NSWNMA survey shows ICU staffing levels fall way short of key ACCCN standards.

Sixty per cent of NSWNMA members who work in ICUs say they will leave critical care nursing within five years. Most of them will leave within three years.

The disturbing finding comes from a union survey of members in 37 of the 40 ICUs in NSW.

Seventy-five per cent of respondents said they are at “breaking point” due to the chronic staffing crisis.

When asked whether they can deliver safe patient care at all times, 88 per cent of respondents answered no.

The union outlined the survey findings in a letter to Health Minister Brad Hazzard during talks about critical care nursing standards.

In the letter, NSWNMA General Secretary Brett Holmes said the implementation of standards set by the Australian College of Critical Care Nurses (ACCCN) would deliver a “significant and rapid” improvement in working conditions and raise the standard of care delivered.

“This will in turn allow nurses to continue working in our ICUs across the state,” Brett said.

In September, around 750 critical care nurses signed a letter to then Premier Berejiklian and Minister Hazzard calling for permanent staffing improvements to ensure safe patient care.

The letter said ICUs were in crisis before the COVID-19 pandemic.

“We experienced chronic understaffing, an increased junior skill mix as a result of senior staff leaving due to burnout, and ever-increasing workloads.

“The added demands of the COVID-19 pandemic, testing capacity and surging admissions, is forcing our clinical workforce to the brink, placing our registration at risk on every shift and compromising safe patient care,” it said.

Nurses get support from CICM

The letter added that critical care nurses’ health and safety “are constantly being placed at risk both physically and mentally by the current inadequate staffing levels. The pandemic has only multiplied these impacts.”

“We believe that the Local Health Districts, the Ministry of Health and your government are failing to consider or meet your obligations in relation to our mental health and wellbeing, as well as the impact this pandemic is having on an already overstretched system.

“We do not want to be harmed, just by attending work. We do not want to see our patients die as a result of understaffing.”

Michelle Rosentreter, an ICU nurse delegate taking part in talks with Mr Hazzard and ministry officials, said the nurses’ position was strengthened when the NSWNMA secured a letter of support from the College of Intensive Care Medicine (CICM), which oversees the training and education of intensive care specialist doctors.

“Intensivists find it incredibly frustrating when they cannot accept a patient with a life-threatening illness, because they don’t have enough nurses with the required skills to deliver the high level of care associated with intubation, dialysis, ECMO et cetera,” Michelle said.

In January, Brett Holmes authored an article in the Sydney Morning Herald  that outlined the strains being placed on nurses in all areas of the NSW hospital system.

Regarding ICU nurses, Brett wrote that they “are once again working excessive hours of double shifts and overtime. They are caring for a combination of ventilated and high-dependency patients, some with COVID-19 and some without.

“Over the weekend, ICU nurses at an outer-metropolitan hospital declared, ‘we are falling like flies’. In the state’s north, an ICU nurse said, ‘we’ve had two years to prepare for this, and it’s still shit everywhere’, while another reflected, ‘there’s nothing left in the tank’.

“Staffing has become so bad that many ICUs are working without team leaders or the nurses they need in addition to bedside nurses, to keep the units working seamlessly.

“Nurse educators have been forced to stop offering clinical supervision to take on patients of their own. Meanwhile, ICU teams are still attending to medical emergency calls from other parts of their hospitals.