HSE plans to cut 700 staff nurses

Vorsprung

HSE issues circular on staff cuts
EITHNE DONNELLAN

The number of staff nurses in the health sector must be reduced by 700 as a matter of urgency, according to a new circular issued by the Health Service Executive today.

The circular, issued to hospital managers and also to health unions, states that these posts will be filled instead by student nurses on placement.

The document, which deals with employment control and the moratorium on recruitment in the health sector, states that where possible vacancies which arise should be filled by redeploying existing staff.

Overall it says the HSE's employment ceiling will be reduced by 1,035 whole time equivalents.

It stresses managers must abide by the strict new rules now in place for filling vacancies, including vacancies that become vacant in emergency situations. Breaches of these "may result in disciplinary action being directed against the service/line manager".

The first version of the HSE's service plan for this year, published last December, also referred to the need to cut staff numbers this year. It said savings would be achieved in 2009 partly by a 3 per cent reduction in management/administrative payroll costs in the HSE and the voluntary hospitals.

A reduction in expenditure by about 3,000 whole-time equivalent staff in pay costs, which it said would be achieved "through actual staff reductions, staff redeployment and pay related savings as a result of changing how some services are provided" was envisaged in the plan.

Labour Party spokeswoman on health Jan O'Sullivan branded the proposals a "panic reaction" to the organisation's budgetary crisis.

"While the plan to divert resources from administration to front line community health services is welcome, some of the other proposals will cause very serious difficulties and may further damage health services," she said.

"The exemption to the filling of vacancies is very limited and does not, for instance, include key health professionals, such as physiotherapists."

Ms O'Sullivan expressed concern over proposals to reduce the number of staff nurses by 700.

"Nurses in most hospitals are already badly overworked and such a major reduction in numbers would be bound to undermine the level of care," she said.

Source

When will the HSE learn how to keep people the Government have paid to train in the service. It's a joke, and I'm glad I'm getting out.

And for the attention of nurses reading these boards, I humbly present the following

Exhibit A
Exhibit B
Exhibit C
Exhibit D

Chunky Monkey

Apparently Beaumont aren't hiring agency staff anymore? There's no jobs for agency staff (nurses and care assistants) at all in Dublin so I've heard so have to stay in England for the summer I feel really bad for the staff who are left working.

Chunky Monkey

The circular, issued to hospital managers and also to health unions, states that these posts will be filled instead by student nurses on placement.

Hang on...WTF...

Vorsprung

Chunky Monkey wrote: »

Hang on...WTF...

Already happening in my place I work in

Traumadoc

Mine too.

DrIndy

bigjimthefirst wrote: »

When will the HSE learn how to keep people the Government have paid to train in the service. It's a joke, and I'm glad I'm getting out.

And for the attention of nurses reading these boards, I humbly present the following

Exhibit A
Exhibit B
Exhibit C
Exhibit D

I like your style! LOL

Don't forget about New Zealand or Canada or Middle East

The circular, issued to hospital managers and also to health unions, states that these posts will be filled instead by student nurses on placement.

I am 99% sure this against the term of reference for Nursing DEGREE students - they are supposed to be 100% supernumerary as per the requirements of their course to ensure their student time is for education and training rather than service provision - so if they are replacing staff nurses as semi-care-assistants as per former diploma system - there may be legal implications.

Correct me?

drzhivago

DrIndy wrote: »

I like your style! LOL

Don't forget about New Zealand or Canada or Middle East



I am 99% sure this against the term of reference for Nursing DEGREE students - they are supposed to be 100% supernumerary as per the requirements of their course to ensure their student time is for education and training rather than service provision - so if they are replacing staff nurses as semi-care-assistants as per former diploma system - there may be legal implications.

Correct me?

Then why do they get paid???

missannik

My gut reaction is that this is scary news indeed! Especially since Big Jim has included links to Australia!!! :eek: I hope this doesn't affect me when I come over in a few days.

Here's the INO's press release. http://www.ino.ie/DesktopModules/Articles/ArticlesView.aspx?TabID=6722&ItemID=7763&mid=54491

DrIndy wrote: »

I am 99% sure this against the term of reference for Nursing DEGREE students - they are supposed to be 100% supernumerary as per the requirements of their course to ensure their student time is for education and training rather than service provision - so if they are replacing staff nurses as semi-care-assistants as per former diploma system - there may be legal implications.

