October 30, 2024

st vincents

St Vincent’s and Mater members reach landmark private hospital pay and ratios deal

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After extensive negotiations, St Vincent’s and the NSW Nurses and Midwives’ Association (NSWNMA) have come to an historic enterprise agreement which will see nurses and midwives at the organisation’s NSW private hospitals among the highest paid in the state – public or private – as well as introducing nurse-patient ratios.

The agreement – described by the NSWNMA as “profound” and sending “a strong message” – provides for an immediate payment of $1,000 for all full-time nurses and midwives (pro rata for part-time and casual staff), and guarantees an 11 per cent pay rise over the next three years.

Nurse to patient ratios across multiple wards and clinical areas will commence introduction in July 2024.

St Vincent’s CEO, Chris Blake, said the health and aged care provider was very pleased to reach agreement.

“St Vincent’s fundamentally recognises that our nurses and midwives are the heart and soul of our organisation,” said Chris Blake.

“The negotiation was not without its challenges. Both sides had to give ground to find a common place. Ultimately, we listened to our nurses and midwives and reached an agreement that was best for them while making sure it was sustainable.

“We want to work with the NSWNMA as an active partner in promoting St Vincent’s to their members as an employer of choice. Our private hospitals have some of the best patient and safety scores in Australia. We now offer industry-leading pay and conditions.

“In a highly competitive employment market, that should stand out as a beacon to any nurse or midwife looking to a career in private hospitals. St Vincent’s is the best possible place to work.”

NSWNMA General Secretary, Shaye Candish, welcomed the historic agreement and confirmed it had been endorsed by a majority of members.

“This new agreement exemplifies our members’ resolve in advocating for nurse to patient ratios and safe midwifery staffing to ensure the best possible care for patients,” said Ms Candish.

“The outcome required robust discussions from both parties, each with the objective of valuing the nursing and midwifery contribution. We commend St Vincent’s for listening to the clinical professionals who repeatedly outlined what is necessary to reform the private hospital sector.

“Nurses and midwives at St Vincent’s private hospitals look forward to the implementation of this agreement, and the wide-ranging benefits for both patients and staff.”

St Vincent’s budget woes lead to redundancies

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St Vincent’s Hospital is resorting to voluntary redundancies to try to overcome a budget shortfall.

St Vincent’s Hospital in Darlinghurst has initiated a surprise voluntary redundancy program and closed
a bed on every ward.

This follows the widespread temporary closure of beds and services in December and January, in order to cut costs.

Assistant General Secretary of the NSWNMA, Judith Kiejda, said the union wanted to ensure that any offers of redundancy did not put additional strain on nurses who remain.

“We acknowledge St Vincent’s Hospital is facing some serious budgetary issues,” Judith said.

“However, any plan to resolve these problems must not impede the clinical needs of the health service being provided to the local community.

“Losing our most experienced nurses is not an option when searching for solutions to budget shortfalls.

“Experienced nurses are needed to keep our public health system together and retention of this experience is essential as new graduates build their experience in a clinical setting.”

Expressions of interest in the redundancy program closed last month.

The hospital’s NSWNMA branch called on management to convene a forum to explain the redundancy program.

The branch resolution outlined questions it wanted the forum to answer.

Among other questions, the branch wanted to know how much money would be saved through voluntary redundancy, which nursing positions had been identified for voluntary redundancy and what nursing model of care was being proposed for each affected department.

It asked how voluntary redundancy could be justified in light of the large number of positions already vacant and whether contract workers would be hired to fill vacant nursing positions.

The forum took place just two days before redundancy applications closed.

Vague replies to important questions

Branch secretary Kristel Alken said hospital executive members gave vague replies to important questions and nurses remained unhappy with the lack of information.

“You could feel the tension in the room,” she said.  “This has caused a lot of anxiety and morale is even lower than during the December/January period of bed closures.”

She said management did not satisfactorily explain why it was planning redundancies when the hospital said it was seeking to recruit staff for 77 full-time-equivalent vacancies.

“On my ward, for example, three nurses have gone on maternity leave and only one vacant position has been recruited for.

“They have closed a bed on every ward and, on some wards, the equivalent of one staff member per shift has been reduced according to the nursing hours per patient day calculated by senior management.

“Affected nurses are being redeployed.”

At the forum, nurses quizzed management about winter staffing plans.

