoporosis nurses

• RNID with regard to the provision of educationservices for people with severe and profoundlearning disabilities.

A very big thank you goes to all the national sectionofficers and activists both incoming and outgoing fortheir enthusiasm and who continue to support andwork tirelessly for each of the sections and specialinterest groups nationally.

Accident and EmergencySectionThe mission statement of this section is – The A&ESection of the INO jointly working together as anational group will congregate on a regular basis todiscuss interests and concerns of those nurses whomthey represent.

The section had four meetings in 2005 of which onewas a very well attended workshop. Much work hasbeen done by the A&E section with regard tohighlighting the acute shortages within this specialistwork area. Following discussion at the previous yearsAGM, an incident audit form was devised anddistributed to all A&E departments throughout thecountry.

The purpose of this incident audit form is to gatherstatistics on the number of violent and abusiveincidents that are taking place in A&E departmentsthroughout the country. This will assist the

Organisation in the accurate correlation of violent actsagainst staff which the Organisation will in turn use tohighlight the issue and promote zero tolerance of suchoccurrences.

Educational input to this section included apresentation on the role of the advanced nursepractitioner in the A&E department by GabrielleDunne. John Lonergan, Governor of Mountjoy Prison,addressed the annual general meeting of the section inNovember.

Governor Lonergan addressed the following topics:

• The management of prisoners in A&E departments

• The effects of the Celtic Tiger on society today;

• The psychiatric patient in prison – is this the correctplace for them?

• Clients who have repeatedly attended the A&Edepartments who end up in prison – has the healthservice failed them?

The Section ran a very successful and extremely wellattended workshop in February, at which RobertSowney talked about major incidence and disasterplanning. He drew on his extensive experience fromthe Omagh Bombings. The afternoon session wastaken by Pauline Coughlan on the management ofbereaved relatives in the A&E department. The sectionare hosting another workshop this February, its themebeing Major Trauma.

Assistant Directors ofNursing/Public Health/NightSuperintendents SectionThe section adopted the recommendations of the 2004AGM to continue holding four meetings throughoutthe year, ie. two meetings at INO headquarters andtwo meetings outside Dublin. The section meetingswould continue to contain an educational componentand reflect members’ ongoing concerns with thechanging health service demands. At its meetings

Jean Carroll, AssistantSection DevelopmentOfficer

Also at the A&E Section Meeting were (l-r): Jackie Brennan and Marianne Kelly, StVincent’s University Hospital, Dublin; and Margaret Furlong, Kilkenny

At an A&E Section meeting which took place early in 2005 were (l-r): CarolineOverton, Portlaoise General; Marie McCafferty, National Secretary, A&E Section;and Joe Holohan, Portlaoise General


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Annual Report 2005

throughout the year, a number of issues werediscussed including:

• Healthcare assistants

• Nursing Home Act

• Fitness to Practice

• ADoN salary and grading

• Relevance of section to members

• Health Service Executive

• PPARs

• Management programme.

• National section officers workshop

• Annual delegate conference

• AGM

• A&E crisis.

• Pay scales and grading

• Special delegate conference

• Programme for 2006.

The meetings for 2005 were in general very wellattended, with guest speakers Mary Harris, ChangeManagement Consultant (July meeting) and JimComiskey, Conflict Management (AGM, November).

The section attracted a new group of members fromthroughout the country. It was noticeable that very fewattendees were from the public health divisioncompared with previous years.

The pay and regrading of assistant directors ofnursing/midwifery was constantly referred to,particularly in light of the exhaustive new assistantdirectors of nursing/midwifery posts. The INOmanagement programme was welcomed andcommended by those who had participated.

In general the section is progressing, informed andwelcomed by its members.

Care of the Older PersonSectionOver the past year the Care of the Older PersonSection has grown from strength to strength. This timelast year at our national workshop and AGM welaunched our Guidelines on Elder Abuse documentwhich was welcomed nationwide. Our Presidentinformed us at this meeting that the INO had intendedto carry out research on the quality of care for theolder person nationwide.

Earlier this year this was put on hold because thispiece of research was being carried out by the NationalCouncil on Aging and Older People. This researchfocused on the quality of life for older people in public,private and voluntary long stay services in Ireland.

It is being carried out by the National University ofIreland and is being led by Dr Kathy Murphy. They wereundertaking the research under five main themes –inclusive of measuring dependency, staffing, quality ofcare, quality of life and policy.

At our meeting in January we nominated a delegateand observer to attend the ADC. A motion was decidedupon for conference and subsequently debated inKillarney. Our motion was that “the care of the olderperson would become a specialised category withinAn Bord Altranais”.

There was much discussion surrounding the motionand it was remitted to Executive Council. Our Maymeeting focused on the impact of the new careattendants training course. Your attendance at ourmeetings will always be appreciated.

Clinical Nurse/Midwife Manager SectionThe section was formed in November 2004 to includeall CN/MM1s and CN/MM2s and the section met threetimes during the year.

The mission statement of the section is: “The CN/MMsection will be the representative clinical voice fornurse/midwifery ward managers committed to raisingthe job profile thereby enhancing the standards ofpatient/client care”.

The aims of the section are:

• Highlight the role of present day ward manager ashead of clinical practice at unit level

• Secure supernumerary status for all CN/MM2s andacting up CN/MM2s

• Protected time for CN/MM1s for management duties.

The section objectives are:

• Lobby Department of Health and Children/HSE toensure the provision of relevant education for wardmanagers

• Influence nursing and policies locally and nationally

• To ensure that ward managers are represented on allhospital/regional groups relevant to patient care,inclusive of service planning etc.

• Uniformity/equality of role for clinical managers.(Review of workload weighting/measurement tool)

• Mandatory administrative support for wardmanagers

• To network and share information amongmembership

• Forge links/partnerships with other sections withinthe INO.

During the past year we have concentrated onincreasing our membership and strive to have a


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Annual Report 2005

representative attending our section meetings fromevery hospital in the country.

The networking opportunities proved very valuableover the last year. We are aiming to have aneducational workshop in September 2006 and a sub-committee is working on the components of thisworkshop.

Clinical Placement Co-ordinators SectionAs with last year’s report it is clear that some of ourissues remain. Student CPC ratios continue to be amatter of concern. However our motion to establish anational student CPC ratio was passed unanimously atthe annual delegate conference.

This motion was supported from the floor and theExecutive Council. Our thanks to our colleagues fortheir support and to Vanessa Roche and Mary McTaguefor attending the conference.

The annual conference is a valuable and enlighteningexperience. We have consistently made theopportunity to represent the section as open to all oursection members. This has resulted in new delegates ateach conference. However it is a requirement thatdelegates also attend section meetings.

The workload and quality of service we provide hascontinued to be a matter of concern as the BSc coursehas entered its fourth year and the demands of therostered year have hit home in the practice areas. TheDepartment of Health and Children’s ceiling onrecruitment has curtailed the increase in CPCs tomatch the increase in student numbers and althoughthis may be addressed by a national ratio we areseeing the effects now.

This puts us under increased pressure. However thesection cannot function without members andrepresentation. For the section to be viable and to workwe need to support it. We all need to contribute.

The CPC Section web page currently gives very basicinformation and could still be the perfect opportunityfor a member with IT interests to develop their skillswith support from the Organisation as well asimproving communication.

Community General NurseSection Another busy year for this active section, which heldthree meeting in 2005. We provided a number ofeducational sessions at these meetings, aimed atkeeping members updated on developments innursing.

We are delighted that a small number of nurses havecommenced the Bachelor of Nursing Studies in

Community Nursing Degree in DCU since Septemberlast and we look forward to there being a sizableincrease in the uptake of the course in the comingacademic year.

Directors of Nursing/Midwifery/Public Health Nursing Section Directors of Nursing/Midwifery/Public Health Nursingmet on two occasions in 2005. The section wasdelighted to have as a guest speaker, Pat McLoughlin,Director of National Hospitals Office of the HSE attendthe meeting on the 6 September at which he discussedan analysis of the acute hospital sector within thereformed health services and its implications forsenior nurse managers. This forum also provided for aquestion and answer session which was mostengaging. A series of educational courses specificallyaimed at directors and assistant directors of nursinghave been well attended and found to be mostbeneficial and informative by all participants.

The objective for the Directors of Nursing/Midwifery/Public Health Nursing Section for 2006 will be tohighlight and progress their claim to have clearreporting pathways within the new managementstructure of the HSE, review and develop conditions ofemployment and aim to enhance their role andfunction.

Interventional Radiology Nurses Section An eventful year has gone by for the section, withsome disappointment but with much optimism for thefuture of interventional radiology nurses.

Sadly, at the Labour Relations Commission in Augustwe were unsuccessful in obtaining a nationalagreement for the allocation of the location allowance.This struggle, lasting the past two and a half years,came to an end with the LRC recommended that “….The review groups”, subjected to two reviews, “did notconsider it appropriate to designate the radiologydepartment as an appropriate area to warrant theallowance” (page 3, LRC18298). The court noted “…management’s support for the development of ahigher diploma course in radiology nursing torecognise its speciality status”. (page 3, LRC 18298).

Therefore the focus has been on the development of ahigher diploma in interventional radiology. Acommittee organised approximately two years agobegan to address this issue. The Royal College ofSurgeons in Ireland has worked very closely with thisgroup to develop this course. The course aim andcontent has not been clearly identified and the goal isto commence this course in September 2006, if not2007.

Four meetings were held during the year as follows:


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Annual Report 2005

• January 2005 – Whitworth Building

• May 2005 – ADC

• September 2005 – INO Cork

• November 2005 – Whitworth Building.

Issues arising included:

• PPARs

• Staffing levels

• The role of the HCA in the radiology department

• The specialist nurse

• The extension of nursing roles

• Location allowance

• Specialist course.

The website for the Interventional Radiology Section isstill under construction.

We hope to address the issues of collecting statementand standards for the database, as well as include thepolicies and any relevant research that may have beencompleted. In the next year the committee havedecided to arrange for a professional development dayto be held annually. The location of this venue andtopics for discussion are still to be confirmed andpresented to section members. Two meetings to beheld annually in Dublin and Cork as well as attendanceat ADC.

Midwives Section The section met four times during the year. Two of themeetings were held at INO HQ and for the others webenefited from the generosity of our midwife teachermembers who regularly offer their premises formeetings.

AGM: At the last AGM Sally Millar was elected as vicechairperson.

Annual Delegate Conference: At the ADC in May thechairperson represented the section. The motionproposed by the section regarding the representationof midwives and nurses on all health policyformulating bodies and decision was passed.

Section Development: There was one meeting ofsection officers this year and the chairpersonrepresented the midwives section. The main item onthe agenda was the future of the sections. It isproposed that the sections themselves become moreactive in section development.

The issue of attendance at meetings is viewed as ameasure of the success of a section and is a cause forconcern for almost all sections. However, we questionthe validity of measuring the success of a section bythe numbers attending meetings.

Midwives and nurses have many work related

meetings to attend and are, understandably, reluctantto use their free time for more meetings. It wasproposed that the number of meetings be reduced but,because of the volume of work, this is not a viableoption for the Midwives Section. It was decided toproduce a newsletter to keep midwives informed ofthe main issues of interest and to continue with theusual meetings.

Annual Joint Conference:The 12th joint RCM/MidwivesSection Conference was held in Armagh in October2005. The attendance was excellent and the conferencewas evaluated positively. This year the conference willtake place on Thursday, 19 October 2006, at theLandmark Hotel, Carrick-on-Shannon

International Confederation of Midwives:The highlightof the past year was the International Confederation ofMidwives (ICM) council meeting and congress. It washeld in Brisbane, a beautiful city, and the conventioncentre was an excellent venue. The Midwives Sectionwas represented by Deirdre Daly, the internationalofficer, and by the chairperson.

At the council meeting the business and future of theICM were debated together with many importantissues pertaining to midwifery. Of particular interest toIrish midwives was the realignment of the Europeanregion of the ICM. There are now three regions andIreland and the UK belong to the Central Europeanregion. The regional representative is Andrea Steifel, aGerman midwifery teacher.

