albury wodonga

Public hospital members step up in support

October 29, 2018 by Rayan Calimlim

STOP PRESS

When Albury and District nursing home staff were threatened with dismissal if they went public about looming hours cuts, NSWNMA members at Albury Base Hospital stepped into the breach.

Seven Albury Base Hospital members, including six from mental health unit Nolan House, joined a rally outside Japara’s Albury nursing home to support their aged care colleagues.

They waved placards alongside the busy road and collected signatures on a nationwide nurses’ petition calling for mandatory ratios in aged care.

Catherine Winchester, NSWNMA branch president at Nolan House, said members believed the public deserved to be told about the threat to nursing hours and resident care.

“We are a strong group and one of our biggest bugbears is management not allowing staff to have free speech,” she said.

“When we found out that aged care workers were not allowed to have a voice because their jobs were threatened, we decided to stand up and support them.”

Catherine reported a positive response to the rally from passers-by and family members arriving for a meeting inside the nursing home.

“Most people know from personal experience or friends of friends that there is understaffing and that nursing home staff were really pushed.

“They were appalled that staff numbers could be cut even further.

“Most of them could relay stories to you about someone they know in a poor state in a nursing home. They were disgusted to hear that it would get worse as a result of nursing hours being cut.”

Management block out rally

Inside the nursing home, management pulled down the window blinds – presumably so people inside could not see the rally. They also called the police, who sat in a van nearby.

“After a while the police drove off, giving us a toot and thumbs up,” she said.

“Talk about wasting police time – we were loud and vocal, but we were not dangerous.

“We knew as long as we didn’t go onto nursing home land we weren’t breaking any law.”

Catherine worked in aged care for more than three years until a resident’s sad passing prompted her resignation.

It was dinnertime and Catherine was scrambling to care for 14 residents by herself. One of them, an old lady, was dying.

“I wanted to sit with her and hold her hand, so I rang the manager and asked him to send someone to assist me with the other residents,” she said.

“He told me to leave the old lady and do my job.

“It took four hours for her to pass, which is not a long time – four hours when someone could have sat with her and held her hand.

“She was a country and western fan and all I could do was put on one of her cassette tapes, a Charlie Pride album.

“During that time, I was trying to toilet and feed the other residents and all I could think of was that old lady.

“Now and then I ran back to her room and checked on her and I kept the doctor updated. When I heard the music stop, I’d run back in and change it.

“After she passed, I had 45 minutes to wash her, change her nightie and lay her out, ready for the undertaker.

“I thought, this is the last thing I can do for this woman; make sure she’s clean before they come and take her.

“The residents didn’t get their evening showers that night because there wasn’t time.

“That night I decided to walk away from aged care and I never went back.”

Catherine says the experience “will live with me forever. I don’t believe anyone should leave this earth on their own. Management could have prevented that if they had been prepared to authorise another nurse to come in.”

She describes her experience of working in aged care as “like being on a production line”.

“I was going home feeling guilty because I hadn’t had time to properly care for someone.”

Letters to the Editor
Share your thoughts on this article or anything else important to you as nurses and midwives by sending a Letter to the Editor.

Four letters are published in the Lamp each month and the letter chosen as Letter of the Month will win a gift card. Please include a high-resolution photo along with your name, address, phone and membership number. You can submit your letter by emailing the Lamp:lamp@nswnma.asn.au

‘A disgraceful breach of trust’

October 29, 2018 by Rayan Calimlim

STOP PRESS

As The Lamp goes to print Japara announced the proposed changes were no longer to go ahead. The staffing at all Japara facilities is an ongoing concern to the ANMF. The residents’ families say staffing is still inadequate to ensure safe resident care and wish to continue fighting with the nurses.

The daughter of a resident of Japara’s Albury nursing home told The Lamp she had seen increasing pressure on “good and caring nurses who are distressed that they are no longer able to give the quality of care that is needed for the well-being of the residents”.

“The decrease in staff work conditions and resident happiness has been very obvious over these last months,” she said.

“When I visit, the residents openly talk of Japara not really caring about them. They say Japara is only interested in making more money for their shareholders and for their executive bonuses.”

