Wage freeze

Thank you to ALL nurses

May 12, 2023 by Madeline Lucre Leave a Comment

Today, on International Nurses Day, we reflect on the invaluable and crucial contribution nurses make to the world.

Nurses lie at the heart of so many parts of our society: public and private hospitals, aged care facilities, nursing homes, community health centres, the defence force, research and academia, schools and universities, and mental health centres.

Nurses have been there for world wars, pandemics, and natural disasters and their tireless efforts demonstrate their resilience, compassion and dedication to serving their communities.

Nurses carried the world through the COVID-19 pandemic, while being consistently undervalued, understaffed, and underpaid by their employers.

Nurses are highly educated and work in dangerous environments around the clock, yet aren’t given the respect that the profession deserves. Low wages, abuse, long hours and burnout have become the norm and that will never be acceptable.

It’s our mission to change that, and we will always continue the campaign to make sure nurses are respected and valued by their employers and communities, and that their working conditions and wages reflect how important they are.

If you need any form of healthcare, chances are it will be a nurse that helps you. Every boss, every politician, and every Australian has received care from a nurse.

Despite hostility from governments and employers, the resilience displayed by nurses to do their job, often thanklessly, speaks volumes about their selflessness and character.

Just like every day, today, we honour these healthcare heroes, and say thank you.

Although gratitude alone doesn’t reduce workloads or pay the bills, make sure you tell the nurses in your life that you appreciate the work they do.

International Nurses Day marks the anniversary of Florence Nightingale’s birth, honouring the vital role nurses play in healthcare across the globe.

Our Nurses. Our Future. is the official theme for 2023 and will be a global campaign that sets out our goals for nursing to address global health challenges and to learn from the pandemic.

With the release of the State of the World’s Nursing report, the Global Strategic Directions for Nursing & Midwifery, the Sustain and Retain in 2022 and Beyond, the ICN and other organisations have shown the evidence for change and are calling for action.

COVID dramatically accelerated nurse and midwife shortage

March 9, 2023 by Madeline Lucre Leave a Comment

Even before the pandemic there was a serious shortage of nurses, midwives and other essential workers but the situation has deteriorated markedly in the last few years, new research confirms.

Labour shortages have been on the rise in Australia but dramatically so in essential occupations like nursing, midwifery and teaching, a report by respected labour market academic Professor David Peetz from Griffith University says.

The research he compiled found that by 2022, the number of internet vacancies for “essential” occupations – such as nursing and midwifery – was 98 per cent higher than it had been in 2018. For other occupations the number was just 26 per cent higher than in 2018.

In NSW there has been a progressive worsening in the shortage of registered nurses for more than a decade, with an acceleration over the last five years and in particular during the pandemic.

Internet vacancies for registered nurses trebled between 2012 and 2022 – rising by 205 per cent, with a 125 per cent increase over the past five years and a 48 per cent increase over the two years to 2022.

The report notes a strong gender dimension to essential work: 75 per cent of workers in essential occupations are female, compared to 47 per cent in the workforce as a whole. Some 46 per cent work part-time, compared to 34 per cent in the economy as a whole.

The shortages of essential workers are particularly marked in regional areas, the report says.

Between 2017 and 2022, all internet vacancies grew by 22 per cent in Sydney but by 117 per cent in provincial and rural regions. Vacancies in essential occupations grew by 74 per cent in Sydney but trebled – growing by 203 per cent – in provincial and rural regions, with the fastest growth in the North Coast and Riverina-Murray regions.

“Vacancies for essential occupations are more consequential in provincial and rural regions than they are in metropolitan regions and, in some non-metropolitan regions, advertised vacancies for essential occupations disproportionately dominate vacancies in that region,” it says.

The report notes there have been high rates of dissatisfaction with aspects of work, and high rates of attrition leading to a worsening of shortages. Some job-related factors such as work intensity, burnout and stress may also be contributors, it says.

Conditions of employment – in particular pay – also help to explain labour shortages.

“When employers say there is a labour shortage, it sometimes is better interpreted as a shortage of wages they are willing to offer to attract labour,” the report says.

“As recent public sector pay policies have led to declines in real wages for many people in essential occupations, it is highly likely this has depressed the supply of labour to essential occupation labour markets and thereby promoted labour shortages.”

“An easing of public sector wage restraint could not be the only solution to shortages of essential workers. There is no single solution. But it is difficult to see shortages being overcome in the absence of appropriate changes to wages policy.”

NSWNMA Assistant General Secretary Michael Whaites says the Peetz report is the latest in a long line of studies that reinforce the need for ratios.