The first meeting of the new region took place inFebruary. Deirdre Daly and the chairperson attended it.The main focus for the meeting was the state ofmidwifery in Europe.

Miscellaneous: The section officers believe that inorder to improve the Irish maternity services it iscrucial that women and midwives work together. Thesection is now represented on LINKS, an organisationof women and midwives working together with theaim of improving the maternity services andincreasing the availability of midwife led care.

As usual the Midwives Section responded to requeststo review reports and made submissions on issuesmainly pertaining to midwifery and the maternityservices. Most recently comments were made on thedocument Better Health for Children – Revisited and asubmission was made to the Institute of Obstetrics andGynaecology. The chairperson was asked by theNational Federation of Voluntary Bodies to co-ordinatefocus groups to discuss the development of bestpractice guidelines for informing parents of theirchild’s disability.

This project is being carried out in conjunction with theHealth Services National Partnership Forum and issupported by the Department of Health and Children.The section was represented at a Department of Healthand Children Workshop on Tackling Inequalities in theOccurrence of Low Birth Weight Babies in Ireland.


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Annual Report 2005

The European Midwives Association: The midwivessection has been, for many years, a member of thisimportant group for European midwives. At theSeptember 2005 meeting Deirdre Daly was elected itspresident. This is a great honour for Ireland, themidwives section and the INO. It will increaseconsiderably Deirdre’s workload but it is a fittingtribute to her efforts on behalf of midwives.

The Future: Autumn 2006 will see the beginning ofdirect entry midwifery education in third levelinstitutions. The future of postgraduate midwiferyprogrammes has not been addressed as yet.

At the time of writing this report the promisedamendment to the 1985 Nurses Act is still awaited.Many midwives believe that until this amendment ispassed their efforts to promote midwifery as aseparate profession are severely hampered.

It is noteworthy that the Minister for Health andChildren, Mary Harney, considered that advertising fora Nurse/Midwife Adviser was an adequate response toour request that the vacant post of midwifery advisorbe filled.

Nurse Tutors and ClinicalTeachers SectionMary Cotter took up the chair at a most challengingtime for the section with regard to:

• Change in the title of the section

• Ongoing discussions regarding the commencementof the undergraduate degree programmes inmidwifery and general/children’s nursing into thethird level sector

• Sub-committees submission on behalf of the sectionto the HSE

• Ongoing negotiations with regard to theestablishment of Centres of Nurse/MidwiferyEducation as per the 2002 agreement.

Change in the name of the Section: Followingdiscussion at the AGM on 29 November 2004 it wasagreed by members that due to the INO successfullynegotiating former nurse tutors, now nurse lecturersin the third level institutions had the opportunity to beaffiliate members of the INO for professional andeducational issues, that a more appropriate title forthe section was required.

Various titles were suggested. The discussionconcluded with an agreement to change the name ofthe section to: ‘Nurse and Midwifery EducationSection’.

Section sub-committee Submission Group: This groupcontinued with their work on the submissiondocument. At the June 2005 section meeting PhilDonnelly reported on the committee’s work to date andcirculated draft four to the members. Some minor

changes were suggested and approved and the finalsubmission document was forwarded to Liam Doran,General Secretary, in September 2005.

Undergraduate Degree Programme – Midwifery andGeneral/Children’s Nursing: Throughout the year therewere numerous meetings and discussions with therelevant stakeholders, ie. HSE; Liam Doran, INOGeneral Secretary; section members; the Tanaiste andMinister for Health and Children; and the third levelinstitutes with regard to the above.

On 16 November 2005 the Tanaiste, Mary Harney,confirmed the provision of funding for thecommencement of the undergraduate midwifery andgeneral/children’s nursing programmes into the thirdlevel sector from September 2006. This long awaitedinitiative is very welcome. However, at the time of thisreport no commitment has been given with regard tothe transfer of the postgraduate midwifery orchildren’s nursing programme to the third level sector.

Centres for Nurse/Midwifery Education: The particulardifficulties with regard to the operational structures asper the 2002 agreement of the CNEs continue.

Occupational Health NursesSectionA number of meetings were held throughout the yearas follows:

• Three working group meetings attended in INOheadquarters in Dublin (day) on 13 January, 4 Marchand 29 September 2005. These working groupmeetings were aimed at developing enhancedstructures to make the section more relevant to themembers

• Eastern regional meetings were held on the eveningsof 3 March 2005 and 7 July 2005

• Southern regional meetings – a number were held inCork

• National meeting was held on 14 July 2005 in INOheadquarters.

Section Webpage Developed

The section webpage provides:

• Information on OHN Section officers

• HSA information seminars on the new Act 2005.

Conferences highlighted include:

• INO/OHNAI Conference

• Irish Healthcare Risk Management Association,annual seminar – 29 September 2005

• RCN Society of Occupational Health Nursing, annualconference and exhibition, 30 November 2005 – 1December 2005.


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Annual Report 2005

FOHNEU

The INO was represented at two FOHNEU boardmeetings:

• Gothenburg: 21-23 April 2005

• Athens: 10-12 September 2005.

An Irish delegate is on the fundraising working group.

The FOHNEU constitution have defined four aims:

• To contribute to the total health, safety and well beingof the European working population

• To raise the profile of occupational health nursingwithin the European Union

• To promote European training, and standards forprofessional qualifications

• To encourage research in areas of occupationalhealth practice, education and management andservice with the publication of the results.

FOHNEU was represented at a meeting in Brusselsarranged by the European Federation of NursesAssociations EFN (PCN) to continue discussions on thefuture development of the collaboration between theEuropean Specialist Nurses Organisations (ESNO) andEFN collaboration. FOHNEU has played a central rolein these activities for the past five years.

At our last meeting a short survey was made toidentify some of the current trends in occupationalhealth nursing in the EU. It is our aim to make finaladjustments and finalise the survey and use theinformation as a baseline to benchmark our position atregular intervals. The Greek delegate has finalised thesurvey on OHN education. Both surveys reveal thediversities within our European context and thechallenges for our profession. Each country has beentwinned with a new EU country and Ireland is twinnedwith Hungary, with whom we have made contact. Wehope that they will attend our next meeting in Turku,Finland from 6-8 April 2006.

Operating Department NursesSectionThe year has passed quickly and I hope you agree ithas been a good year for the section. I wish to take thisopportunity to thank you, the section members, theother section officers, the European representatives,conference planning committee and the EORNAC localcommittee, who have all worked together over the last12 months to keep this section vibrant and relevant tooperating department nursing.

ODN Section Mission statement: A professionalspecialist-nursing group dedicated to enhancing theprofessionalism of operating department nurses. We believe in a holistic approach to the perioperativecare of our patients through the optimal sharing of our knowledge, skills and experiences.

Aim of ODN Section:This special interest group of theIrish Nurses Organisation provides a forum andnetwork of support, communication, dissemination ofinformation and continuing education for operatingdepartment nurses throughout Ireland.

Achievements: The annual conference themedPathways to Progress, held in Kilkenny City on 11 and12 November 2005 was a successful educationalconference. Throughout the year we organised foursection meetings, an AGM and, in addition, aninaugural section study day in June.

The section was represented at a number of foraduring the year namely:

• American Operating Room Nurses Congress, NewOrleans, USA, April 2005 – Liz Waters

• ADC in Killarney, May 2005 – Eileen Whelan

• EORNAC local committee meetings throughout theyear – Liz Waters, Anne O’Brien, Caroline Higgins andAnne O Callaghan

• Section officers workshop, March 2005 and October2005 – Theresa Herity and Liz Waters

• Special Delegate Conference, Croke Park, Dublin,September 2005 – Therese Cummins

• World Congress on Surgical Care, Barcelona, Spain,September 2005 – Ann O’Brien and Theresa Herity

• Association for Peri-operative Practice (AFPP),Harrogate, UK, October 2005 – Therese Cummins,Kay Nagle and Margaret B Murphy

• EORNA board meetings, Cyprus (April 2005) andIceland (October 2005) – Anne O’Brien and CarolineHiggins.

The section is proceeding to commission Mary Nicell,recently retired ODN tutor, to update the section healthand safety document 1990. Work recommenced inNovember 2005 and it will be ready for publication inspring 2006. Anne O’Callaghan, who retired in March2005, continues to be an active member of the section.Anne was nominated for her outstandingcommitment, to represent the section for the GobnaitO’Connell Award 2005.

The ODN section donated sums of money from sectionfunds to Trócaire for the Tsunami relief fund and theIrish Nurses Rest Association.

The family of Shelia Byrne RIP past chairperson of theODN section, have published her autobiography titledThe Final Journey. The ODN section are promoting thisemotional and moving book at cost e10, of whichproceeds go to the National Hospice Foundation. Thebook can be obtained from Kathy Foy Newman of theINO.

European Operating Room Nurses Association(EORNA): Working very hard as ambassadors of IrishODN nursing are our two representatives on the


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Annual Report 2005

EORNA board at present – Anne O’Brien, UniversityChildren’s Hospital Temple Street Dublin and CarolineHiggins, St Vincent’s University Hospital, Dublin. TheEORNA board meets twice yearly and the officiallanguage is English. More information can be obtainedon www.eorna.org.

EORNA Congress 2006: The INO ODN Section will hostthe Fourth European Operating Room Congress inDublin in May 2006 and work is well underway tomake this congress the most memorable one to date.The scientific programme features many Irishperioperative nurses as speakers.

The theme of the congress is Perioperative Care: Onthe Shores of Excellence and we hope to attract inexcess of 2,500 delegates from all over the world.Anne O’Brien, chairperson of the organisingcommittee, and Caroline Higgins, member of theorganising committee, are working extremely hard forthis congress and more information is available onwww.eornac.ie.

I look forward to the year ahead and hope to meetmany new section members over the next fourmeetings.

Orthopaedic Nurses SectionThis group was established in 2005 to provide a forumfor orthopaedic nurses to network, to exchange practiceinformation and to promote education events relevantto this specialist area. Its main objectives are to:

• Protect and promote the professional interests ofmembers

• Meet twice yearly (once in Dublin and to rotate thesecond meeting to various areas around the country)

• Network with colleagues locally/nationally/internationally

• Promote study days/conferences

• Provide financial assistance to attend conferences/study days

• Present/discuss pertinent research relevant toorthopaedic nursing

• Promote developments in orthopaedic practicenationwide

• Establish links with other areas of interest, eg.rheumatology, rehabilitation, Irish Nurse PracticeDevelopment Association.

It is open to all nurses who are engaged in orthopaedicnursing and/or any related speciality, as well asmembers who have an interest in orthopaedicsirrespective of their work location. In our first year wehave concentrated on promoting the section at variousorthopaedic conferences that took place through outthe country (Dublin, Galway and Limerick) anddeveloping the information on the web page.

We plan, with the offer of a bursary, to encouragenurses to attend the RCN Society of Orthopaedic andTrauma Nursing to network with colleagues, exchangeinformation and feedback to colleagues here in Ireland.In 2007 we plan to encourage nurses to travel toAmerican Orthopaedic Nurses Conference.

Overseas Nurses SectionThe Overseas Nurses Section continued to becomeone of the most active and dynamic sections of theINO in 2005. Though more focused on socio-culturalissues like migration, cultural diversity and equality asa group, individual members were encouraged toactively participate at their local branches on particularindustrial issues. This is evident in the increasingnumber of overseas nurses participating in INOmeetings and conferences held around the country asbranch representatives.

The year 2005 saw the publication of two importantgovernment documents that would have significantimpact on the integration of overseas nurses in Irishsociety. The Proposed Immigration and Residency inIreland was generally welcomed by the sectionalthough concerns were raised on the increasedministerial discretions and secondary legislationalluded to in the bill. The section responded to thisproposal after thorough and careful examination andparticipating in debates and conferences organised bythe Immigrant Council of Ireland, Migrants InformationCentre, NCCRI, Law Society of Ireland and other NGOs.

