Midwifery
Public back midwives in staffing campaign
Maternity staff at Wollongong Hospital have made gains in their campaign to raise staffing levels and service standards but say there is still a long way to go.
On a recent count, Wollongong Hospital’s maternity unit was short by 9.5 FTE (full-time equivalent) staff – about half the number recorded almost a year ago.
The reduction in vacancies follows a public awareness campaign launched by Wollongong Hospital’s NSWNMA branch in September 2017.
The campaign included an open letter to the executive committee of the Illawarra Shoalhaven Local Heath District (ISLHD) signed by 112 Wollongong Hospital staff.
They warned that a shortage of midwives, poor staff mix and other issues had led to an increase in re-admissions and clinical incidents in the maternity department.
NSWNMA members also took industrial action to get after-hours cleaners employed.
Members voted to refuse to clean maternity beds, which forced management to employ cleaners on afternoon shift. The unit also won the employment of a much-needed ward clerk on weekends.
Emma Gedge, a midwife on the postnatal ward, said community organisations and public opinion had swung behind midwifery staff in recent months.
“Before we started our campaign, the community tended to lump staff and hospital together and midwives were being publicly criticised for things like taking too long to answer the buzzer,” she said.
“Now, the public have heard our message about understaffing and have a better understanding of the issues.
“We’ve had so much more community support since we started working to get rid of the ‘us and them’ attitude between midwives and mums.
“Lobby groups such as Better Births Illawarra have become good allies. They meet with hospital management and have achieved positive changes in the birth units.
“The community realise if we can get better staffing they can access the maternity care that women deserve.”
Workloads disadvantage patients
Emma said maternity unit staffing is still “way below par. It’s still a rarity for a shift to be fully staffed.”
“We go from being well staffed with six midwives on the ward – meaning a patient load of five women and babies each – to two midwives and a RN for 20 women on the next night shift.
“That means 10 women and babies for each midwife because the RN can’t provide all the care required.
“The acting director of nursing will come around to the ward and say, ‘That’s good, you’ve got five on afternoon shift.’
“That’s a false picture if the staffing is three midwives and two RNs rather than five midwives.
“If you have a ward with 28 women, it means two midwives have 10 women plus babies each and the third midwife has eight women plus babies.
“The midwives with 10 women are allocated a RN but a lot of tasks are outside the RN’s scope of practice.
“It’s a heavy workload for the midwives and frustrating for the RNs if they feel they are doing nothing of clinical importance.
“Most importantly, it disadvantages the woman. For example, it’s impossible for one midwife to help 10 women breastfeed properly.
“Even though the hospital is still using RNs in the staffing numbers, there is a positive aspect in that most of them then apply for the Midstart program and become midwifery students with us.”
Emma says afternoon and night shifts seem to be the most poorly staffed. Afternoons are often “frantic” because the in-charge midwife also has a patient load.
Health budget ignores baby boom
Wollongong MP, Paul Scully, told The Illawarra Mercury more than 2,500 babies were born at Wollongong Hospital in 2017 and the state government health budget had failed to account for the baby boom in the Illawarra.
He said the ISLHD was continuing to look for midwives, a clinical midwifery educator and nurses with expertise in post-anaesthetic care for mothers who had caesareans.
According to the ISLHD’s Acting Executive Director Nursing and Midwifery, Karen Tuqiri, the hospital is actively trying to recruit more midwives.
This was happening through a “centralised and fast-tracked recruitment process with ongoing rolling advertisements in place as well as advertisements for casual registered midwives,” Ms Tuqiri told The Mercury.
However, several experienced midwives have resigned over the past year.
“It seems as soon as we get a new staff member, someone else leaves,” Emma said. “It’s a revolving door and it’s so hard to find midwives.
“We are all really tired and for a lot of people it comes down to a choice between putting up with bad working conditions or getting another job out of the area, which usually means moving house and school.
“We still have an amazing group of midwives who have each other’s backs and continue to come to work because of the people they work with.”
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