Icelandic Doctors and Nurses Sign Ceasefire Petitions

Nurses Hospital Landsspítalinn við Hringbraut

Over 400 Icelandic doctors have signed a petition calling on the Icelandic government to denounce Israel for its attacks on Gaza and demand an immediate ceasefire, mbl.is reports. A separate letter from Icelandic nurses with the same demands has 254 signatures, RÚV reports. The letter outlines the deaths and destruction of infrastructure caused by Israel’s attacks in Gaza and call the situation a humanitarian crisis.

“In the past few weeks, Israel has carried out extensive attacks on Gaza in revenge for a terrorist attack which was carried out in Israel. Israel’s attacks have killed at least 10,569 Palestinians, including at least 4,324 children. The attacks have also caused tremendous destruction of Palestine’s infrastructure, which is at the point of collapse. Israel has cut off all water, electricity, and food supplies to residents of Gaza and is significantly restricting all aid from Egypt. A serious humanitarian crisis is happening that must be responded to as quickly as possible,” the opening of the letter from Icelandic doctors reads.

Demand Icelandic government puts pressure on Israel

The letter outlines the impact of the attacks on healthcare services in Gaza, including the killing of healthcare staff, destruction of hospitals, clinics, and ambulances. “The healthcare system in Gaza collapsed a long time ago,” it reads, in part. “Hospitals in Gaza cannot fulfill their role.”

“We the undersigned send this letter with the sincere wish and demand that the Icelandic government responds to the serious events that are now happening and demands a ceasefire,” the letter continues. “The government should put pressure on Israel to stop the continuing attacks on innocent residents of Gaza and on healthcare services in the area and condemn [Israel’s] actions.”

Locals in Iceland have held regular protests calling on the government to denounce Israel’s attacks and pressure for a ceasefire. A protest in support of a ceasefire will be held outside the US Embassy in Reykjavík today at 5:00 PM.

Patients Wait in Ambulances Due to Lack of Beds in ER

All of the beds in Landspítali’s emergency room at Fossvogur were full on Friday night, forcing patients to wait in ambulances until beds became available in the ER, RÚV reports.

According to the duty officer at the Metropolitan Fire Department, which also oversees capital-area ambulance transportation, it’s not unusual for patients to wait for a bed in the ER, although the duty officer was careful to say that Friday’s situation is not a common problem. Rather they stressed that paramedics provide patient care to those waiting to be admitted to the ER and room is always made for priority patients.

See Also: Mass Resignations at the University Hospital

Fourteen nurses resigned from the ER at the end of August, largely due to stress within the department.

According to Soffía Steingrímsdóttir, who was an ER nurse at the Landspítali for almost eight years, the resignations were “a long time coming. We’ve been trying to call attention to stressful work conditions and the threat to the safety of our patients for years now. Over these past two years, especially – when conditions have been unacceptable.”

At the time, hospital director Runólfur Pálsson said that hospital administrators would do everything in their power to reverse this trend. “The work conditions are extremely difficult. There’s a lot of stress, which means that people resign, which leads to staff shortages, which makes things even more difficult. It’s a vicious cycle that we’ve been trying to break.”

On Friday, nurse and assistant head of the ER Hildur Dís Kristjánsdóttir weighed in, saying the ER didn’t need to employ as many nurses as it previously did, as there are fewer patients being admitted on a regular basis.

As of September 1, the hospital’s stated goal is that no more than 20 patients should be in the ER at any one time.

Mass Resignations at the University Hospital

landspítali hospital

Fourteen emergency-room nurses completed their final shift at the National University Hospital of Iceland (Landspítali) yesterday, RÚV reports. The departures are “a cause for worry,” Director Runólfur Pálsson stated, although he remains confident that brighter days lie ahead.

“A long time coming”

Speaking to RÚV yesterday, Soffía Steingrímsdóttir, who’s been employed as an emergency room nurse at the National University Hospital (Landspítali) for almost eight years, explained why she and 14 of her colleagues had decided to quit their jobs:

“It’s been a long time coming. We’ve been trying to call attention to stressful work conditions and the threat to the safety of our patients for years now. Over these past two years, especially – where conditions have been unacceptable.”