The publication of the Employment Permits’ Bill,however, caused more alarm for overseas nursesbecause of the obvious inadequate discussion about it.Though the bill proposes a ‘green card system’, acloser look suggests that it lacks certain elements to beon par with the known green card system in othercountries like America. There is also increasingambivalence due to the ‘two-tier’ system created byproviding more opportunities for high skilled workerslike nurses, and limiting workers in the low skillscategory.

Attendees pictured at a lively Overseas Nurses Section meeting at the INO CorkOffice


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The section also participated in numerous researchstudies conducted in relation to migration andintegration. Notably a research exploring theexperiences of overseas nurses recruited in the Irishhealth service, conducted by a member of the section.Other research examined the participation of migrantwomen, including nurses, in the Irish labour market.The completion of the documentary South Circular,conducted and produced by DIT’s Centre forTranscultural Research and Media Practice, willhighlight the section’s political participation within theINO and in Ireland. These studies, and other researchconducted in relation to migrant workers, willhopefully bring more evidence and practice basedapproach on labour migration in Ireland.

The ‘brain drain’ phenomenon, the large scalemigration of high skilled professionals from lessdeveloped to developing countries without significanteffect on remittances and transfer of knowledge ortechnology, has become a major socio cultural andpolitical issue globally. The section activelyparticipated in discussion and debates exploring thisphenomenon at international level (eg. experts’roundtable discussion on the mobility of healthcareworkers organised by Oxford University andGeorgetown University; Parliamentarians for GlobalAction’s forum held in Dublin).

In Ireland, however, the concept of ‘brain drain’ stillremains to be an issue confined within the academicfield. Though more research is needed to explore thisphenomenon, the INO is in a pivotal position to initiatediscussion and debate exploring ‘brain drain’ and onhow the Irish government could positively respondand deal with it.

Other issues that dominated the overseas nursessection’s meetings held in Dublin, Cork and Limerick in2005 are the chronic understaffing particularly inprivate nursing homes, the perceived lack ofpromotional opportunities for overseas nursesespecially in the learning disability sector and bullyingand discrimination in the workplace. The election ofnew officers for 2005-2007, during the annual generalmeeting in November, proved that the section willcontinuously address these issues.

Practice Nurse SectionThe year began with the publication of the surveyreport undertaken by the INO at the end of 2004, whichhighlighted areas of concern for GP nurses. Thissurvey was distributed to 500 practice nurses andthere was a 25.8% response rate. The main areas ofconcern were, as usual, pay and conditions, in additionto the lack of access to a public pension scheme. Themajority favoured a change from private to publicsector employment and the main reason given wasaccess to superannuation and standardisation of pay.

With this in mind efforts were increased to set up a

meeting with the Department of Health and Childrenwith a view to discussing the possibility of includingGP nurses in the Department of Health and Childrensuperannuation scheme. After two postponements thismeeting took place in August. Dave Hughes, BernaRackert and Mary Cashen met with representatives ofthe Department of Health and Children.

While sympathetic to our cause they were emphaticthat they were not in a position to change it. As the GPis the employer they maintained that any negotiationswould only be conducted with the GP. They did makereference to the GMS review, but it was unclear howthe INO could become involved with this process.Dave Hughes recommended the following options:

• That claims be lodged with GP employers andactively followed up in a way that would cause themto have the matter dealt with by the ICGP

• That simultaneous claims be lodged with the ICGP

• That we lodge a claim with the HSE for the inclusionin one of the existing superannuation schemes.

This issue remains high on our agenda.

In October a motion was successfully taken to theIPNA conference calling for greater collaborationbetween the Practice Nurse Section and the IPNA.Following this a letter was sent to each IPNA branchrequesting that two link people be selected, one ofwhom would attend the section meetings to reportback to the branch. Also as chairperson of the section,Mary Cashen will be accepting an invitation to the INOto attend the IPNA executive council meeting to reportand discuss further collaboration between the twogroups.

At our section meeting held in August the necessityfor a job description to enable us to move forward witha tiered pay scale was discussed. It was brought to theattention of the chairperson that Ruth Taylor,Professional Development Co-Coordinator, was in theprocess of undertaking this task for the new bookletdue to be published by the ICGP in collaboration withthe IPNA. When this is available it will be a tool to helpus move forward with this issue.

Public Health Nurse Section2005 was a disappointing year as An Bord Altranaischanged the rule for entry into public health nursingand the Minister signed it off. Since then many lettersand meetings have resulted in the involvement of theINO in the steering committee set up by An BordAltranais to oversee a full consultative process arisingfrom the rule change. Indeed the issue of themidwifery qualification as a requirement for entry intothe PHN diploma programme may be part of thisconsultative process.

The clinical nurse specialist grade still awaits thecourt’s hearing and outcome. There is progress on the


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advanced nurse practitioner and the INO will belaunching an information booklet on what steps arerequired to become an advanced nurse practitioner.However, to date, it is hard to attain this grade in publichealth nursing.

There are still a large number of vacancies in publichealth nursing with no end in sight. The workload isincreasing with elderly clients wishing to stay at homeand requiring much needed care, resources andinterdisciplinary input which does not appear to bethere. Birth rates have increased and many of thesebabies are born to non-nationals who need a lot oftime and input to develop and build up a relationshipbased on trust. We, as public health nurses, areinvolved in many other activities which help build upthe supports within the family. We are very active inpreventing child abuse and neglect by home visits andoutreach work that we do on a daily basis. We areinvolved with school health as well as ourgeographical day to day work.

Issues requiring attention are:

• Large number of patients are being discharged dailyfrom the hospitals with multiple needs

• Still no IT facilities or clerical supports and no tools tocarry out child assessments

• Health centres are not up to standard.

Rehabilitation Nurses Section

Formed in 2002, this section, recognising the diversityof the rehabilitation area, has extended membershipto all nurses working in any area of rehabilitationservices. There were five meetings held in 2005 one ofwhich was the running of a most successful workshopwhich attracted a substantial attendance. The contentof the workshop included the following topics:

• Role of the rehabilitation nurse

• Community disability services

• The rehabilitation continuum

• Therapeutic recreation

• Developing political awareness.

The members of the section, at their AGM inDecember, took the decision to alter the structure oftheir section meetings. They now plan to meet for fulldays, and not just for two hours.

They felt that more work could be achieved in this way.They will not meet as often during the year. It is alsothe section’s objective to promote rehabilitation ingeneral hospitals in the coming year.

RNID Section The year draws to a close with little progress made ona number of issues affecting RNIDs. The specialworking group met only once and that was in April2005. Little progress has been made on professionalissues, a number of which remain outstanding sincethe membership rejected the earlier report. Theseinclude:

• The reporting relationship of the registered nurse

• Scope of practice/delegation of tasks, such as theadministration of medication

• Role of the RNID in the education of the severe andprofoundly intellectually disabled person

• Greater clarity on the introduction of CNS poststhroughout the ID sector.

Scope of Practice: It was clear that this issue could notbe addressed without clarity from An Bord Altranais. Todate no meeting has taken place between workinggroup members and An Bord Altranais despite thechairman, Michael Bruton, indicating that the issuesraised could not be further addressed in the context ofany revised report, without clarity being given on anumber of issues by An Bord Altranais.

Clinical Career Pathways: No meeting has beenconvened with the National Council for theProfessional Development of Nursing and Midwiferyon the need to review the criteria which leads to theestablishment of CNS and ANP posts in the ID sector.To date there are only 117 CNS in the ID sector, not allof which are full time posts.

Role of the RNID in the education of the severe andprofound person with an intellectual disability: Ameeting did take place between the INO, theDepartment of Education and Science and theDepartment of Health and Children. Agreement wasreached to undertake a review, which will involve a fullanalysis of the programme of education followed bythe RNID student within the degree programme. Thisreview will demonstrate the expertise of the RNIDs andthe critical role they should play in the area ofeducation.

The organising committee for the Rehabilitation Nurses Section workshop (l-r):Betty Hillary, vice secretary; Eva Wallace, secretary; Mary Seymour, IrishWheelchair Association; Trish Cormack, vice chairperson; Ann Prescott,chairperson; Fanchea McCourt, education co-ordinator, NRH; and St EileenCrowley


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Work is also ongoing within the section on a paperExploring the Role of the RNID Working in theEducation and Development of Children/Adolescentswho have a Severe/Profound Intellectual Disability. Ameeting of this group will be reconvened in the NewYear.

There was also much discussion on the An BordAltranais rule change, which would allow access byany registered nurse to the higher diploma in publichealth and having completed the mother and childmodule be eligible for employment as a PHN.

The majority of RNID members at the Septembersection meeting, while welcoming the change of entryrequirements into the higher diploma in public health,welcome a career pathway which would lead to a‘specialist’ PHN/community nurse role, providing aservice to our population of people with an intellectualdisability, 61.9% of whom live at home accessingcommunity services.

At ADC a number of concerns were raised regardingthe erosion of the role of the RNID and the unsafepractices of non nursing staff administeringmedication. These issues were raised by ExecutiveCouncil members with the Nursing/MidwiferyEducation and Nurse Practice Committee section ofExecutive Council. Annette Kennedy, Director ofProfessional Development, brought these issues to theattention of Eugene Donoghue, Chief Executive Officerof An Bord Altranais. We await the outcome.

The Special Delegate Conference held in Croke Park inSeptember, saw a decision made by delegates not toenter into a second benchmarking exercise as theterms of reference had failed to address our issues.

The priority status of Labour Court recommendations17805 and 17526, which dealt with the pay anomaly,claims for a 35 hour working week, improved shiftallowances and a Dublin weighting allowance. Alleight of our claims have been lodged with theemployers and we look forward to seeing an end tothis anomaly in 2006.

School Nurses Section Following the AGM last year we met in February 2005where Christine Meredith spoke to us on thepossibilities of developing a diploma for ourspecialism.

Her proposal would involve covering one subject on adiploma course. However we would like to haveseveral modules encompassing a broad spectrum ofour daily dealings, ie. sports injuries, counselling,pharmacology, pastoral care, etc. We agreed thatmembers of the section would research severaldifferent topics for this initiative.

We were delighted to have our first article published inthe World of Irish Nursing and Midwifery during thesummer. Well done to Julie McTiernan for getting the

ball rolling. It is the section’s aspiration that we willhave more contributions for the magazine this comingyear.

Irene Henebry has been working hard behind thescenes to produce a ‘poster presentation’ inNovember.

Student Section The national Student Section has seen a veryproductive year. The first initiative was an on-linestudent nurse questionnaire which is hosted on thehome page of www.ino.ie. This questionnaire hasreceived hundreds of hits from students across thecountry. Its main aim is to attract some comments,ideas and thoughts from the student nursemembership with regard to the services that theOrganisation provides and, more importantly, theirviews on how the section could be developed andenhanced.

In June the national student officers were afforded theopportunity to attend the European Nursing StudentGroup AGM in London. Student nurses from 14countries across Europe attended the meeting. Thepurpose of the meeting was to enable student nursesto come together to discuss issues relevant to theirnursing studies. The trip to the ENSG provided avaluable insight into the life of student nurses andallowed the officers to identify common positives anddifficulties experienced by student nurses on aninternational level.

The foundation was set up to promote equality and topave the way for the voice of the student nurse to beheard on a national and international level.

The Student Section met a number of times during theyear – in September in Galway, December in Dublin,and January in Dundalk. Various issues were debatedthroughout the year, amongst them the fact thatstudents going out on specialist placement duringtheir rostered year will be paid. Also registrationpapers from An Bord Altranais will be issued as soon

Student nurses protested outside St James’s Hospital over being charged forimmunisations necessary for them to undertake their clinical placements in thehospital


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as possible following final examination rather than theprevious suggestion of delaying until November, andthe ongoing issue of travel expenses and how theyvary between each HEI. A working group has beenformed from amongst members of the section to lookat this particular issue in more detail.

