Chronic understaffing at Wollongong maternity services
Midwives take action, including a ban on bed washing and claiming overtime for missed breaks.
For several years, midwifery representatives on Wollongong Hospital’s Reasonable Workloads Committee tried to tell manage-ment the maternity service was seriously short staffed.
“We would have up to 80 vacancies on a 30-day roster but management kept telling us we had our full number of FTE (full time equivalent) staff. They produced various figures to try to bamboozle us,” said branch president Denis Wann, a clinical midwifery educator.
“It was very frustrating and we felt as if we were hitting our heads against a brick wall.”
The introduction of the Birthrate Plus tool to determine midwifery staffing led to a staffing review in March 2016. It revealed the maternity service was short by 19.5 FTE midwives.
“Management kept preaching to us about core values such as respect but they showed us no respect by not listening to us.
“We had midwives crying on wards because they were so stressed from overwork. But management wouldn’t even acknowledge we were critically short staffed.”
Management agreed to advertise for more midwives but new recruits did not start to appear on the wards until late August this year.
Still short 10 FTE
During that 14-month wait the maternity ward typically accommodated up to 26 women with 15-20 babies cared for by one midwife, one student midwife a few weeks into her training, an RN and an AiN.
Denis said that as clinical midwifery educator he took on half the ward with help from the AiN. The student midwife and RN looked after the other half.
“At the end of the shift I had to write 14 adult notes and 14 baby notes, which took me more than two hours.”
The maternity service is still short by about
10 FTE midwives and there is also a shortage of cleaners and clerks.
This has forced midwives and nurses to clean and make beds and do a range of clerical jobs such as filing, scheduling and making appointments – all of which cut down the time available for patient care.
In September, the NSWNMA branch decided that midwives and nurses would no longer wash beds. This has resulted in beds being washed by the nurse unit manager and facilities manager.
“We are so overworked that we often can’t get babies checked by paediatricians until late at night. That means we sometimes can’t discharge mothers and babies before midnight.
“There are no cleaning staff on at night so the midwives are expected to do it.”
Management hamstrung by lack of funding
The branch also agreed that staff would claim overtime for missed tea and lunch breaks.
“Midwives aren’t taking breaks or claiming for overtime when they miss breaks, as they are entitled to do under the award,” Denis said.
“Management said we must take breaks but you just can’t just put down tools when a lady is having a postpartum heamorrhage followed by another lady in labour and a neonatal baby who needs to be resuscitated.”
Midwives from each area of the maternity service met with management in September to outline their staffing requirements. Most requests were for clerical and cleaning support.
Denis said most midwives left the meeting feeling frustrated because they believed management was hamstrung by lack of funding.
“Some managers including our new director of nursing are trying their best to help us but they appear to be fairly powerless.
“Also, there continues to be a disconnect between the understanding of top level management and the reality on the floor.”