According to Soffía, the 14 nurses who completed their final shifts yesterday will not be easily replaced; experience and competence only come with time. A similar number of resignations are expected to be tendered next month.

Trying to break the vicious cycle

Speaking to RÚV, Runólfur Pálsson, Director of the National University Hospital, stated that hospital administrators would do everything in their power to reverse this trend. “The work conditions are extremely difficult. There’s a lot of stress, which means that people resign, which leads to staff shortages, which makes things even more difficult. It’s a vicious cycle that we’ve been trying to break.”

Runólfur stated that he was hopeful that resources designed for patients who have completed treatment at the hospital but cannot leave on account of disabilities would help lighten the load: “And we’ve been waiting for hospital and rehabilitation rooms, which we hope will be available in September. We have high expectations for these new facilities. They will help lighten the emergency room’s load.”

Soffía stated that the nurses were sad and disappointed that no measures were taken in response to their resignations: “I certainly hope that I haven’t completed my last shift at the emergency room, that I’ll return when an acceptable work environment has been created.”

Cuts to After-Hours Medical Care in Capital Area

COVID-19

Læknavaktin clinic, responsible for providing after-hours medical care in the Reykjavík capital area, will shorten its opening time by 1.5 hours starting September 1, Fréttablaðið reports. Stefán Ari Guðmundsson, Læknavaktin’s CEO, says a shortage of staff is the reason the clinic will now close at 10:00 PM instead of 11:30 PM. He does not expect the change to impact quality of services.

The decision to shorten the opening hours was made in consultation with the Ministry of Health, the National Hospital, and capital area health clinics, according to Stefán, and the change is here to stay. He believes it will in fact shorten wait times at Læknavaktin.

“We will be able to staff it better because we are closing earlier, those are basically my expectations,” Stefán stated. He also believes the change will not greatly impact the National Hospital’s emergency ward, as home care services will continue to be available between 10:00 PM and 11:30 PM. People will be able to call the 1770 emergency line, where a nurse will determine whether home care services are necessary.

Tired staff

While Læknavaktin was previously open until 11:30 PM, new patients were registered until that time, meaning that staff would in fact finish their shifts as late at 1:00 AM by the time all patients were attended to. Stefán points out that much of Læknavaktin’s staff work at health clinics during the day, where they start their shifts as early as 8:00 AM.

A review of the patients that came to Læknavaktin between 10:00 PM And 11:30 PM showed that an average of 17-18 patients came to the clinic during that window, “many cases that maybe have no business at this kind of service,” Stefán stated. He believes Læknavaktin will continue to meet the demand for its services, despite shorter operating hours.

24-hour phone line partially transferred to health clinics

In addition to providing clinical services, Læknavaktin operates a 24-hour phone line [1770] where those seeking medical advice can speak to a nurse. Last June it was announced that Læknavaktin would lay off all nurses working the phone line and the service would be transferred to capital area health clinic receptionists. That decision has been partially reversed: starting tomorrow, capital area health clinics will answer the phone line on weekdays between 8:00 AM and 5:00 PM, but Læknavaktin nurses will answer calls outside those hours.

Chairman of Medical Association Warns of Doctor Shortage

Nurses Hospital Landsspítalinn við Hringbraut

Chairman of the Icelandic Medical Association, Steinunn Þórðardóttir, stated in a recent interview with Fréttablaðið that Iceland faces one of the lowest ratios of general practitioners to the population in Europe, raising concerns over both adequate healthcare for patients and excessive workload for doctors.

Iceland only has 60 general practitioners for every 100,000 inhabitants. Averages for Western Europe are generally around 100 per 100,000, with most other Scandinavian nations having double or more of the Icelandic ratio. According to Steinunn, this lack is especially felt in pediatrics.

Because the Icelandic medical system lacks specialized facilities, many doctors must go abroad for medical school to finish their training. Some 847 Icelandic doctors are currently employed abroad, and Steinunn blames difficult working conditions as a major reason why these doctors do not choose to work here in Iceland. In order to retain the doctors that do train in Iceland, and entice doctors working abroad to work in Iceland, the medical system must make improvements to the working conditions.