She said it was sad to know that her father and many other Australians from the “silent generation (1925–1945)” are seen as “a source of greedy profit by a company that could do more”.

In a letter to the management of Japara Aged Care Australia, she and her family described the proposed cuts to night shift staff as “a disgraceful breach of trust and duty of care”.

They said the nurses and carers aimed to care for residents with “professionalism and compassion”, but this care could not be sustained with fewer workers.

“The residence building is large and so it is difficult for staff to move from one section of the building to respond to residents’ calls. Response times to resident needs are  presently inadequate and will be totally compromised if further staff cuts are made,” they warned.

They said they were shocked by a Japara management directive reportedly issued in May that staff no longer check on residents overnight.

They described the practice of not employing temporary staff when permanent staff are sick or away as “barbaric, further putting staff under incredible stress and potential injury”.

In a subsequent letter to Japara, they urged the company to “be bold, brave and ethical and act to increase your staff ratios before the Royal Commission demands you do so”.

Letters to the Editor
Share your thoughts on this article or anything else important to you as nurses and midwives by sending a Letter to the Editor.

Nolan House battles to keep CCTV

January 31, 2018 by Rayan Calimlim

Cameras are essential in a high-risk mental health unit, nurses say.

Nurses are resisting an attempt to remove security cameras from a high dependency mental health unit (HDU) on the Albury Wodonga Health campus.

Nurses say the cameras at Nolan House HDU are an essential safety measure.

The unit was upgraded with state of the art CCTV to eliminate blind spots, after a critical incident resulted in a ‘root cause analysis’ (RCA) and coroner’s recommendations in 2014.

Albury Wodonga Health campus is on the border of NSW and Victoria. Nurses are employed by NSW Health and seconded to Victorian health authorities who manage the campus.

Nolan House is a 24-bed acute unit including a seclusion room and the three-bed HDU, with bedrooms, lounge and a courtyard. As a non- gazetted unit the HDU receives lower funding and staffing numbers.

The HDU was shut down in July 2017 and reconfigured to make it more secure after nurses refused on safety grounds to be permanently stationed inside the unit (see The Lamp November 2017).

During renovations, Victoria’s chief mental health nurse Anna Love visited the unit and said CCTV did not have a role in Victorian or NSW mental health services.

She said cameras would be removed in the interests of “patient privacy and therapeutic engagement”. Ms. Love reassured nursing staff that workplace health and safety education would be provided as a matter of priority.

CCTV ensures safety

Branch secretary Gillian Rhodes said CCTV allows one staff member to see patients and other staff in all parts of the HDU other than bathrooms at all times – not only at the 15-minute intervals required under NSW Health engagement and observation policy.

“CCTV allows staff to monitor, evaluate, and provide escalation or de-escalation and early intervention,” she said.

“This ensures the safety of patients and staff and is also a great comfort to patients’ families.

“It does not replace the required physical, therapeutic engagement with staff members every 15 minutes.

“Since the introduction of CCTV our unit has had a low incidence of self-harm, disinhibited sexual behaviour, assaults and reportable incidents – and there have been no more RCAs or critical incidents.”

Gillian said branch members believe 15-minute visual observations are “inadequate to maintain the safety of our highest-risk and most vulnerable patients.”

“Members strongly believe that therapeutic relationships are not impaired by the use of CCTV, which has enhanced safety for both staff and patients.

“The CCTV does not record footage as a measure to protect patient confidentiality and privacy.”

Difficult to recruit and retain in rural areas

She said the unit’s location in a rural catchment area created difficulties in recruiting and retaining staff.

“CCTV helps to maintain the safety of patients, staff and visitors when we have such limited staff resources.

“CCTV is increasingly used to improve safety in public places such as squares, airports and shopping centres; it’s just been installed in Albury CBD, for example.

“It is therefore a backward step for CCTV to be excluded from a high-aggression and high-risk work area.”

Gillian said it was unrealistic to expect staff to view every patient every minute.

