Recently, a case was brought against a local medical practitioner for malpractice. The courts ruled against it. Reading the following report, one has caused to wonder what effect this local case had and will continue to have on the parties involved, how it will effect them going forward and the consequences this case will have throughout the local medical profession as it interacts with the public.
Has a time bomb been set in place for patients and professionals alike? Many of the stressors in the article are reported to be present in the local arena.
On 17 January, striking nurses from the Unity Workers Union once again took the streets of the capital Bridgetown to press their demands that the government address their long held grievances and abandon its attempts to starve them into surrender. United with one voice behind their slogans of ‘No retreat, no surrender’ and ‘Touch one, touch all’ the nurses marched from Cheapside to the newly opened Golden Square Park which commemorates the struggles of a previous generation of fighting workers from the people’s rebellion of 1937. Many onlookers expressed their support for the striking nurses, condemned the government for ‘unfairing the nurses’ and demanded that they address the nurses’ longstanding grievances. One of the striking nurses, who has worked in the health care system for over 14 years was interviewed. The interview is presented below.
Can you tell us why you are here today? Why are you marching today?
So, today I am marching because of the different grievances that have been ongoing and current things that have taken place within the nursing fraternity. Mainly the straw that you can say broke the camel’s back was the safe zones that were brought up and then we heard, “oh, it wasn’t ready”. But we know it’s just a matter of time before that comes back. How could it be right that a nurse could not work for 14 months? I thought I had heard incorrect. 14 months? That is a year and two months. Who will do that? I mean, I, myself, when I first started, I worked three months without pay. I had to wait three months so I can understand but I honestly, lots of things that were happening because the institutions, you don’t know everything that’s going on at different institutions, I could not believe it. I could not believe that at a healthcare institution, at a hospital, they would not be phones on a ward, that nurses are using their cell phones to call doctors, or the nurses would have to walk across a yard day or nighttime. No, man, this is Barbados. It’s ridiculous. Nurses are using or re-using things like NG tubes. I am sorry, but I wouldn’t want that for my relatives. And I cannot condone that. If you can find money to do all kind of other things, why can’t you find money to do what is important and you say that you care about the health of our nation? That says something different to me. That’s just some of the things, but there, there are more issues, but enough is enough. It’s time that we take a stand.
I think by nature, nurses try to accommodate everybody. But what are you doing to your colleagues who are going all of this time with families and can’t support them? It hard for people who get paid every month, furthermore for people who ain’t get paid for a long time. It is ridiculous. Something has to be done about it. And that’s why I’m here today to lend my support. I mean, it’s not happening to me personally, but if my colleague is hurt, we have to work as a team. If my colleague is hurt, I will feel that pain. I think that in the workplace, it is toxic, for lack of a better word. I think the workplaces are toxic and people would just give you lip service, but they’re not doing anything. They just putting on makeup on a face full of pimples. So that’s why I’m here today to lend support and demand that change comes about. We are not unreasonable. We know that you can’t meet all of the grievances that we have, but you have to start somewhere. And the mere fact that you met with taxi people, but up to know, you have not met to see what’s going on to see how you will bring resolution or redress. I think it is ridiculous.
The government said they will talk to you, but first you have to call off the strike. What do you think about that?
No. So does that make sense? You can talk to me after I call off the strike. So if you give me things that are not in agreement with me, I already gone back to work. So that makes no sense? Nobody with common sense would do that. No, no. You meet with me. You meet with the representative, the general secretary, and we tell the general secretary what we want. So when you meet with him and he brings back what your proposals are, we will say, we agree with this, or we don’t agree with this. For me to stop striking and go back to work that means I surrender and I say all is well. And all is not well.
So you know this is the election time. We got an election coming up on Wednesday. As a nurse, who’s involved in this struggle for your rights as nurses and to protect the patients as well, do you have any message to send to either the existing government or whoever should be the new government when they come in after Wednesday?
Whoever comes, whoever wins, I know that their job will be difficult, but if you understand the pandemic that we are in, you have to make your nurses comfortable. Comfortable workers have good production. So that’s what you need to do. I know that everything will not be able to be done at one time, but you have to prioritize what is important. So we will see.
The attached recording, of a striking nurse phoning into Down to Brass Tacks, needs no explanation. This moving call speaks for itself. The issue is what we as Bajans are going to do about the situation. As the saying goes, evil triumphs when good people do nothing. We have a responsibility to take a stand in defence of the nurses and to condemn the government’s attempts to starve them into submission. We can raise our voices, especially in this election period, and demand that the government stop its attacks on them and sit down with their representatives to address their issues. We can also donate to their strike fund. Bank details are presented at the end of the transcript. We have a responsibility to the striking nurses. Let’s take it up.
For those of you who have or are not able to listen to the phone in call, a transcript is below.
