understaffing

At Westmead Hospital’s Neonatal Intensive Care Unit (NICU), critically ill and/or premature babies often have to be ‘double parked’ in one bed space.

Babies requiring 1:1 or 1:2 nursing care may even be ‘triple parked’ under the care of a single nurse who might be working a double shift.

“We only have 44 bed spots but often have up to 50 babies or more,” said NSWNMA member Emily, who asked that her last name be withheld for personal reasons.

“It’s not uncommon for nurses to have to work from 1.30 in the afternoon to 7 the next morning,” she added.

Emily was speaking before the Health Ministry’s commitment of additional funding for Westmead NICU, which followed media publicity generated by the NSWNMA’s push for more staff for the neonatal unit.

Emily works at the NICU as a casual, which used to mean she wasn’t rostered on any shifts and would only be called upon to plug gaps.

Now, she is on a Monday to Friday roster and is asked to extend her 8-hour shift to a 12-hour shift every time.

“I could work seven days a week and pick up any shift I wanted. It’s not overtime pay because I’m casual but a lot of staff are on overtime. Sometimes four to seven nurses are on overtime each shift.”

The West’s population has grown

She said the NICU is funded for 44 beds and has been at 44 or above for at least a year.

“We are staffed on 80 per cent capacity and the roster is capped at 21 nurses  per shift, though we need 24 to 26 per shift.

“However, when Monday comes along, we might have one or two nurses sick leave and then we’re down to 19 or 20.

“When we are full, we don’t have anywhere else to send a baby – and when we’re full, more babies keep coming to us.

“The government needs to invest in neonatal services in western Sydney as the population has grown and continues to grow.

“We are currently unable to safely meet the demands of our community.

“We are led to believe that one in four dollars of the state budget is spent on health but clearly it is not being spent where it is needed. It’s not being spent on the front line.”

Nurses warn of severe understaffing at Western Sydney neonatal intensive care unit.

Tiny lives deserve safe care was the theme of a rally by nurses at Nepean Hospital’s Neonatal Intensive Care Unit (NICU), which cares for some of the state’s sickest babies.

The rally called for more staff to ensure safe staff to patient ratios for sick and preterm babies.

Nepean Hospital is located at Kingswood in western Sydney and its NICU receives sick babies from all over NSW.

The hospital’s NSWNMA branch organised the protest, which members attended in their own time. Some came into the rally on their day off while others had just finished a long shift.

As of July 2025, the hospital was funded for 38 beds in the NICU. They included 25 special care nursery beds and 13 intensive care beds.

However, patient numbers often exceed funded bed capacity.

“These are the most vulnerable patients in the health system – tiny, sick and pre-term babies who don’t have a voice and are reliant on their caregivers for all their daily needs,” said Branch Secretary and Delegate Alicia Rodgers.

“Often, they’re as sick as adult intensive care patients, but they don’t get the same level of safe staffing as their adult counterparts.

“The state government has agreed to roll out minimum staffing ratios of one-to-one care to adult ICUs but not NICUs.

“At Nepean NICU we absolutely strive to give our sickest babies 1 to 1 care. However, staff and/or patient numbers don’t always guarantee that level of care.

“We are seeking a government commitment so that its guaranteed that we can nurse the most critically ill patients on a one-to-one basis.”

Families need care too

Alicia said NICU patients receive similar levels of medical care as adult ICU patients and have additional needs such as neurodevelopmental care for very pre-term babies.

“We also provide care to entire families; for example, we support them to care for their preterm babies and we provide breastfeeding support,” she said.

“In order to meet these demands, we desperately need more staff to stop the reliance on overtime, extra shifts and deployed staff from other units.

“Constantly surging beyond our funded intensive care beds and our overall bed capacity within the NICU and special care nursery really stretches our ability to be able to provide the safest and most effective care to our most vulnerable patients.

“The neonatal unit is funded for 38 beds but we sometimes surge up to 43 beds. We might have between 14 to 16 staff on the floor for that many patients.”

Alicia said nurses enthusiastically supported the Nepean Hospital rally and hoped that a government promise to increase staffing at Westmead NICU would lead to a similar commitment for Nepean NICU.

“There is a real sense of anticipation at Nepean as to what our action might be able to achieve for us given the result at Westmead.”