Nurses decide on powerful new strategy for the future

It was only a small sign, but it was a sign all the same, of the formidable ability of the members of the Irish Nurses' Organisation…

It was only a small sign, but it was a sign all the same, of the formidable ability of the members of the Irish Nurses' Organisation to get things done.

On the first day of the conference all trains to Killarney from Heuston Station were cancelled due to the ATGWU strike.

Yet, far from allowing themselves to be put off, by that night nearly every delegate had turned up to the INO's biggest conference for a debate on the sort of action they would be prepared to take in future industrial disputes.

The private debate started at 8 p.m. Forty-five minutes later they were on their way to dinner, having briskly changed the way they will do business in the future.

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What they had done was to fashion a powerful new weapon, not just for when they go on strike but for the more limited situation of a work-to-rule.

It has always been assumed that nurses will provide emergency cover during a strike. That cover was provided during the 1999 strike, and many nurses feel they got little thanks. Nurses who were working for nothing to provide emergency cover on wards long after managers and consultants had gone home were infuriated to find themselves being criticised for not providing enough cover, sometimes in statements issuing from consultants.

As far as they were concerned, their willingness to provide cover was taken for granted. They were determined that this would not happen again.

What they decided in Killarney was that in future they would turn the screw slowly but effectively on health managers by steadily withdrawing emergency cover except from the most life-threatening situations, such as intensive care and emergency departments.

In future, on the third day of a strike, nurses providing emergency cover will refuse to communicate with managers either verbally or in writing. They will refuse to deal with the routine administration of drugs; and they will withdraw from all medical and surgical wards for an hour.

They will continue to escalate this withdrawal, day by day, until on the seventh day they will withdraw completely from the medical and surgical wards.

They will continue to look after intensive care units and other life-threatening situations, but in effect they will have shut down almost everything going on in the hospitals.

This is a remarkably sophisticated programme of escalation indeed, one which members of ASTI can only view with envy.

But they took two additional steps which will make them a force to be reckoned with in future disputes.

In the 1999 dispute the executive council of the INO suspended the strike to allow nurses to examine the settlement proposals.

Some members were angry that the strike had been suspended before they had seen the proposals.

The executive council looked for explicit permission to suspend future strikes in these circumstances. In that busy, effective and efficient 45minute meeting, the permission was refused.

In future the members and not the executive council will decide if a strike is to be suspended. What this seems to mean is that a strike will continue until after the settlement proposals have been considered by everybody. If they are not happy the strike goes on.

The second step was to decide that in future when they have a work-to-rule they will stop administering intravenous drips and will not admit patients to private beds or organise ambulance services.

That will certainly get the attention of consultants and managers. It will mean non-consultant hospital doctors administering drips, for which they may not have much experience.

That all this was done without a row and at a time when nurses are not caught up in the heat of an industrial dispute suggests that the 1999 strike and its aftermath have wrought a seachange. The angels of mercy have turned themselves into a formidable fighting force.

pomorain@irish-times.ie