A lack of staff and a gender imbalance in the acute psychiatric unit in Tralee General Hospital mean female nurses often rely on hospital security staff when dealing with disturbed patients.
A list of grievances is to be submitted to a Labour Court hearing by the Psychiatric Nurses Association (PNA) in the new year.
A dispute at the unit led to a work-to-rule two days a week for the past five weeks. The industrial action has been suspended pending the hearing in early January."It is now often the case that the hospital security staff are female also," said Ms Angela Barrett, chairperson of the PNA in north Kerry.
The nurses do not have a problem with accepting disturbed patients, she said. "All we want to know when we go to work in the morning is that we are in a safe place and the patients are safe also."
She said the report of the Inspector of Mental Hospitals for 2001 said the present secure facilities in the admission unit were "neither safe nor satisfactory" for dealing with disturbed patients as they were never designed for that purpose.
She said there have been 12 emergency admissions, all involving men, brought under Garda escort, to the unit since November. Frequently the patients are handcuffed and delivered by up to five gardaí into the hands of two female staff and one male. Sometimes there are only female nurses on duty.
Talks with the health board on staffing and other issues had broken down a number of times. Ms Barrett said a male and a female nurse had been assaulted at the unit. Locks and doors had been damaged and patients with depression were upset and disturbed by violent behaviour and the banging on doors by highly-troubled patients admitted under escort.
Her union is also demanding that sufficient staff trained to deal with emergency admissions are put in place.
Mr Des Kavanagh, general secretary of the PNA, said the Employment Equality Act had led to a shortage of male staff in some situations. There was no arrangement in Tralee as in other hospitals where a minimum number of male staff would be on duty.
Mr Pat Madden, the head of Kerry's mental health services, said staffing levels were comparable to other psychiatric units in the health board.
A health board statement said patients requiring immediate access to mental health service and requiring Garda escort were admitted to the hospital's acute psychiatric unit under the mental health legislation (2002).