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New Ramsay EA after company-wide campaign

December 2, 2021 by Madeline Lucre Leave a Comment

Member leaders played a vital role in negotiations.

NSWNMA members at Ramsay Health Care have overcome pandemic-related disruptions and obstacles to finalise a new, two-year enterprise agreement.

The NSWNMA started negotiating with Ramsay in April 2021 and staff voted to accept the company’s improved offer in October.

During this six-month period, COVID-19-related lockdowns in NSW forced a shift from face-to-face to Zoom meetings and created other campaign difficulties.

Despite this, a total of 12 Ramsay members from hospitals in Sydney and the regions joined with NSWNMA officials to coordinate the campaign and take part in negotiations.

These bargaining representatives from across NSW ensured members from all Ramsay hospitals had a voice in the campaign.

The new agreement protects all existing conditions and provides a pay and allowance increase of 3.5 per cent over two years with back pay to July 2021.

After the company withdrew its claims for cuts to nurses’ and midwives’ working conditions, Ramsay members voted to accept the agreement.

In the run-up to negotiations the NSWNMA surveyed members to find out what changes they wanted in the new agreement.

A record number of surveys were returned, showing members’ top concerns were improved staffing levels and improved pay.

Missed meal breaks and insufficient notice of rosters were also priorities to be addressed.

The NSWNMA drew up a set of claims focusing on staffing ratios, fair rostering and better pay.

Three negotiation meetings were held before the COVID-19 lockdown in June 2021, which then forced negotiations to go online.

Ramsay wanted cuts to conditions

NSWNMA General Secretary, Brett Holmes, said the meetings gave member leaders the opportunity to speak candidly about staffing and other concerns.

“Despite a hostile attitude from the company during negotiations, our bargaining reps raised many situations where staffing was an issue, backed by examples in support of the claims,” he said.

“During the campaign over 2200 Ramsay nurses and midwives signed a petition calling for staffing ratios, a safer skill mix, ACORN standards, the ability to take meal breaks and fair rostering.

“However, Ramsay flatly refused to consider any of our claims relating to ratios.

“They maintained that their existing staffing arrangements provided safe patient care but refused to provide information on the formula, citing ‘commercial-in-confidence’.”

Ramsay came to the table with their own demands for cuts to working conditions, including greater “flexibility” in rostering, but later withdrew them after members stood together to reject them.

The new two-year agreement will expire on 31 March 2023. It includes the following pay and allowance increases:

1.5 per cent increase backdated to the first pay period on or after 1 July 2021
0.5 per cent increase from the first pay period on or after 1 January 2022
1.5 per cent increase from the first pay period on or after I July 2022.

Ramsay is the largest private hospital operator in Australia, with 72 private hospitals and day surgery units.

‘A lot of people were happy to put their names to the petition, which was signed by over 2200 people.’— Deanna Hayes

COVID-19 lockdown hindered Ramsay negotiations

An NSWNMA member representative on the enterprise agreement (EA) bargaining committee, Deanna Hayes from St George Private Hospital, said COVID-19 made it harder for members to campaign for a better agreement.

“I think the public health regulations and general level of uncertainty during the pandemic made nurses less likely to take action to press their claims. People didn’t know what was happening to their hours, and how COVID-19 would impact the community.

“The COVID-19 lockdowns in NSW interrupted our bargaining process and forced us to meet with management online. COVID-19 caused a hiatus in the middle of negotiations.”

Deanna said it was disappointing the company “cried poor” and claimed it could not afford to pay a substantial wage increase, despite Ramsay’s share price rising through most of the negotiation period.

“Yes, some procedures were postponed, but every Ramsay nurse like me who got redeployed to vaccination hubs or rural areas had their costs covered by NSW Health. And a lot of private hospitals took public patients by agreement with NSW Health.”

According to the Australian Financial Review, Ramsay CEO Craig McNally’s pay tripled to $5.9 million in the 2021 financial year, and the company’s statutory profit is up 58 per cent despite lockdowns.

The Commonwealth government’s $1.3 billion rescue package more than compensated for bans on elective surgery, with Ramsay receiving almost $1 billion in subsidies from governments in Australia and Europe. Even without these subsidies, revenue was up 3.9 per cent.

Around 430 Ramsay nurses and midwives were deployed to support the public health system during the COVID-19 outbreak.

“They claimed Ramsay had their own method for working out safe staffing but wouldn’t say what this was, because it was ‘confidential’,” said Deanna.

