The Executive of TTRNA met with the management of the NCRHA to address concerns of nursing personnel.
Present in this meeting were
Roslyn Renaud (GM Nursing)
Judy Martinez (GM Industrial Relations and Employee Services)
Judy Thomas. (GM Human Resources)
The CEO was unfortunately summoned to a meeting called by the PS of the Ministry of Health and was unable to attend. The representatives for TTRNA were
Idi Stuart (President)
Letitia Cox (Chairperson Northern Branch)
Aleisha Edwards (staff Representative)
Susan Harrison (staff Representative)
Avion Bailey (Staff Representatives)
Corey Dillon (Secretary)
The meeting commenced at 2:30pm with greetings from the President and apologies from the GMHR for the unavailability of the CEO. The matters discussed are outlined below and the status of discussions on same:
DIALYSIS EXTERNSHIP PROGRAMME
A private institution has been sending their students into the hospital to acquire practical training in haemo and peritoneal dialysis. Some of these individuals are lay persons and were being exposed to sensitive patient information. These persons were also to be supervised by the nurse. The TTRNA was not in agreement with this. The GMHR verbalized that this has now ceased.
Issue resolved
DELAY IN THE PAYMENT OF INCREMENTS
The GMHR verbalized that they are having challenges in this due to the current appraisal system and staff absenteeism. The HR system is currently being modernized to incorporate the Human Resource Information System (HRIS) a computerized system which will be able to flag persons or areas which need immediate/urgent attention. The appraisal system is currently being reviewed to make it more objective. TTRNA reiterated that it is the responsibility of HR to ensure that files are up to date. The GMHR verbalized that she has taken over the mantle of GMHR only in August 2016 and by August 2017 we should see some improvements. Increments are being done in batches but the economic climate may delay payment. Mr Idi Stuart reiterated that the increments are already earned and must be payed as some persons are as much as 10 years behind where they should be currently.
Discussions ongoing
APPRAISALS AND OTHER HR ISSUES
APPRAISALS
Reports were made regarding some staff appraisals that were carried out in the absence of the staff being appraised. The GM of nursing said that she is unaware of same but will inform Head Nurses of the proper procedure.
Matter resolved
TARDY VACATION APPROVAL
An incidence of approval for vacation being issued after staff is due to proceed on same was highlighted. Additionally staff are not apprised of there accumulated vacation leave eligibility, resulting in a situation in which the staff basically has to guess their leave balance. The GMHR gave the assurance that she will work on resolving the issue to ensure that prior to going on vacation approval is granted and an accompanying letter with leave balance is attached.
Matter being worked on
RECOVERY OF VACATION LEAVE FROM POST BASIC COURSES
Mrs. Harrison raised the issue of staff vacation days that are currently being reduced as same is considered not earned while on study leave for post basic training courses. This occurs in no other RHA. In one particular case a nurse who enrolled and a course 10 years ago had vacation days taken which has delayed her retirement and her pension. The GM Employee Services and Industrial Relation said that leave while on a programme is not an entitlement. It was reiterated that this has been the custom and if it has been changed the employees need to be informed of same and also how can it be retroactive. It was explained to the GM Employee Services and Industrial Relations that post basic courses in nursing is peculiar and it is similar to an apprenticeship and cannot be considered as the other courses for which vacation is not accrued.
Discussions will continue
UNAUTHORIZED SALARY DEDUCTIONS
The GMHR informed those present that this practice has ceased and staff will be informed in advance of instances that require recovery of overpayment so that a payment plan can be established. There is one exception in the event of an arrears payment all outstanding monies will be recovered (Exchequers Act).
Matter resolved
PENSIONS
None of the attendees representing the NCRHA were able to give information on the status of pensions at present and why there is such a long delay for retired persons to receive their pensions. They reported that a pensions committee exist but were unaware of the members.
Discussions continue
INADEQUATE AMBULANCE SERVICES
This is an issue of significance because of the recent accident on the Priority Bus Route involving an ambulance attached to NCRHA. The GMHR verbalized that they are in the process of restructuring this service by
1. Ensuring that the attendants on the ambulance are EMT trained
2. Procuring a list of persons at Arima District Hospital and Chaguanas Health Facility who may travel on the ambulance to acquire risk insurance for them
3. Retrofitting the current ambulances to meet immediate demands
The president of TTRNA was in agreement with the first suggestion but had issue with the second and third suggestions because the risk insurance need to be acquired for all nursing staff of the NCRHA not some because in the event that none of these staff who have coverage are present how will a client be transported.
