The Irish Nurses' Organisation (INO) has refused a request from the country's largest children's hospital, Our Lady's hospital in Crumlin, Dublin, for an exemption from the current nurses work-to-rule.
General secretary of the INO, Liam Doran, said appropriate arrangements had been put in place locally to ensure services were maintained for patients, but no overall hospital-wide exemption from the work-to-rule was being provided.
Our Lady's hospital said that in recent days, 15 per cent of elective admissions had been deferred and in some outpatient clinics, up to 30 per cent of appointments had been rescheduled.
A spokeswoman said that in some specialities such as cancer, cardiac and dermatology, it would be usual for parents to ring up to speak to a clinical nurse specialist about the condition of their child, who was being managed at home. The hospital had put in place a screening mechanism to vet such calls as, in general, phones were not being answered by nurses as part of the work-to-rule. Emergency cases are being referred on to clinical staff.
Under the work-to-rule, nurses are not answering non-essential telephone calls or carrying out clerical or IT duties. In a separate development, health service management has expressed concern about the impact of the work-to-rule on the operation of some intensive care and oncology units. The HSE Employers' Agency said it had raised with the INO cases where nurses were not answering emergency phones in intensive care units.
It was also concerned at the impact of the action on the tracking of patients and the maintenance of records in oncology units. However, Mr Doran said the INO "absolutely refuted" that patient care had or would be compromised in intensive care or oncology units. Contingency plans had been put in place on a hospital-by-hospital basis covering all intensive care and oncology facilities. He said these services differed from hospital to hospital.
The HSE said A&E departments around the country and particularly in Cavan, Drogheda and the Mater in Dublin were experiencing congestion. It urged patients not to attend A&Es unless absolutely necessary and advised patients to attend their GP or out-of-hours service. The HSE said the hospital system was slowing down, with problems relating to the discharge and the admission of patients and the ordering of tests.
There were no developments yesterday between the parties on the nurses' pay claims.