"SERVICE without walls" was a phrase used in a recent study of public health nurses' work in the community. But one of the first motions passed at this year's conference of the 17,000 strong Irish Nurses' Organisation in Ennis yesterday called for an end to flexibility in community medicine and specialist posts.
Such changes should be used as a basis for negotiation under the Programme for Competitiveness and Work, the motion said.
Delegates will be discussing the unsuccessful pay negotiations this morning, but the indications last night were that they were in an unforgiving mood as far as the Government was concerned. Their view on the efforts of their leaders has yet to be expressed.
A policy document on the future of nursing, Pathway to Progress, was the main item on last night's agenda. It put forward radical proposals to restructure the profession and make nurses more effective in planning, as well as delivering, a service to patents.
Many of the motions passed in connection with it, such as allowing nurses to manage patient care in situations of long term illness or prescribe basic medications in certain circumstances, were as much about redefining the role, and the value of the nurse, in the community as any pay claim.
Ms Catherine Broderick, a public health nurse from Dundalk, said nurses already influence doctors' decisions and provide the primary care for people with chronic illnesses. So why could they not be given "the legitimacy of prescribing" medicine for them.
A study in Guy's Hospital, London, showed that nurses on night duty did 65 per cent of the work normally done by doctors. If this was the case, said Ms Clare Spillane from Carlow, then nurses should be receiving the appropriate training "and the appropriate remuneration".
The delegates passed a number of motions calling for a reduction in the number of temporary nurses, who represent 17 per cent of the total work force, a faster filling of vacancies and a pension scheme for nurses unable to obtain permanent positions.
Ms Annette Kennedy, education and research officer of the INO, introducing Pathways to Progress said. "For the first time in our history we have found unity, strength of voice and political awareness." She added "Should we not use the frustration and anger we now feel to develop and make a future for ourselves.