Labour Court Database __________________________________________________________________________________ File Number: CD9088 Case Number: LCR12839 Section / Act: S67 Parties: VOLUNTARY HOSPITALS - and - IRISH NURSES ORGANISATION |
Claim by the Union that a special allowance be paid to nurses working in accident and emergency departments.
Recommendation:
5. Having considered the submissions the Court has formed the
opinion that a sustainable case can be made for the extension of
the allowance claimed by the Irish Nurses Organisation for nurses
employed in Accident and Emergency Departments but, having regard
to the imminent comprehensive review of wages and conditions
generally in the nursing profession, the Court takes the view that
it is in that context that the matter should be finalised.
Division: Mr O'Connell Mr Brennan Mr Devine
Text of Document__________________________________________________________________
CD9088 RECOMMENDATION NO. LCR12839
INDUSTRIAL RELATIONS ACTS, 1946 TO 1976
SECTION 67
PARTIES: VOLUNTARY HOSPITALS
(REPRESENTED BY THE FEDERATION OF IRISH EMPLOYERS)
(LOCAL GOVERNMENT STAFF NEGOTIATIONS BOARD)
and
IRISH NURSES ORGANISATION
SUBJECT:
1. Claim by the Union that a special allowance be paid to nurses
working in accident and emergency departments.
BACKGROUND:
2. Since the early 1970's nurses working in certain specialist
areas have been in receipt of a special allowance (currently #226
per annum) which acknowledges the additional skills required to
work in those areas. The areas include theatre, geriatric long
stay, intensive care and cancer units. Over the years the agreed
interpretation of intensive care has allowed the payment of the
allowance to nurses working in additional areas such as coronary
care, renal dialysis and ophthalmic units. The Organisation is
claiming that the allowance should be paid to nurses employed in
accident and emergency casualty departments in voluntary hospitals
throughout the country. The Organisation maintains that the work
associated with accident and emergency casualty units quite easily
compares in terms of specialist skill and additional strain with
the areas in which the allowance is already being paid.
Management has rejected the claim on the grounds that work in an
accident and emergency department is a normal part of nurses
duties and a special allowance is not warranted. Local
discussions and a conciliation conference held on the 2nd
February, 1990 failed to resolve the dispute which was referred to
the Labour Court on the 5th February, 1990. A Court hearing was
held on the 10th April, 1990.
ORGANISATION'S ARGUMENTS:
3. 1. The validity of the claim is borne out by the existence of
specialist courses in accident and emergency nursing. These
courses of six - nine months duration are held in some of the
major Dublin hospitals (details supplied to the Court). It
should be noted that courses of similar nature and length are
held to cover theatre and intensive care. It is surely
therefore anomalous to recognise the additional effort and
expertise in only two of these three areas. Nurses working in
accident and emergency units are expected to be capable of
undertaking duties which would not be common to general wards.
These duties include electrocardiographs, blood samples,
resuscitation procedures, gastric lavage, major trauma
treatment, application of plaster of paris, minor operative
procedures, and initial intensive care unit procedures. These
duties are in addition to the usual tasks of dealing with
minor trauma.
2. Accident and emergency nurses are also expected to deal
with the relatives and friends of the injured patient, a duty
which although often ignored is very important and time
consuming. Nurses in accident/emergency departments can also
be required to work a greater amount of un-social hours due to
the need to staff the units with sufficiently experienced
staff. It is simply not possible to roster inexperienced
nurses in charge of the casualty units due to the work. The
vast majority of nurses working in this specialist area are
also required to travel to emergency calls in the ambulance.
This unique and very stressful element to accident and
emergency nursing work requires the nurses total expertise and
competence as they are first to reach the accident scene,
assess the situation and decide upon immediate action. This
element of the position alone most certainly places the nurse
in as stressful a position as her intensive care or geriatric
unit colleagues (who receive the allowance).
3. There are approximately 400 nurses working in accident and
emergency departments countrywide. At present cost concession
of this claim would involve an additional #80,000
approximately. Quite apart from this cost the allowance if
paid would at least acknowledge in some small way the
additional training and experience of these staff. The
present arrangements pertaining to this allowance are both
anomalous and inequitable as they exclude for no apparent
reason nursing staff who have undergone exactly the same
amount of additional training as their theatre and intensive
care colleagues. Due to the changing trends in health care
recent events have shown that accident and emergency
departments are increasingly providing the route of admission
to hospital of many people, and the nationwide increase has
placed an ever greater strain on the nursing staff. Payment
of the allowance would give tangible recognition to the
additional demands placed on nurses working in accident
emergency departments and would at least acknowledge the
specialist nature of the work involved.
MANAGEMENT'S ARGUMENTS:
4. 1. The pay of general nurses was the subject of a major
review in 1979/80. This review culminated in an arbitration
report which recommended increases ranging from 25% to 30% for
the different grades of nurse. In their submission to the
arbitrator the Organisation stated -
"There is in addition no demarcation of work areas or work
practices despite the existence of a wide variety of
specialised areas of nursing which would, were it not for
the flexibility of the profession be categorised as
separate occupations within any other profession. An
indication of the extent of specialist knowledge and skill
demanded of the nurse can be seen from an over-view of
some general nursing areas.
- Surgical nursing including casualty, gynaecology,
orthopaedic, ophthalmic renal, ear, nose and throat
and operating theatre.
- Medical nursing including neurology, outpatients,
infectious diseases, paediatrics and geriatrics.
- Midwifery including anti-natal clinics post-natal
clinics, nursery, labour ward, maternity wards."
2. It is Management's view that the arbitrator took
cognisance of all the Organisation's arguments in setting the
appropriate salary levels for general nurses. Management is
opposed to any extension of the allowance since it would serve
only to further fragment the nursing pay structure and would
almost inevitably result in similar claims from other nurses.
General nurses are currently in line to receive special
increases totalling 16% phased under clauses 3.3 and 3.4 of
the Agreement on Pay in the Public Service adding an extra #61
million to the annual payroll. The Organisation has recently
submitted a claim for a major review of the pay and
differentials structure of general nurses. Any claim relating
to the remuneration of general nurses should therefore be
dealt with as part of the claim for a major review.
RECOMMENDATION:
5. Having considered the submissions the Court has formed the
opinion that a sustainable case can be made for the extension of
the allowance claimed by the Irish Nurses Organisation for nurses
employed in Accident and Emergency Departments but, having regard
to the imminent comprehensive review of wages and conditions
generally in the nursing profession, the Court takes the view that
it is in that context that the matter should be finalised.
~
Signed on behalf of the Labour Court
John O'Connell
________________________
11th May, 1990. Deputy Chairman
T.O'D/J.C.