With INMO director of industrial relations Phil Ní Sheaghdha

Query from member
I work as a nurse specialist and have been advised that my job description has been altered and I have been issued with a new job description. I am not the only nurse specialist working in this location but it would appear that I am the only one who has had an altered job description. Is this correct and if not, what can I do in respect of it?

Reply
Job descriptions for most nursing posts are nationally agreed. We have noticed of late that a practice has developed whereby attempts are being made to change job descriptions both locally and nationally without formal consultation with the INMO. Your job description cannot be changed without your consent. The job you applied for would have included a job description and if there is any alteration to it, this has to be the subject of full discussion and dialogue with you and your representative, if so required.

Additionally, there are some jobs for which the job descriptions are agreed nationally and therefore would have had to go through an agreed process before being changed. In the event that you require representation on this issue, I strongly urge you to contact your INMO official who will, assist you in dealing with this matter and will examine your job description to determine whether or not it is a nationally agreed job description and would have any knock-on effects for others, in your grade, if altered. I hope this answers your question but please contact us with more details in respect of the changes to the job description, as a matter of priority.

Query from member
I work in a very busy medical ward in a regional hospital. The acuity of patients is very high and our staffing levels and skill mix are of huge concern to both me and other nurses I work with. We are concerned about the level of expertise in our ward and the high reliance on student nurses, who are supposed to be in supernumerary placement but, unfortunately, are relied on to take responsibility for patients, because there is not enough staff available. My own belief is that this is no longer a learning environment and we are constantly fearful of making a mistake.

Our manager is supportive, however doesn’t appear to be dealing with the issues when we raise them. We are constantly told that there is a recruitment moratorium and that there is nothing they can do; that agency budgets have been cut and that we have to do our best.

My colleagues and I are really concerned and don’t believe that this is an issue that we can condone for much longer. We fill out risk forms, we action and identify risks, however the feedback to this exercise is usually that it is related to staffing levels and that there is nothing the hospital can do. I would be grateful for some advice as my colleagues and I believe that both our registration and patient safety are at risk.

Reply
The situation you describe unfortunately is one that is becoming more regular in our acute hospitals. The first thing you have to do is seek the support of your line manager in raising the issue with the director of nursing to seek an examination of the admitting criteria to your area and the skill mix available. The INMO official who covers your area can meet with you and go through the issues with a view to assisting you in raising your concerns to senior nursing management. You should do this without delay and we will assist in respect of representing you and your colleagues to ensure that safety measures are put in place, including consideration for clinical risk and clinical safety, consideration of your health and safety as employees working in a stressful situation, and consideration of the learning environment and whether it is conducive to education for student nurses.

In the meantime, it is good practice to record the incidences that occur as a result of staffing deficits. For example, you should record patient care that has not been possible due to the staffing levels/skill mix. This can be done as a survey that demonstrates the issues you are raising. Some nursing staff have conducted surveys that highlight slips, trips or falls, medication delays, medication errors, and delays in attending to patient needs that result from staffing deficits/skill mix issues.

We encourage you to go through these procedures as soon as possible. In the event the issues you raise with management are not dealt with internally in the hospital, the INMO can refer the matters externally to the Labour Relations Commission under the Grievance Procedure.

I know this doesn’t answer your immediate issues but it is important that you deal with it as a matter of priority as the situation you describe is one that is very serious and one that would appear is not being dealt with at local level.

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