In her interview, she states that because of a shortage of specialists in other fields, doctors must often work as psychiatrists and social workers as well. The unclear nature of the work further adds to the burden of an already heightened workload.

Central to the problem is the fact that Iceland simply produces too few doctors and nurses. An average of 60 are admitted to the University of Iceland’s medical school every year, but significant amounts of Icelandic medical students also choose to study abroad. According to Steinunn, Iceland cannot rely on other countries to fill this gap, and it is critical for the University of Iceland’s medical school to expand both its capacity and specialized facilities.

The shortage of trained professionals is by no means limited to general practitioners. Iceland is also experiencing a nursing shortage, with increased strain during COVID a major reason why nurses have left the field.

Similarly, Magnús Þór Jónsson, chairman of the Icelandic Teachers’ Association, has described the difficulty in recruiting and retaining teachers for this coming Fall. During the pandemic, teachers often had to adapt to a changing environment with increased responsibilities and workload. Citing these deteriorating conditions, Magnús states that many teachers have left the profession, either to temporarily work in other fields or else permanently in favour of better conditions.

 

Thirty Nurses Laid Off, 24-Hour Medical Consultation Hotline to be Handed Over to Receptionists

doctor nurse hospital health

All thirty nurses working for Læknavaktin were laid off at the end of May, RÚV reports. Læknavaktin has been responsible for not only providing after-hours medical care in the capital area, but its nurses also staff a free, 24-hour phone line for the whole country. Starting September 1, phone consultations will be handled by receptionists at Heilsugæslan health clinics in Reykjavík, a change that Elva Björk Ragnarsdóttir, director of nursing at Læknavaktin, believes will have an adverse effect on the services provided.

Nurses at Læknavaktin have been available 24-hours a day to patients all over the country via the 1770 phone line. Currently, anyone who calls this free number is able to speak to a Læknavaktin nurse who will help them assess the severity of their situation and offer advice on how to address the matter, be that to visit a local health care clinic during business hours, go directly to a hospital emergency room, or, in certain circumstances, receive a house call from a physician.

The decision to have receptionists at the capital’s health care clinics handling these phone consultations rather than trained healthcare professionals strikes Elva Björk as a misstep.

“I mean, around 80-90% of the calls we get here need an education in healthcare to address,” she said. “The [1770] phone number has become increasingly well-known—people know they can call here, which is a good thing in many ways, because often, we can prevent unnecessary visits to the ER and the children’s ER and to Læknavaktin here.”

See also: Four Nurses Resign from Emergency Ward

The change in service will ultimately have the greatest impact on people living outside of the capital area, where healthcare services are not generally available outside of business hours.

“In that the Heilsugæslan health care clinics do not appear to be fully staffed during daytime hours, it doesn’t make sense to me to be taking on a 24-hour service that in reality, you need nurses to oversee,” said Elva Björk.

Asked if she thought services to public would deteriorate as a result of these changes, Elva Björk didn’t hesitate: “Yes, I would say so, if it’s going to be set-up the way it’s been presented to me.”

Emergency Ward Staff Shortage Puts Patients at Risk

emergency department hospital

Management at the National University Hospital of Iceland is working to address the doctor and nurse shortage at the hospital’s emergency ward, RÚV reports. This summer 500 shifts at the ward are expected to have a shortage of nurses and four doctors at the ward have resigned so far this year. While staff has been vocal about conditions at the ward for years, Director of the Emergency Doctors’ Association Bergur Stefánsson says staffing issues have never been worse.

Bergur says Iceland’s Director of Health has sent around five reports and memoranda to the Minister of Health since 2018 addressing the emergency department’s issues. Despite those communications, “The situation has definitely not improved.” He adds that staffing issues among physicians have never been worse and if conditions at the ward do not improve, it will be impossible to ensure patients’ safety. “And with that, we are putting them at risk.”

Partial Audit Gave Ward a Failing Grade

In 2019, a partial audit published by the Directorate of Health found neither lodging nor staffing conditions at the emergency ward fulfilled regulations and that the ward could not ensure patients’ rights regarding care. “Now it has come to pass that the problem is of such magnitude that we cannot let these conditions go on,” the audit stated. “It can create grounds for unexpected incidents and the risk of additional staff dropout.”

