Level of nursing cover to vary throughout State

Nursing cover is expected to be reduced to between a quarter and a third of normal levels in hospitals today as picketing begins.

The level of cover will vary throughout the State due to the fact that emergency plans have been negotiated locally rather than under a national framework, as desired by health employers.

All local strike committees have agreed, however, to provide full cover for emergency cases and to accept the opinion of consultants who will determine whether a patient is classified as in urgent need of treatment.

For routine treatment, patients will be diverted to other services such as their family doctors.

In general, the following cover can be expected in the case of:

Birth:

Delivery and intensive care units will be staffed as normal. But non-urgent services such as scanning, tracing and post-natal treatment will be curtailed. Midwives will not carry out certain duties such as electronic foetal monitoring or facilitate research projects. Consultants will be required to take up the slack.

Mothers will be discharged from hospital within 24 hours rather than the average of two days. Caesarean section cases will be discharged within two or three days rather than the normal six or seven.

In some hospitals, such as the Coombe in Dublin, private wards will be closed.

Broken limb:

Nurses will be working on a night-duty basis in most accident and emergency departments. More hospital consultants than normal may be available as they are being diverted from non-emergency services. This will vary from hospital to hospital depending on the staff available.

Fracture clinics will operate as normal although longer delays may arise. Nurses will administer all necessary treatment in cases deemed emergency by consultants. In non-urgent cases, however, they will refuse to carry out blood tests, administer intra-venous injections, or perform dressings.

Once the patient has left the intensive care or casualty unit, the level of cover may decrease. Admissions staying in hospital overnight can expect to find fewer nurses and a lower degree of care.

Fever:

People arriving at casualty suffering from fever or illness are likely to be sent to their own GP. For a speedier diagnosis, patients have been urged to contact their GP first. The GP will decide whether admission to hospital is necessary.

If a GP suspects serious illness such as meningitis it will be treated in hospital as an emergency case. Tests and observation should proceed as normal. However, hospital consultants have warned that, as the strike continues and working conditions worsen, the likelihood of mistakes being made will increase.