Claire Mahon’s first year as INMO president has been an uphill battle, but one that she has been happy to fight. Gillian Tsoi reports

Nurses, midwives and all public servants have already paid more than their fair share towards Ireland’s economic recovery. This was the message from INMO president Claire Mahon at the recent ADC in Letterkenny.

Addressing the delegation, she described how INMO members are living from month to month, “many of them not able to pay all of their bills, many of them increasingly in mortgage arrears and all of them simply trying to provide for themselves, their families, their children and their loved ones”.

Ms Mahon said that she “cannot stay silent, or passive, if the government moves to act unilaterally and cut our pay”.

“If the government forces through, by legislation, pay cuts and other negative measures, I will be the president of the INMO who will actively participate in a campaign of opposition, resistance and, if necessary, industrial action.“

“The choice will be government’s. We are willing to re-engage. We are willing to make payroll savings and we have made suggestions of alternative measures which can produce savings without any further reduction in our income, in our pay rates, in our premium rates or other conditions of employment.”

Following the adoption of an emergency motion at the conference, the Organisation is now mandated to take industrial action with others if required.

She said: “The INMO will be positive and constructive, in any engagement with the employers. However we will be equally forthright, in conjunction with our fellow public service unions, in any campaign necessary to defend our members’ incomes from further cuts.”

Ms Mahon decided to defy tradition by delivering her talk a day before the Health Minister, James Reilly. She explained: “I am doing it today as I believe that I should address you, not a Minister who has shown little or no regard for our professions. I feel that you, the members of this Organisation, deserve my full attention and appreciation. You, the activists are the back bone of this Organisation. It is because of your ongoing and continued commitment that our professions and this Organisation are so highly regarded internationally.”

Ms Mahon spoke of the challenge of coming to the INMO presidency during these tough times. “It has been an uphill battle for all of us during these last few months, but it has been one that I have been more than happy to fight, and will continue to fight, on your behalf,” she said.

Carrying out the presidential role throughout the year has reinforced Ms Mahon’s pride in being a nurse. “I have been proud to represent you all around the world, proud to hear praise for Irish nurses and midwives and their abilities abroad.”

According to Ms Mahon, nurse and midwife colleagues overseas see the dangers that Irish nurses and midwives are faced with and recognise them as a threat to the professions.

She said: “Colleagues, we are no longer advocates for our patients alone, we are now the advocates for our professions because if we do not stand firm and fight for what we believe in, then no one will.”

Ms Mahon described her first year as president as “interesting, exciting, inspiring and thought-provoking”. She acknowledged the launch of the hugely successful Pink Power campaign a breast check service for members of the income protection scheme, the uptake of which has exceeded all expectations.

She commented: “It has been good to see something being given rather than taken, and in a sense, it is very positive to see someone finally ‘caring for the carers’.”

Staffing survey
In August, Ms Mahon travelled to the 67th annual conference of the New South Wales Nursing Association in Sydney, where she updated delegates about the impact of austerity on Irish nursing. The conference centred on the Association’s campaign to provide safe staffing levels to ensure safe patient care.

The INMO’s own staffing level survey, launched in November 2012, incorporated international research on staffing ratios and the value of the registered nurse. This research confirmed that the presence of a registered nurse leads to improved patient outcomes, shorter length of stay, reduced cross infection and reduced hospital readmission rates.

In the INMO survey findings, Dr Keith Hurst, a renowned expert in staffing and its impact on patient care, clearly indicated that Irish staffing levels are much below that of the UK. This is despite the fact that UK staffing levels have been shown to compromise patient care the starkest example of this was in Mid-Staffordshire.

During her address, Ms Mahon expressed her fear that a Mid-Staffordshire situation is happening in Ireland today.

She said: “We know that poor staffing is one of the key factors of poor patient care; therefore we should say ‘no’ when we do not have enough staff. We should say ‘no’ when we know patients are risk. Do not stand idly by and watch your profession and career being damaged because of someone else’s budget targets or poor practices. When you say ‘no’ the INMO will be standing right beside you.”

