Israeli Medical Association Chairman Dr. Leonid Eidelman enters second week of hunger-strike; “I will stop the hunger strike only if there’s an agreement, or when I cannot function any longer,” he said. Dan Even, Ha'aretz, August 2, 2011 The doctors’ protest rally outside the Prime Minister’s Office in Jerusalem will continue in shifts, a statement from the Israeli Medical Association said Monday. Meanwhile, the Nurses’ Union has also joined the doctors’ struggle and is planning joint protests. ... Doctors

Judy Siegel-Itzkvitch, Jerusalem Post, June 27, 2011 As public hospital doctors continue their sanctions - closing outpatient clinics half of the country from Sheba Medical Center and northwards on Tuesday - the Israel Nurses Association said Monday that they will intensify their sanctions the same day and reduce by hundreds the number of beds in all internal medicine departments. The doctors sanctions have gone on for over 80 days, while the nurses’ protests began only last week to show their displeasure over the Treasury’s "failure to keep promises" of additional nursing manpower slots in internal medicine departments and intensive care units.

Judy Siegel-Itzkovich, Jerusalem Post, July 7, 2010 Litzman: No new ministry budget unless demographic changes addressed. Establishing a new profession of nurse assistants; attracting Israelis studying medicine abroad and Western doctors to make aliya; attempting to close three international medical schools and finding more places for clinical teaching in hospitals are among the recommendations of a committee of experts on ways to cope with the looming shortage of doctors and nurses here. The 64-page report was presented Monday by its chairman, Health Ministry chief economist Dr. Tuvia Horev, to Deputy Health Minister Ya’acov Litzman after two years of study and deliberations. ... Panel

Dan Even, Haaretz, July 6, 2010 A Health Ministry report released yesterday warns of a growing shortage of doctors and nurses in Israel and calls for immediate steps to increase the number of medical personnel. Among the reasons listed for the predicted dwindling of doctors and nurses are physicians' aging, doctors leaving the country or the profession, a decrease in doctors immigrating to Israel and defensive medicine practices (designed to avert the possibility of malpractice suits ). The report presents a plan to the tune of tens of millions of shekels to increase the number of medical personnel and stave off the future shortage. ... Health

Nancy Falchuk, Jerusalem Post, May 13, 2009 The increasing role nurses play in medical care has developed over the past decade without being recognized by the public. With a national nursing shortage looming, this lack of recognition must be corrected immediately. Nurses today administer complex treatment from bone marrow transplantation to monitoring neonate nutrition. In addition, they are involved in running evidence-based research studies and heading public health programs. Despite the complexity of their work, they continue to maintain the caring relationships with patients that yield work satisfaction. In this period of economic instability ... Averting

Judy Siegel-Itzkovich, Jerusalem Post, November 11, 2008 Easier conditions for professional licensing are now being offered to immigrant doctors and nurses by the Absorption and Health ministries, which are well aware of the looming shortage of medical professionals. There are now only 3.5 physicians per 1,000 Israelis, down from one of the highest rates in the world in the 1990s, when masses of new immigrant doctors arrived from the former Soviet Union. In addition, there are only 5.8 nurses per 1,000 Israelis - the lowest figure in a decade. ... Government

Fadi Ayadat, Haaretz, June 17, 2007 Care providers at the psychiatric hospital in Tirat Carmel have stated that the hospital's policy is to extend patients' hospital stays as long as possible in order to raise revenue, often times against the patient's own best interests. Two senior nurses at the hospital stated that their institution's policy was to stretch as many hospitalization days as possible out of each patient and to try to discharge as few as possible. "We spoke to the administration and told them that we were hospitalizing patients that don't need our treatment," said one of the two nurses. The nurse stated that a department head told him in response that "If we do otherwise, we won't have any work. This is our livelihood." ... Psychiatric

UzReport, November 28, 2006 Israeli nurses from Clalit Health Services arrived in Khorezm region to conduct two week practical courses. The event is held within the framework of the Ministry of Health of Uzbekistan and Israeli "Mashav" Joint Project on Nursing Development. The aim of the event is practical implementation of the trainings the nurses from Khorezm region had taken in Israel on a number of studying tours. ... Israeli

IsraelNationalNews.com, October 24, 2006
About 3,000 nurses working at Klalit Medical Clinics went on strike Tuesday morning in protest of what they say is a severe personnel shortage. The nurses claim an addition of 200 nurses is necessary. The National Labor Court, however, hours later issued a court-order preventing the strike, ordering the nurses to resume work immediately. The court also demanded a resumption of negotiations between the nurses and the Klalit HMO.