Nurse: It was always said to us “It’s not the right time to strike. It’s not the right time to take action. Just wait. We’re going to talk and see what happens”. This has been years and nurses are now to the point, just fed up. It’s real hard every day you go to work. And the conditions you have to work in and you’re not seeing a salary at the end of the month. You’re overworked, overlooked and you’re still expected to come work with a smile on your face and work to the best of your ability.
I myself have gone more than four months without a salary. I have colleagues that have gone longer and it’s hard. You are at work. You owe the nursery, you owe the bank and no one wants to hear “oh I didn’t get my salary yet”. They’re still calling you expecting you to pay them. So I have all that stress from elsewhere on me. I’m still not receiving my salary.
Persons are saying that we’re only making noise about hazard pay. That is not the case. Nurses are not even receiving their regular salary and it’s hard. They’re saying even not only a basic salary, nurses have also gone on to be qualified, even if it’s a psychiatric nurse, a geriatric nurse, we go and specialise. You’re not even receiving the money that you’re supposed to get on your salary for these qualifications. There are nurses that have gone over ten years and have not got the increase on their salary.
And persons think this is fair. They’re saying it’s Covid times, things are going on. We shouldn’t be doing this. But look at it. Would you, yourself, go and work?
Would you continue to do that? There are times you don’t see ‘go to the bathroom’, you work through lunch, you work through break just to make sure that your patients are good. But you, yourself, your health is deteriorating. But no one is looking at you and it’s hard.
The prime minister came on and said she gave the nurses hazard pay. Persons were appointed. If there were 600 nurses and you appointed two, what happened to the other four? My thing is, the other four will still have problems and they said they gave hazard pay. To my knowledge, a lot of my colleagues have not
received hazard pay for the month of December either. Seen not a cent of this hazard pay.
And I go to work. Where I work, I have been spat on. I have been hit, cussed. I have went through it and it’s just frustrating and hard to hear persons saying that we don’t care and we still go to work in all these conditions and they’re saying we do not care. How could that be?
Phone in host: I’m really sorry to hear this call and all of the things that you have expressed. Tell me, what do you think is going to happen over the next few weeks while we are waiting for an election? Do you think you will get any resolution? Are you willing to go to the work in the interim?
Nurse: No and it was very interesting that she did not hear out the nurses and our problems before they even run and do that. That meeting that was supposed to be held was cancelled. You did not hear all our problems, and you are saying that this is a critical time in terms of health care, and you did not hear out the nurses that are on the front line. How dare you?
Nurses have families at home. There were many nurses that had not seen a salary for December, and they have families. When you were home having your meals, what were they doing and telling their children? But no we’re to come to work every day with a smile on our face.
They’re saying they didn’t have enough nurses, so they had to bring in nurses.
Ask them why they didn’t have enough nurses. Because persons from England are recruiting our nurses. Persons from the States are recruiting our nurses because we are really good nurses. So if they’re recruiting our nurses, the nurses, are leaving because you’re not treating us right. The nurses have no choice than to leave. It’s been years we have been asking. We have been asking to be heard we are not being heard. If someone else is recruiting us, why should we stay?
Phone in host: This is really difficult to listen to, not because anything that you said is wrong. But I can hear the pain in your voice. And I really do hope that something can come of this, because it is really important that we treat those on the front lines, our health care professionals much better. You are very important to us to our healthcare system, and you need to be treated properly. So I hope that you will get some kind of resolution. I hope it will be sooner rather than later. And I don’t know what is going to happen in these three weeks leading up to the election, but I hope that something is being put in place at the level of your union to assist those of you who are on strike. And I hope that you all are able to make a decision that benefits you in terms of whether you will remain on strike or go back to work. But thanks.
The strike fund of the nurses can be supported by making donations to:
Having considered the background I must stand with all those who support the Nurses and offer my 2 cents. There’s a legal and a moral dimension to all this.
It’s not in dispute that any employee who experiences poor working conditions and no pay has a legitimate right to raise those concerns before a competent employer. A look back in history will put this strike into context. It spans several years during which the nursing profession has been raising grievances about pay & working conditions.
As far as I can tell these grievances are not vexatious, frivolous or manifestly unfounded. Mr Bostic appears to believe they are legitimate. But what is an employee to do if those grievances go unresolved over any length of time? Any right-thinking employer would know, there will appear a bright line in the sand – the point at which employees say ‘thus far and no more’. In legal parlance it would be cited as the straw that breaks the camel’s back.
The point of a grievance process is to act on and resolve the issues it raises in a timely manner. Hence, I come to this “crisis” with some expertise in labour law. Well drafted employment law should create balance in the relationship between employer and employee. Any detrimental action against an employee must be considered objectively against the back drop of reasonableness. It is trite to say that an employee’s right to strike is a lawful and essential part of developing an organisation’s mind around the concepts of justice and fairness.
