May 17, 2022

Workplace News

Gunnedah fights for better ratios

by

Shoppers at Gunnedah’s produce markets got an insight into conditions at the local hospital when they stopped at a colourful stall set up by NSWNMA members last month.

Wearing union T-shirts and displaying banners that read “Ratios – put patient safety first”, nurses asked market goers to sign pledges of support for the improvement of nurse-to-patient ratios at Gunnedah District Hospital.

“People were interested in what we had to say and were happy to sign the pledges and show support,” said registered nurse Heather Franke, acting secretary of the hospital’s NSWNMA branch.

In conjunction with the union’s statewide ratios campaign, Gunnedah nurses are battling to have their Category C hospital correctly classified in order to qualify for ratios that should apply.

Some locals who stopped at the union stall already knew about the campaign thanks to earlier publicity generated by branch members.

Many Gunnedah shopkeepers had posted pledge notices in their windows after they were approached by Heather and branch president Jennifer Crough.

“A lot of the community are not aware that we do not have nurse-to-patient ratios. Store owners were all very happy to support us and put the notice in their windows,” Jennifer said.

Country patients deserve the same rights as the city

The pair also did a video interview with the “My Gunnedah” Facebook page focusing on two main demands: equal ratios for country and city hospitals and ratios to be safeguarded by legislation as in Victoria and Queensland.

“For interview talking points we used a media release from Brett Holmes (NSWNMA General Secretary),” Heather said.

“Currently if we have only three staff members on the general ward, one of those nurses could have eight or nine patients. This is not safe practice.

“Evidence has shown that having nurse-to-patient ratios saves lives and makes good economic sense.

“Big Category A hospitals have 1:4 ratios and we think our patients deserve the same care as they would get in a Sydney hospital.”

In the next stage of their campaign the NSWNMA branch is planning a community walk along the town’s main street and will invite nurses from surrounding towns in the state’s northwest to join them.

Things you can do

Like our Ratios put patient safety first Facebook page: https://www.facebook.com/safepatientcare?ref=hl

Sign up to get regular information about our ratios campaign: http://action.nswnma.asn.au/page/s/ratios-put-patient-safety-first-newsletter

For more information www.nswnma.asn.au

Transfer details start to trickle down

by

After years of waiting, nurses are finally getting some facts on the privatised Northern Beaches Hospital.

Well-attended union meetings and a staff petition appear to have prompted health authorities to finally start disclosing vital information for nurses transferring to Sydney’s new privatised Northern Beaches Hospital.

Nurses will be expected to move from Manly and Mona Vale public hospitals to the Healthscope–operated Northern Beaches Hospital when it opens in November 2018.

Staff have been seeking answers to basic questions – such as what positions will be offered, how will positions be filled, and what transition arrangements will apply – since the government announced the hospital would be built and run by a private operator four years ago.

In late 2016, the NSWNMA went to the Industrial Relations Commission to try to get some answers.

Commissioner Peter Newall said employees should not have to decide their employment futures without knowing basic information and recommended a Ministry of Health senior representative attend the next meeting between unions, Northern Sydney Local Health District and Healthscope.

Last month the NSWNMA and other health unions called meetings of members at Mona Vale and Manly hospitals.

Each hospital held two meetings at noon and 1.30pm to cater for staff after the morning shift and before the afternoon shift.

The meetings endorsed a petition calling for staff to be given the information they need at least 12 months before the hospital opens.

Mona Vale hospital branch secretary Robyne Brown said staff were frustrated that consultative meetings held with the LHD every two months had produced almost no hard information in writing.

“Every time we asked a question the LHD would it take on notice and refer it to the Health Ministry.

“Nurses would like some answers so we can work out whether it will be worth our while to transfer or not.”

She said that following Commissioner Newall’s recommendation, a Health Ministry representative did attend a consultative meeting but arrived an hour and a half late.

Pressure leads to more info

However last month’s union meetings and petition appear to have had some effect.

The LHD has since emailed nurses to advise they will receive a transfer payment of one week’s pay for each year of service up to a maximum of eight weeks if permanently employed for six years or more.

And the ministry has given unions some information about employment entitlements and conditions.

Robyne said that in a further sign of progress, an LHD manager had been assigned to work at the ministry to obtain answers for staff.

NSWNMA General Secretary Brett Holmes said the NSWNMA was reviewing the information provided “but it is evident that concerns will remain”.