“I know, and understand, that you are under pressure in every hospital and care area across the country. In the acute hospitals, in elderly care, the community, on maternity wards, in operating theatres, emergency departments.”

She said: “You must maintain your standards and ensure that the only criticisms coming from our hospitals are directed at the cuts and staffing shortages. It is imperative that we maintain our standards even if that means saying ‘no’.”

Ward Watch
Ms Mahon went on to speak about the recent launch of the INMO’s Ward Watch, which measures hospital-wide overcrowding. The initiative, an addition to the Organisation’s long-standing Trolley Watch (a daily count of overcrowding in EDs) was instigated at the request of members, following the adoption of a motion at last year’s ADC.

She said: “The early weeks of this new measurement have demonstrated that five hospitals namely Tallaght, Connolly Hospital, Limerick, Wexford and Mullingar regularly place additional beds on inpatient wards, thus compromising the care of all inpatients, without declaring they are in full capacity.

The early weeks of Ward Watch have indicated that overcrowding in patient wards is not the solution to overcrowded EDs.

The INMO president assured ADC delegates that the Organisation is in discussions with the Special Delivery Unit of the Department of Health with regard to both ED and hospital overcrowding.

“In these discussions we will continue to demand that the only solution, particularly in the hospitals affected on a daily basis, is additional bed capacity as no amount of system reconfiguration will deal with the demand for inpatient care in these locations,” she said.

“We all know that all of our acute hospitals currently have bed occupancy rates well exceeding 95% and some, indeed, exceeding 100%. When desired improvements in patients’ length of stay, length of admission and same day admission rates are considered, it is clear that patient acuity and dependency is much greater now than ever before.”

Ms Mahon continued: “This reality, of increased productivity in a health system, is clearly missed by those demanding more cuts and cost reductions in our hospitals. We cannot solve our overcrowding problem without additional beds, without nursing/ midwifery staff and without additional community support services. To think otherwise is simply to ignore the reality and to compromise the care of patients.“

Graduate initiative boycott
Ms Mahon applauded members for their participation in the successful boycott of the government’s graduate recruitment campaign, which sought to recruit 1,000 new graduates at just 80% of the proper staff nurse salary.

“I salute in particular the graduates for their absolute refusal to submit to this coercion thus preventing the undermining of the pay, and value, of every nurse and midwife in this country,” she said. “We are against underpaying new graduates and we will utilise every resource at our disposal to protect their interests, secure proper paid employment for them and give them a future, in this country, where their energy, enthusiasm, and professionalism are so badly needed.”

Organisational/other developments
Despite the troubled times, the INMO has continued to grow its services to members, including opening its new Cork office, which facilitates training and meetings for members in the South.

During the year, six INMO members were also elected to new Nursing and Midwifery Board. Ms Mahon congratulated them on their success: “We look forward to new beginnings and developing a strong, constructive and pro-active relationship with the NMBI in the future.”

According to the president, the INMO’s safe practice campaign has had a very successful year, which included the commencement of a legal studies programme.

“This programme will enable members to build on the skills achieved in the safe practice training. When combined we hope these programmes will empower nurses and midwives in their decision- making,” she told the delegation.

Ready to fight
During her speech, the president and delegates kept the “critical and unacceptable“ position of the Irish healthcare system at the forefront of their minds.

“Government ministers and health service management continue to respond to the pressure of the ill-informed, outside commentators, who push for further reductions in staff and a downward adjustment of the existing skill mix,” said Ms Mahon.

“This effectively means fewer qualified, regulated professionals on ward rosters,” she said. “When the HSE and the Minister embarked on the assault on our professions little did they realise the depth of feeling, the steely determination and the dogged defence nurses and midwives, through the INMO, would display.

“This fight is not over... I am strengthened in the knowledge that I represent a group of professionals willing to stand together and support each other in the face of the oncoming storm.

“Our day is coming - we are ready.”

ADC - Presidential address - Ready to act