I take my starting point at s2 & s40A of the Trade Unions Act 1964. Since this is available to be read; I paraphrase it;
Section2, “For the purposes of this Act, the expression “employer” means “the Crown”, with respect to any person employed in a civil capacity thereunder. The title to section 40A; Adversely affecting employee or employer on account of trade union activities. s40A. An employer who – (a) adversely affects the employment or alters the position of a workman to his prejudice because that workman – ss(ii) being a member of a trade union, which is seeking better labour conditions, is dissatisfied with his conditions; is guilty of an offence”.
It’s clear their complaints have gone unresolved over several years. The extent to which this inaction has adversely affected the nurse’s employment is a question of fact and degree. Assuming resolution of the grievances in favour of the nurses is objectively necessary, then failure to resolve them has prejudiced the Nurses to the extent that it hastens strike action – which then causes the PM to adopt a legal footing.
Is it reasonable to reduce the pay of a worker who does not turn up to work? Objectively? Yes. The bargain struck between employer and employee must be a fair bargain. I doubt any employer anywhere in the world would pay a person to deliberately not turn up for work. But, that’s only one side of the employment coin. A fair question to ask is; is it reasonable or even lawful for employees to suffer hazardous working conditions that may adversely affect their safety and health? Is it reasonable or even lawful to pay employees sporadically? Objectively, the answer must be no.
Part of the problem here is, this legislation is at odds with the Public Service Act 2007 – the section the government relies on, s20. This presents a conundrum that needs to be resolved in the courts – since withholding pay adversely affects employees.
Moreover, if the reports about freezing bank accounts are true then, ladies and gentlemen of the Republic of Barbados, you don’t need me to tell you that is an absolute violation of the Constitution, and action within the gift only of lawful authority in pursuit of the proceeds of a crime. The action taken by the Government toward nurses appears high handed and politically charged. Why? Because there is still the moral dimension in which it’s worth asking the question; within a landscape which shows some years of under pay, sometimes no or late pay, poor working conditions, long hours, increased risk to personal health, and no sign from any Government of positive action to remedy these matters, is it reasonable to dock their pay and freeze banks accounts?
Now that things have got this far, it seems somewhat churlish that opponents of the strike besmirch the nurse’s professional integrity for the position they take. The Government appears to have made their moral responsibility toward their employees subservient to the moral responsibility of Nurses toward their patients and thereby make State action far less unconscionable; this is wholly unjust and manifestly unfair. To be clear; a striking nurse does not, by their strike action, say, imply or infer that they care less about their patients or the State. That is a step to far. No one asked for this pandemic and nurses have been on the front line fighting it for months – in less than favourable working conditions. Had their grievances been properly resolved, pre-pandemic, perhaps this action would never have arisen.
Contractual performance cuts both ways. But for any Government’s inactivity to remedy the Nurse’s grievances, this action would not have happened. It is neither just nor fair to hold nurses over the moral ‘barrel’ whilst deliberately, or otherwise, failing to act upon their own legal and moral obligations.
The Barbados Labour Party administration has reportedly asked other political parties to condemn the current strike action by some of our nurses. Solutions Barbados position has not changed on this type of matter – Solutions Barbados does not condemn anyone based solely on the accusations of that person’s accusers. That is fundamentally unfair – and unjust.
The following was reported. “The Prime Minister’s condemnation was shared by the Barbados Private Sector Association (BPSA), the Barbados Workers’ Union (BWU), the National Union of Public Workers (NUPW), the Barbados Nurses Association (BNA) and the Congress of Trade Unions and Staff Associations of Barbados (CTUSAB).” (Nation 16 December 2021).
If these national groups have condemned our nurses’ strike action without hearing Senator Franklyn’s side, then they have taken Barbados across a dangerous boundary, that we should have been trying our best to avoid as a country.
Since the Barbados Labour Party administration is requesting public condemnation of Senator Franklyn, then Senator Franklyn should be offered the same space in the media to publicly defend his position. Only then can the public, including public groups, be capable of rendering a fair judgement.
Those groups that have prematurely judged Senator Franklyn should remember Jesus’ warning about such type of judgements: “For in the same way you judge others, you will be judged, and with the measure you use, it will be measured to you.” (Matthew 7:2).
I am a Chartered Arbitrator who has resolved many disputes over my 30-year career. Rather than pre-judge Senator Franklyn and the striking nurses, I am willing to fairly resolve this dispute – for the benefit of Barbados.
The blogmaster can recall that in 2010 former Minister of Health Donville Inniss announced a plan to change the nursing program at the Barbados Community College (BCC). The objective was to ensure that Barbados responded to a shortage of nurses.