“It is clear that the union meetings, along with the petition, have already had an effect on the LHD and ministry. However, more needs to be identified and made known,” he said.

“For example, it was still unclear whether government regulations would allow redundancy payments to be offered to staff.”

‘Every patient deserves the right to excellent, timely and safe nursing care.’

by

‘Specials put a huge load on what is already a very busy, high-stress department.’

“Every patient deserves the right to excellent, timely and safe nursing care. As a senior nurse I sometimes feel we are letting people down due to staffing constraints,” says Sabrina Sharp, NSWNMA delegate at Royal Prince Alfred Hospital.

An emergency nurse, currently on secondment to another department, Sabrina strongly supports the union’s push to introduce nurse-to-patient ratios in hospital emergency departments.

“The union’s claim is for a 1:3 ratio in EDs, plus a triage nurse and an in-charge nurse. We feel our patients are entitled to that level of care,” she says.

“Currently the ED can have two nurses looking after over 30 people in the waiting room. Some of them should be in beds on monitors but because of bed block there is nowhere to take them.

“The ED never closes its doors. When we are full we are still taking ambulances and attending to increasing numbers of walk-ins. Inadequate staff numbers force us to prioritise people who are in pain, distressed, and need timely treatment and other interventions. It seems like we’re juggling a lot of the time.

“Elderly people could be sitting in the waiting room for hours because of the acuity of other patients who don’t stop coming through the door. And if we don’t have appropriate staff numbers those patients can face lengthy delays to treatment.”

Sabrina says ratios would help to protect the ED skill mix by reducing high staff turnover partly due to some staff leaving in search of less stressful roles.

“The ED gives nurses great opportunities for education and our senior nurses are highly trained.

“The nurses in ED are very passionate about their work and are motivated by their desire to help people.

“Losing them is so wasteful because it’s a huge cost training people to a high level.

“And our junior nurses can’t properly learn if there are too few senior nurses to guide them.”

Sabrina says ED nurses now perform certain tasks previously attended only by medical staff. This was aimed at improving both the flow of ED and outcomes for patients.

“We enjoy working at a high level and it benefits the whole department, but if we’re getting bogged down by sheer numbers we’re not able to do that.”

The NSWNMA claim calls for additional nursing hours to be allocated when a department provides ‘specials’ for patients who require one-on-one care.

“Specials are needed every day and if we have 20 nurses at the start of a shift and three end up assigned to specials, it puts a huge load on what is already a very busy, high-stress department.

“Our staffing claim is based on achieving positive nursing environments where nurses feel they can always deliver the safe and timely care our patients deserve.”

_61R5585

‘It’s not right that smaller country hospitals are still fighting to get what we have.’

Westmead Hospital’s midwifery service benefited from staffing increases achieved through Birthrate Plus, a staffing tool for maternity services won for major hospitals in the union’s 2011 award negotiations.

In 2014, Birthrate Plus achieved a 29 per cent staff increase across the birthing unit, maternity ward, antenatal clinic, and home visits service of Westmead, the state’s second biggest maternity hospital.

Westmead midwife Joanne Robertson, the hospital’s branch secretary and delegate, says it is now time to support the union’s current award claim for guaranteed staffing arrangements at non-Birthrate Plus maternity services.

“The state government must fund smaller hospitals and services to employ adequate staff so that all women and babies across NSW get the care and education they need,” she says.

After 2014 Westmead’s staff ratios and skill-mix gradually eroded until the gaps were filled by recent recruitments based on Birthrate Plus calculations.

“Before the recent intake it wasn’t uncommon to find three or four assistants in midwifery under the supervision of one midwife looking after 41 women and babies.

“Due to the shortage of midwives we had to get assistants in nursing, endorsed nurses and registered nurses from the casual pool to replace people on sick leave.

“A lot of our recent recruits are new midwives and 3rd year bachelor of midwifery students employed as AiMs.

“So it’s quite common to be the only senior midwife on afternoon shift in a full ward.

“Fortunately, the hospital has just employed an after-hours educator to cover the maternity and antenatal wards on afternoon shifts, which will help take a bit of pressure off the staff.”

“The increasing acuity of patients makes it more important to guarantee safe staffing of all hospitals across the state. It’s not right that smaller country hospitals are still fighting to get what we have.”

_61R5741

Government neglecting the bush

“Our patients should be entitled to the same level of care as patients in the big city hospitals, but the state government doesn’t seem to care about the bush,” says Gunnedah District Hospital registered nurse Heather Franke.

