On the 2nd of February 2017 members of the Executive of TTRNA met with some members of the management of the ERHA. The members representing TTRNA were Mr. Idi Stuart President, Mr. Corey Dillon Secretary, Mr. Christopher Toussaint Chairperson Eastern Branch and Mrs. Natasha Prince Vice Chairperson Eastern Branch. The members representing the ERHA were Mr. Roland Jack General Manager Human Resources and Mrs. Sharon Duffield-George General Manager Nursing. The Chief Executive Officer Dr. Maharaj did not attend.
The meeting commenced at 10:20am. This is the 4th RHA management that we have met with as we strive to build relationships between employer, employee and professional association/union for the best interest of the internal and external clients. The matters discussed are outlined below
INADEQUATE AMBULANCE SERVICE
This is a matter of immediate concern to our members in light of the recent incident in which one of these said ambulances was involved in an accident on the bus route and the nurse involved is yet to receive word on any type of compensation. TTRNA reiterated that the ambulances in use do not meet the specifications outlined by the Ministry of Health Emergency Personnel Act and Ambulance act. These ambulances which should more appropriately be called “vans” do not meet specifications in terms of size, spacing on the inside, equipment on the ambulance. There are also issues surrounding the other staff on the ambulance. All staff on the ambulance must be trained in first aid, CPR of some other basic life saving technique. This is not the case. The Ministry of Health has an ambulance registry in which none of the RHA’s are registered. The GMHR said that they are soon to receive some new ambulances. When asked what shall we as the professional association tell our members in terms of use of these vehicles that are not suited he had no answer. There are EMT’s attached to the ERHA but they work in the Emergency Department and do not transport patients. The TTRNA is soon to release an official position on what our members should do if asked to transport patients on these “vans”. There was also the problem that no ambulances are outfitted to transport children safely. Incubators are strapped to the trolley making transport unsafe for the child. No ambulances have an incubator. Important to note in terms of coverage Workmen’s Compensation which is always used as the type of coverage only becomes available if you lose a limb or life. Risk insurance which should be provided for all persons on the ambulance is only provided for the driver.
Matter not resolved TTRNA to soon release an official statement on nursing personnel use of the RHA Ambulances.
UNAUTHORIZED SALARY DEDUCTIONS
This was not a problem in the ERHA as the GMHR said persons are informed if monies are to be deducted at any time. They are also informed as to why and a payment plan is negotiated between employer and employee. If this is occurring or has occurred please inform you branch officers.
Matter resolved
INCREMENT PAYMENT DELAYS
The GMHR verbalized that some permanent and some temporary workers to receive their increments shortly. He gave us the assurance that all outstanding increments will be rectified by the end of March. Some of the issues he said they were having are late receipt of staff appraisals we brought to his attention that the late receipt is due to it being disseminated late from HR. We reiterated that the process of appraisal and disbursement of increments is a function of HR and by law increments should be paid within 3 months after it becomes due (civil service act).
Matter resolved
CONTRACT EMPLOYMENT
The issue of contract employment for nursing staff was raised. The GMHR and the GM Nursing said that permanent contracts have been prepared for a number of nurses. These letters will soon be issued to the relevant persons who wish to take up the offer or permanent employment. Those who have not received their offer of permanent employment need to contact your branch officers.
Matter resolved
SPECIALIZATION ALLOWANCE
It was brought to our attention that persons are working in specialized units and not receiving the mandated allowance which is in full if you are so trained and part if you are not trained but work in the specialized area. The GMHR said that the names of persons in these areas need to be forwarded from the supervisor or head nurse to HR and the payment can begin contingent on the specialty being cabinet approved. Some are not. Trauma, ICU, OT and Oncology are approved. The others we will seek the addition, radiology is one such specialty. The issue of head nurses working in the supervisor’s office was also raised. The GM nursing said it was training in preparation for when they may become supervisors. When asked who supervises these head nurses to ensure they are learning the proper thing and are mentored, she could not answer. This is exploitation as they receive no allowance for this and most importantly are unable to adequately supervise and mentor the young nurses who are left on the wards.
