Former health minister calls for re-introduction of low-level nursing course

Deguara said that a solution to the nursing shortage is not an easy one. Simply increasing the number of students let in to university will result in qualifications gained in Malta not being recognised in the EU due to student mentor ratios.

“It is unnecessary to have degree-level nurses doing hospital chores such as preparing the patient for surgery or handing instruments to the surgeon. These can be done by nurses trained in a lower academic level course, leaving university qualified nurses to deal with chores in areas such as post-op care.”

This course was offered in Malta in the past, but was not a recognised qualification in other European states. Due to the aims for excellence in the health sector, the course was considered obsolete and discontinued.

Deguara believes re-introducing this course could be the answer to tackling the shortage of nurses at local hospitals.

The Ministry of Health is accusing the Malta Union of Midwives and Nurses (MUMN) of issuing a series of illegal directives to support its call on the government to address worsening staff shortages at Mater Dei Hospital.

The ministry has informed in writing both MUMN and all senior nursing staff in hospitals of the obligation to offer all essential services to patients in terms of the Employment and Industrial Relations Act.

However, no punitive measures are envisaged against nurses who obey the union’s directives. The ministry is appreciative for the dedication and commitment of its nurses and the valuable contribution they offer to the health care system.

A spokesperson for the Minister of Health Joseph Cassar said, “The Ministry is keeping particular vigilance to ensure and ascertain that all patients receive all essential services.”

The Malta Employers Association (MEA) echoes the same view, stating that the MUMN should not resort to actions that put patients in the crossfire. Both parties need to come to an agreement for the short term (employment of foreign nurses) and for the medium term (to ensure an adequate supply of qualified nurses is available to meet the increased demand).

The MEA emphasise that both the Ministry of Health and MUMN have an obligation towards to patient.

“If the parameters set by the Employment and Industrial Relations Act do not guarantee a continuation of the service to patients, then they should be revised to avoid a repetition of what is currently happening in our hospitals.”

But Paul Pace, the president of the MUMN, rebuts claims that the directives are illegal, especially in the light of Article 64, which was quoted by the government, where essential duties were not defined.

Pace denies claims that the directives go against patient safety, saying that it is the government’s refusal to tackle the shortage of nurses that is detrimental to patient welfare.

Ministry slams EFN’s ‘misleading’ statement

The Ministry of Health has responded to a press release by the European Federation of Nurses (EFN) cautioning them on the use of inaccurate and misleading statements, which are exacerbating an already difficult situation, and inviting the general secretary Paul de Raeve to Malta to meet with relevant stakeholders to make an informed assessment of the situation. 

The EFN is backing the MUMN saying that EU member states and the European Commission need to support the Maltese government to act towards a safe health system and urges MEPs to monitor what is going on in their own country enabling the implementation of the European Parliament Declaration on EU workforce for health.

Nurses have been instructed not to pick up medicines from the Mater Dei Pharmacy and not to administer medicines brought to the ward by subcontracted nurses. They were also told to leave the ward if patients became aggressive due to missed treatments.

At Mount Carmel Hospital, nurses have been ordered to leave the wards in the event of a power cut leaving gas lamps at the front of the hospital. The lack of a generator at the hospital is another issue the union is demanding government attention on.

Pace has written to the Health Minister warning of more serious directives to come in the coming week.

Pace said that there is a current shortage of 550 nurses with some nurses working up to 80 hours a week in overtime.

He insists the issue should be tackled by training more nurses rather than employing foreign nurses. He says that employing nurses from Pakistan is “unethical and unprofessional” and more resources should go into education and training of local nurses.

Out of the 300 nurses applying to work in the public sector, only 50 were Maltese. The remainder was foreign – 46 were Pakistani – and will commence work in Malta in September.

Helen Borg Bonnici of the National Council for the Elderly also expressed her dismay at this ongoing shortage of nurses and questions the recruitment of foreign nurses. She fears for the future of recruitment of local nurses in that disappointment will lead to fewer applicants.

“It is feared, that in future years, the number of applicants for Nursing Studies will dwindle to a small number after the disappointment experienced by many applicants in 2009 and 2010.

“It is deplorable that in the summer of 2009 when 379 students applied for the Course, only 165 applicants were selected and this year, when 309 students applied, another 165 were accepted by the University to start studies in October 2010.This means that the number of applicants 'refused' was 214 for Year 2009 and 140 for Year 2010! Surely, this is a waste of valuable human resource very badly needed in our hospitals where there is an acute shortage of trained Nursing Professionals.”