Heather, acting secretary of the hospital’s NSWNMA branch, says the government’s refusal to extend nurse-to-patient ratios to small regional hospitals disadvantages her patients.

“Extended ratios would help to overcome the serious, long-term under-staffing that puts the safety of both patients and nurses at risk.”

The hospital serves Gunnedah’s 10,000 residents plus workers at area mine sites. Heather works in the emergency department and 25-bed general ward.

“In ED we only ever have one RN on each shift and at night that person has to cover both the ED and general ward. And sometimes you’re designated in charge of the hospital as well.

“When you’re working in ED at night you might not get down to the ward until 3am. Usually that leaves just two endorsed enrolled nurses unsupervised on the general ward.”

“When we ask for another RN for night shift, management offers to reassign someone from elsewhere, which is not what we want. We want to gain a staff member, not lose one from some other part of the hospital, which is also understaffed.

“Morale here is pretty low but the situation is not well known in the community. We are about to start a campaign to tell local people what’s going on. It’s important to get them onside.”

_61R5623

Big back pay win at Royal North Shore

by

Fifteen nurses at Sydney’s Royal North Shore Hospital will get back payment of the in charge of shift allowance they were denied for more than four years.

Hospital management finally agreed to the back payment after the NSW Nurses and Midwives Association filed an industrial dispute in the NSW Industrial Relations Commission.

The 15 nurses worked in the post-anaesthesia or recovery unit on the afternoon shift. Back payments for some of them will total several thousand dollars.

A member of the unit, Michelle Keith RN, said nurses were very happy with the result.

“Some people don’t even know it’s coming, so they might get a nice surprise when they see their pay slips,” she said.

“The union staff did amazing work – they were so supportive of us.”

Michelle and Edward Makepeace, the RNSH branch secretary, were on the NSWNMA team that negotiated with management over the back payment.

The public health system award for nurses and midwives says a registered nurse who is designated to be in charge of a ward or unit when the Nursing Unit Manager (NUM) is not rostered for duty, shall be paid an allowance – currently about $30 per shift.

The award also says the allowance must also be paid when the NUM is rostered on duty but the day to day clinical management role for the shift is delegated to a designated registered nurse/midwife.

Staff pressure pays off

The hospital paid an in-charge allowance for the afternoon shift until August 2010 when a second NUM was appointed to the anaesthesia and recovery units.

“We desperately needed a NUM in each department but we were told we would have to sacrifice our in-charge allowance for the afternoon shift in return,” Michelle said.

“However, despite the appointment of a NUM, management continued to designate a RN to be in charge of the afternoon shift.

“At meetings with management over the years we questioned the non-payment and were told it wasn’t up for negotiation.

“It was finally reinstated in February 2015 after a lot of pressure from the staff. But we were told back payment was out of the question.

“When a manager tells you it’s not up for negotiation you tend to accept it. But there was a strong feeling among the staff that it wasn’t right.”

Michelle took the problem to the hospital’s NSWNMA branch, which approached management and got an offer of three years back pay.

Edward said the branch believed members were entitled to full back payment and “tried to negotiate a local solution. But we weren’t able to agree so we got the union head office involved and went into dispute.

“The hospital finally agreed to full back payment when the case went to the Industrial Relations Commission.

“It was a good outcome but it was ridiculous that it had to get to that point.”

Staffing must be addressed in South East Regional Hospital review

by

The NSW Nurses and Midwives’ Association (NSWNMA) is cautiously optimistic a review into South East Regional Hospital will resolve ongoing workload issues and staffing shortages plaguing the Bega facility.

Since the new hospital opened last March, NSWNMA members have repeatedly called on Southern NSW Local Health District to address their concerns which have been compounded by an increase in demand for health services.

General Secretary of the NSWNMA, Brett Holmes, said it was unacceptable for local hospital management to provide only minimum staffing and ignore the clinical needs of the community.

“Our members are exhausted and struggling to deliver their professional commitment to provide safe patient care at all times,” Mr Holmes said.

“We are aware of up to 30 occasions when three operating theatres have opened for procedures, despite South East Regional Hospital only having a budget to fully staff two operating theatres and a procedure room – this puts enormous pressure on exiting nursing staff in these areas.

“Local management has a duty of care to both staff and patients in their hospital. It’s their responsibility to manage budgets to supply the necessary staffing for the entire financial year.

“Local management claims it provides minimum staffing as per the Public Health System Nurses’ & Midwives’ (State) Award, ignoring the fact that staffing should increase to reflect any increased acuity of patients.