Correct me?

From what I've been told nursing students are counted in staff numbers, that they have patient loads. Two nursing students equals one general nurse, in the skill mix. Mind you, this is second-hand info, I'll find out soon enough.

ZYX

Why do we need so many nurses in this country? We have 15.4 practising nurses per thousand population. This compares to an average of 9.7 in other OECD countries.

Chunky Monkey

drzhivago wrote: »

Then why do they get paid???

AFAIK they only get paid for 6 months of their placement time.

missannik wrote: »

From what I've been told nursing students are counted in staff numbers, that they have patient loads. Two nursing students equals one general nurse, in the skill mix. Mind you, this is second-hand info, I'll find out soon enough.

How can 2 people who don't know what they're doing equal one person who does?

ZYX wrote: »

Why do we need so many nurses in this country? We have 15.4 practising nurses per thousand population. This compares to an average of 9.7 in other OECD countries.

Have you ever worked on a short staffed ward?

ZYX

Chunky Monkey wrote: »

Have you ever worked on a short staffed ward?

Well by the looks of the figures very few nurses in Ireland ever have. Why do we need so many nurses in this country compared to other developed countries?
This link is from 2000 when Ireland dad the highest nimber of nurses of any OECD country. Obviously since then Irelands number of nurses has become even higher. Look at page 15. (sorry I was unable to copy graph)
http://www.oecd.org/dataoecd/11/10/34571365.pdf

missannik

Chunky Monkey wrote: »

How can 2 people who don't know what they're doing equal one person who does?

Beats me. But with all due respect they are final year students, so surely they would have a developing knowledge base, basic skills and they would be supervised.

(I am in no way justifying or belittling whatever practice is in place, for at this present time I am not a practising nurse in Ireland... but I will be shortly *fingers crossed*)

RobFowl

ZYX wrote: »

Why do we need so many nurses in this country? We have 15.4 practising nurses per thousand population. This compares to an average of 9.7 in other OECD countries.

AFAIK it's in part because we have a poorly developed community and primary care system so are over reliant on hospital based services which are more nurse intensive.
Also there is a differing skill mix ratio compared to for example the UK where the use of Care assistants is much more common.
We also train a lot more nurses but have difficulty retaining them within the system (i.e. large amounts leave nursing).

ZYX

RobFowl wrote: »

AFAIK it's in part because we have a poorly developed community and primary care system so are over reliant on hospital based services which are more nurse intensive.
Also there is a differing skill mix ratio compared to for example the UK where the use of Care assistants is much more common.
We also train a lot more nurses but have difficulty retaining them within the system (i.e. large amounts leave nursing).

Possibly that is part of the problem but why is the number of nurses rising. According to An Bord Altranais there were 60,774 active registered nurses in 2004 (out of a total of 76,045 registered nurses). In 2008 there were 68,614 active nurses in Ireland (out of a total of 88224 registered nurses). Would our health service really be much worse off if we reduced the number of nurses by 8,000 and returned to 2004 levels? Has the health service improved enough in the last five years to justify all these extra nurses?
Before people ask, I am a GP and yes I also believe we have too many GPs.

RobFowl

ZYX wrote: »

Possibly that is part of the problem but why is the number of nurses rising. According to An Bord Altranais there were 60,774 active registered nurses in 2004 (out of a total of 76,045 registered nurses). In 2008 there were 68,614 active nurses in Ireland (out of a total of 88224 registered nurses). Would our health service really be much worse off if we reduced the number of nurses by 8,000 and returned to 2004 levels? Has the health service improved enough in the last five years to justify all these extra nurses?
Before people ask, I am a GP and yes I also believe we have too many GPs.

I think it may have a lot to do with the explosion in private hospitals over the past 8 years but thats only my opinion.
I worked in UK hospitals who have 3 nurses for every 7 care assistants and the level of care seems no worse then here where it it close to the other way round.
At the end of the day if The Beacon, Hermitage, Galway and god knows how many other private hospitals open then more nurses will be needed.
I have to say I fear they will be cut from where they are most needed (like AE) and the bloated sectors where the majority are on permanent contracts will be left untouched.

JuliusCaesar

RobFowl wrote: »

I have to say I fear they will be cut from where they are most needed (like AE) and the bloated sectors where the majority are on permanent contracts will be left untouched.

Which sectors are bloated?

