After a day of labor sanctions by the country's nurses, the National Association of Nurses reached an agreement with the Finance Ministry last night to end the dispute.
The deal calls for the addition of about 200 nursing positions at the country's hospitals and enhanced care for patients on respirators in hospitals' internal-medicine departments. Under the agreement, hospital occupancy rates this year will not exceed 120 percent.
The Health Ministry said that within 21 days, it would send out a circular on how the matter will be implemented, including which patients will be treated in internal-medicine departments and a policy encouraging some patients to be transferred to geriatric units. The agreement calls for internal-medicine occupancy rates to decline to 115 percent next year or lower.
In imposing its labor sanctions yesterday, the union announced that nurses would not admit patients to internal-medicine departments where occupancy is already over 100 percent.
Service was disrupted at 90 departments at 22 hospitals owned by the government and the Clalit health maintenance organization.
Although the labor action frustrated people seeking admission to the hospital, fewer showed up compared to most days, apparently because many patients were aware of the nurses' sanctions.
Hospital overcrowding is common during the winter. In the country as a whole, the occupancy rate in internal-medicine departments was 110 percent yesterday, the Health Ministry said.
"I've been with my mother for two weeks and the staff here is collapsing under the strain," said Leah before yesterday's deal with the nurses. Her 77-year-old mother is a patient in an internal-medicine department at Ichilov Hospital in Tel Aviv. "The nurses are 100 percent right in their battle. I hope the sanctions help."
Exceptionally high rates were reported yesterday at Jerusalem's Hadassah University Hospital on Mount Scopus at 156 percent, Hadassah Hospital at Ein Karem (152 percent ), Hillel Yaffeh Medical Center in Hadera (144 percent ), Shaare Zedek Medical Center in Jerusalem (142 percent ), Barzilai Medical Center in Ashkelon (128 percent ), and Ichilov Hospital in Tel Aviv (119 percent ). Overcrowding was also reported at Assaf Harofeh in Tzrifin, Haemek in Afula and Sieff Hospital in Safed.
"We've been working for several weeks at an occupancy above 130 percent and have to put patients in the corridors with minimal facilities," said Flora Strikholevsky, an internal-medicine nurse at Ichilov. "That means all medical care is given in the hallways, including bathing and bodily functions. We also are forced to discharge patients earlier with follow-up care from home, which makes the families angry."
Because of the sanctions, the hospitals set up control centers to help transfer patients from the emergency room to the internal-medicine departments. The director of Ichilov Hospital, Gabi Barbash, said the internal-medicine units are also getting backup support from departments such as geriatric rehabilitation, dermatology and neurology, and that staffing of doctors and nurses in the emergency room had also been increased.
He said that during his years of practicing medicine, he would complain about patients in the halls. "The nurses' battle has the support of all sectors at the hospital," he said.
Amid the sanctions, the Health Ministry opened a situation room to collect reports from the country's hospitals. The ministry's director of medical administration, Hezi Levy, said the sanctions put pressure on emergency rooms, and the ministry was trying to address the situation at each hospital individually.
At Haemek Hospital in Afula, elective surgery was deferred, and at Barzilai in Ashkelon, psychiatric patients at the hospital for the day were being discharged to free up rooms for patients from the emergency room.
At a stormy meeting yesterday of the Knesset's Labor, Welfare and Health Committee, chairman Haim Katz called on the Finance Ministry to negotiate with the nurses immediately.
Deputy Health Minister Yaakov Litzman said there is no quick fix to the problem, saying the sides must resolve a problem that developed over 10 years. Litzman had agreed with the treasury on funding that would gradually add 950 hospital beds throughout the country over the next six years, though a final agreement has not yet been signed.
During the day yesterday, the Finance Ministry called on the nurses to end the sanctions immediately, saying the ministry had been involved in two days of intensive discussions on relieving the workload of hospital nurses.
Health Ministry Director General Roni Gamzu said he intends to limit occupancy in hospitals' internal-medicine departments. Giving an annual, cumulative figure, he said around 70,000 days are spent in hospital corridors by patients admitted to internal-medicine units.
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