Wollongong Hospital

Fiery rally in Wollongong

October 7, 2022 by Madeline Lucre Leave a Comment

‘HEED OUR WARNINGS’ was the front-page banner headline introducing the Illawarra Mercury’s coverage of the strike in Wollongong.

The Mercury said hundreds of nurses marched from Wollongong Hospital to a rally in MacCabe Park.

“As they marched down Crown Street, they were met with honks of support from stopped traffic, and pedestrians and shoppers stopped to applaud or say thank you,” the Mercury reported.

Marchers carried placards, including one that showed portraits of Premier Perrottet and Health Minister Brad Hazzard, labelled, “The two biggest hazzards to the health of NSW.”

The Mercury, quoting nurses, said the hospital was short 136 full-time staff.

“If a hospital is 136 nurses short, the only way it’s functioning, is from nurses working their absolute arses off on overtime and there sure as hell are shifts where patient safety is being compromised. Heed our warnings,” said Genevieve Stone, NSWNMA delegate at Wollongong Hospital.

At the “fiery” rally, local Labor MPs got “a mixed response from fed-up nurses, with some clapping but others shouting questions from the crowd,” The Mercury reported.

Since the rally Labor has committed to supporting important parts of our 2022 claim.

Rallies put understaffing of midwives in the spotlight

January 29, 2019 by Rayan Calimlim

The public are increasingly aware of the need for ratios to overcome a statewide shortage of midwives.

Midwives have held lunchtime rallies outside many of the state’s public hospitals in support of ratios of at least one midwife to three mothers in postnatal wards.

At the Wollongong Hospital rally, NSWNMA members were joined by former maternity patients who spoke to the media about their birth experiences.

Wollongong councillor Cath Blakey – who brought her one-month-old daughter Jedda to the rally – told the Illawarra Mercury she had complications with pre-eclampsia so had to spend two weeks in the maternity ward prior to Jedda’s birth.

“I had my baby by emergency caesarean and when we were moved back to the ward, we were counted as one patient even though I’d had major abdominal surgery.

“It’s a sneaky way to understaff hospitals – by not counting babies as patients.

“While the care I received from the nurses and midwives at Wollongong was fantastic, they were restrained by lack of staff.”

NSWNMA branch president, Sarah Morton, said midwives received strong support from “women who understand what is going on and want to help change it.”

“We are very lucky to have amazing community support. People are starting to understand that we need increased funding statewide because every single maternity unit in the state is understaffed.”

Midwives would work more hours with ratios

At Wollongong Hospital, two midwives look after as many as 28 women during night shift. Sometimes, only one midwife and one registered nurse or enrolled nurse are rostered on overnight.

“The staff are just too busy to give women all the breastfeeding support they need, which is a serious public health issue,” Sarah said.

At the end of 2018, the maternity unit was short-staffed by about 18 full-time equivalent midwives, including permanent and temporary staff.

“During one recent four-week roster period there was a total of 56 hours of overtime worked in the birth unit and only 19 hours of that was sick leave – the rest was to cover gaps in the rosters.

“People have had to come off the floor to fill educators’ positions that haven’t been replaced so there has been lots of overtime recently.

“Hospital management are working hard to get recruitment happening and using casuals but unfortunately there are just not enough midwives available.

“Management are doing what they can – we just need legislated ratios in order to safely provide this care.”

Sarah said midwives work a 20-hour week on average and many would work more hours if the workplace was not severely understaffed.

“People who work in short-staffed situations tend to reduce their hours. The NSWNMA has done a survey where at least half of respondents would increase their midwifery hours if we had adequate ratios.”

Working with the community for positive change

August 1, 2018 by Rayan Calimlim

Nurses, midwives and the community all have a common interest in improving the public health system.

For some time now pressure has been building in maternity services throughout NSW due to a significant shortage of midwives in our major hospitals.

Recently there were 28 midwife vacancies at Westmead, Wollongong had just under 10, Royal North Shore Hospital 16 and Blacktown Hospital 23.

Midwives working in these units are constantly stretched and this creates a situation that is a lot less than optimal for the mothers and babies who depend on their care.

Because there are shortages of midwives in post-natal areas mothers and babies are being discharged as soon as possible. This means there is a risk that mothers are not getting the assistance they need to establish breast feeding and to avoid complications that can lead to mothers returning to hospital if their baby is dehydrated and unwell.

NSW Health has been claiming publicly that there is no significant shortage of midwives, that there are merely “challenges” in some districts due to population growth.

This complacent analysis jars strongly with the real life experience of midwives on the ground. They are telling the Association that there are not enough midwives to deliver the care to be able to adequately support the mothers and babies they have responsibility for.

The intense workloads that midwives are working under often compound the problem. Working extra shifts – often double shifts – has led some midwives to reduce the number of hours they work in order to manage this pressure. Some seek alternative employment. In many cases vacancies are being filled by non-midwifery staff.

The Association is very concerned about how these vacancies and the subsequent stress they put on maternity services impact on the quality of care for mothers and babies.