“The report clearly shows that NSW nurses and midwives are stretched to the limit. We know that puts lives at risk. We also know ratios save lives.

“The election on 25 March will be pivotal for our public health system going forward. It is vital we all support candidates who support our ratios claim.”

‘The report clearly shows that NSW nurses and midwives are stretched to the limit. We know that puts lives at risk. We also know ratios save lives.’

— NSWNMA Assistant General Secretary Michael Whaites

“It is difficult to see shortages being overcome in the absence of appropriate changes to wages policy.”

Crucial moment for public hospitals

March 9, 2023 by Madeline Lucre Leave a Comment

The people of NSW go to the polls on Saturday 25 March. NSWNMA local leaders tell The Lamp why the public health system is a vital election issue.

The ALP has promised to introduce maternity ratios of one midwife to three mothers and to review Birthrate Plus to ensure babies count.

“The poor state of public health services will be a big issue at the election”

Midwife Elise Spanner and fellow NSWNMA members in Wollongong plan to hold a public forum and community picnic to focus attention on health care, including maternity services, in the lead up to the state election.

“I think the poor state of public health services will be a big issue at the election, especially given what we’ve been through during the pandemic,” says Elise, Delegate, NSWNMA Wollongong Hospital Branch.

“At some level everyone has felt the impact of the system’s weaknesses – the care deficit is definitely on people’s radar.”

Achieving mandatory staff-to-patient ratios is the most important issue for midwives, she believes.

“Heavy workloads are causing a great deal of mental frustration and a lot of burnout for me, my colleagues and among midwives across the state.

“The pressure is so intense that a lot of staff are leaving. Retaining staff is now a real challenge.”

The ALP has promised to introduce maternity ratios of one midwife to three mothers and to review Birthrate Plus to ensure babies count.

“Under the current system, maternity doesn’t have any staffing safeguards – not even the minimal protection of nursing hours per patient day” Elise says.

“We do have Birthrate Plus but each LHD gets to decide how they use the allocated hours. Hospitals can allocate a lot of that time to educator or policymaker roles, for example, rather than putting sufficient people on the floor.

“I might have eight mothers on an average shift, but because babies aren’t counted, that means writing 16 sets of notes, a minimum of 16 obs, and everything else.

“That workload is not reflected in the current staffing system.”

As a NSWNMA local leader Elise has met politicians from different parties over the last few years.

“It’s been very obvious the Liberal Party has no intention of even speaking with us or trying to understand where we are coming from.

“Other parties have at least been willing to have a conversation with us.”

‘The public needs to know the health system has a smart and dedicated workforce that is being undermined by government inaction.’

— Michelle Rosentreter, Delegate NSWNMA Hornsby and Ku-ring-gai Hospital Branch

“The current government has shown a complete disregard and disrespect for healthcare professionals”

Whoever wins this month’s state election needs to think differently about public health services and funding, says Michelle Rosentreter, a senior intensive care nurse and Delegate, NSWNMA Hornsby and Ku-ring-gai Hospital Branch.

“Governments will always face budget constraints, but now they need to ask themselves whether they can afford to maintain the current approach and do nothing,” she says.

“By tolerating constant short staffing and the ridiculous workload demands placed on clinicians, the current government has shown a complete disregard and disrespect for healthcare professionals.

“I don’t know why they feel it’s okay to be as inactive as they have been.”

Michelle says the election is a great opportunity for the next government to step up and invest in public health and the workforce.

She says this can be achieved via a payrise to make nursing a more attractive career and “a staffing footprint that must be recruited to above what we currently have”.

“The next government has got to understand there needs to be incentives and empowerment of the existing workforce.”

Labor has promised to adhere to the latest professional standards laid down by the Australian College of Critical Care Nurses, including access nurses.

Michelle believes the pandemic has helped bring about greater community awareness of public health issues and the system’s limitations.

She says members of the public she speaks to can’t believe that some politicians deny or make light of the system’s failings.

“People can see how busy nurses are when they go to visit their relatives in hospital. Patients don’t want to ring the bell because they can see the nurses are understaffed and overworked.

“And because nurses and midwives took a united stand in support of four massive rallies and lots of independent stopwork actions, they showed the public that short staffing and unsafe workloads are a problem in every community.”

Nurses and midwives should take every opportunity to speak to anyone regarding the system’s challenges and solutions, such as staffing ratios and a pay rise to retain and incentivise the highly trained workforce.

“The public needs to know the health system has a smart and dedicated workforce that is being undermined by government inaction.