“However, technology advances such as CCTV have made this possible, making it safer for both patients and staff. Why take away an invaluable tool used to enhance visual observation and safety for both patients and staff?

“Members appreciate previous WHS and violence de-escalation training, but this does not replace the 14 minutes of visual observations, as the nurses can only be in one area at any given time.

“We are expected to accept the most dangerous patients, some of whom have forensic histories and most patients are under the influence of illicit substances.

“In the past staff have accepted this position, but only because of the added security that CCTV provided.

“If asked to do the same job without such security advances and less funding than gazetted mental health units, the members say ‘No’.”

Until recently, Nolan House staff were not permanently stationed inside the HDU because it had only a single entrance/exit door that needed a key to be opened from the inside.

Earlier this year the chief mental health nurse visited the facility and without consultation with nurses, directed that staff should stay inside the HDU at all times. If not, they were to record every episode as a seclusion.

That led to nurses deciding to close beds and refuse to admit patients on safety grounds. The NSWNMA branch passed resolutions criticising the lack of consultation with nurses and attempts to intimidate staff to comply with the directive.

An occupational health and safety review by the NSWNMA resulted in an agreement to reconfigure the HDU to make it safer.

Nurses reject dangerous work practice

November 1, 2017 by Rayan Calimlim

Mental health nurses in Albury force authorities to shut down and remodel an unsafe facility.

NSWNMA members have refused on safety grounds to work as directed in the high dependency unit (HDU) of Nolan House, part of the Albury Wodonga Health campus on the border of NSW and Victoria.

Their stand – including closing beds and refusing to admit patients – led to an occupational health and safety review, a meeting with a NSW minister and an agreement to reconfigure the HDU to make it safer.

Nolan House is a 24-bed acute unit including a seclusion room and the three-bed HDU with bedrooms, lounge and a courtyard. The HDU accommodates acutely mentally ill patients, who may be highly aggressive/homicidal or suicidal and/or drug induced.

Both states fund the service and though the nurses are employed by NSW Health they are seconded to Victoria, which manages the campus.

A lack of clear jurisdiction bet-ween the states has caused confusion about which policies and practices nurses should follow.

Nolan House staff were not permanently stationed inside the HDU, which had a single entrance/exit door that needed a key to be opened from the inside.

Instead, staff constantly mon-itored patients through large windows plus state-of-the-art CCTV to eliminate blind spots.

Victorian directive inconsistent with NSW

Gillian Rhodes, secretary of the NSWNMA’s Nolan House branch, said staff “constantly met patients’ needs by frequently entering the HDU in pairs in a safe environment.”

“However, the Victorian chief psychiatrist visited the facility and without consultation with nurses, directed that staff should stay inside the HDU at all times. If not, they were to record every episode as a seclusion.

“The directive may have been in line with Victorian policy, but it was inconsistent with NSW Health policy.

“With an exit by key only there were episodes when staff were trapped and unable to exit the HDU until they were safely extracted with the aid of police and/or hospital security and porters.

“Branch officials told the chief executive of Albury Wodonga Health (AWH), Leigh McJames, that members would not comply with the request of the chief psychiatrist.

“The union organised an OHS inspection, which confirmed the unit was unsafe and we presented the findings to the CEO.”

The branch decided to close the HDU beds and refuse to admit patients in the emergency department who were deemed to be high risk and requiring an HDU bed.

It also passed resolutions criticising the lack of consultation with nurses and attempts to intimidate staff to comply with the directive.

“After a lot of discussion AWH agreed to suspend the operation of Nolan House and refer patients needing HDU level of care to other facilities,” Gillian said.

“Despite this understanding there were subsequent attempts to transfer ED patients into the closed HDU and the seclusion area, which were rejected.

“We also sought a meeting with the NSW Minister for Mental Health, Tanya Davies, to outline problems arising from the confusion over which state legislation and policies we were supposed to be under.”

The minister met with a union delegation including branch president Catherine Winchester, and delegates Jason Pascoe and Gillian.

Ms Davies agreed the situation was complex and said nurses’ concerns would be addressed by a redrafting of the memorandum of understanding governing management of AWH, which was
due to be finished by December.