Surgical and Medical Day Services SectionThe aim of the section is to raise awareness nationallyof the specialised nature of day surgery

The mission statement agreed by the group was: “TheINO Surgical and Medical Day Services Section worksto provide the highest quality holistic care to patientsand carers, by encouraging high standards ofprofessionalism, by providing members withopportunities to share information, by pursuingeducational initiatives and by striving to achievecentres of excellence.”

The objectives are as follows:

• To establish INO national standards for surgical andmedical day services by developing best practicenational policies and guidelines

• To establish competencies for all areas of practice

• To formulate generic patient information leafletssuitable for use in all units using a standardisedformat

• To share information of mutual interest

• To campaign nationally on issues of joint concernrelated to day surgery

• To network and form links nationally andinternationally.

Future Plans

• To complete drafts of guideline documents

• To hold a national conference on day care late nextyear

• To develop web site

• To recruit more day care units.

Telephone Triage Nurses SectionOver the past 12 months the Telephone Triage Sectionhas accomplished a great deal. The first meeting inFebruary 2005 was held in Limerick. We had a greatattendance with representative from seven of the co-operatives nationally. Alva Barry gave an excellent talkfrom Shannondoc on “Eye problems in the out ofhours setting”. From this meeting a subsection wasformed for the co-operative clinical nurses thus

enabling them to partake in the educationalcomponents of the telephone triage section.

Mary Reddington and Rita Corcoran both fromWestdoc went forward to represent the section at theADC in Killarney. They brought forward our motionwhich was passed at conference. This motion asked theINO “to pursue real links with appropriate highereducation institutes who would facilitate or provideformal post registration education for all primary carenurses inclusive of telephone triage nurses”.

Breege Clarke and Geraldine Byrne from Caredoc, attheir own expense, also attended ADC in order tocirculate information at the conference on the role ofthe telephone triage nurse and to make our colleaguesat conference more aware of what we do.

The section held its second meeting in Thurles on 24May 2005. Paul Luck from Southdoc gave a veryvaluable take and updated the group on childhoodvaccinations. At this meeting a steering committeewas formed to look at what the educational needswere for section members and to look at ways ofmoving these needs forward. This steering committeewas spearheaded by Fiona Kennedy from Caredoc.

The National Telephone Triage Conference was held inSeptember in Tullamore. The conference was superblyattended with 88 attendees.

The section’s AGM was held in INO Cork and again wehad a large attendance. Dr Jerry McCarthy, accidentand emergency consultant in CUH, gave a talk on‘Paediatric Emergencies and the Challenges facing theTelephone Triage Nurse’. Following positive feedbackfrom the national conference it was decided to run asimilar conference in 2006.

The section was saddened when section secretary,Mary Guerin-Lavin, stepped down though we weredelighted to welcome Camilla O’Donoghue fromShannondoc into the position.

At the Telephone Triage Nurses Section first annual conference were (l-r): MaryGuerin-Lavin, Section secretary; Margaret Curran, vice chairperson; and DorcasCollier-Hannon, chairperson


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A&E

The year began with the A&Ecrisis worse than ever and theINO was constantly in the media,both print and broadcast. Thehighest ever number of patientson trolleys was recorded on 12January 2005 (422) and LiamDoran called on the LRC toconvene an emergency meetingof the A&E Forum. Articlesquoting the general secretaryappeared in numerous papers on

13 January 2005 including the Irish Independent –Empty beds unused as 422 stuck on trolleys.

Following an eight hour emergency meeting of theA&E Forum on 17 January 2005 the INO warned that“members would have to consider taking industrialaction if action to deal with the A&E overcrowding wasnot taken immediately” under the heading A&E crisis:surgery to be deferred (Irish Examiner, 18 January2005).

Western IRO Noreen Muldoon speaking about the A&Ecrisis in Galway said “If a patient is waiting for a bed inA&E, that means the patient is not getting the propercare and attention he/she would get in a ward wherethey would have a comfortable bed and access to abathroom…it is an affront to their dignity” Nursesleader seeks meeting in Galway hospital beds crisis(Galway City Tribune – 21 January).

In an article in The Kingdom (25 January 2005)Hospital may be forced to cancel some admissions –IRO Michael Dineen said “the accident and emergencyunit is too small to cope with the influx of patients andthe situation is very demanding on staff.”

On 3 February 2005 members of the INO A&E NursesSection met to review the on-going crisis and voted tobegin lunchtime protests outside affected hospitalssubject to sanction by the Executive Council.

In the Evening Echo (11 February 2005) IRO Patsy Doylesaid “Many of our staff are facing burn-out” under theheading Hospital plan has ‘failed to deliver’.

Wexford General Hospital also hit the headlines inFebruary when a huge public meeting was held on StValentine’s night to discuss proper facilities at thehospital. Speaking about understaffing at the Hospital,IRO Claire Mahon was quoted under the heading Areyou listening Minister Harney in the Wexford Peopleand the Gorey Guardian (16 February). She said: “Forareas like Wexford to attract nurses is very difficult.Because of the staff ceiling they cannot offer thempermanent positions”.

Meanwhile many stories were reported in the papersof patients languishing in A&E departments, eg.Drogheda Independent (4 March 2005) under Casualtycrisis forcing local patients to Newry – Tony Fitzpatricksaid “the situation is only going to get worse unless

there is major investment” and the Evening Herald (8 March 2005) Catalogue of human misery as A&Enightmare worsens – Edward Mathews was quoted“the staff felt they were working in conditions akin toan overburdened field hospital”.

At the March meeting of the Executive a decision wastaken to begin the protests. The campaign was named‘Enough is Enough’ and this was widely covered in themedia over many weeks. David Hughes was quoted inthe Irish Times (23 March 2005) – “Aside from singinga mantra that the Tanaiste’s 10 point plan will solve theproblem, there was no real evidence of priority actionon the A&E issue”.

The INO identified a large number of beds which couldeasily be refurbished and opened – Irish Independent(27 April) – Over 100 beds lying empty in midst ofcrisis, nurses claim – Dave Hughes, deputy generalsecretary blamed “a bureaucratic black hole” for the“failure of the Health Service Executive to come upwith funding promised to staff the beds.” TheOrganisation called on the Taoiseach to intervene butin an article in the Irish Times (27 April) under theheading Taoiseach rules out personal role in A&Es hesaid “The Government as a whole worked on theissue. Everybody is involved”.

However, we read in the Irish Independent on thefollowing day Harney to brief FF on health servicestrategy. In the same article the Taoiseach said that“the Government needed the goodwill of theapproximately 1,000 nurses who work in A&E toextend rosters and examine the situation during thebusy periods.”

A&E nurse Alan O’Riordan was quoted in the IrishDaily Mirror (26 April) under the heading I’ve beenpunched, shoved, spat on and verbally abused –“Because people’s lives are in our hands we keepgoing but we can’t physically stretch any more or wewill snap”.

In the run up to our Annual Conference the Irish Times(30 April) reported on an Initiative to move A&Epatients into wards which said that “the HSE wouldwrite to hospital managers instructing them to movepatients from trolleys into additional beds to be placedin existing wards”. Liam Doran in the same article“accused the HSE of seeking to hide the extent of theproblem”.

Next we read in the Irish Examiner (2 May) that –Nurses may lose pay increases – Liam Doran said “Weview it as being a retaliatory strike arising from theA&E protest”. In the Irish Examiner (3 May) under theheading Nurses claim threat to pay rise linked toprotests – Dave Hughes said “It is a spurious attemptusing a trumped-up charge to deprive 30,000 people oftheir pay increase”. In the Irish Times (3 May) under theheadline Harney to warn on health sector dissent –Liam Doran warned “that if the pay increases werewithheld, it would have national repercussions andcould lead to industrial action”.

Press and Media

Ann Keating,Media Relations Officer, INO


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Annual Delegate Conference

The Organisation’s issues were very well covered overthe days of conference both nationally and locally.Claire Treacy, Social Policy Director was quoted in theIrish Examiner (3 May) regarding the launch of aposition paper at the Annual Delegate Conferenceunder the headline – Nurses seek protection forwhistleblowers – when she said “Nurses/midwivesand other healthcare employees should be able tospeak out to their employers without fear of reprisalwhen practices, which are of concern, are found to betaking place or have occurred.”

Some of the headlines which emanated from theconference were as follows: Evening Echo (4 May) –Nurses call for units for sick kids; Irish Independent (5May) – Nurses ‘targeted for highlighting crisis in A&EUnits; Industrial Relations News (5 May) – Healthemployers threaten to withhold pay rises for 30,000nurses; Irish Examiner (5 May) – Nurses’ pay claimvote could lead to industrial action; Kerry’s Eye (5 May)– Harney to face heat in Killarney. Other headlinesincluded – Irish Times (6 May) – INO mandated to takeaction to get June pay rise; Irish Independent (6 May)– One in 10 patients pick up a new infection.

Gearing up for strike action following threatby HSE to withhold pay increases

After our annual delegate conference we geared up forstrike action following the threat by the HSE not to payincreases due to nurses on 1 June 2005, because ofalleged non cooperation with the introduction of thehealthcare assistant grade. In the Irish Times (13 May2005) – 31,000 nurses preparing to go on strike nextmonth – Liam Doran said “members had identifieddifficulties ‘on professional, legal and ethical grounds’with healthcare assistants doing this work, and hadsought talks with all regulatory bodies andstakeholders to air their concerns. Their request hadbeen refused.”

On Wednesday, 25 May 2005 the INO issued a pressrelease stating that the Organisation withdrew thethreat of industrial action following a meeting with theNational Implementation Body. This was carried in TheSun (26 May) – Nurses end pay threat where DaveHughes said “This was never a matter for railroadingby the employer”.

A force to be reckoned with…

Elsewhere in the news research done by Media Marketshowed that the INO out performed all otherstakeholders including the Minister for Health andChildren, the HSE, the IMO, the IHCA and the Healthand Safety Authority in relation to media coverage ofthe A&E crisis. In the Irish Independent Business (12May 2005) under the heading Harney the casualty asnurses’ A&E campaign makes deepest PR cut –Michael Farrelly, managing director of Media Marketsaid: “The INO has proved it is a force to be reckoned

with when it comes to media performance”. He alsocalled the trolley watch campaign “priceless”.

Trolley Watch

Meanwhile, as the Organisation continued to distributedaily trolley figures which were regularly mentioned inpapers all over the country, the HSE announced a fallin the numbers of people on trolleys in May – IrishIndependent (16 May 2005) Fall in A&E patients ontrolleys ‘a PR exercise’. Liam Doran said “if the HSEspent more energy on the issue than on PR everyonewould be better off”.

The A&E trolley numbers showed no sign of thetraditional drop during the summer months. The e70million package announced by Minister Harney inNovember was announced again in June but reducedto e63 million. In The Sun (13 June 2005) – HealthService gets e63 million – Dave Hughes said: “Part ofthat announcement is the transition unit in the Mater.Why wasn’t the money given to them in January?There has been an awful lot of misery for the poor oldpatients and staff in the Mater from January to now.”

Care of the Elderly

In the aftermath of the Prime Time Investigatesprogramme on Leas Cross Nursing Home the INO wasquoted in the Irish Times (1 June 2005) – Plans forindependent body to take months – “The INOcondemned the conditions highlighted on theprogramme as ‘disgraceful and indefensible’ and saidit feared this might not be an isolated incident.”

In a story in the Irish Examiner (26 July 2005) – Angeras elderly patients put to bed before 4pm – NoelTreanor said: “Eight of the residents have to go to bedby 4pm each day in order to sustain the level of work”.

Care of the elderly was in the news again in earlyAugust when the INO called for an immediate reviewof staffing levels and conditions of accommodation forelderly citizens who are being looked after by the State– Irish Examiner (5 August 2005) – Lack of Nursinghome staff ‘ignored by Government’ – Phil NiSheaghdha said: “Almost seven years after this

Nurses and midwives were joined by patients and their families on the first day ofthe ‘Enough is Enough’ campaign


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recommendation was issued by the Commission onNursing the issue remains as urgent as it did then”

Nurse Patient Ratios

President Madeline Spiers in a letter to the editor –Irish Examiner (31 August 2005) – Emergency Call: weneed more nurses per patient – said: “Mandatednurse/patient ratios have a critical role in the provisionof safe levels of care in our hospitals”.