The problem with the third suggestion is that an ambulance needs to meet certain specifications (dimensions) and the current ‘mini-vans’ do not. It will be a waste of tax payers’ dollars to retrofit when if challenged they will have to be disposed of. It was raised that this is a national problem and that Ambulances used by the various Regional Authorities are not registered within the Ministry Of Health as mandated by the Emergency Ambulance Act.
Further lobbying and Advocacy
UNSAFE STAFFING LEVELS
It was stated by the GM Nursing that staff shortages is a national and probably a global problem. We at TTRNA agree that while this may be true, the NCRHA need to consider a change in its management strategy to curb the prodigious turnover of staff at its facility. Mr. Stuart raised the point that the NCRHA is creating the perfect storm for nurses to be reluctant to attend work which will further exacerbate the staffing issues. Some of these are
1. Reduction of pool to 80hrs per week which is usually exhausted by nurses before the end of the 2nd week of the month leaving the remainder of the month for only skeleton staff to operate and in some areas like neonatal ICU there are at times 1 nurse to 5 babies wherein the national ICU policy mandated 1:1 in ICU Departments. The policy for 80hrs per week has not been shown to staff. TTRNA is suggesting removal of this cap on pool. Staff has also been restricted from working pool whilst on vacation. Staff was informed by GMIR to write the CEO requesting permission to take up paid employment while on vacation.
2. Taking into account that the majority of nursing personnel are women we inquired as to the establishment of a daycare facility which will help with staff absenteeism. We were informed that a site has been selected in Arima for the pilot to begin. Same to be taken to the board by the GM nursing for approval. Mrs Harrison also admonished that such a facility is required urgently at Mount Hope Womens as both Doctors and Nurses assigned there have children under the age of three.
3. Deplorable situation in which for weeks wards do not have soap and gloves, basic tenants for reduction of nosocomial infections. There are also inadequate needles and other basic hospital supplies with nurses having to improvise to ensure minimal care is given to the patient. Management looked bewildered.
4. Ms Avion Bailey highlighted that Head nurses are acting in the supervisor’s office without an acknowledgment letter or acting allowance for same. This has been ongoing for years. Additionally Male nurses are not allowed to attain supervisory positions because midwifery is a prerequisite. The need for a post basic in nursing to be a supervisor was discussed and the need may be irrelevant now as persons have degrees and masters in management studies. The GM nursing has committed to redo the job description and minimum qualifications for nursing supervisors. Head nurses acting as night and evening supervisors still to be resolved.
5. Nurses being placed on temporary contracts for one year. At the end of this first year, vacation is denied due to staff shortages and staff are being required to sign new temporary contracts under duress with no idea when they can proceed on their end of contract vacation entitlement. List of names to be forwarded to the GMHR for resolution.
6. There are no incentives as the ‘best nurse’ is not recognized for his/her dedication and an example was raised by the GM Nursing of a Philipino male nurse who is an exemplar to others in his 3yrs of service but when asked if he received any recognition for same she could not answer. It was raised that when electricity, water or air-condition services are not working all other departments in the hospital can leave except nursing. No plan
7. Short staff in the community is in dire straits due not only number of persons but also the age of those still there. Over 50% of DHV’s are over 60yrs of age. No plan
The TTRNA inquired as to the use of the workload index to ascertain exact staffing levels. Same is not currently in use.
Their only gain in staff was the successful acquisition of 6 midwives of the last batch to bolster their maternity department. The GMHR also stated that she is currently seeking approval to make temporary staff permanent.
The President of TTRNA did offer to use our academy as an avenue for professional development courses for nurses free of charge all we require is that the requisite time be given to staff. Partnering with their Staff Development Unit is also an option.
We also informed them of the conference to be held in the last quarter of 2017 and we are hopeful that they can sponsor 20 persons.
The meeting concluded at 4:55pm
