The Minister for Health, Simon Harris, has appointed Karen Greene to the Board of NMBI. She will represent Directors of Nursing or Directors of Midwifery.

Karen successfully qualified as a General Nurse in 1999 in Beaumont Hospital and currently holds the position of Director of Nursing. Her career to date has been predominantly spent specialising in the field of Neurosciences holding various nursing management positions including CNM 2 of a neurosurgical ward, CNM 3 of the Neuro-Oncology Service and a number of years as part of the directorate leadership team in the position of Directorate Nurse Manager for Neurosciences, ENT, Ophthalmology and Cochlear Implant services. Karen obtained the position of Deputy Director of Nursing in 2013 where she led the nursing department particularly in the areas of service and workforce planning. She joined the executive management team of Beaumont Hospital in 2015 when appointed as Director of Nursing.

Karen replaces former Board Member Tanya King and her appointment is until 5 December 2020.

The Minister for Health, Simon Harris, has appointed John Horan to the Board of the NMBI under section 22(1)(j) of the Nurses and Midwives Act 2011.

John Horan has a wide range of experiences at Senior Management and Board level. He is currently Chairperson of the National Treatment Purchase Fund, having been a Director and Chair of the Finance and Audit Committee.

He served for more than 20 years in a variety of roles in the Aer Lingus Group. He was Chief Executive of the Irish Hotels Federation for seven years and of Veterinary Ireland for ten years. He is now an Honorary Life Member of the national organisation for the Veterinary profession.

For many years he represented these sectors at Council and Board levels in a range of National and European organisations.

He is an IBEC nominated Member of the Employment Appeals Tribunal and is a member of the Law Society’s Complaints and Client Relations Committee.

He has received a Master of Science Degree in Management Practice MSc(Mgmt) from Trinity College, Dublin.

John’s term of office is until 5 December 2022. He will replace Elaine Cassidy on the Board.

NMBI has prepared for the Withdrawal Agreement and has also put contingency plans in place for the possibility of a no-deal Brexit. These policies and procedures will ensure that UK qualified nurses and midwives can continue to register with NMBI with minimum disruption.

Currently, there is EU legislation that allows EU citizens to have professional qualifications recognised (‘the Directive’ 2005/36/EC). If you have already had your qualifications recognised by the NMBI, there will be no change; that qualification remains recognised and you can continue to practise in Ireland once you are on the NMBI Register of Nurses and Midwives.

There are three options regarding what may happen once a decision is made regarding how and if the UK leaves the EU:

1. Withdrawal Agreement: EU legislation, including Directive 2005/36/EC applies for the duration of the Withdrawal agreement.
2. If the UK decides to remain an EU member state, all current provisions in the Directive will continue and NMBI will continue to process UK qualifications in accordance with our current policies and procedures. There will be no change.
3. No-deal Brexit: In the event of a no-deal Brexit, NMBI will accept for recognition UK qualifications in general nursing and midwifery which:

- were obtained on or after 29 June 1979 (23 January 1983 for midwifery) and were then compliant with Annex V of the Directive;
- were obtained after the withdrawal date and meet NMC accreditation standards and would have been compliant with Annex V of the Directive had there not been a no-deal Brexit.

For all other UK nursing qualifications, NMBI will assess the qualifications against national Irish standards.

The effective date of the proposed policy will be the day after the withdrawal date and it will be reviewed within two years. Applications in train as at the withdrawal date will be processed under the revised no-deal Brexit option set out above.

However, it should be noted that applicants with UK qualifications should not experience any difference in the process; it is only the legal basis for the recognition of their nursing/midwifery qualification that is changing.

See our Brexit webpage for examples and further information.

NMBI has launched a public consultation regarding Section 40 of the Nurses & Midwives Act, which concerns the Professional Indemnity for Midwives.

The closing date for this consultation is 13 May 2019 .

Please see the Midwife Indemnity Consultation webpage for full details.

A research project being carried out at Trinity College Dublin is examining the experiences of newly qualified nurses and is looking for participants for an online survey. The research aims to explore newly qualified nurses’ experiences of the internship period.

All newly qualified nurses who graduated in Ireland from the General, Mental Health, Intellectual Disability and Combined General & Children’s Programmes in 2018/2019 are eligible to take part.

The research study information and survey are available online.

If you would like more information please contact Christina Lydon at: clydon@tcd.ie

The HSE has launched a Storytelling Competition to celebrate the forthcoming International Day of the Nurse (12 May 2019) and International Day of the Midwife (5 May 2019).

Nurses and midwives are invited to submit their story relating to an experience they had in caring for patients. For the purposes of the competition the word ‘Patient/s’ is being used to capture all the terms that are applied to the care of the population we serve, e.g. mothers, children, service users, clients etc.