Appointment of Professor Drumm

The INO welcomed the announcement of ProfessorDrumm as the new chief executive officer of the HSEand the story was carried in the Echo – Tallaght (23June 2005) – Drumm will bring ‘dynamic leadership’ toHSE – Tanaiste – Dave Hughes, welcoming theappointment said: “Irish nurses and midwives want tobe part of developing a people centred, equity-basedhealth service and feel their input is vital at all levels ofstrategic planning”.

Early in September we read comments from ProfessorDrumm that there was no quick fix solution to the A&Ecrisis and that in fact it would take up to two yearsbefore it would be resolved. In an article in the IrishTimes (14 September 2005) – Drumm sets out stall onfuture for hospitals – “The INO expressed concern thatit could take another two years to improve the A&Esituation and claimed Ms Harney’s plan was notworking”. In the Irish Examiner on the same day –Drumm unfazed by the challenge – when speakingabout his future plans Professor Drumm said: “I canabsolutely put my hand on any book and say I’mtotally committed to the development of nursing. I sawnursing as being the engine that was always going todrive the health services forward”.

Monument to waste

In the Longford News (14 September) – in a story on alarge protest regarding the lack of progress on openingPhase 2B of the Longford/Westmeath Hospital whichhas been built but lying idle for years – Thousandstake to the streets to protest over hospital delays –IRO, Kevin O’Connor “described the ‘shelled out’building as a monument to waste and that the publicshould “stand up and insist that it be provided andprovided now”.

Special Delegate Conference

Much space was given over a few days to the specialdelegate conference in September including – the IrishExaminer (28 September 2005) – Nurses break frombenchmarking body – Dave Hughes said “theorganisation now felt it was better off on its own inmaking the case for better pay and conditions for theirmembers.” Also in the Examiner – A&E campaign to bestepped up – Liam Doran said we “could not allownurses and patients to wait at least another two yearsbefore the situation was addressed.”

PPARS

In early October the PPARS (Personnel, Payroll andRelated Systems) debacle, which had cost the taxpayere150m, was all over the news when Professor Drummcalled a halt to its roll-out pending a complete review.In the Irish Examiner (5 October 2005) An unhealthystate of affairs – The INO described it as “an‘unstoppable’, out of control project which tookprecedence over all other issues, including patientcare”.

Student nurses protest in St James

Sixty first year student nurses staged a sit-in followedby a demonstration at the gate of St James’s HospitalDublin against a charge of e100 for immunisationahead of their six week unpaid placement with thehospital. Nurses protest against e100 charge IrishTimes (22 October 2005) – Phil Ni Sheaghdha said“These student nurses are the future of nursing inIreland.”

In the Examiner on the same day – Student nurses endprotest over immunisation charges – the sit-in endedas the hospital agreed to proceed with theimmunisation but still insisted that the students beinvoiced for the cost.

National Conference – Mullingar

The national conference in Mullingar on 26 October2005 was well covered in the papers. HSE chief favourspublic system for healthcare Irish Times (27 October2005) – Professor Drumm addressing the conferencesaid “I really believe healthcare should be provided inas many facets as possible through the publiclyprovided system.”

Nurse prescribing – Good news at last

In the Irish Independent (27 October 2005) – Nursesgiven the green light to prescribe drugs – Ms Harneysaid “she would push to have the necessary legislationby December, with regulations to follow next yearoutlining the scope of such prescribing.”

Hygiene Audit

Named and Shamed: Ireland’s dirtiest hospitals – wasthe headline in the Irish Examiner (4 November 2005)– following the publication of the findings of theHygiene Audit. Dave Hughes said “memberswelcomed the audit’s findings. If the next report is asbad as this one, we will all have a lot to answer for.”

Assaults

In all the papers on 11 November 2005 we read of thevicious attack on a nurse in St Vincent’s Hospital,Dublin. Philip McAnenly said in the Daily Star – “Thisepisode highlights the unsafe environment that ourmembers are being exposed to on a regular basis”.


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New Galway Office

The Irish Nurses Organisation opened a regional officein Galway on 15 November 2005.

This was well covered in many of the papers includingthe Galway Advertiser (17 November 2005) – INOopens regional office in Westside – Liam Doran said

“The Galway office will serve as a hub providingindustrial relations, educational and training servicesin the area”.

Privatisation of the Health Service

In a story in the Medicine Weekly (30 November 2005)on a conference regarding privatisation of the healthservice – Medical groups call a halt to creepingprivatisation – Madeline Spiers said “We would be farbetter, as a society, to invest in public beds in publichospitals.”

Same old story at the end of the year…

In a story on overcrowding in Limerick Regional A&Edepartment written in the Limerick Post (3 December) –Nurse shortage compounds A&E crisis – Mary Fogartyexplained that “despite requests from INO members toopen the overflow unit, this has not taken placebecause they have been told that there are no nursesavailable.”

The INO once again called for emergency funding forthe A&E crisis ahead of the Budget – Irish Times HealthSupplement (6 December 2005) – A&E overcrowdingat crisis level, says INO – Liam Doran said “Thisfunding can be used to open available beds and toestablish minor injury clinics in other health facilitiesin major urban areas.”

Above is just a small sample of the coverage affordedto the INO over the last 12 months. INO officials andactivists also gave numerous interviews on nationaland local radio and also on TV during the year.

Opening the INO Regional Office in Galway were Mayor of GalwayCity, Cllr Brian Walsh, and INO President Madeline Spiers (right).Theyare pictured cutting a celebratory cake made by INO member MaryBarrett, from Ballinasloe


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The INO is affiliated to the following bodies:

National• Irish Congress of Trade Unions• Economic and Social Research Institute• Irish Society for Quality in Healthcare• Mental Health Association of Ireland• Inclusion Ireland (formerly National Association for

Mentally Handicapped – NAMHI)• National Women’s Council of Ireland• Institute of Public Administration• Irish Association for Industrial Relations• Irish Labour Society• Health Informatics Society of Ireland.

The Organisation also sponsors the Open UniversityProgramme at the National College of Ireland, andcontributes to the Economic and Social Research FundRaising Campaign.

International• International Council of Nurses (ICN)• Nursing and Midwifery Forum of the World Health

Organisation (WHO)• European Federation of Nurses Associations (EFN)• European Midwives Association• The Midwives Section of the INO is affiliated to the

International Confederation of Midwives (ICM)• The Operating Department Nurses Section is

affiliated to the European Operating Room NursesAssociation (EORNA)

• The Occupational Health Nurses Section is affiliatedto the Federation of Occupational Health Nurses inthe European Union (FOHNEU)

• European Healthcare Management Association• Workgroup of European Nurse Researchers (WENR)• American Nurses Credentialing Centre (ANCC)

International Advisory Council

INO Representation on IrishCongress of Trade Unions andOther Bodies• ICTU Executive Council

Liam Doran, Clare Treacy• ICTU Public Services Committee

Madeline Spiers, Liam Doran, Dave Hughes, PatsyDoyle, Phil Ni Sheaghdha, Philip McAnenly, MaryFogarty, Tony Fitzpatrick, Michael Dineen, EdwardMathews, Liz Curran.

• ICTU Equality NetworkClare Treacy

• ICTU Third World CommitteeLiam Doran

• ICTU Youth CommitteeEdward Mathews (Chairperson)

• ICTU Women’s CommitteeMadeline Spiers, Clare Treacy (Secretary)

• ICTU Health and Safety CommitteeCatherine Samuels

• ICTU Disability CommitteeCora McGrath, Noreen Muldoon

• ICTU Retired Workers CommitteePeg Nealon

• ICTU Representatives on the followingBodies/CommitteesThe Women’s Health Council – Clare TreacyNUI Maynooth – Annette Kennedy

Other Bodies/CommitteesNational

• National Council for the Professional Developmentof Nursing and MidwiferyNine INO members are on this Council

• Monitoring Group – (for the implementation of theReport of the Commission on Nursing)Madeline Spiers, Deirdre Daly, Liam Doran, David Hughes

• Office for Health Management(Professional Development for Nurse Management)Annette Kennedy

• National Implementation Committee –Midwifery/Children’s NursingUndergraduate degree programmeLiam Doran, Denise Lawler, Sara Raftery

• High Level Group – Role of the Healthcare AssistantMadeline Spiers, David Hughes, Annette Kennedy

• European Working Time Directive – NIG MedicalLiam Doran

• European Working Time Directive – Nursing andMidwifery Expert GroupLiam Doran, David Hughes, Phil Ni Sheaghdha, Joe Hoolan, Jo Tully, Teresa Hayes

• National Women’s CouncilMadeline Spiers, Bernie Smyth

• Comhairle na nOspideal Anne Cody• Inclusion Ireland (formerly National Association for

the Mentally Handicapped of Ireland – NAMHI)Marie Gilligan

International• ICN Council of National Representatives

Madeline Spiers, Annette Kennedy• ICN Remuneration Network

David Hughes• European Federation of Nurses Associations (EFN)

Annette Kennedy (President 2005-2007)• European Midwives Association

Deirdre Daly (President 2005-2009)• European Forum of National Nursing and Midwifery

Associations and WHOMadeline Spiers

• American Nurses Credentialing Centre Advisory Body

Affiliations


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Benevolent FundThe Finance and General Purposes Committee, and/orthe President and General Secretary, continued toauthorise payments from the INO Benevolent Fund tomembers, and retired members, who find themselvesin difficult situations.

The Benevolent Fund is primarily funded by incomegenerated from the Organisation’s affinity partnershipswith different commercial companies. In return foraccess to our membership, for the purposes of offeringservices at competitive rates, these companies makepayments to the Benevolent Fund arising from thegenerated.

In 2005 contributions were, in this context, receivedfrom the following:

• Friends First Finance Direct (preferential loans) –e22,000

• MBNA (affinity credit card) – e9,250

• HMCA (health insurance) – e19,600.

Educational Loan FundThe Organisation continued to grant interest-freeloans, in accordance with the regulations of the fund,to members in 2005. The Organisation believes thatthis investment is of major significance in the ongoingdevelopment of the nursing and midwiferyprofessions.

Irish Nurses Rest AssociationTwo members, from each of the following, arerepresented on the committee of the Irish Nurses RestAssociation:

• Irish Nurses Organisation

• Irish Guild of Catholic Nurses

• Association of Irish Nurses Managers

• Superintendent Public Health Nurses Association.

Winifred Collier and Jo Tully Executive Council,represent the INO.

The Association is open for applications fromnurses/midwives in need of convalescence or aholiday, for a limited period, who are unable to defrayall the expenses they may incur, or for the provision ofgrants to defray other expenses incurred in thepurchase of a wheelchair or other necessary medicalaid.

Publications

The World of Irish Nursing and Midwifery(WIN)

The World of Irish Nursing and Midwifery (WIN), the

official journal of the INO which is published monthly,aims to cover a wide range of issues of interest to Irishnurses and midwives. This includes industrial relationsnews and ongoing developments within the INO,general nursing/midwifery news, profiles,international news, features about innovation innursing/midwifery, clinical articles, education andresearch.

The journal also has an expanding classifieds sectionwith nursing recruitment advertising and acomprehensive diary of events. Forthcoming coursesorganised by the Professional Development Centre arefeatured each month.

The journal is produced in a full colour A4 format andis posted to members’ preferred addresses. Itcontinues to go from strength to strength and thefeedback from the membership remains very positive.

The journal welcomes ideas and suggestions forarticles and the editorial team at MedMedia isavailable to discuss these in detail with members.

Circulars

In addition to WIN, regular circulars to branch officers,section officers and nurse representatives were issuedfrom the General Secretary and the officials to ensurethat members were fully briefed on issues as theydeveloped, during the year.

