Threatened nurses strike

From yesterday's Irish Times Health Supplement article on "man"power shortages at Our Lady of Lourdes Hospital in Drogheda:

"the midwife to deliveries ratio in Drogheda is about 1:58 compared to 1:35 in some of the Dublin hospitals. It would be even less in Cork and there seems to be no explanation for this inequality"
"An Bord Altrainais reported that in the 2 months prior to its visit (to OLOL Hospital) last October, 29 fulltime and parttime nurses and midwives had left the materit and paediatric services in the hospital. "Many have cited deficits in staffing levels and staff skills as reasons for leaving." "

There are generally no redundancies in nursing......they just leave to find better hospitals.
 
ashambles said:
I didn't think the relocation expense claim was rediculous, being asked to work in the other side of Cork city could add an hour per day commute time, or require a car to be bought.
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Or might reduce travelling times in many instances.

The new maternity hospital is in the western suburbs and is serviced by a regular bus route. It is also much closer to the South Ring Rd than two of the maternity hospitals it is replacing and will be easier/faster to access by car.
 

i agree, the other 3 hospitals don't have enough parking (free or otherwise) as it is and they are all located in the city at present and I can only imagine that it is a nightmare for some at the moment to get to work.
 
I don't recall the figures but minister Harney said on the radio yesterday that the patient to midwife ratio would be better in the new hospital than in the combined old hospitals, even at the current lower level. She also made the point that the existing ratio was better than any of the other maternity hospitals in the country.
The HSE is not blameless in this and the adversarial environment between management and staff (unions) in the health service is a disgrace which reflects badly on all involved.
 
Gordanus said:
There are generally no redundancies in nursing......they just leave to find better hospitals.
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Or to find nice, clean 9-5 jobs as sales reps with pharmaceutical companies.

I'd be cautious about drawing conclusions from statistics like these in isolation. You'd need to compare the number of beds, the number of GP's, the number of physios and speech therapists, the investment in preventative medicine and many other figures to draw any sensible conclusions.

sherib said:
Is it not likely that the amaglamation of three old hospitals and their replacement by a newly designed modern one could be expected to yield efficiencies at all staffing levels?
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Like I said last time, "Perhaps you can make specific suggestions about how economies of scale would apply to midwifery?". I can see how there would be economies of scale on administration and support services like radiography & lab services, but I don't see how ecomonies of scale apply to midwifery. It's a pretty hands-on business. So perhaps before you rush to judgement, you might throw some light on how these efficiencies would be found in midwifery.
 
"I can see how there would be economies of scale on administration and support services like radiography & lab services, but I don't see how ecomonies of scale apply to midwifery. It's a pretty hands-on business. "

I think I would disagree. A mother might come in to hospital anything from 4-48 hours before the actual 'hands on' element of the birth. Even with a quick birth, free of complications, there is a large element of waiting around, with midwives popping in every now and again to keep an eye on progress. One midwife might not comfortably manage 4 births on her own, because of the danger that she will be urgently needed in two places at once (I am plucking this figure from the air, for illustrative purposes only). Keeping with the same proportions, two midwives would be far more comfortable managing 8 births between them. Three midwives would be more comfortable again managing twelve births between them.

I think there are almost definitely economies of scale. Perhaps this is not the exact right term to use - but with more staff, in a bigger hospital, and with more births, there is less volatility in the workload for each individual midwife, and less chance of a crisis due to sudden overload of work.
 
I never suggested that each mother required a dedicated midwife for the duration of her labour. I agree that each midwife can probably handle more than one birth simultaenously, but this doesn't nothing to explain how economies of scale can be derived from merging 3 hospitals into one. If anyone can throw any light on this, I'd be delighted to hear it.
Purple said:
Rainyday, do you support the nurses stance?
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I really don't know enough about the matter to come out either way. Interestingly, this limitation doesn't seem to stop most posters on this thread from jumping to conclusions which are not supported by the facts.

Now it's my turn - Are you going to enlighten us as to where/when "the INO said they would not go on strike if they were paid off" as you claimed earlier?
 

Holy god! MOB must be male! There SHOULD be continuous attendance in labour..... prior to the birth, maybe one midwife for 4 women, but we never know just how fast or slowly a birth will progress. And if a woman is there for 48 hours before the baby is expelled, she's having problems. It's Murphy's Law that anything that can go wrong will go wrong - it's always when there is short-staffing that things go wrong due to inadequate monitoring. Would anyone risk his wife's/baby's health/life? (I was in labour on my first birth for 2 and a half days - my baby went into distress and I was seriously depleted - beginning to break down muscle mass for energy - by the time it was born.)
 