“We need everyone to understand that investment is the key – and we need a government that will start to fix things, not just talk.”

‘If you don’t have time to engage with patients and observe them, they will suffer and the health system will suffer.’

— Nick Howson, Delegate, NSWNMA Cumberland Hospital Branch

Healthcare should not be about political parties, it should be about the safety of patients

“Mental health nursing is built around engagement with, and observation of patients,” says Nick Howson, a mental health nurse and NSWNMA Delegate, Cumberland Hospital Branch.

“If you don’t have time to engage with patients and observe them, they will suffer and the health system will suffer.”

Nick says that over the past six years, documentation requirements for mental health nurses in NSW have dramatically changed from short, narrative, handwritten entries and rounding checklists to continuous observational documentation.

“These changes have far outstripped the staffing calculations developed a decade prior and still in use today.”

To ensure acute mental health wards are adequately staffed, the NSWNMA is seeking ratios of 1:3 on morning and afternoon shifts and 1:5 on night shifts.

However, the Liberal government will not even discuss ratios, Nick says.

“The Liberals keep making false and empty promises that something is coming to alleviate the staffing crisis, but have yet to actually announce anything,” he adds.

The ALP has promised to convert all NHPPD wards to shift-by-shift staffing, which Nick agrees is a better system.

However, Labor’s promised ratio of 1:4 would leave mental health acute wards slightly worse off, he says.*

“Currently under the NHPPD the ratio is about 1 to 3.3, though we are rarely staffed to it.

“As a branch and an interest group we have spoken with Labor’s shadow health minister Ryan Park, but we haven’t had much movement on that unfortunately. I don’t believe Labor understands the situation and I think they really need to.

“It wouldn’t cost a great deal more to slightly increase the ratio in mental health and the benefits of that additional bit of time would outweigh the cost.

“In mental health an extra 15 minutes or half an hour with an individual is a huge benefit to them.

“Our patients require significant resources and take up the most time in EDs as repeat presentations and sitting around waiting for beds in mental health units.

“Properly staffing mental health units would have a flow-on effect in making sure there is less stress on EDs.

“Discussions about health care should not be about political parties – they should be about safety of patients and nurses and the benefits to the state.”

*Editor’s note: Labor is promising no unit or ward will be worse off following the implementation.

‘As nurses we need to use our votes far more carefully.’

— Colette Duff, Delegate, NSWNMA Sutherland Hospital Branch

We have some clout and we need to use it

This state election may be the last opportunity to rescue the NSW public health system from its understaffing crisis, says ED nurse Colette Duff, Delegate, NSWNMA Sutherland Hospital Branch.

“I think we have a very small window to make some progress,” she says. “If we don’t get some significant change and some hope into this environment very soon, the resignations will keep mounting up.

“Almost every day, our nurses are leaving or saying they are looking for other jobs. I’m looking elsewhere too. I need some hope and at the moment the current government offers me no hope that anything is going to be fixed.

“We are really overworked and the staff is extremely junior. We don’t have enough senior nurses to support the new grads and look after our own patients.

“I want the juniors to be supported like I was supported when I started my career 27 years ago.

“I remember all these fantastic nurses who mentored me, answered my questions, gave me a hug when I needed it, and I feel bad because I just don’t have the time to give today’s new grads the same support.”

Colette says nurses who raise staffing problems are usually told to “make do” or “reprioritise”.

“That’s insulting – I have a master’s degree in critical care nursing and many years’ experience, and if I say I don’t have enough staff to do the job, then the government should be listening to me and other nurses.

“I can prioritise everyone over the person with the broken leg, but that person is still sitting in the corner with a broken leg and they are a human being who deserves better.”

The ALP has pledged to introduce nurse-to-patient ratios of 1 to 3 in all EDs if it wins government.

Sutherland Shire is regarded as a Liberal Party stronghold, but Colette says locals are increasingly aware the hospital staffing crisis needs to be fixed.

“As nurses we need to use our votes far more carefully. We are a fairly big and influential group of people; we have some clout and we need to use it.

“We need to remind our MPs they are accountable to us, the electorate, and not to the premier or the Liberal Party, who are not listening to us.

“We have to show our MPs that if they don’t look after our interests, we will vote them out.”

Vote for the future of public health

March 9, 2023 by Madeline Lucre Leave a Comment

The state election on 25 March will be a critical moment in our campaign for ratios.

The NSWNMA wants the NSW state election to be a referendum on shift-by-shift ratios, says General Secretary Shaye Candish.

