HSE pulls memo under threat of industrial action

The HSE has been forced to withdraw a controversial memo placing additional responsibilities on nurses working in an acute psychiatric unit in Cork under threat of industrial action.

The memo, which relates to patients presenting for assessment to the acute mental health unit on the Cork University Hospital campus, stated that nurses from the unit should accompany patients to the hospital’s emergency department “if an overdose is suspected” or if the patient had an acute medical condition that required urgent attention.

The memo also stated that an initial assessment must be conducted at the unit “in most cases” by a doctor, but leaving the door open for assessments to also be carried out by nursing staff.

Des Kavanagh, general secretary of the Psychiatric Nurses Association (PNA), said the additional responsibilities were against a backdrop of the HSE continuing “to fail to maintain agreed staffing levels” at the 50-bed unit.

Mr Kavanagh wrote to the HSE warning that, “You are now placing us in a position of having to issue a direction for non co-operation. If that is required, so be it.”

Siptu shop steward Des McSweeney, who works in the unit, said management had used a “top-down approach” in drawing up the memo and that the “vast majority” of nurses’ managers were opposed to the proposals and considered them clinically unsafe.

Mr McSweeney said they had concerns around a clinical nurse manager being tasked with assessing patients while simultaneously having responsibility for the unit. He said dedicated assessment nurses were required, as provided at the Mercy University Hospital, which also has an acute mental health unit.

Mr Kavanagh said the union’s position was that “any introduction of new arrangements have got to be negotiated, they can’t just be enforced”. He said what was proposed posed a risk to both patients and staff.

“If the employer is depending on nurses to accompany patients to the main hospital it would mean reduced nursing numbers in the unit creating additional pressures for remaining staff in relation to patient care and safety and their own safety,” he said.

The PNA has repeatedly raised concerns about the level of assault on psychiatric nurses in the country’s acute mental health units.

Concerns have also been raised in relation to patients having to sleep on chairs on at least two occasions at the Cork unit.

On Tuesday, the HSE agreed to withdraw the memo, saying it would “welcome further discussion”. Further negotiations are due to take place next week between unions and the HSE.