Judy Siegel-Itzkovich, Jerusalem Post, October 22, 2006 More than 3,000 Clalit Health Services clinic nurses will begin an open-ended strike on Tuesday morning. The Clalit workers union, representing 32,000 nurses, administrative and maintenance staff and technical workers, said the walkout will "completely shut down" all the clinics and is a "first shot in the struggle to replace management." It will be the first time in 20 years that the health fund's community nurses strike. Last week, the union declared a work dispute and demanded the removal of the health fund's management. ... Clalit

Avirama Golan, Ha’aretz, September 14, 2006 The public health nurses' struggle against the transfer of school health services to a manpower company can of course be described - as Finance Ministry officials are doing - as a battle over employment conditions. Not that that's so terrible: After all, there seems to be some logic in a person's desire to preserve job security. But in the case of the nurses, who in recent years began working under a private association and are not civil servants in any case - that is not the main thing. At the heart of the attempt to minimize the blow to these services lies a much more important struggle - against the sweeping privatization of the health services. ... Privatization

Relly Sa'ar, Ha’aretz, September 12, 2006 The vast majority of the 3,700 educational institutions in Israel, attended by more than a million elementary and junior high pupils, have a nurse's office. But for the past three years, "most nurses offices are abandoned most days of the week," says Irit Levana, the Education Ministry official responsible for health matters. The reason: Continuous budget cuts have made it impossible to fund vital health care, including immunizations against potentially fatal disease and first aid, at Health Ministry standards. ... Where

Arutz Sheva, IsraelNationalNews.com, March 3, 2006

The Ministry of Health, in cooperation with the Ministry of Immigrant Absorption, has decided to hold a government examination at the level of registered nurse for those who have completed nursing studies abroad. For those candidates whose mother tongue is not Hebrew, the test will be administered in the following languages: English, French, Russian and Spanish in addition to Hebrew and Arabic, the official languages. ... Government

Yoel Donchin, Haaretz, February 28, 2006

The area surrounding very important people who are protected by very young people, security guards, is called a "sterile zone" in professional lingo. I, who come from the operating room, look at sterile zones in a totally different way. Until recently, I never came in close proximity with those people who are in the apple of the state's eye and must be protected from all harm. However, in the last few weeks, they penetrated my sterile zone in the hospital, and I see them doing their wonderful work.

I am sure that experts on personal protection and experienced security officials know exactly how many people are needed to protect a senior figure, what the risks are and for which situations they must be prepared. I am convinced that without the communication devices affixed to the ear, weapons, fast cars, metal detectors and a suitable salary, it would be impossible to maintain a proper democracy.

I cannot specify how many people are generating a sterile field around the figure they are now protecting inside the hospital, since I do not want to damage, heaven forbid, the security of the person, the security of the state or the stability of the government.

Nonetheless, the number of nurses who treat patients in the intensive-care unit is not confidential, and neither is the number of nurses found at all times on the morning shift in the operating room, the number of nurses in the internal medicine ward in my hospital, or the ratio of nurses who keep premature babies alive in other hospitals compared with the patients they have. And these numbers need to be significantly increased.

I don't presume to determine the needs involved in protecting public figures, but I can say with certainty that the number of nurses in the intensive-care units who work alongside the security guards and are responsible for the lives of more than six patients is far smaller than the number of guards.

A series of significant articles has recently shown that the mortality and morbidity rates in a hospital are an outcome of the number of nurses on shift. The more nurses there are, the better the patients will be treated and the more the number of mistakes and the rate of complications will diminish. Statistics show that adding a single nurse to a ward is more valuable than adding sophisticated equipment. Due to budget constraints, which apparently do not affect our friends the security guards, who also protect the patients, nurses are forced to cope with tasks that are not normally part of the nursing field, such as answering telephones, cleaning, and serving as messengers when there is a need to bring medication.

It has been found that nurses are interrupted between five and 10 times while carrying out a single action, such as preparing medication for distribution. In addition, stringent safety requirements demand that two nurses sign off on calculations of medication dosages and approve giving a unit of blood before the transfusion begins. Instead of increasing safety, however, these requirements decrease it by providing additional distractions. Nurses in hospitals have a very heavy workload, and many of them burn out and leave for less demanding jobs.

Despite my lack of knowledge about protecting public figures, I am not so certain that the large number of people surrounding the figure in question indicates an ability to protect him. One can deduce from history and from successful assassinations of heads of state (including the murder of a prime minister by a security guard) that leaders who espoused peace paid with their lives, even when they were surrounded by a sterile, clean and unrestricted zone. But who dares to say that the emperor has no clothes?

The large number of security guards and small number of nurses, the means available to the authorities and those unavailable to the wearers of white coats, indicate more than anything else what the priorities are of those who allot enormous resources on one hand, and prepare reduced health baskets on the other. But personal security and democracy are the outcome, not of the number of security guards, but of the number of nurses.

The writer is an anesthesiology expert at Hadassah University Hospital.

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