Discussions to continue on the matter.
PENSIONS
TTRNA inquired into the nature of this fund as members who contribute to this fund are unaware of the dollar value of the fund. The GMHR said that there is a pensions committee in the RHA who deals with matters pertinent to the staff pensions. He said that there are elections for the persons and that a circular is sent when these elections are approaching. TTRNA executive members who work in the ERHA said that no such circular has ever been seen. The GMHR did say that he thinks there is a nurse on the committee. We requested the possibility of changing the person to one of our members who will bring back information to our members. We also inquired into the delay in disbursement on retirement. He spoke about the fact that it needs to go to comptroller of accounts and to their actuaries Baylon and Wodruff for calculations and Republic bank because they are the trustees. The GMHR said that the process commences a year before retirement but persons are still receiving their pensions late. We advocated for the process to begin 2 years before retirement. The RHA agreed to send to all employees a yearly statement on their pension contributions cumulatively. No word on how fast retired employees will receive their pension. Circular will also be sent when next elections are due for persons on the pension committee in the RHA.
SAFE STAFFING LEVELS
The issue of staffing levels was also ventilated in this meeting. The General Manager Nursing verbalized that she has submitted a 3 year strategic plan aimed at boosting staffing levels at the RHA. She said that the plan outlines filling vacancies in specialties also as this is the ERHA most acute problem in staffing. They have also created position called Coordinator Staff Development but this post remains vacant due to the low remuneration package. The GMHR says they need to engage the CPO to have the salary adjusted. We reiterated the call for 3 nurses to be scheduled to work on the night shift. In the event one fails you still have 2. The habit of having one nurse on a ward is fraught with danger in the event of a phone order from a doctor or the use of medication from the DDA cupboard you need 2 nurses.
The staffing numbers in ERHA is better than other RHA’s but the main problem is the number of junior nurses working unsupervised because their head nurses are doing nights in the supervisor’s office. Mr. Toussaint said that there is need for an immediate solution because this is affecting patient care. They had no solution. Another issue that is affecting the nurse’s capacity to function on the ward is the absence of a clerical officer on all wards. This means that many times the nurse has to do clerical work. TTRNA vehemently opposes this practice that is becoming customary wherein any category of staff is absent the nurse fills their role. We advocated for the creation of a ward coordinator. It is a position that is being used in the private setting with good results and allows nurses to do nursing.
One position TTRNA presented was the creation of a 24hr daycare facility for staff to help with absenteeism. The profession is predominantly woman and it has been noticed that staff do take a lot of time from work to take care of their kids. The GM Nursing said that a site was located but the management of the ERHA is not pursuing it at this time. We at TTRNA intend to push for the creation of this daycare for staff.
Discussions ongoing
OTHER ISSUES
The ERHA does not have an Employee Assistance Programme (EAP)
The ERHA does not have a Staff Development Unit (SDU)
It is mind boggling that an RHA can exist in the absence of these 2 fundamental institutions. They verbalized that they are working to create same.
TTRNA EDUCATION PROPOSAL
Being the professional association we offered our services to help educate our colleagues through our academy. All we require from the ERHA is that the individuals are given the requisite time. The courses will be for free. More details on these programmes to come shortly. We informed the RHA that continuing education is a criterion of a profession and it is mandated by law that Registered Nurses complete 32 contact hours in continuing education each year and 16 hours for Enrolled Nursing Assistants.
TTRNA CONFERENCE
TTRNA will be hosting its annual conference in the last quarter of 2017. We are optimistic that the RHA can sponsor 20 persons to attend.
CONCLUSION
The meeting was cordial and was conducted in good spirits. We look forward to our next meeting when we can ascertain the progress made in the resolution of the issues mentioned above.
