Doctors working 30 hour shifts and over 70 hours a week cannot do Nurses’ work
The Medical Association of Malta (MAM) refers to the statement by the Malta Union of Nurses and Midwives (MUMN) that giving intravenous treatment is not a nurse’s job. Nurses have being giving intravenous medication for a number of years and many have undergone specific training for this. Indeed this is confirmed by the MUMN itself when it issued the directive. It would certainly not have made sense for the MUMN to direct nurses not to do something that they were not doing anyway! The fact the MUMN felt the need to direct its members not to give intravenous treatment confirms that it acknowledges it as being part of nurses’ job. Nurses’ job description, in fact, states that individual nurses have to “carry out medical instructions”.
MAM fully sympathizes with individual nurses’ position since they have been overburdened by the overcrowding problem at St. Luke’s Hospital. However, one cannot withhold giving treatment to acutely ill, hospitalized patients. Neither does it make sense to shift the work on to doctors who are affected by the overcrowding problem at least as much as nurses are.
As a representative of health care professionals, MUMN is ethically bound not to issue directives that may harm patients. Indeed, the position taken by the MUMN may unfortunately have a negative impact on the image of hard-working nurses and on the good reputation that nurses have rightly enjoyed. One simply cannot understand how it is implied that only doctors have ethical obligations to patients.
The Employment and Industrial Relations Act clearly prohibits directives which interrupt the provision of essential services to the extent that employees following such directives are not protected from disciplinary action, civil liability for tens of thousands of liri in damages as well as criminal responsibility for omission of duties.
As with a number of previous directives by MUMN, doctors, because of their ethical constraints, have been left to collect the pieces and protect patients from potential harm. However, this is straining the emergency services provided by the already overburdened doctors who work 30 hours shifts and average over 70 hours per week. This is not conducive to optimal patient care. This is why MAM hopes that the situation be remedied as soon as possible. Otherwise it will have no option but to issue directives and take whatever legal actions it deems fit so as to protect its members and patients alike.