“The election is both a moment for accountability and an opportunity to progress our campaign for ratios,” she said.

“When nurses and midwives cast their ballot on 25 March, we would like you to remember what your lived experience has been like in the workplace over recent years and to vote for candidates who support ratios so we can make things better.

“There is a clear choice between parties that support safe staffing and an incumbent government that clearly does not.

“The Perrottet government does not even listen to nurses and midwives – witness the conspicuous silence after four massive statewide strikes over the last 12 months – and this must change. Without a government that is prepared to listen and to respond to nurses’ and midwives’ warnings, the public health system has a grim future.”

What Labor has committed to

The ALP hasn’t committed to the NSWNMA’s full ratios claim but they have signed up to five key areas, starting with emergency departments. Under a Labor Minns government:

All existing NHPPD wards will convert to a shift-by-shift system. For those currently at 6 NHPPD, a minimum of 1:4, 1:4, 1:7 enforceable on every shift will apply – with an additional nurse designated as “in charge of shift”/“clinical coordinator” on at least two shifts. Assistants in nursing will be additional to the minimum
In EDs there will be a move to a shift-by-shift minimum of 1:3 + triage; 1:1 in resus; 1:3 in EMUs and 1:4 in MAUs. A clinical initiative nurse and assistants in nursing are to be additional to the minimum
In Maternity there will be a full review of Birthrate Plus® in consultation with NSWNMA; shift-by-shift minimum of 1:3 in postnatal wards. Midwifery group practice/midwifery-led models of care will continue
ICUs will be staffed to the latest Professional Standards outlined by the Australian College of Critical Care Nurses, as relevant to the department
Multi-Purpose Services with Level 2 ED open 24/7 will get a shift-by-shift minimum of three nurses, two of whom must be registered nurses and two must be FLECC or ENECC trained.

The Perrottet government’s position

As The Lamp went to print, the NSW Government hasn’t moved beyond its announcement from last year’s June state budget when it claimed it would enhance the public health system with 10,148 additional full-time-equivalent staff.

NSWNMA Assistant General Secretary Michael Whaites says there has never been any clarity about how many new nurses and midwives are within this figure, where they will be allocated, or when they will be recruited, and there still isn’t.

“These numbers include a rehash of previous announcements and include the NSW Ambulance service as well as at least 1600 nurses and midwives from a 2019 announcement.

“There’s no guarantee how many will actually be recruited because the government said it would allocate funds to Local Health Districts to use at their own discretion.

“What we do know is ratios are completely off the table as far as the Perrottet government is concerned.”

Other parties

Both the Greens, and the Shooters, Fishers and Farmers Party have committed to support mandated safe staffing ratios.

When nurses and midwives cast their ballot on 25 March, we would like you to remember what your lived experience has been like in the workplace over recent years.

– NSW General Secretary, Shaye Candish

‘The result of this election will probably either make or break the health system’ — Shane Slade, RN

“Ahead of the state election, we are raising awareness of our ratios campaign in the area around St George Hospital, where I am NSWNMA Branch President. Understaffing is the number one issue for members, along with excessive workloads. People are being pushed over the edge and doing jobs in excess of nursing. There is an incredible incidence of overtime in the ICU, and it is really hard to fill the gaps because you need someone trained.

“There are some critical seats in and near the hospital, such as Kogarah, held by the Labor leader Chris Minns, and the seats of Rockdale and Oatley, and we are trying to speak with as many candidates and sitting MPs as possible about ratios. We are hitting the ground with letterbox drops and going to train stations and handing out flyers there, and having a chat with anyone who has a minute to stop. We are also using social media: our members at St George are putting messages on Facebook, Instagram and Twitter to share with their families and friends.

“We’ve spoken to all the Greens candidates in the area, and they are very committed to supporting ratios if they win. The Labor candidates have committed to five areas, and they call for ‘safe staffing’, so it is a good start, but there is a long way to go. We’re advising people to ask their local candidates and MPs to support ratios fully, and then ask which candidates best support those.

“It is critically important to set up the public system for the next decade. The result of this election will probably either make or break the health system.

“We are generally receiving quite a positive reaction, and there is a lot of public support for nurses and midwives.”

Nurses and midwives’ real wages almost $3000 less than a decade ago

February 8, 2023 by Madeline Lucre Leave a Comment

A new report released this week from The McKell Institute titled ‘A decade of wages lost’ has found that the average real wage of an essential worker is lower today than it would have been at any time since 2011. Nurses and midwives are some of the worst affected, taking a real pay cut of almost $3000.