Government Departments/Other BodiesWe would like to formally thank the Tanaiste andMinister for Health and Children, the Ministers ofState, and the officials of the Department of Health andChildren, for the courtesy shown to us during a verychallenging year of negotiations and discussions.

We would also like to thank the newly establishedHealth Service Executive, and the Health ServiceExecutive – Employers Agency, for numerousengagements during the year, and we look forward toworking constructively with them in the years ahead.

Our thanks is also due to officers of An Bord Altranais,the National Council for the Professional Developmentof Nursing and Midwifery and the Irish Congress ofTrade Unions.

We also wish to express our appreciation to theofficers of the Labour Court, Labour RelationsCommission and the Irish Business and EmployersConfederation (IBEC).

Finally we also wish to thank the many othergovernment departments and bodies, with whom wemet during the last year, including the Department ofJustice, the Department of Enterprise andEmployment, the Employment Equality Agency andHealth and Safety Authority.

For the Record


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Press and MediaThe Organisation continues to maintain a high mediaprofile to promote the Organisation’s policies andactivities in the media. We would like to place onrecord our sincere gratitude for the media coverage inthe last year.

Honorary OfficersIt gives us great pleasure to place on record our deepappreciation to all our honorary officers and nurserepresentatives for their talent, time and commitment,

and without whose excellent work the INO could notdevelop. To those currently in office and to those whohave now resigned we are most grateful.

A list of current officers can be found in Appendices Iand II.

INO StaffWe wish to express appreciation for the very hardwork and commitment of all of our staff, in our headand regional offices, during the year. It is greatlyappreciated.


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Appendix I: Branch Officers – Currently in Office

BRANCH CHAIRPERSON VICE-CHAIRPERSON SECRETARY TREASURER

ATHLONE Mary Nooney Teresa Guinan Patricia Hayes Joan ScanlonAthlone District Hospital Athlone District Hospital Loughloe House St Hildas M’Cap ServicesAthlone, Co Westmeath Athlone, Co Westmeath Athlone, Co Westmeath Grace Park

Athlone, Co Westmeath

ATHY/ Michelle Wall Anne Ball Philomena McNamaraBALTINGLASS St Vincent’s Hospital St Vincent’s Hospital St Vincent’s Hospital

Athy, Co Kildare Athy, Co Kildare Athy, Co Kildare

BALLINA Sheila McAndrew Mary Ita Reynolds Margaret O’Malley Kathleen SheehanBallina District Hospital St Augustine’s Welfare Home Arus Deirbhle St Augustine’s Welfare HomeBallina, Co Mayo Ballina, Co Mayo Belmullet, Co Mayo Ballina, Co Mayo

BALLlNASLOE Thomas Caulfield Bernadette Griffin Mary Barrett Mary FallonPortiuncula Hospital Portiuncula Hospital St Brendan’s Home Portiuncula HospitalBallinasloe, Co Galway Ballinasloe, Co Galway Loughrea, Co Galway Ballinasloe, Co Galway

BALLYSHANNON Valerie McGonigle Bríd Curristin Clare Harte Audrey SheerinSheil Hospital Donegal Town Community Rock Nursing Unit 2 ClyhoreBallyshannon, Co Donegal Hospital, Donegal Town Ballyshannon, Co Donegal Ballyshannon, Co Donegal

BANTRY Elizabeth O’Sullivan Aileen O’Donovan Mary O’Regan-BarsumBantry General Hospital Bantry General Hospital Bantry General HospitalBantry, Co Cork Bantry, Co Cork Bantry, Co Cork

CARLOW Carmel Shannon Ellen Burtchaell Aine Kearney Lorna ElmesCarlow District Hospital Carlow District Hospital Carlow District Hospital Carlow Emergency Carlow Town Carlow Town Carlow Town Doctor, c/o Carlow District

Hospital, Carlow Town

CARNDONAGH Maria McLaughlin Catherine McLaughlin Geraldine Diver Margaret Mary GilmoreCarndonagh Community James Connolly Centre Carndonagh Community Carndonagh CommunityHospital, Carndonagh Carndonagh Hospital, Carndonagh Hospital, CarndonaghCo Donegal Co Donegal Co Donegal Co Donegal

CASHEL (SEHB) Mary Fanning Claire Gleeson Grainne Kiely Judy LeeOur Lady’s Hospital Our Lady’s Hospital Our Lady’s Hospital Our Lady’s HospitalCashel, Co Tipperary Cashel, Co Tipperary Cashel, Co Tipperary Cashel, Co Tipperary

CASTLEBAR Regina Durcan Catherine Walsh Jacinta Flynn Mary KellyMayo General Hospital Scared Heart Home Gurteen, Ballyhaunis Mayo General HospitalCastlebar, Co Mayo Castlebar, Co Mayo Co Mayo Castlebar, Co Mayo

CAVAN Raymond Boyle Mary Angela Durkin Patricia Allen Mary C ReillyCavan General Hospital Lisdarn Hospital Cavan General Hospital Virginia Health Care CentreCavan Lisdarn, Co Cavan Cavan Virginia, Co Cavan

CLARE Mary Rowe Concepta K Lillis Oliver O’Halloran Josephine McGrathEnnis General Hospital ‘Copper Beech House’ St Joseph’s Hospital St Joseph’s HospitalEnnis, Co Clare Ballyalla, Ennis, Co Clare Ennis, Co Clare Ennis, Co Clare

CLONAKILTY/ Ann Josephine Harnedy Margaret Pat MurphySKIBBEREEN Skibbereen District Hospital Skibbereen District Hospital

Skibbereen, Co Cork Skibbereen, Co Cork

CLONMEL David Clarke Marie Corry(HSE – Sth East) South Tipperary South Tipperary

General Hospital General HospitalClonmel, Co Tipperary Clonmel, Co Tipperary

CORK HSE Julia Redmond Lorraine O’Connor Adrienne MurphyBRANCH St Finbarr’s Hospital Cork University Hospital St Finbarr’s Hospital

Douglas Road, Cork Wilton, Cork Douglas Rd, Cork

CORK Gobnait Magner Helen Carey Margaret Frahill Katherine MoylanVOLUNTARY/ Mercy Hospital Bons Secours Hospital Mercy Hospital St Joseph’s HospitalPRIVATE BRANCH Grenville Place College Rd Grenville Place Mount Desert, Lee Road

Cork Cork Cork Cork

DROGHEDA Martin Smith Kathleen Smyth Andrea McCabeOur Lady of Lourdes Hospital St Mary’s Centre Our Lady of Lourdes HospitalDrogheda, Co Louth Drumcar, Co Louth Drogheda, Co Louth


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DUBLIN EAST Madeline Spiers Marian P Hendrick Bernadette Smyth Eileen Mary KellyCOAST BRANCH St Columcille’s Hospital Mount Carmel Hospital St Columcille’s Hospital Clonskeagh Hospital

Loughlinstown Braemor Park Loughlinstown ClonskeaghCo Dublin Churchtown, Dublin 14 Co Dublin Dublin 6

DUBLIN Moira Wynne Carmel Gormally Caroline Cullen Kay O’CarrollNORTHERN Dublin City University St Vincent’s Centre Dublin City University Bon Secours HospitalBRANCH Glasnevin, Dublin 11 Navan Rd, Dublin 7 Glasnevin, Dublin 11 Glasnevin, Dublin 9

DUBLIN SOUTH Alan O’Riordan Eileen O’Farrell Norman JonesWEST BRANCH Adelaide & Meath Hospital 57 The Park, Kingswood St James’s Hospital

Tallaght, Dublin 24 Heights, Tallaght, Dublin 24 James’s St, Dublin 8

DUNDALK Geraldine McCabe Colette Vize Anne E GilliganLouth County Hospital Louth County Hospital Louth County HospitalDublin Road Dublin Road Dublin RoadDundalk, Co Louth Dundalk, Co Louth Dundalk, Co Louth

GALWAY Ann Martin Maureen Lydon Mary P Burke Mary Esther WalshGalway University College St Francis Nursing Unit Galway University College Bon Secours Private Hospital, Newcastle Road Newcastle Hospital, Newcastle Road Hospital, RenmoreGalway Co Galway Galway Galway

KlLDARE/NAAS Margaret Armstrong Mary P Coonan Derek Reilly Edwina Elizabeth WeirNaas General Hospital Naas General Hospital Naas General Hospital Naas General HospitalNaas, Co Kildare Naas, Co Kildare Naas, Co Kildare Naas, Co Kildare

KILKENNY Olive Cullen Helen Butler Margaret Dalton Martina McCormackSt Patrick’s Centre St Luke’s General Hospital Kilcreene Orthopaedic St Patrick’s CentreKells Road, Kilkenny Kilkenny Hospital, Kilcreene Kells Road, Kilkenny

Co Kilkenny

KILLARNEY Shelia Dickson Mary Joy Nora Deirdre Buckley Kathleen PyneSt Columbanus Home St Joseph’s Nursing Home Killarney Community Hosp. 113 Woodlawn ParkKillarney Ballykissane, Killorglin Killarney KillarneyCo Kerry Co Kerry Co Kerry Co Kerry

LAOlS Joseph Hoolan Caroline Overton Bernadette Parsons Cora McGrathMidland Regional Hospital Midland Regional Hospital Midland Regional Hospital Midland Regional HospitalPortlaoise, Co Laois Portlaoise, Co Laois Portlaoise, Co Laois Portlaoise, Co Laois

LElTRIM Sheila Carney Irene Argue Maureen Guihen Anne Marion CoxSt Patrick’s Hospital Drumharkin Glebe St Patrick’s Hospital St Patrick’s HospitalCarrick-On-Shannon Cloone, Carrick-On-Shannon Carrick-On-Shannon Carrick-On-ShannonCo Leitrim Co Leitrim Co Leitrim Co Leitrim

LETTERKENNY Teresa Cassidy Mary Howley Edel Peoples Nuala RichardsonLetterkenny General Hosp. Chapel Road Letterkenny General Hosp. Letterkenny General Hosp.Letterkenny, Co Donegal Dungloe, Co Donegal Letterkenny, Co Donegal Letterkenny, Co Donegal

LIMERICK Anna Malone Bridget Hayes Thomas Murphy Margaret Mary Hayes96 Lynwood Park Limerick Regional Hospital St John’s Hospital Limerick Regional HospitalSt Patrick’s Road, Limerick Dooradoyle, Co Limerick St John’s Square, Limerick Dooradoyle, Limerick

LONGFORD Kelly Neville Aoife Maguire Marie McGivneyTrean Beihy CloonaghMohill, Co Leitrim Drumlish, Co Longford Dring, Co Longford

MALLOW Mary Fennessy Mary J Ryan Ellen FeehanHeatherside hospital Mallow General Hospital Mallow General HospitalButtevant, Co Cork Mallow, Co Cork Mallow, Co Cork

MEATH Margaret O’Reilly Dympna Fegan Anne Tully Evelyn M MaguireOur Lady’s Hospital Our Lady’s Hospital Our Lady’s Hospital St Joseph’s HospitalNavan, Co Meath Navan, Co Meath Navan, Co Meath Trim, Co Meath

MONAGHAN Patricia Toal Rita Corcorcan Margaret McAdam Margaret KeenanSt Mary’s Hospital Monaghan General Hospital Monaghan General St Mary’s HospitalCastleblaney, Co Monaghan Monaghan Hospital, Monaghan Castleblaney, Co Monaghan


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MULLINGAR Ann Quinn Catherine Tormey Ann FarrellSt Mary’s Hospital Mullingar General Hospital St Mary’s HospitalMullingar, Co Westmeath Mullingar, Co Westmeath Mullingar, Co Westmeath

NENAGH Ann Nevin Pat RyanNenagh General Hospital Nenagh General HospitalNenagh, Co Tipperary Nenagh, Co Tipperary