Who remembers the public outcry when nurses from the Philippines and elsewhere were recruited at the QEH? The underlying reason for the shortage was that student nurses were failing the Regional Examination for Nurse Registration. Inniss indicated that a committee would be setup to come up with recommendations to address the issue.
Some of the recommendations reported in the media:-
Admission requirements and student intake – no more than 80 students should be admitted annually over the next three years. This would be reviewed at the end of the period.
Admission should be considered at three levels – academic requirements, entrance level/proficiency test, and aptitude assessment.
All tutors should participate in clinical activities, and a comprehensive examination should be reinstated.
The Nursing Council of Barbados has evaluated the General Nursing Programme and has submitted its report to stakeholders,” said Inniss as he listed the changes.
In February 2019 Minister of Health Jefferey Bostic was reported in the press that he will be asking for a meeting with the Minister of Health to review the course work at BCC because of a high fail rate by nurses completing the regional examination. The minister’s position is supported by the following news column with a call to recruit nurses from overseas.
The question to our planners is – with the heavy investment in education why do we have to recruit nurses from overseas? What is so difficult about ensuring the nursing syllabus at BCC is aligned with that of the Regional Examination for Nurse Registration?
QEH to look abroad for nurses
Henderson Pinder, Director of Nursing Services at the Queen Elizabeth Hospital.
personnel are coming from that institution, Pinder said.
“The Barbados Community College and the Queen Elizabeth Hospital have a partnership in which Barbados Community College offers aspiring nurses with the educational framework to pursue a career in nursing, and the QEH provides BCC nursing students and graduates with internship and job opportunities.”
“However, although many nursing students go on to attain a Bachelor of Science degree in nursing from the Barbados Community College, many fail to pass Regional Examination for Nursing Registration (RENR). This is a matter which we need to urgently rectify to increase the number of registered nurses available on island.”
Chairman of the QEH’s Board of Management, Juliette Bynoe-Sutherland said: “We also recognize that we retain nurses who work at the QEH by making them feel more valued, recognizing their contribution and addressing matters such as salary, conditions of work, benefits and staff amenities. The Government has committed to providing for upward mobility of nurses as specialist nurses and the QEH will be working closely with the Barbados Nurses Association and Nursing Council to achieve this goal.”
Given the shortage of nurses, the Queen Elizabeth Hospital plans to look overseas.
Director of Nursing Services at QEH, Henderson Pinder, said it was necessary to ensure the continued, safe, patientcentred delivery of nursing services, especially in the Accident and Emergency (A& E) Department.
The need to look outside for nurses has been compounded by those interested in the profession but failed examinations at the regional level after successfully gaining their Bachelor of Science degrees in nursing from the Barbados Community College (BCC).
“Unfortunately, there are not enough critical care trained nurses in Barbados to meet the QEH’s staffing needs. As such, in an effort to fill the establishment, we’ve expanded the search for critical care trained nurses to other jurisdictions,” Pinder told the Sunday Sun.
Nurses are being recruited from St Vincent and the Grenadines, Grenada and the Philippines.
Pinder noted the QEH has been continuously trying to improve the quality of nurses, and recently 29 completed the highly-rated Canadian Triage Acuity Scale (CTAS) training programme. A second cohort of nurses is to benefit from similar training .
In spite of the shortage, the QEH continues to maintain standards which allows it to deal with the dozens of emergency cases which flow through the heavily trafficked A & E Department, Pinder said.
“The nurses of the Accident and Emergency Department are able to provide an excellent standard of care despite the large number of persons who present to the department,” Pinder noted. “In instances when the number of persons who require care overwhelms the A& E’s staff complement, additional staff is deployed to the department and various other surge staffing measures are employed. Even on these occasions, the care given to our patients meets and surpasses the standards of practice for patient care.”
The lack of nurses on an annual basis casts the spotlight on the facility’s ability to draw from the BCC special programme, as it is clear not enough Fail exam
By Barry Alleyne barryalleyne @nationnews.com @barry_nationbb
All professions are important to ensure the productive capacity of the country is firing away on all cylinders. Is is true to say however that some professions can be viewed as being more important than others? BU subscribes to the view in the Barbados context teachers, policemen and nurses represent core professions which are key to building and sustaining a productive society.
It is interesting to observe in recent years how the three professions named have declined if measured by their ability to attract and retain human resources.
Many of our teachers can’t wait to retire. This is an indicator which can be used to judge the state of teaching in Barbados. Many of our teachers are also being recruited by several countries around the globe. BU recalls in the last 3 years several of our best teachers were raided by school boards from Kentucky and New York. Importantly is the fact few men are being attracted to the teaching profession in Barbados. Some statistician worth their salt maybe able to do some analysis to show cause and effect as far as tracking the lack of male relationships in the school system and the boys (men) in crisis syndrome which has appeared.