Winning 1:3 ratios in ED was hard fought and the transition has been challenging but the rewards are undeniable, say Kelly Falconer and Victoria Dane.
There are now almost 80 EDs in NSW that have implemented ratios, with multiple new nursing positions introduced across NSW.
One of the rejuvenated EDs is at Wyong Hospital on the Central Coast.
“Having 1:3 means that patients are getting better care, the staff are getting breaks and it’s just more relaxed in the department,” says Kelly Falconer, NSWNMA Wyong Hospital Branch President. “We’re still busy, we always have been, but it’s just made a world of difference.
“With less patients to look after, we’re spending more time with them doing what we should be doing, asking them questions and talking to them. It’s made a difference with the care that we give our patients. Ultimately, that’s what we wanted.”
Kelly says there has been “a bit of a transition period” since the roll-out started at the end of November.
“Here we are in July, and we’re almost there. But it takes time to hire up to 30 people. You can’t just have 30 people start and ‘we’re all good’. You do it in a transition phase.
“First, we did the acute pod, which had the most need, then we moved to the fast-track area. And now we’re moving to peds.
“It’s taken a good six months, but it’s been a great transition the way we’ve done it. We’re pretty close to being fully staffed.”
A more attractive job
Victoria Dane, an RN who also works in the Wyong ED, says the improvement brought about by the introduction of ratios has kept her in the profession.
“It’s a much nicer environment to work in now. People just get on better. Because you are not drowning so much in work, and you have time to interact with people rather than be task-orientated robots.
“Work is so much more relaxed, and people are happier. So, it’s more likely to keep people in the profession than before.
“There was certainly a period, probably about three years ago, where I was going to walk away from nursing altogether.
“At my lunch or on my breaks, I was looking up other jobs. And then they said safe staffing is coming, and it gave me a little bit of motivation to stay and stick it out and see what it was going to be like. And I’m now really glad that I have.
“Now you’re truly seeing the difference that it makes because we have the staff. The rosters are appropriate to the model of care.”
Victoria says there has been plenty of interest from other parts of the hospital about the changes in ED.
“They ask what it’s like and you say, ‘it’s game-changing’ with the amount of stuff that you can actually get done, and there’s not so much pressure. I try and reassure them that it is going to come for them too.
“They see it’s rolling out in their ED. But they were fighting for it to roll out on the floor as well. They deserve it.”
The next stage of ratios begins
The NSW government announced the next stage of the Safe Staffing Levels (SSL) policy rollout in May. The next tranche includes general medical, surgical and specialty wards including neurology, respiratory and oncology, moving away from the current Nursing Hours Per Patient Day (NHPPD) methodology.
Public hospital wards will see minimum nurse-to-patient ratios of:
- 1:4 on morning and afternoon shift
- 1:7 on night shift
- Additional in-charge of shift positions
NSWNMA General Secretary Michael Whaites says this significant win is the result of the sustained campaign by members over many years.
“Our collective action cemented the introduction of ratios as a key election commitment from the government, including funding for an additional 2480 full-time equivalent (FTE) nurses and midwives into the healthcare system, ensuring the community gets improved care,” he said.
“By bringing in 1:4, we are working to stop the practice of surge beds not being staffed, repeated shifts being worked short, and improving the skill mix on wards.
“For the first time, there will be limits on the number of assistants in nursing that can be rostered on shift, ensuring registered nurses and enrolled nurses are prioritised within staffing profiles.
“For those wards and units already compliant with NHPPD, members will see the introduction of an additional in-charge on some shifts – an important recognition of workload, coordination and leadership responsibilities on shift. Wards that are not compliant with NHPPD will see a lift in their numbers.”