OFFALY Mary Quirke Mary Keane Anne Dack Marie McCafferkey144 Arden Vale Tullamore General Hospital Tullamore General Hospital Tullamore General HospitalTullamore, Co Offaly Tullamore, Co Offaly Tullamore, Co Offaly Tullamore, Co Offaly

ROSCOMMON Elizabeth Stephens Eileen Kelly Catherine GallagherSacred Heart Home Sacred Heart Home Roscommon County HospitalRoscommon Roscommon Roscommon

SLIGO Anne McGowan Catherine Judge Breda McHugh Mary WalshSligo General Hospital Sligo General Hospital St John’s Hospital Sligo General HospitalThe Mall, Sligo The Mall, Sligo Ballytivnan, Sligo The Mall, Sligo

TIPPERARY Ursula Paine Aileen Bourke Mary B TierneyNORTH Hospital of the Assumption ‘Dunarra’ ‘Lanespark House’(HSE – MidWest) Thurles Tyone, Nenagh Ballynonty, Thurles

Co Tipperary Co Tipperary Co Tipperary

TRALEE Eileen Carmody Veronica Houlihan Noirin Taylor Johanna DillaneThe Old Bridge, Laharn Dingle Community Hospital Kerry General Hospital Bon Secours HospitalListowel Road, Tralee Dingle Tralee TraleeCo Kerry Co Kerry Co Kerry Co Kerry

WATERFORD Claire Mahon Fiona McKeown Mary McCormack-SandisonWaterford Regional Hospital 48 The Strand, Somerville Waterford Regional HospitalArdkeen, Waterford Tramore, Co Waterford Ardkeen, Waterford

WEXFORD Hanna Nolan Fiona Galvin Mary KehoeWexford General Hospital Wexford General Hospital Wexford General HospitalWexford Wexford Wexford

WICKLOW Marion Byrne Mary P Esmonde Nancy GrennanWicklow Town District St Colman’s Hospital Wicklow Town District Hospital, Wicklow Rathdrum, Co Wicklow Hospital, Wicklow


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Appendix II – Section Officers – Currently in Office

SECTION CHAIRPERSON VICE-CHAIRPERSON SECRETARY

A&E SECTION Sile O’Sullivan Patrick GallagherNaas General Hospital Beaumont HospitalNaas, Co Kildare Beaumont, Dublin 9

ASSISTANT DIRECTORS Colette Tarrant Helen Buckley Marie HoeyOF NURSING SECTION Our Lady’s Hospital Naas Hospital James Connolly Memorial Hospital

Crumlin, Dublin 12 Co Kildare Blanchardstown, Dublin 15

CLINICAL NURSE Niamh Doyle Mary Gallagher Monica CunninghamMANAGER SECTION Wexford General Hospital Letterkenny General Hospital Beaumont Hospital

Wexford Co Donegal Beaumont, Dublin 9

CLINICAL NURSE Geraldine Hogan Margaret SullivanSPECIALIST SECTION Naas General Hospital Limerick Regional Hospital

Naas, Co kildare Dooradoyle, Limerick

CLINICAL PLACEMENT Carolyn McLean Mary McTagueSECTION Adelaide & Meath Hospital Mayo General Hospital

Tallaght, Dublin 24 Castlebar, Co Mayo

COMMUNITY NURSES Anne Cullen Sarah McKiernanSECTION (RGNS) 7 Cherrygarth 161 Hillside

Mount Merrion, Co Dublin Greystones, Co Wicklow

DIRECTORS OF NURSING Evelyn Barry Breda HayesSECTION St Colman’s Hospital St Mary’s Hospital

Rathdrum, Co Wicklow Dublin 20

GP PRACTICE NURSE Mary Cashen Berna Rackard Lorraine DillonSECTION Benedine ‘Carrickfoyle House’ 40 Glencairn Walk

Nenagh, Co Tipperary Barnstown, Co Wexford Leopardstown, Dublin 18

INTELLECTUAL Marie Gilligan Kathleen Smyth Josephine RyanDISABILITY SECTION Cregg House St Mary’s Centre St Joseph’s Centre

Sligo Drumcar, Co Louth Clonsilla, Dublin 15

MIDWIVES SECTION Mary P. Higgins Margaret Crowley-MurphyErinville Maternity Hospital St Munchin’s Maternity Hospital, Western Road, Cork Ennis Road, Limerick

NATIONAL CARE OF Breda McHugh Ann Coyne-Nevin Geraldine DeeganOLDER PERSON St John’s Hospital, St Patrick’s Hospital St Vincent’s HospitalSECTION Ballytivnan, Sligo John’s Hill, Waterford Mountmellick, Co Laois

NATIONAL Janet Choi Clodagh Gowen Maureen WoodnuttINTERVENTIONAL Bon Secours South Infirmary/Victoria Hospital St James’s HospitalRADIOLOGY SECTION College Road, Cork Old Blackrock Road, Cork James’s Street, Dublin 8

NURSE MIDWIFERY Mary Cotter Sara Raftery Gervaise MaherEDUCATION SECTION Adelaide & Meath Hospital Children’s University Hospital Beaumont Hospital

Tallaght, Dublin 24 Temple Street, Dublin 1 Beaumont Road, Dublin 9

OCCUPATIONAL HEALTH Una Feeney Marie Hennigan Mary FordeSECTION 9 Woodlands 70 Clonkeen Drive Bupa Ireland Ltd

Cappagh Foxrock Ballina, Co MayoKinsale, Co Cork Dublin 18

OPERATING Elizabeth Waters Teresa Herity Theresa CumminsDEPARTMENT NURSES Naas General Hospital Mater Misercordiae Hospital, Mater Misercordiae Hospital, SECTION Naas, Co Kildare Eccles Street, Dublin 7 Eccles Street, Dublin 7

ORTHOPAEDIC SECTION Rosemary Masterson Charlotte Hannon Paula DevittCappagh Orthopaedic Hospital Sligo General Hospital Merlin Park HospitalFinglas, Dublin 11 The Mall, Sligo Merlin Park, Galway

OVERSEAS NURSES Carmelito Abragan Emmanuel Etcheri Judith TabuenaSECTION 11 The Court, St Loman’s Psychiatric Unit St. Vincent’s Centre

Dalcassian Downs Adelaide & Meath Hospital LisnagryDublin 9 Tallaght, Dublin 24 Co Limerick


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SECTION CHAIRPERSON VICE-CHAIRPERSON SECRETARY

PHN SECTION Mary Redmond Fiona McKeown Deirdre Duffy39 Riddlesford, Kilruddery 48 The Strand, Somerville 5 Grange Close, (Off Pottery Rd)Bray, Co Wicklow Tramore, Co Waterford Dun Laoghaire, Co Dublin

REHABILITATION Patricia Cormack Eva WallaceNURSES SECTION Irish Wheelchair Association National Rehabilitation Hospital

Rochestown AvenueDun Laoghaire, Co Dublin

SCHOOL NURSES Julie McTiernan Irene HenebrySECTION 80 College Park 9 Kilsheelin Heights

Newbridge, Co Kildare Castlecomer Road, Kilkenny

STUDENT SECTION Moira Wynne Barry McConaghy Caroline CullenDublin City University Trinity College Dublin City UniversityGlasnevin, Dublin 11 Dublin 2 Glasnevin, Dublin 11

SURGICAL/MEDICAL Mary Fleming Noreen Flannelly-Kinsella Annette HughesDAY CARE SECTION Mount Carmel Hospital Our Lady’s Hospital Merrion Day Surgery

Braemor Park, Churchtown Navan, Co Meath 205 Merrion Road, Dublin 4Dublin 14

TELEPHONE TRIAGE Dorcas Collier Margaret Curran Camilla O’DonoghueNURSES SECTION Carlow Emergency Doctor Carlow Emergency Doctor Shannon Doc

c/o Carlow District Hospital c/o Carlow District Hospital c/o St Camillus HospitalAthy Road, Carlow Athy Road, Carlow Limerick


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Appendix III: INO Secretariat – 2005

General Secretary: Liam Doran MA BA RGN RMHNDeputy General Secretary: Dave Hughes MA (Industrial Relations)Director of Professional Development: Annette Kennedy MSc BNSDirector of Organisation & Social Policy: Clare Treacy RGN RPN Dip IR Dip EO

Industrial Relations StaffHSE South West Area and other Dublin health agencies: Phil Ní Sheaghdha RGN Dip IR & TU StudiesHSE East Coast Area and other Dublin health agencies: Philip McAnenly BA (Pers Mgt & IR) RGN RPNHSE Northern Area and other Dublin health agencies: Edward Mathews RNMH HSE Midland Region and some Dublin health agencies: Kevin O’Connor RGN RPN ROMHSE Mid-West Region: Mary Fogarty Dip Communications, RGN HSE North East Region and some Dublin health agencies: Tony Fitzpatrick Hdip A&E, RGN HSE North West Region: Noel Treanor BA (Hons) RGN HSE Southern Region: Michael Dineen RPN, Patsy Doyle BSS RPNHSE South East Region: Liz Curran RPNHSE Western Region: Noreen Muldoon RGN Media Relations Officer: Ann KeatingInformation & Research Executive (IR): Colette Mullin Dip Emp Law, BA IR & PMInformation Officers: Catherine Hopkins Dip Mgt & Emp Rel, Dip IT, JEB

Lorraine Monaghan Dip Emp Law, BA IR & PM

AdministrationAdministration Manager: Dorothy Mullarkey Dip Management & IROffice Manager: Claire CluxtonPersonal Assistant to General Secretary: Michaela Ruane Dip HRM, JEB Dip ITPersonal Assistant to Deputy General Secretary: Martina DunnePersonal Assistant to Director of Social Policy: Noeleen SmithAdmin Support Staff: (HQ) Edel Bose

Phyllis FoodyAnn O’BrienJacinta MoylesMary Cradden (Appointed October 2005)

Admin Support Staff (Cork): Rosemary O’SullivanAdmin Support Staff (Galway): Kylie MattersonAdmin Support Staff (Limerick): Karen Buckley Accounts Manager: Una O’Brien MIATIAccounts Assistants: Dolores Proudfoot

Sinead LoyAngela Coffey

Membership Services Officer: Kevin DowneyMembership Assistant: Una McEvitt (Appointed June 2005)Telephonist/Receptionist: Marion Behan

Professional Development CentreEducation and Promotion Officer: Kathy Foy-Newman RSCN Dip IR, Dip PRCourse Co-ordinator: Marian GodleyAssistant Course Co-ordinator: Linda DoyleResearch/Personal Assistant to Director of Professional Development: Maria MoynihanAdmin Support Staff: Helen O'Connell

Section DevelopmentSection Development Officer: Mary Power MA RGN RMAssistant Development Officer: Jean Carroll BA Psychology Dip BSAdmin Support Staff: Geraldine McNamee

LibraryLibrarian: Muriel Haire Dip LISAssistant Librarian: Niamh Adams MA BA HDip LISLibrary Assistant : Rhona Ledwidge

Aileen Rohan Dip LIS

Maintenance/HousekeepingMaintenance Officer: Stuart Mc NeillCleaner/Housekeeper: Edita Stasitiena

Jurate Jakubonyte (part-time)


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Appendix IV: Salary scales applicable from 1 December 2005

Following application of 1.5% cost of living increase as provided for under Sustaining Progress

Incremental point 1 2 3 4 5 6 7 8 9 10

Student Nurse III 22,342

Student Nurse (Degree students 22,53912 month rostered placement)

Student Nurse Mental Handicap (Degree 22,539students 12 month rostered placement)

Post Registered Student Nurse 24,167 25,608

Student Midwife 28,174

Student Paediatric Nurse 28,174

Staff Nurse (including Registered Midwife, 28,174 29,584 30,997 32,408 33,813 35,028 36,246 37,459 38,672 39,864Registered Sick Children's Nurse, Long service increment after three years on maximum of scale 41,136Registered Mental Handicap Nurse)

Senior Staff Nurse/Midwife 43,195

Dual Qualified Nurse 31,868 33,981 35,108 35,976 36,931 38,204 39,443 41,267(registered in any 2 of the 5 disciplines) Long service increment after three years on maximum of scale 42,541