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RainyDay said:
Now it's my turn - Are you going to enlighten us as to where/when "the INO said they would not go on strike if they were paid off" as you claimed earlier?
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Liam Doran said that he asked for €1000 as a sweetener to get the Nurses to move. This seems to have been dropped over the last day or so and according to Mr Doran on the radio last night it is all to do with staffing at this stage. The issue at this stage, as I understand it, is that the hospital well cater for 175 beds when at full staffing levels but the HSE want to open it with 124 beds, which is the existing number of beds that are covered by the existing three hospitals. The INO say that the staffing level will only be able to handle 116 beds. So basically the HSE are saying that the same staff in one new hospital will be able to cater for the same capacity as they catered for in 3 smaller old hospitals. The INO disagrees.
The INO may well be legitimate concerns but I don't think 8 beds is a good enough reason to hold up the whole show. Of course if the management of the HSE were any good it would never have come to this.
Whatever about the details my problem is the holier than thou image the INO seek to project. They are a union, and a good one, that represents the interests of their members. It would take a lot to convince me that this would not be happening now if the nurses had been offered five grand to move...
 
"I agree that each midwife can probably handle more than one birth simultaenously, but this doesn't nothing to explain how economies of scale can be derived from merging 3 hospitals into one."

I think you may have missed my point. I don't know how many births (on average) one midwife can handle simultaneously - the point is that with a larger number of midwives in one place, the total is greater than the sum of its individual parts. Using wholly illustrative numbers, my point is that it is going to be a lot easier for 10 midwives to manage an average of 40 births a day than it is for 2 midwives to manage 8 births a day. At some point, the returns from scale may diminish, but with a larger unit, you can surely have better quality of service (or reduced manpower, or a bit of both). Is this not an economy of scale?
 
I think the HSE agrees with you MOB. That's why they think the capacity can increase by 6-7% in the new hospital.
 
I think part of the problem is that the new wards are smaller (a problem for the nurses, not the patients of course). Whereas two nurses could manage two eight bed wards before, they need more nurses to cover four 4 bed wards (or words to that effect, I may have the numbers wrong).
 
That's fair enought, but it still doesn't stand up your earlier claim that "the INO said they would not go on strike if they were paid off". If you are unable to stand over this claim, it is only fair that you withdraw it.

I had missed your point, but I get it now. But your point is based on the assumption that the midwives are not fully utilised in their existing hospitals. They may well have already achieved the maximum 'economy of scale' in their current hospitals, none of which are small clinics. Now I can't say for sure that there is no economy of scale involved in the move, but I'm pretty certain that none of the posters on this thread can say for certain that there is an economy of scale. Perhaps we shouldn't rush to judgement in the absence of the facts....
 
http://www.tribune.ie/article.tvt?_...&id=64804&SUBCAT=Tribune/News&SUBCATNAME=News

"Sadly for the INO ... it emerged on Saturday morning that it had indicated to Harney that if a compensation of 1,000 was paid to each member, the midwives would work.."

Seems to collaborate Purple's post, anyway their concerns of patient "safety" seem to have been allayed. So now the INO can concentrate on their 10% more for 10% less claim - probably also in the interest of patient safety.
 
Oh I see - fair enough then, when was that post by the way? The thread restarted on Mon 26 March, the Saturday referred to in the article is fairly clearly Sat 24 March.
 
RainyDay said:
No it doesn't, given that Purple's post pre-dates the Saturday morning mentioned in the article. I look forward to Purple's clarification.
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ashambles is correct. The information in the Tribume was on the radio all week.
 

Like most of the public service they are overpaid as it is. Mary Harney tonight was on the TV saying last year the average nurse earned 54,000 euro last year. This is much more than the average industrial wage, yet they enjoy security of employment and other perks. The country is gone mad.
 
I am not sure whether I think an average of 54k per annum is high or not - I would probably need to have a think about it. However, I am fairly sure that the average industrial wage is not an appropriate comparator. Nurses these days are educated to degree level: whatever the appropriate benchmark is, it is not the average industrial wage. I do think that - in common with many other public sector workers - the nurses probably take for granted many of the standard benefits which apply in the public sector and which - if fully costed out - would be demonstrably unattainable in the private sector (pensions being one item in particular); but this is not a dig at nurses in particular.
 
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