Award claim aims to protect ICU standards
The NSWNMA’s claim for ICU staffing ratios draws on feedback from a statewide ICU nurses’ forum.
Forum member Michelle Rosentreter, who is president of the NSWNMA’s Hornsby Hospital branch, says ICUs are not covered by a NHPPD (nursing hours per patient day) formula.
Instead, Hornsby ICU nurses aim to follow guidelines formulated by the College of Intensive Care Medicine of Australia and New Zealand and the Australian College of Critical Care Nurses.
The guidelines apply to work practice, caseload, staffing and operational requirements for the ICU.
“The guidelines are the minimum standards needed to keep our patients and staff safe,” Michelle says.
“Minimum standards are paramount in ICU because of the level of technology we use, the drugs we use and the amount of education we need.
“On average, it takes a nurse about five years to reach a level of competence and confidence needed to deal with the critically unwell in ICU.”
Michelle says that in the absence of ratios, ICUs are under pressure from hospital executives to take more patients than is safe.
“People running hospitals may lack knowledge of what is required to manage patients with life threatening illnesses. It can’t be compared to ward staffing.
“You might hear an executive member say, ‘ICU has got six nurses and only three patients.’
“But those three patients might be hooked up to over 15 infusions, have an artificial airway and dialysis as well as requiring CPR, while you have the primary nurse and another nurse helping to maintain their airway and keeping them haemodynamically stable”.
“I’ve been appalled to learn that some of our tertiary hospitals do not follow the minimum staffing standards developed by these colleges – most notably no free Team Leader/Clinical Coordinator or ACCESS nurse.
“My heart sank when I saw the struggles my colleagues are having at some hospitals, where they are not heard by their executive or their district.
“For instance, at one level 6 ICU – the highest level – the clinical coordinator running the unit also has to do direct patient care and support junior nurses, while trying to manage deteriorating patients and respond to emergency code blues.
She says it’s time the Berejiklian government and the Ministry of Health listened to nurses and midwives.
“We need a fair and reasonable pay increase, shift by shift ratios and better conditions for work – to deliver the care we are trained to do and not to be disregarded.”