“A lot of people were happy to put their names to our petition, which was signed by over 2200 people, because they don’t always get meal breaks due to inadequate staffing.

“They tell stories of being on night duty with just one other staff member and 20 post-op patients.”

She said the company was dismissive of these examples of staffing shortages that the bargaining reps passed on to them from their workplace colleagues.

“We tried to explain it to them numerous times, but they wouldn’t accept that what we were saying
was true.”

COVID-19 lockdown hindered Ramsay negotiations

December 2, 2021 by Madeline Lucre Leave a Comment

“The COVID-19 lockdowns in NSW interrupted our bargaining process and forced us to meet with management online. COVID-19 caused a hiatus in the middle of negotiations.”

Around 430 Ramsay nurses and midwives were deployed to support the public health system during the COVID-19 outbreak.

“They claimed Ramsay had their own method for working out safe staffing but wouldn’t say what this was, because it was ‘confidential’,” said Deanna.

“A lot of people were happy to put their names to our petition, which was signed by over 2200 people, because they don’t always get meal breaks due to inadequate staffing.

“They tell stories of being on night duty with just one other staff member and 20 post-op patients.”

She said the company was dismissive of these examples of staffing shortages that the bargaining reps passed on to them from their workplace colleagues.

“We tried to explain it to them numerous times, but they wouldn’t accept that what we were saying was true.”

Ramsay backs down on cuts after staff resistance

December 2, 2021 by Madeline Lucre Leave a Comment

Ramsay management came to the bargaining table with their own claims to downgrade nurses and midwives’ working conditions.

Amid the pandemic, Australia’s biggest private hospital operator, Ramsay Health Care, opened negotiations with the NSWNMA by demanding greater “flexibility” in rostering and other measures.

The flexibility, however, was all in the company’s favour.

Ramsay HR sought the right to change rosters with as little as 24 hours’ notice and to roster contracted hours over an eight-week period instead of the current two weeks.

It also wanted:

reduced breaks between shifts after overtime from the current 10 hours after overtime to eight hours
the right to direct staff to take annual leave with just two weeks’ notice during periods of low activity
further restrictions to when meal breaks can be taken
an increase in the kilometre range from 20 km to 50 km when asked to work at another site.

Jacky Soucoulis, a theatre nurse in Sydney’s Inner West, was one of 12 NSWNMA members to take part in the negotiations.

She said management was unable to explain how its “flexible” rostering proposal would work.

“It didn’t surprise me that they were trying to take people’s conditions away from them. They seem to care only about their bottom dollar and not their staff,” she said.

“I think they were trying to avoid paying overtime. I wouldn’t be surprised if it raises its head during the next EA.

“It’s not right to force you to take a day off when it only suits the company.

“Nor is it right to work a two-week period and still not get your contracted hours in, so you have to claim annual leave to get
your money.”

Ramsay withdrew its demands at the third round of negotiations.

Members ‘visual’ presence at talks.

Management representatives arrived at that meeting to find the negotiation room at North Shore Private Hospital packed with posters showing nurses holding signs in support of the union’s log of claims.

The signs included “Ratios Save Lives”, “Ratios Not KPIs”, “Enough Staff to Cover Meal Breaks”, “People Before Profit”, “In Charge Without a Patient Load”, and “No to Forced Roster Changes”.

“The staffing issue meant a lot to us because we were fighting for ourselves, our colleagues and our patients to be safe.

“Members have consistently rated staffing as one of their top concerns for a number of years.”

She said management representatives also ignored evidence from NSWNMA members of EA breaches at some hospitals.

“For example, when members raised the issue of some hospitals refusing to pay for missed meal breaks, the company denied such practices ever happened – even when they were given concrete examples.

“Or they claimed these were rare and isolated site issues.”

The COVID-19 lockdown in Greater Sydney and elsewhere put an end to face-to-face negotiations, which were followed by one Zoom negotiation.

Jacky said the lockdown weakened the campaign and made it easier for Ramsay to wind up negotiations.

“Before the lockdown we managed to get over 2200 Ramsay nurses to hand-sign a petition calling for guaranteed safe staffing ratios, safe skill mix, ACORN theatre standards, fair rostering and the ability to take meal breaks.”

Hospital branch meetings also relied on Zoom meetings and online chat services.

Jacky used a WhatsApp group for her branch members, to keep them informed of developments in bargaining meetings.