Senior Dual Qualified Nurse 44,668

Clinical Nurse/Midwife Manager 1 40,647 41,422 42,516 43,628 44,723 45,825 47,054 48,199

Clinical Nurse/Midwife Manager 2/ 44,279 45,040 45,683 46,735 47,896 49,036 50,176 51,459 52,652Clinical Nurse/Midwife Specialist (plus allowance of E745 pa payable on a red-circled basis to Theatre/Night Sisters who were in posts on 5 Nov 1999)

Clinical Instructor 46,273 47,049 47,623 48,689 49,764 50,923 52,088 53,252 54,415

Clinical Nurse/Midwife Manager 3 51,203 52,249 54,895 55,935 56,981 58,041

Nurse Tutor 52,410 53,145 53,876 54,612 55,346 56,082 56,812 57,549 58,284 59,018

Principal Nurse Tutor 55,047 56,118 57,095 60,148 61,215 62,220 63,476 65,160

Student Public Health Nurse 29,387

Public Health Nurse 43,102 43,844 44,477 45,476 46,625 47,737 48,858 50,117 51,290(plus allowance of E1,490 pa payable on a red-circled basis to staff who were in posts on 5 Nov 1999)

Asst. Dir. of Public Health Nursing 51,207 54,112 55,306 56,406 57,517 59,038

Director of Public Health Nursing 60,106 61,452 62,802 64,148 65,495 66,850 68,195

Advanced Nurse Practitioner 51,714 52,748 53,745 56,808 57,772 58,892 59,939 60,979 65,164

Assistant Director of Nursing 51,714 52,748 53,745 56,808 57,772 58,892 59,939 60,979 65,164(Band 1 hospitals)

Assistant Director of Nursing 49,028 50,108 51,207 54,112 55,306 56,406 57,517 59,037(Non Band 1 hospitals)

Director, Nursing & Midwifery 87,150Planning& Dev Unit – HSE ERA

Asst. Director, Nursing & Midwifery 78,598Planning& Dev Unit – HSE ERA

Director, Nursing & Midwifery Plan 78,598& Dev Unit – HSE Non ERA

Director of Nursing/Matron Band 1 69,341 71,269 73,200 75,124 77,051 78,984 80,909(plus performance related pay)

Director of Nursing/Matron Band 2 65,250 67,087 68,929 70,763 72,609 74,448 76,288

Director of Nursing/Matron Band 2A 64,728 65,883 67,041 68,195 69,353 70,506 71,663




Director Centre of Nurse Education 60,419 62,354 64,288 66,223 68,157 70,092 72,026 74,043


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Location and Qualification Allowances applicable from 1 December 2005

Dual Qualified Scale: Applies to nurses in possession of two of the five registered nursing qualifications or in training forthe second qualification on 1 October, 1996. In the case of midwifery and sick children’s nursing, the dual qualified scaleis effective from 1 August, 1998. A staff nurse can only receive either a dual qualified scale or an allowance, whicheveris the greater. The exceptions to this are: (a) Nurses who were paid on the dual qualified scale on 1 October, 1996 and in receipt of a location allowance at 1

August, 1998 or eligible for a new location/qualification allowance from 31 March, 1999. In such cases the value ofthe location/qualification allowance is ¤1,297 which they receive in addition to their dual qualified scale;

(b) With effect from 26 November, 2003, nurses who are paid on the dual qualified scale and who then move to an areathat attracts a location/qualification allowance will continue to be paid on the dual qualified scale and will alsoreceive the abated value of the location/qualification allowance of ¤1,297. Payment of the allowance will cease if thenurse moves out of the qualifying area.

Eligibility

Nurses eligible for payment of location/qualification allowances are Staff Nurses, Senior Staff Nurses, CNMs 1 & 2 (incl.Theatre Sisters). A nurse may benefit from either a qualification allowance or a location allowance when eligible – thehigher of the two – when working on qualifying duties. Pro-rata arrangements apply to job-sharing and part-time staff.

Grade Nature of Allowance

Registered General Nurses Employed on duties in the following locations: ¤1,729Accident & Emergency Depts, Theatre/OR, Intensive Care Units,Renal Units, Cancer/Oncology Units, Geriatric Units/Long-stay Hospitalor Units in County Homes

Registered Nurses Employed on duties in the following locations: ¤1,729Units for Severe and Profoundly Handicapped in Mental Handicap Services, Acute Admission Units in Mental Health Services, Secure Units in Mental Health Services, dedicated Care of the Elderly (excluding Day Care Centres) and Alzheimers Units in Mental Health Services and the Intellectual Disability Sector* (including Psycho-geriatric Wards, Elderly Mentally Infirm Units, Psychiatry of Later Life Services). (*Allowance effective from 1 January, 2004.)

Registered Nurses a) Employed on duties in specialist areas appropriate to the ¤2,596following qualifications where they hold the relevant qualifications:

With effect from 1 March, 2002 • Accident & Emergency Nursing Coursepayment of the specialist qualification • Anaesthetic Nursing Courseallowance is extended to all specialist • Behaviour Modification Coursecourses confirmed as Category II by • Behavioural Therapy CourseAn Bord Altranais • Burns Nursing Course

• Child & Adolescent Psychiatric Nursing Course• Coronary Care Course• Diabetic Nursing Course• Ear Nose & Throat Nursing Course• Forensic Psychiatric Nursing Course• Gerentological Nursing Course• Higher Diploma in Midwifery• Higher Diploma in Paediatrics• Infection Control Nursing Course• Intensive Care Nursing Course (incl. Paediatric Intensive Care

& Special and Intensive Care of New Born)• Neurological/Neurosurgical Nursing Course• Operating Theatre Nursing Course (incl. Paediatric Op. Theatre)• Opthalmic Nursing Course• Orthopaedic Nursing Course• Higher Diploma in Cardiovascular Nursing/Diabetes Nursing/

Oncological Nursing/Palliative Care Nursing/Accident & Emergency Nursing

• Rehabilitation Nursing Course• Renal Nursing Course• Stoma Care Nursing Course

Registered General Nurses b) Holding recognised post-registration qualifications in midwifery ¤2,596or sick children's nursing and employed on duties appropriate totheir qualification

All Public Health Nurses & Receive Qualification Allowance of ¤2,596Assistant Directors of PublicHealth Nursing


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Annual Report 2005

Other allowances applicable from 1 December 2005

Grade Nature of Allowance

Relevant Nursing Staff Nurse Management Sub-structures – Special Allowance forweekends/public holidays ¤2,768

Psychiatric Nurses Community Allowance ¤4,616

Nurses assigned to Occupational Therapy (Qualified) ¤3,473Nurses assigned to Occupational Therapy (Unqualified) ¤1,583

Public Health Nurses Island Inducement Allowance ¤1,643

Public Health Nurses Fixed payment ¤26.18Week-end Work First call on Saturday and first call on Sunday ¤34.76

Each subsequent call on Saturday and Sunday ¤17.41Payment in lieu of time off for Emergency work ¤26.15

Theatre Nurses who participate On-Call with Standby – Each Dayin the On-Call/standby Monday to Friday ¤39.39Emergency Services Saturday ¤50.60

Sunday and Public Holidays ¤68.39All of these figures based on a 12-hour period. Pro rata to apply after hours.

Call-Out Rate – Monday to Sunday(a) Fee per operation per 2 hours (17.00-22.00 hours) ¤39.39(b) (i) Operation lasting more than 2 hours and up to

3 hours (17.00-22.00 hours) ¤59.08(ii) Operation lasting more than 4 hours and up to 5 hours ¤98.47

(c) Fee per operation per hour (after 22.00 hours) ¤39.39

On-Call without Standby(a) Fee per operation, call-in without standby ¤78.78(b) Overruns from roster at normal overtime rates (no time back in lieu)

On-Call over WeekendIn situations where no rostered duty is available over the weekend, thefollowing will apply on a pro-rata basis (i.e. appropriate rate divided by 12,then multiplied by number of hours available). No time back in lieu will apply.

Nurse Co-Ordinator AllowanceA shift allowance of ¤16.83 will be paid to a staff nurse who undertakes therole of formalising the reporting and accountability relationship with theTheatre Superintendent. The allowance only applies to a nurse who fulfilsspecified duties when called in (DoHC circular refers).

Midwives providing Domiciliary Fee per service ¤115.78Care under the Maternity and Reduction with a/n visit is after 36th week of pregnancy ¤7.22Infant Care Scheme Patient removed to hospital before onset of labour and

not accompanied by midwife ¤42.96

Patient removed to hospital before onset of labour andaccompanied by midwife ¤57.37

Patient removed to hospital after onset of labour and notaccompanied by midwife ¤71.89

Patient removed to hospital after onset of labour and accompanied by midwife ¤86.00

Abortions and Miscarriages ¤57.35

Special Co-ordinator Allowance ¤4,018


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Annual Report 2005

Appendix V: INO Private Nurses Fees – (Emergency &General Nurses Section Effective 1 July, 2005-30 June, 2006)

• Nurses are advised to ensure that a Doctor is in attendance on cases in Private Homes to which they are called.

• Responsibility for payment of fees:

The person (employing authority or individual) who engages the nurse is responsible for the payment of his/her feeswithin one calendar month.

• Shift payments outlined are inclusive of statutory rest periods as per the Organisation of Working Time Act (1977).

• If called during a period of Theatre On-call/Sleep Over the full night duty rate (not the on-call allowance) shouldbe paid from the time the on-call period started

• Private Industry Fee E30 per hour daytime. Shifts commencing AFTER 6pm should attract an additional 25%

• Patients insured under the VHI are covered up to a certain figure for the services of a special nurse in the home

• Nurses must send receipts to patients immediately on receipt of fees.

Mon—Fri Mon—Fri Saturday Saturday Sunday Sunday 25, 26 & 31 Dec

Day Night Day Night Day Night Day & Night

Up to 4 Hrs E100 E118 E151 E198

5 Hrs E107 E127 E165 E234

6 Hrs E122 E144 E189 E271

7 Hrs E139 E162 E214 E306

8 Hrs E154 E169 E178 E189 E239 E247 E343

9 Hrs E162 E179 E188 E202 E250 E263 E379

10 Hrs E182 E202 E210 E226 E275 E296 E415

11 Hrs E202 E223 E231 E251 E299 E329 E451

12 Hrs E221 E247 E253 E277 E324 E362 E488

13 Hrs E243 E270 E275 E302 E349 E395 E524

Twilight Shift 8 p.m. - 12 Midnight Escort Rates On-Call Fees

Mon - Fri E141 1st Hour E62 Mon - Fri E70

Saturday E163 2nd - 8th Hour E13 Saturday E77

Sunday E200 After 8 Hours E20 Sunday E84

ICU/CCU/A&E/Haemodialysis/Midwifery Theatre Allowance 15%


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Annual Report 2005

Appendix VI: Subsistence Rates

Subsistence (Normal) Rates:

Class A (salary above E48,610 per annum)

E

Night Allowance 138.41

Day Allowance 10 hours or more 40.01

Day Allowance 5 hours but less than 10 16.32

Class B (salary E48,609 and below)

E

Night Allowance 127.49

Day Allowance 10 hours or more 40.01

Day Allowance 5 hours but less than 10 16.32

Mileage Rates

Official Mileage in a Calendar year up to 4,000 4,001 & over

cent cent

Engine capacity up to 1,200cc 86.05 43.50

Engine capacity 1,201cc to 1,500cc 101.27 50.29

Engine capacity 1,501cc and over 128.10 59.49


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Annual Report 2005

Notes

A n n u a l R e p o r t 2 0 0 5

N U R S E S

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I r i sh Nurses Organisat ionCumann na nA l t r a í Gae l a cha

Head OfficeWhitworth Building, Morning Star Avenue,North Brunswick Street, Dublin 7Tel: 01 664 0600 Fax: 01 661 0466Email: [email protected] http: www.ino.ie

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