Also, a lot of the active registered nurses are working part-time. What you need to compare is the amount of WholeTimeEquivalents (WTE) in different countries.

RobFowl

Don't want to insult any one ! so will not name any, but there are units with nurses acting as roster managers, in purely admin roles and some older hospitals which have lost their acute roles yet retained staffing levels.
Also the infamous grade 8's clerical/middle managers !!
I 'm not saying nursing levels should be cut BTW , just that tthere is plenty of scope for cuts among admin and if there is among nursing staff I have no faith in the HSE to target the right areas.

Dr Galen

Julius hit the nail on the head, we may have more registered nurse per capita here, but counting the growth in private facilities and all the smaller country hospitals we have, along with the amount of part-time and job sharing positions that can be accounted for pretty quickly.

Also comparing say the Dutch system with the Irish is disingenuous, as they operate off a different baseline, with more adjunctive roles, like physicians assistants etc meaning that a lot of the things that nurses do here are covered by other jobs over there.

I would agree though that a shakeup needs to happen, but it will have to be root and branch reform of the service from the top down and the bottom up, and that has been discussed to death here

Dr Galen

ZYX wrote: »

Well by the looks of the figures very few nurses in Ireland ever have. Why do we need so many nurses in this country compared to other developed countries?

well i have. So has my wife, in fact they are so short staffed right now were she works (major Dublin Hospital) that it's getting dangerous.

There is much data around this topic and how in certain areas, acute surgical etc, the nurse/patient ratio actually has a positive effect on patient mortality. I don't have time now to find and post link, but I will later on.

ZYX

Mystik Monkey wrote: »

Julius hit the nail on the head, we may have more registered nurse per capita here, but counting the growth in private facilities and all the smaller country hospitals we have, along with the amount of part-time and job sharing positions that can be accounted for pretty quickly.

Unless you are saying just about every single nurse works part time then your figures do not make sense. Even if you exclude all nurses in private hospitals or employed by GPs then the number of nurses in public employment is still greater than the OECD average.
Between 2000 and 2006 the number of nurses in HSE increased by 26% to 36,737. Since then that number has increased even further.

norrie rugger

DrIndy wrote: »

I like your style! LOL

Don't forget about New Zealand or Canada or Middle East



I am 99% sure this against the term of reference for Nursing DEGREE students - they are supposed to be 100% supernumerary as per the requirements of their course to ensure their student time is for education and training rather than service provision - so if they are replacing staff nurses as semi-care-assistants as per former diploma system - there may be legal implications.

Correct me?

AFAIK it is still going on, using the rotation of students to cover maternity leave and such

norrie rugger

ZYX wrote: »

Unless you are saying just about every single nurse works part time then your figures do not make sense. Even if you exclude all nurses in private hospitals or employed by GPs then the number of nurses in public employment is still greater than the OECD average.
Between 2000 and 2006 the number of nurses in HSE increased by 26% to 36,737. Since then that number has increased even further.

It is also typical here to have trained people in non-trained positions.

4-5 nurses in an outpatients clinic? all they do is hand files to the doctors and call people into see the doc.

Why have we got nurses answering phones or doing admin work?

There should be lesser paid admin staff doing these roles, not medical professionals.


It is the same in the Gards, why do we need a Garda on the reception desk?
Why is there no Trained admin staff in the stations, taking paper load from gards that could be on the street etc

ZYX

norrie rugger wrote: »

It is also typical here to have trained people in non-trained positions.

4-5 nurses in an outpatients clinic? all they do is hand files to the doctors and call people into see the doc.

Why have we got nurses answering phones or doing admin work?

There should be lesser paid admin staff doing these roles, not medical professionals.


It is the same in the Gards, why do we need a Garda on the reception desk?
Why is there no Trained admin staff in the stations, taking paper load from gards that could be on the street etc

I couldn't agree more. Many nurses could easily be moved away from non-nursing duties but this will never happen unless the unions cop on to themselves. In response to the threat of a reduction of 750 nurses, rather than use this as an opportunity to stop nurses doing non-nursing duties. Rather than face up to the huge problems we face in this country, rather than take the lead in advancing nursing in this country, Liam Doran says:

"In the interim we continue to liaise with all other health service unions in order to arrive at a collective agreement as to how all unions will oppose any attempt by the HSE to introduce these draconian staffing cuts."