July 3, 2022

prince of wales

“Feeling ignored”: Randwick nurses and midwives rally for ratios

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Angry nurses and midwives braved the elements to rally outside Prince of Wales Hospital, frustrated by the NSW government’s rejection of shift-by-shift ratios and insulted by a 1.04% pay offer.

NSW Nurses and Midwives’ Association (NSWNMA) Assistant General Secretary, Judith Kiejda, said members felt ignored and disrespected by the latest pay offer, especially after receiving 0.3% last year during the COVID-19 pandemic.

“The NSW government is happy making zero changes to support nurses and midwives at the bedside, completely ignoring their ever-increasing workloads,” Ms Kiejda said.

“At Prince of Wales Hospital, members tell us they’re often short staffed, unable to replace colleagues at short notice for sick leave or because of unfilled vacancies and regularly miss meal breaks.

“Our members want to offer the best possible patient care with safe staffing. The NSW government has the power to do this, but they want to shirk all responsibility.

“We call on the NSW government to respect and value nurses and midwives by delivering shift-by-shift ratios and decent pay, not a pitiful 1% offer.”

Over 40 members of the Association’s Prince of Wales Hospital Branch gathered alongside community supporters to call on the NSW government to deliver nurse-to-patient ratios, improved conditions and a respectful pay rise.

Keith Donnelly: our May nurse of the month

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Keith is a Clinical Nurse Manager at the Euroa Centre at Prince of Wales Hospital and Founder of ‘Keith’s Closet’.

Keith has always enjoyed working in mental health. He understands how important it is to reach out and offer support to clients who are extremely vulnerable and isolated.

Working as a nursing student back in Dublin, Keith was in the general waiting room looking for a client. He remembers walking back with him, feeling really ashamed that he could pick the client out from a crowd in a very busy waiting room, just based on his appearance.

From that moment on, Keith raided his wardrobe, his wife’s wardrobe and started asking friends for clothing donations. This is where the idea of Keith’s Closet started.

Watch his story below.

To donate clothes visit Keith’s Closet on Facebook or Instagram OR send an email to SESLHD-keithscloset@health.nsw.gov.au

Changing the rules includes hospital staffing

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Nurses and midwives were prominent at rallies around Australia on May Day advocating for “Change the Rules” on hospital staffing to improve safe patient care.

Sydney May Day march Prince of Wales, Patrick Gould, mental health nurse
“I attended the May Day rally with about 100 other nurses to support the Change the Rules campaign. It was just really good to see people from diverse backgrounds coming together to try to get our voices heard with other unions, in true solidarity. Unionisation has always been very important to me. It is about protecting your rights, making sure we have a safe workplace, are well paid, and making sure we can have the best quality of work and life. A lot of our patients in my mental health area are in there because of unemployment or recent unemployment, or issues with their jobs. When people are being underpaid, getting stuck in that poverty cycle, and living pay cheque to pay cheque, they are in constant financial stress. The biggest issue at Prince of Wales we wanted to march for are ratios: at least one to three in EDs, and also counting mothers and their babies as separate individuals and patients.”

Illawarra May Day march Wollongong Hospital, Sarah Morton, nurse and midwife
“I attended the May Day rally in Wollongong. There were about 40 nurses and midwives. It was my first May Day rally so I wasn’t sure what to expect, but everyone was really positive and enthusiastic. Change the Rules means we’re fighting for a fair go at work. For the nurses and midwives it is really about the ratios campaign, and midwives really wanting babies to be counted in the ratios. At the moment there are high rates of readmission of babies and poor breastfeeding rates, which probably contributes to some women’s feelings of postnatal depression and anxiety. We have got almost equal nurses to midwives in the postnatal ward, but the women there need specialised midwifery assistance and breastfeeding assistance, and it is outside nurses’ scope of practice to offer this. A lot
of the Shellharbour staff members know they can have a successful campaign after they saved Shellharbour Hospital from being privatised.”

Our 2018 ratios campaign begins!

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Nurses and midwives throughout NSW have been coming together to kick off our campaign for improved and extended ratios and a fair pay rise in our Public Health System.

Prince of Wales Hospital started their the campaign with a launch meeting on 19 April. Nathaniel Mitchell told The Lamp: “We are going to be organising an area contingent to march in the May Day rally. We want ratios to be defined really clearly, and to be part of NSW health policy so they can’t be taken away. Over time we’ve been expected to do more and more with the same staff.

“At POW workloads are increasing without increased staffing to match. And we’re also seeing RNs and ENs being replaced with AINs. I used to work in our rehabilitation ward, and the ratios there are one to five during the day, but the biggest issue they have there is if someone calls in sick they would replace an RN or an EN with an AIN. That would leave the nurses with a ratio of one to ten in practice.”

Members of our Macquarie Mental Health branch in the North Sydney LHD pledge to fight for safe staffing in mental health units during our 2018 campaign.

NSWNMA members from Liverpool Hospital were joined by Paul Lynch, the state MP for Liverpool and Charishma Kaliyanda, a Liverpool City Councillor, to express their support for our ratios campaign.

Brian Grant, Liverpool Hospital Branch President, told The Lamp: “The Liverpool emergency department is probably the second busiest in the state and they are employing ratios of one to four in the subacute area and they really should be at one to three. The other area that is a problem is the maternity unit which counts mothers and their babies as one patient. But the Liverpool maternity unit is a level five unit and takes complicated births. There is a general shortage of experienced midwives too.”

Babies should be counted in staffing

Maternity services need staffing ratios that apply to babies as well as mothers, says Stephanie Austin, a midwife at a northern Sydney hospital.

“We can’t give good midwifery care with staffing the way it is,” she says.

“We are badly understaffed. Midwives are working under extreme pressure and some have resigned as a result.

“Ratios should be guaranteed in black and white, not the grey area that applies under the Birthrate Plus® system, which doesn’t reflect the acuity of the women and babies we are seeing.

“My ward is funded for 33 beds yet it often goes over census and it is common to have 36 to 38 mothers at any one time.”

Stephanie supports the union claim for newborns to be counted as patients for the purpose of determining staff numbers in postnatal wards.

“Increasingly, babies require at least as much care as mothers.

“Most babies are on regular observation and we have to write notes and fill out care plans for all babies daily.

“For example, we have jaundiced babies on bili beds, babies who need feeding support, babies on sepsis obs and others who need blood sugar levels monitored.

“Our midwives are caring for late-preterm newborns who require extra assistance with feeding, blood sugar levels and general observations.

“Babies like these are cared for in special-care nurseries in other hospitals.”

The union’s award claim also seeks to provide a better staff skill mix in maternity services, which Stephanie agrees is badly needed.

“Absent midwives are often replaced with RNs or AiNs, who are unable to take a patient load.
This amounts to an increased patient load for midwives.

“Student and transitional midwives on the maternity ward often feel overwhelmed with heavy patient loads. It’s unfair that they should be left feeing unsafe, especially because senior midwives don’t have the time to support them.

“Junior midwives have a high burnout rate; quite a few have left and others are looking at alternative employment options.”

She says midwives lack the time to properly educate new mothers.

“If midwives had the time to sit with women through a breastfeed and educate new parents on normal newborn behaviours we would have fewer patients being readmitted with issues around jaundice, weight loss and feeding.

“Readmissions end up costing the hospital more in the long run.”

For more information on our campaign

Visit the Ratios put Patient Safety First Facebook page at: https://www.facebook.com/safepatientcare/