How to Apply

There are two categories that capture the five nursing and midwifery divisions (similar to the Higher Education Institutions (HEI) programmes.

These include;

• General Nursing
• Children’s’ and General Nursing (integrated)
• Intellectual disability Nursing
• Psychiatric Nursing
• Midwifery

A panel of judges will select the top three stories from nursing and the top three stories from midwifery. All finalists and guests will be invited to attend an awards ceremony where the stories will be read out by the author or nominated person.

The winners will be announced at a special evening award ceremony in Dublin on Saturday 11 May 2019 when prizes will be presented.

Entries should be submitted to NMaward.event@hse.ie before 5pm on Thursday 18 April 2019.

Stories should be no longer than 1,000 words maximum and should be previously unpublished and must not have won a prize in any other writing competition.

The submission date deadline for Advanced Practice registration was 8 April 2019. Eligible applicants will be contacted directly and can expect the Review Panel to take place on 7 and 8 May 2019.

Advanced practice is defined as a career pathway for registered nurses and midwives, committed to continuing professional development and clinical supervision, to practice at a higher level of capability as independent, autonomous, and expert practitioners. Registered Advanced Nurse and Midwife Practitioners have to meet the Board’s Criteria for Registration to enter the Advanced Practice Division of the Register (NMBI, 2017).

For information on the registration process see the NMBI website.

Article Two: Complaints about nurses and midwives relating to a relevant medical disability

What is a relevant medical disability?

The Nurses and Midwives Act 2011 defines a relevant medical disability, in relation to a nurse or midwife as:

"a physical or mental disability of the nurse or midwife (including addiction to alcohol or drugs) which may impair his or her ability to practice nursing or midwifery or a particular aspect thereof."

Complaints:

Complaints about registrants solely on the basis of a relevant medical disability are extremely rare. If a registrant has a physical or mental disability and they are receiving treatment from an appropriate health professional and adhering to that treatment, then they are extremely unlikely to be the subject of a complaint.

The most common scenario giving rise to a complaint is where the registrant does not fully accept that they have a health problem; is not receiving any or any appropriate treatment; and as a consequence engages in behaviour that may constitute professional misconduct.

Examples of such behaviour are:

• Being on duty whilst in an unfit state, e.g. under the influence of drugs or alcohol or when their metal state is affecting on their ability to give safe care;
• Theft of drugs, prescription pads, needles and syringes from their place of work;
• Forging of prescriptions;
• Forging of colleagues signatures in drug records, e.g. the MDA Schedule 2 Register; and
• Making false entries in patient records.

It is these actions that give rise to the complaint, not the underlying health issue. Many of these actions may also result in a registrant facing criminal charges.

The Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (NMBI December 2014) states that:

"You are responsible and accountable for your own health and wellbeing. If you become aware that your own health is affecting your ability to practice safely, you must get help to manage your condition."

Registrants who fail to seek help to manage health issues may find themselves the subject of complaints on the grounds of non-compliance with the Code of Professional Conduct, in addition to the grounds of relevant medical disability and professional misconduct.

How common is this type of complaint?

The most common health issue that gives rise to a complaint is abuse of drugs. The drugs may be taken for their effects alone or to self-treat underlying problems such as depression and/or anxiety or chronic physical pain. A history of un-addressed traumatic events is not uncommon. Abuse of alcohol may also be a feature, though abuse of drugs is far more common.

Historically these types of complaints were rare. When made, they almost always lead to a Fitness to Practise inquiry being held. In the last few years the numbers of these types of cases has increased. In 2017, one third and in 2018, just over a quarter of all inquiries held related to these types of cases.

The drugs abused: The most commonly abused drugs are:

• Opioids, e.g. morphine, pethidine, cyclimorph, fentanyl, codeine and oxycodone. Abuse of these drugs may start with abuse of over-the-counter preparations containing codeine.
• Benzodiazepines, e.g. midazolam, diazepam, alprazolam.
• Hypnotics, e.g. zopiclone, zolpidem tartrate.
• Other drugs abused have included antidepressants, propofol, steroids and levothroxine.

The use of ‘street drugs’ is not common but has been an element of some complaints.

The abuse of these drugs potentially poses very significant health, personal and professional risks for the individuals themselves, in addition to the potential risks for patients and employers.

Avoiding a complaint:

Registrants can reduce the likelihood of being the subject of this type of a complaint by seeking appropriate treatment from relevant health professionals rather than self-treating if they have a physical or mental health problem. Registrants should avail of health care and support from

• Their general practitioner, including referral for specialist medical services or counselling;
• Occupational health and employee assistance services, if available through their employment; and/or
• Voluntary organisations and professional associations may also provide assistance and support.

For more information on the series please see the Focus on FTP series webpage.