She said some members were left confused by the company’s communications, especially about the pay offer, thinking it was a 3.5 per cent one-off payment. In fact, it is to be paid between July 2021 and July 2022.

“This shows the need for crystal clear communications,” Jacky said.

Nurses and midwives’ pandemic concerns revealed

December 2, 2021 by Madeline Lucre Leave a Comment

A survey of Australian Nursing and Midwifery Federation (ANMF) members has revealed how COVID-19 affected the workforce in 2020.

A survey on COVID-19 and workforce wellbeing conducted between August and October 2020 revealed that the COVID-19 pandemic left about half of Australia’s nursing, midwifery and care worker workforce feeling concerned about the welfare of their colleagues in 2020.

It found that just over half were moderately or extremely concerned about having adequate staff (53.18 per cent), the welfare of their colleagues (52.15 per cent), and having the right skills mix in the workplace (51.43 per cent).

One-quarter of respondents were moderately or extremely concerned about job security. Those who worked in residential aged care facilities were the most concerned (35.75 per cent).

Almost half (46.74 per cent) of all respondents felt their workload had significantly or moderately increased since the pandemic.

Those working in residential aged care facilities were most likely to report their workload had significantly or moderately increased (56.71 per cent).

Aged care members also reported the highest levels of workplace demand, role conflict, and work–life conflict, as well as the lowest role clarity compared to all other workplace groups. They also reported the lowest job satisfaction.

Most respondents (59.24 per cent) had experienced or felt community support for the work they do.

Out of the four main workplaces, those working in residential aged care facilities were the least likely to have experienced support or felt supported (43.37 per cent).

High numbers experienced abuse

One-third of respondents (33.22 per cent) had experienced abuse or been threatened by members of the public/patients at work, and 15.91 per cent had also experienced abuse by members of the public in settings outside of work.

Workers of Chinese ethnicity were the most likely to experience abuse or feel threatened outside of work (25.55 per cent).

More than 65 per cent of respondents rated the COVID-19 information provided by their workplace as good to excellent in regard to being timely, trustworthy, clearly written, consistent with other sources and comprehensive.

Protocols for general cleaning and cleaning of isolation rooms were also viewed as being good to excellent by most respondents.

Areas that were rated poor to very poor by at least 20 per cent of staff were managing staff abuse, access to workplace mental health support, and access to alternative accommodation.

Areas that were rated poor to very poor by at least 30 per cent of staff were being able to deploy more staff if required and debriefing processes.

The majority (57.61 per cent) of respondents agreed or strongly agreed that they were supported by their workplace regarding PPE concerns and requirements.

Forty per cent reported their workplace had cared for someone with confirmed COVID-19.

For those who worked in a setting where care was provided to COVID-19 patients/clients, only 21.01 per cent had provided direct care to those with con-firmed COVID-19.

Less than half (46.06 per cent) of respondents answered that they had not missed work due to reasons associated with COVID-19.

For those who had missed work, the most common type of leave taken was personal/
sick leave (64.12 per cent) or special COVID-19 paid leave (22.45 per cent).

About the workforce survey

The survey was conducted by the Rosemary Bryant AO Research Centre for the NSWNMA’s federal body, the Australian Nursing and Midwifery Federation (ANMF).

The online, anonymous survey ran over 12 weeks between August and October 2020.

Across Australia, 11,902 nurses, midwives, personal care workers, and other healthcare providers answered at least one question.

Most responses (71.15 per cent) were from registered nurses, followed by enrolled nurses (14.65 per cent), midwives (7.12 per cent), personal care workers (6.66 per cent) and students (0.42 per cent).

Most responses were from Victoria (45.33 per cent) and NSW (25.53 per cent).

Burnout in healthcare staff is common – and can make empathising with patients difficult

November 15, 2021 by Rayan Calimlim Leave a Comment

Empathy is being able to put yourself in someone else’s shoes, or being able to sense the emotions of the other person, and convey that understanding to them. While undoubtedly important for many aspects of life, being empathetic is especially useful for those working in healthcare.

Empathy helps ensure people receive the best quality healthcare, helps patients from all backgrounds and cultures receive care that works best for them, and helps patients feel safe about their healthcare procedures. But all too often, those working in healthcare can become burnt out – which may have a serious impact on their ability to relate to, and be empathetic, with patients.