“The answers did not seem to reflect the fact that last winter’s extremely busy period was badly handled,” Kristel said.

She said downtime was scheduled for Easter with only two theatres open for emergency and long-waitlist patients.

Early last drinks reducing Sydney ED violence

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A study published in the Medical Journal of Australia (MJA) indicates that alcohol restrictions in inner Sydney have effectively reduced the number of violent alcohol-related injuries.

The emergency room at Sydney’s St Vincent’s Hospital has seen a 10 per cent reduction in the incidence of fractures which are often caused by a punch to the face, over the two years since the so-called “lockout laws” were introduced, reported online news site The Conversation.

The MJA study looked at the rates of alcohol-related orbital (eye socket) fractures before and after the changes to alcohol access. There were 27 fewer fractures that required surgical management during the period of the laws.

Some orbital fractures can be considered minor injuries. But in 2016, some of the study’s authors found a 25 per cent reduction in major alcohol-related injuries in the 12 months after the laws were introduced.

This latest research adds to compelling evidence from Australia and internationally that demonstrates restricting access to alcohol by closing drinking venues early reduces serious assaults and injuries.

An international study on alcohol-related presentations to EDs, which include intoxication and other emergencies besides injuries, found almost one in 10 of all attendances were alcohol-related.

A survey of more than 2000 ED staff in 2014 found nine out of ten had experienced violence from a drunk person in the emergency department.

Beds thrown overboard

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Mass closure prompts concern and confusion at St Vincent’s Hospital.

Nurses were left stunned and confused when cash-strapped St Vincent’s Hospital announced a sudden widespread closure of beds and services in December.

The closures across 10 wards and units started on 18 December and were scheduled to apply for at least six weeks.

They prompted an angry protest by about 130 nurses outside the hospital in Darlinghurst, Sydney.

Management announced that 167 beds would close – about half of all St Vincent’s beds. However, the number of actual bed closures has fluctuated since then.

Management’s shock announcement followed news of an $18 million budget blowout (see page 11).

The hospital had already announced its intention to close a total of 58 beds. The haematology ward is being refurbished and due to the construction noise, the ward below (general, head and neck and colorectal surgical ward) will be closed until the end of February.

The NSWNMA supported the temporary closure of these two wards due to the refurbishment program.

However, the December announcement added a further 75 beds in another six wards and units.

NSWNMA General Secretary Brett Holmes told the nurses’ rally that hospital management had planned the closures in secret.

“Slashing this hospital’s entire bed-base by more than half is a serious restructure – temporary or not – and it warrants a thorough consultation process for both staff and the community,” Brett said.

“It is extremely disingenuous for hospital management to cut its bed capacity and services to this scale and pretend that it is part of a ‘normal summer shutdown’ protocol.

“These restructure arrangements will have implications for drug and alcohol services, palliative care, rehabilitation, medical and numerous surgical wards.

“Not to mention the impact on the surrounding hospitals that will be forced to cope with extra patients; those who have to be turned away from St Vincent’s Hospital.

“St Vincent’s Hospital is operated by a not-for-profit health organisation under a special affiliated health agreement with the NSW government.

“Therefore, the health minister should step in and ensure the community is provided access to the public health services it deserves.”

Forced to take leave

NSWNMA branch secretary at St Vincent’s, Kristel Alken said nurses affected by bed closures had been required to take annual leave.

“Others who did not have enough leave have been redeployed while some have been redeployed without the option of taking leave,” she said.

“For example, management closed four ICU beds out of 20 and redeployed staff without giving them the option of taking leave.

“Hospital downtime is nothing new, but the announcement of 167 bed closures was unheard of.

“It has created a lot of anxiety, especially among nurses who are being redeployed to areas they have never worked in before.

“Our educators and NUMs were all on leave so there has been hardly any orientation and support for redeployed staff.

“That includes after-hours support because the after-hours educators who cover seven days a week
were asked to take leave as well.”

Casual staff faced a complete loss of income during the closures.

“Casual staff have loyally worked here for a very long time and we wouldn’t be able to cope without them. Yet they are not being given any shifts because vacancies are being filled by redeployed staff.”

Kristel said that in the past the branch sometimes had trouble getting members to come to meetings.

“However, since November every meeting has been jam packed, with people having to stand or sit on the floor.

“That shows you how concerned nurses are with the deteriorating situation at the hospital.”

Management losing respect

She said the announced closures followed a number of adverse changes that had left staff feeling discouraged.

