IRISH nursing has never been under the spotlight like it is now. For the first time in our history, the entire nursing profession may be balloted on industrial action: Irish nurses may go on strike.
Nurses, patients and the health service find the prospect of such industrial action surprising and worrying.
Traditionally nurses have been valued for their personal qualities; for their warmth and commitment rather than for their knowledge, skills and qualifications. The personal qualities are the criteria by which Irish nurses are normally judged but in our society these are qualities which are appreciated - but not necessarily remunerated. Nuala O'Faolain has referred to the "patronisingly cosy" attitude people have about nurses. It is understandable that when the public are confronted with the details of what nurses actually do, they find it easier to idealise, not analyse.
However anyone who has experienced nursing care either personally or vicariously will be aware that there are aspects of a nurse's work which are unpleasant, repetitive, physically demanding, emotionally stressful and spiritually draining.
Yes, there are times when nursing is also very satisfying. However it would be naive to believe that every aspect of the work is intrinsically rewarding and that this intrinsic satisfaction compensates for recognised anomalies in nursing pay and conditions.
The knowledge that underpins nursing is complex. It draws on both the behavioural and biological sciences and must be integrated and applied by the nurse in meeting the needs of a person in distress. The range of patients and the diversity of their needs have to be matched by nurses competencies and adaptability.
Nurses themselves have no difficulty recognising the integral value of the diverse nursing roles they occupy. No nurse would consider that her, or his, colleague in the accident and emergency department confronting a violent patient is fulfilling a more important role than the nurse staying with the suicidal patient, the hospice nurse caring for a dying patient, the public health nurse enabling disadvantaged women to become health promoting mothers or the intensive care nurse caring for the critically ill child on a ventilator. Specialisation within the different branches of nursing adds great richness to the profession but also creates problems for it when we are faced with giving a monetary value to what a nurse is worth.
Even within my speciality of midwifery which has very clearly defined boundaries, there is need for diverse competencies. Some midwives are experts in ante natal and postnatal care, others care for women in labour, more look after tiny babies on life support machines, others specialise in bereavement support for women who lose their babies. Still more are involved in preparing women for childbirth and promoting breastfeeding while others specialise in ultrasound.
Each of these roles is of equal value although they require very different knowledge and skills. A synthesis of ability and empathy is necessary for expert practice in any branch of cursing.
Qualified nurses are now to be balloted on an offer of £14,385 after five years education and training. Over and above this, standard unsocial hours payments are made as they are to all public service workers who provide a seven day, 24 hour service.
One would have to have some sympathy with the negotiators who are now trying to grapple with the diversity and complexity of nursing in order to put an equitable monetary value or worth on roles as varied as these.
IN RECENT years difficult fiscal decisions have had to be made which resulted in curtailment and limitations in health services. Simultaneously, an increasingly well educated and informed public began to expect more of the health services rather than less.
Politicians and health service managers have had to make tough decisions which they have done reluctantly, with an intellectual understanding of the implications. But it is nurses in the front line who have had to apologise and explain. Hospital and health service managers have to a great extent relied on the goodwill of nurses to ease the difficulties caused by budgetary restraints.
No matter what the outcome of the current negotiations now is the time to give meaningful recognition to the important role the nursing profession plays in humanising the face of health care in Ireland.