National Hospital representatives have stated they are working to address the expected summer staff shortage as quickly as possible. The 2019 audit however stated that fully addressing the ward’s issues would require broader support from authorities. Bergur says emergency doctors have requested a meeting with the Minister of Health and the Parliamentary Welfare Committee, but have been rejected. “We need real action to be taken, real improvements.”

Nurses Who Vacation Abroad Will Have to Quarantine at Their Own Expense

COVID-19 ward Iceland National University Hospital Tómas Guðbjartsson

Nurses who go abroad on holiday will now be required to quarantine at their own expense when they return. These terms were announced in a press release issued by Iceland’s National and University Hospital this week.

See Also: Iceland Considers Testing and Quarantine of Residents Arriving from Abroad

Nursing staff will be expected to use vacation days to quarantine upon returning from trips abroad. This proceeds from the government’s recent announcement that all Icelandic citizens and residents who re-enter the country must be tested twice for COVID-19. Under the new parameters, they will be tested upon return at the border, go into quarantine regardless of their first test results, return for testing again five days later, and remain in quarantine until they’ve received a second negative result.

The requirement will go into effect on Friday, July 10.

Nurses’ Strike Narrowly Avoided

keflavik airport COVID-19 testing

Nurses in Iceland’s public healthcare system will not go on strike today as scheduled. The State Mediation Officer put forth a mediating proposal in the ongoing contract negotiations between the Icelandic Nurses’ Association (FÍH) and the state. The mediating proposal will be presented to FÍH nurses in meetings scheduled today and tomorrow at Reykjavík’s Grand Hotel, who will have until June 27 to cast their votes.

Icelandic nurses have been without a contract for nearly 15 months. Nurses voted down one collective agreement that was presented at the end of April, citing dissatisfaction with the proposed rise in base salary. When negotiations stalled again, 85.5% of nurses voted in favour of an indefinite strike which was scheduled to start today, June 22. The strike would have affected public healthcare services across the country, and in particular raised concerns that Iceland’s COVID-19 border screening initiative, which is overseen by nurses, would be disrupted.

Base Salary Decided By Arbitration

According to a press release from the State Mediation Officer, the two parties have now agreed on nearly all of the contract’s key issues, including a new working arrangement of day work and shift work. They remain divided on one key issue, however: nurses’ base salary. “Per the assessment of the State Mediation Officer, the difference between the contracting parties is profound and it will not be resolved at the negotiation table.” Therefore, the specific points of controversy regarding nurses’ wages will be directed to a special arbitration committee.

Icelandic nurses have long demanded that starting wages within the profession be raised. This stance was apparent in a survey conducted in May. “Nurses are sending a very clear message,” FÍH chairperson Guðbjörg Pálsdóttir stated when discussing the survey results. “They are ready to go quite far to receive a salary that takes into account their education and the responsibility of their job.”

Nurses Prepare to Strike

Nurses Hospital Landsspítalinn við Hringbraut

The overwhelming majority of Icelandic nurses have voted in favor of a strike, RÚV reports. Per a recent vote of the Icelandic Nursing Association, 85.5% approved a strike; 13.3% opposed it. A total of 2,143 nurses participated in voting, a participation rate of 82.2%.

As a result of the vote, the union has decided that nurses will go on an indefinite strike starting at 8.00am on Monday, June 22. The strike will continue until the union has reached a contract agreement with the Icelandic government.

The strike will extend to nurses working throughout Iceland. “We’re talking about the whole country,” remarked Nursing Association chair Guðbjörg Pálsdóttir. “All healthcare centres and those workplaces that employ nurses working under this contract.”

See Also: Pay Cut Goes Into Effect for Hospital Nurses

Negotiations between the nursing union and the government resumed after nurses rejected the collective bargaining agreement that was presented at the end of April. A key issue is base salaries; nurses demand that starting wages within the profession be raised.

Icelandic nurses have been without a contract for almost 15 months.