According to the report: “A first-year nurse working for NSW Health in 2022 earned an annual wage of $76,403.60. When adjusted to 2022 dollars, that same first-year nurse working in 2012 earned $79,184.68. A nurse is $2,825.33 worse off today than they were in 2012.”

Nurses and midwives are already working harder than ever, under ever-increasing workloads because of the NSW government’s refusal to implement safe nurse-to-patient ratios. Nurses and midwives risked their lives throughout the COVID-19 pandemic, and they’ve been repaid with lower wages and worse working conditions.

The report also stated that Australia’s low wage growth is a caused by a “deliberate result of Government policy architecture”, with some of the most detrimental policies being:

Public sector wage freezes;
Support for a reduction in penalty rates;
Inaction on wage theft and underpayment; and
Opposition to increases in minimum wages.

The NSW Liberal government’s consistent attacks on working people have suppressed wages and caused living standards to go backwards.

In NSW public hospitals, total patient admissions, chronically ill patients and hospital wait times are rapidly increasing, while understaffing continues to run rampant and real wages are decreasing.

It’s time the NSW government started treating essential workers with the respect they deserve and offer safe nurse-to-patient ratios and fair pay increases.

Robbed at work, robbed in retirement

December 16, 2022 by Madeline Lucre Leave a Comment

The Perrottet government’s wage caps have so far cost NSW nurses $80,000 each, left them exposed to an insecure retirement and damaged the national economy, according to a damning new report.

A new report into the impact of the NSW government’s wage caps since their introduction in 2012, shows public sector nurses and midwives will each suffer a cumulative loss of $120,000 in pay by 2023–24, while their superannuation balances will be a further $12,500 worse off.

The report was written by Dr Jim Stanford, economist and director of the Centre for Future Work at the Australia Institute.

“By the 2021 to 2022 financial year, wages for an experienced nurse/midwife working full-time were $335 lower per week – or about $17,500 for the year – as a result of these pay caps in place since 2012,” said Dr Stanford.

“On a cumulative basis, this wage suppression amounts to a combined loss of $80,000 in wages since the pay caps were first imposed.”

The impact of the wage caps has become especially acute with the steep rise in inflation, the report said.

“Real wages for nurses and midwives have already fallen over 3 per cent in the last two years, reducing their real purchasing power by $3000 per year per employee,” it said.

The initial justification for the wage caps was to reduce the deficits incurred by the government after the Global Financial Crisis of 2008–09.

The Australia Institute research shows those deficits were quickly replaced by large budget surpluses – which ran for six consecutive years from 2013–14 to 2018–19 – yet the wage caps were retained.

“It is clear the NSW Government relies upon harsh public sector pay restrictions as a matter of political and fiscal convenience, without negotiation or consideration of normal wage determinants such as rising cost of living, productivity, or wage comparators,” said Dr Stanford.

The pay caps have “contributed to falling real wages, made it more difficult to attract workers to vital service roles (in health care, education, and others), and has undermined wage growth across the broader labour market”.

“(They impose) an intolerable and unfair burden on the essential service workers whose dedication and skill are critical to helping NSW residents through the continuing COVID-19 pandemic.”

“Arbitrary pay caps are also a clear violation of workers’ basic collective bargaining rights. They should be abandoned on both economic and democratic grounds.”

NSWNMA General Secretary, Shaye Candish, said the NSW Government’s wages policy was bad for nurses and midwives now, and into the future.

“NSW is the second-worst-paying state in Australia because of this policy, making it near impossible to attract and retain staff in such a tight labour market. It’s clearly a bad policy for nurses and midwives, but the implications for regional communities and the health sector overall are just as dire,” Shaye said.

By the 2021-22 financial year, wages for an experienced nurse/ midwife like Cj Porter from Campbelltown Hospital, working full-time, were $335 lower per week (or about $17,500 for the year) as a result of pay caps in place since 2012.

Read the report – Cumulative Cost of NSW Public Sector Pay Caps is Enormous

Key points of the report

2.19%

In the 10 years since the pay caps were imposed, pay has grown at an average annual rate of just 2.19 per cent across all classifications.

4%

In contrast, over the twenty years prior to the imposition of the cap, average wages grew at almost 4 per cent per year.

$80k

On a cumulative basis, wage suppression amounts to a combined loss of $80,000 in wages since the pay caps were first imposed.

$390

If the pay caps are retained, those losses will cumulate further over the next two financial years: to $390 per week in lost wages and a cumulative loss of $120,000 per nurse by 2023-24.