“There have also been shortages in administrative staff at South East Regional which have flow on impacts to the reasonable workloads of nurses and midwives.

“South East Regional Hospital isn’t the first new public hospital to experience staffing problems, Wagga Wagga Rural Referral Hospital also suffered a similar fate. It’s clear the Ministry of Health needs to take another look at how funding is allocated for staffing in these new, larger facilities.”

Last Friday the NSW Minister for Health announced an independent review into the operation and management of South East Regional Hospital, which is due for completion by the end of April.

The NSWNMA will continue to lobby hospital management on behalf of its members to address local staffing issues at a matter of urgency.

Download this media release: Staffing must be addressed in SE Regional Hospital review

Disability nurses coerced into new roles

by

NSW legislation allows the Minister to dictate where disability nurses will work.

The National Disability Insurance Scheme Act 2013 (NDIS) was a federal Labor government initiative aimed at giving disabled people and their families more choice and control over the types of care and support they receive.

State governments are mainly responsible for implementing the NDIS. In NSW, state Liberal governments used the NDIS rollout as an opportunity to privatise the entire disability and homecare sectors.

As part of the privatisation process the NSW government passed the NDIS Enabling Act in 2013 allowing it to forcibly transfer disability and home care workers from the state to a private provider.

This means the government avoids its responsibility to find suitable alternative employment in the public sector or alternatively offer a redundancy.

“We have no right to redundancy if we refuse because we have no choice as to where we may work,” said Stockton branch president Kieran Kelly.

Branch secretary Terry Rae said some Stockton nurses through an “expression of interest” process had been offered three month’s retraining to take up nursing positions in the general medical, psychiatric and aged care fields.

“Nurses currently at Stockton are only guaranteed employment for two years after privatisation and we don’t know what will happen to our pay rates, long service leave and other conditions after that.

“We call on the ministry to make funds available to retrain all Stockton nurses who wish to enter an alternative field of nursing.”

Privatised home care service “appalling”

Terry said increasing reports of problems with the privatised home care service did not bode well for the future of Stockton clients.

Families of home care clients in the Hunter region have told the Newcastle Herald the quality of care has dropped dramatically since the service was taken over by Australian Unity in 2016.

Dawn Lhota’s 37-year-old son, Graham Roberts, is wheelchair -bound with a series of physical  conditions including Friedreich’s ataxia, heart disease, insulin-dependent diabetes and scoliosis. Ms Lhota told the Herald home care had deteriorated dramatically since Australian Unity took over midway through last year.

“Home care under the government wasn’t perfect, but it was very good,” Ms Lhota said.

“Under Australian Unity, it’s been appalling.

“Now, we are regularly rung by head office telling us at very short notice that there will be no carer available the next day for my son, that I will have to do it.”

She said her son, being wheelchair-bound, needed help to get  in and out of bed and for other things, including his “Epipen” insulin injections.

“He has an NDIS plan, he has the funding to cover all of this, but they keep ringing to say they can’t get the staff,” Ms Lhota said. “They say, you’ll have to do it. When home care was government owned I went to visit my son, not to care for him.”

Privatisation delivering reduced services

Another family upset with Australian Unity’s management  of home care listed at least nine occasions since August last year when staff had not turned up as  rostered, with no explanation given.

“Australian Unity has no head office person to complain to, you only get a call centre,” this  family said.

The Herald said Port Stephens MP Kate Washington had fielded a growing number of concerns from constituents and home care staff. She said the home care privatisation had been a disaster.

Ms Washington said clients and workers were both “at breaking point” over what was happening.

“Since the privatisation, clients have experienced great difficulty accessing the services they once had. And there appears to be no accountability whatsoever – nowhere to  complain and no oversight,” she said.

Australian Unity told the Newcastle Herald that it accepted there had been problems with the way home care was being delivered, and these had been “compounded by a range of significant industry reforms” including the NDIS and changes to home care packages,  that “occurred simultaneously, directly impacting the same clients and staff”.

But when the Herald sought a response from the new Disability Services Minister, Ray Williams,  a departmental spokesperson said the department was “not aware of any complaints in relation to the quality of services provided by Australian Unity of the nature alleged”.

When Australian Unity did the privatisation deal with the government last year its senior executive Derek McMillan claimed Australian Unity would provide increased levels of care.

“We see the extensive range of services as one of the key benefits we bring to clients of home care,” he said. ■