“Nurses feel overwhelmed at having to do more work with less staff. Nurses have resigned and have not been replaced – even at the top level.

“Nurses feel that their efforts and hard work are not being recognised. For the first time, there was no free Christmas lunch offered this year and the free after-hours car park was changed to a fee-paying car park.

“Nurses are angry about the secrecy surrounding the bed closures.

“A lot of nurses, including me, have lost a bit of respect for management as a result.

“The hospital presents itself as a place where it is okay to ask questions. But top management have failed to create an environment where people feel it’s safe to escalate their concerns.

Hospital policy and procedure documents carry the tag “You said – we did. Speak up, you’ll see the difference”. But as Kristel points out, “In an environment where there is so much secrecy, who are you going to ask?”

At its first meeting for 2018, the NSWNMA branch carried a resolution protesting at the behaviour of members of the senior executive team.

The resolution referred to an incident that happened when the emergency department was full and nurses were unable to offload a patient.

“Members of the executive offloaded the patient from the ambulance stretcher into a bay with no nurse allocated to the patient, who was left unsupervised,” Kristel said.

“The executive should let nurses do their job and give them adequate resources to do it properly.”

Treatment delay saddens nurses

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Closures hit drug and alcohol patients at St Vincent’s.

Bed closures at St Vincent’s Hospital have forced nurses to delay treatment of drug and alcohol patients seeking urgent care.

Gorman House, the hospital’s acute drug and alcohol unit, takes emergency department presentations and elective admissions.

Management cut its bed numbers from 20 to 12 in November, with nurses redeployed to other wards.

NSWNMA branch member Leana Payne says the unit operates an intake line for elective admissions.

“People who want to detox can phone and do an intake interview. Since the bed closures we’ve had
to manage numbers by delaying elective admissions,” she says.

“There have been multiple days when we’ve had to call people who are in a really bad way and need to come in to detox, and tell them we have had to post-pone their treatment, even though there are beds sitting there empty.

“It’s really sad, especially when people are begging us to help them.

“We report the situation to management and discuss it at every meeting, with no obvious changes as a result.

“We put in daily ‘riskmans’ to report hazards and risks that could lead to incidents, but management often doesn’t pass on feedback or responses to them.”

Since November bed numbers have fluctuated depending on executive decisions.

“We were told that if numbers were going to be pushed to 13 or more it had to be cleared by the executive. The maximum has been 14 patients but when bed numbers go up staffing levels haven’t been increased.”

Leana and the Gorman House team feel the staff are being used as a casual pool.

“All 20 nurses apart from the CNS2 and NUM have been affected. In the last 24 hours we have had someone redeployed on every shift.

“I’ve worked on three other wards as well as Gorman House in the last two months.

“I have been sent to work on wards that are outside my clinical specialty and where I have limited experience. When I have brought this to the attention of management I am told there is an educator available.

“Sometimes there is an educator available for support during the day shift but we are deployed on afternoon and nights as well.”

“The stress is horrific because you’re worried you are going to miss something or do something wrong that could be life threatening.”

Leana says Gorman House is not being staffed to what nurses consider to be a safe level.

“The mood among staff is awful. On every shift you’re working short, or the acuity is going up and nothing is done about it.

“No matter what we say, someone senior over-rules us.”

 

Budget woes drive closures

The national body governing St Vincent’s hospital, St Vincent’s Health Australia Group, directed the hospital to find
$18 million in savings to overcome a budget blowout, The Sydney Morning Herald reported.

The Herald said the hospital’s total budget for 2017/2018 was just under $400 million.

The hospital had contracted external consultants to oversee savings measures.

Management blamed the budget blowout on several factors, including “activity-based changes to heart/lung funding arrangements, the rising cost of major goods and services like electricity, and tightening of the revenue from privately insured patients,” the Herald reported.

“One service already affected is the hospital’s H2M service, which provides dedicated psychological and psychiatric care for people with HIV and hepatitis C.

“GPs with patients referred to the service were informed via email that H2M was being ‘wound down and closed because of severe budgetary constraints’ and could not take new referrals effective immediately.

“Current patients will be referred to other mental health services, according to the email.”

FIND OUT MORE

For more information and updates visit the NSWNMA St Vincent’s Hospital Facebook page at:

https://www.facebook.com/StVincentsPublicDarlinghurstNSWNMA/

 

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