Empathy can often be overlooked for its importance in patient care. However, being able to be empathetic can be difficult to achieve, especially since it may require staff to open themselves up to trauma and pain. Staff may not have time to nurture relationships with patients, and empathy also requires healthcare workers to be flexible in order to adapt to each patient and their unique needs, especially if a patient’s beliefs conflict with their own.

Burnout and empathy

These sorts of problems in care can also contribute to burnout, which is common in healthcare workers. Symptoms of burnout can include exhaustion, detachment, cynicism and a reduced sense of achievement, all of which makes quality patient care more difficult.

Burnout happens for a range of reasons, including high-pressure workplaces, lack of support, poor work-life balance or feeling a lack of control over, overwhelmed by, or in conflict with the work itself. Not surprisingly, research shows that as either empathy or burnout increases, the other one decreases – that is, they are negatively associated to each other.

But there’s a culture in the medical field that stigmatises mental health problems like burnout in doctors. And many GPs, for example, report not having the time to meaningfully relate to patients and colleagues. Yet being able to empathise with patients and colleagues is the very kind of nourishment they need.

Unlike some other professions, medicine also traditionally encourages practitioners to manage alone. In the NHS, where one in 12 posts remain vacant, and administration and patient loads can be “relentless”, this can be a recipe for disaster.

In a study my colleagues and I conducted exploring GPs’ experiences of workplace stress and their coping strategies, one GP told us, that they went into a stupor after coming home from work. This due to the large number of people they saw and the emotions they experienced without having time to process them. Another highlighted the constant fear GPs have of making mistakes.

Our research also shows how burnout creeps up on doctors, leaving them feeling broken and trapped. Not surprisingly, alcohol and drug dependencies are the most common medical problems for doctors after depression. Interestingly, however, we found that recovery from burnout could mean greater empathy for patients with mental health problems, as GPs might better understand the patient’s experiences.

Manageable case-loads, debriefing, peer and organisational support may all help people avoid (or recover from) burnout and low empathy. Some advice for those working in healthcare might be to set boundaries in your relationships with patients. For example, counsellors of abused children might have to remind themselves they are not the child’s parent. Healthcare professionals might also engage in self-care (such as taking time off, exercising, or meditating), and make time to regularly debrief with a colleague about difficult experiences.

But self-care can only go so far. Interestingly, the concept of “moral injury” is beginning to compete with “burnout” as a way of understanding the plight of healthcare workers. This is the idea that people can be exposed to trauma at work that violates their moral sense of right and wrong, resulting in a conflict with deeply held values and feelings like shame and betrayal.

Originally used to understand the experiences of war veterans, the term “moral injury” highlights the role of authorities in the way workers may violate their own morals, resulting in work dysfunction. An example of moral injury might be when doctors are so overworked their heads are “too full” to think straight, or when forced to choose which patient to admit into hospital first for treatment.

Cultivating empathy can be difficult for those working in the healthcare sector, especially when the stressful environment can make burnout common. But there is some research that higher empathy levels might protect against burnout.

While this link needs to be studied more, the researchers involved speculate that doctors able to better understand the perspective of their patients might feel more connected – and useful – to their patients. This could alleviate some of the stresses of the work.

Damien Ridge, Professor of Health Studies, University of Westminster

This article is republished from The Conversation under a Creative Commons license. Read the original article.

“Great Resignation” puts further strain on health system

November 1, 2021 by Rayan Calimlim 2 Comments

Increased resignations from health workers is putting additional pressure on the American health system, according to research released by the Harvard Business Review.

According to the research, there have been 3.6% more resignations over the past year within the healthcare sector compared to the previous year, leading to mass vacancies and rampant understaffing in American hospitals.

The phenomenon – dubbed the “Great Resignation” – was high among employees who worked in fields that had experienced extreme increases in workload due to the COVID-19 pandemic. This has led to increased stress and burnout from within the workforce.

The research found that increased resignations were highest among mid-career professionals, with the increase most stark in the 30-45 year-old cohort.

Interestingly, the research found that resignation had decreased in the 25-30 and 60-70 year old cohort, which could be attributed to the increased financial uncertainty brought about by the pandemic.

The researchers indicated that it was a ripe time for the sector to implement retention policies to address the drain that the “Great Resignation” was causing on the workforce.

“Many of these workers have simply reached a breaking point after months and months of high workloads, hiring freezes and other pressures,” the researchers said.

“Adopting a retention strategy isn’t easy, but it’s worth the effort to do it right, especially in the current market”.