In post-natal wards it is imperative that the mother can successfully breastfeed and their baby is well fed, that they can go home safely and won’t suffer from complications.

Our concerns about the state of maternity services are shared by many mothers who use these services and who can see for themselves that midwife numbers are frequently inadequate.

In this issue of The Lamp we talk to mothers from the NSW south coast who have formed their own group – Better Birthing Illawarra – to lobby the local health district for improved maternity services.

Through admirable persistence this group has established regular meetings with the chief  executive and have also met with local MPs.

The group supports our campaign to include babies when calculating Midwife to patient numbers and has raised the need for more staff at meetings with the hospital executive.

Like us, they want to “hold the executive to account and improve the service with more staff and models of care that work in line with what the community wants”.

Nurses and midwives should take heart that we have such strong and influential support from members of the community who, like us, have seen and understand what is happening in our maternity services.

In our campaign for better ratios we need to build and nourish our relationships with such like-minded people in the community. It will be critical to the success of our campaign.

Also in this issue of The Lamp we talk to an energetic group of aged care nurses on the NSW north coast who are taking our campaign for ratios in aged care to their community.

They have been holding stalls in shopping centres, engaging local MPs and spreading our message  through local media.

I understand how many nurses in aged care find it difficult to put their head above the parapet in their workplace. The aged care nurses who have thrown themselves into this sort of community campaigning have found it a safe and rewarding way to improve conditions in aged care.

I would urge you to get involved in this engagement with the community and politicians so we can make aged care a safer and better environment for elder Australians.

Chronic understaffing at Wollongong maternity services

September 29, 2017 by Rayan Calimlim

Midwives take action, including a ban on bed washing and claiming overtime for missed breaks.

For several years, midwifery representatives on Wollongong Hospital’s Reasonable Workloads Committee tried to tell manage-ment the maternity service was seriously short staffed.

“We would have up to 80 vacancies on a 30-day roster but management kept telling us we had our full number of FTE (full time equivalent) staff. They produced various figures to try to bamboozle us,” said branch president Denis Wann, a clinical midwifery educator.

“It was very frustrating and we felt as if we were hitting our heads against a brick wall.”

The introduction of the Birthrate Plus tool to determine midwifery staffing led to a staffing review in March 2016. It revealed the maternity service was short by 19.5 FTE midwives.

“Management kept preaching to us about core values such as respect but they showed us no respect by not listening to us.

“We had midwives crying on wards because they were so stressed from overwork. But management wouldn’t even acknowledge we were critically short staffed.”

Management agreed to advertise for more midwives but new recruits did not start to appear on the wards until late August this year.

Still short 10 FTE

During that 14-month wait the maternity ward typically accommodated up to 26 women with 15-20 babies cared for by one midwife, one student midwife a few weeks into her training, an RN and an AiN.

Denis said that as clinical midwifery educator he took on half the ward with help from the AiN. The student midwife and RN looked after the other half.

“At the end of the shift I had to write 14 adult notes and 14 baby notes, which took me more than two hours.”

The maternity service is still short by about
10 FTE midwives and there is also a shortage of cleaners and clerks.

This has forced midwives and nurses to clean and make beds and do a range of clerical jobs such as filing, scheduling and making appointments – all of which cut down the time available for patient care.

In September, the NSWNMA branch decided that midwives and nurses would no longer wash beds. This has resulted in beds being washed by the nurse unit manager and facilities manager.

“We are so overworked that we often can’t get babies checked by paediatricians until late at night. That means we sometimes can’t discharge mothers and babies before midnight.

“There are no cleaning staff on at night so the midwives are expected to do it.”

Management hamstrung by lack of funding

The branch also agreed that staff would claim overtime for missed tea and lunch breaks.

“Midwives aren’t taking breaks or claiming for overtime when they miss breaks, as they are entitled to do under the award,” Denis said.

“Management said we must take breaks but you just can’t just put down tools when a lady is having a postpartum heamorrhage followed by another lady in labour and a neonatal baby who needs to be resuscitated.”

Midwives from each area of the maternity service met with management in September to outline their staffing requirements. Most requests were for clerical and cleaning support.

Denis said most midwives left the meeting feeling frustrated because they believed management was hamstrung by lack of funding.

“Some managers including our new director of nursing are trying their best to help us but they appear to be fairly powerless.

“Also, there continues to be a disconnect between the understanding of top level management and the reality on the floor.”

Wollongong midwives warn of ‘negative outcomes’

September 29, 2017 by Rayan Calimlim

Worried staff say women and their babies are getting “suboptimal care” at Wollongong Hospital’s maternity department.

A shortage of midwives, poor staff mix and other issues have led to an increase in readmissions and clinical incidents at Wollongong Hospital’s maternity department, says an open letter signed by 112 hospital staff including almost all midwives.

The letter to the executive committee of the Illawarra Shoalhaven Local Heath District said the hospital’s NSWNMA branch is “gravely concerned” with workforce issues in the maternity service department.

It added: “These concerns have been voiced on numerous occasions and at all levels of the organisation, from midwifery managers to the chief executive, at maternity forums, workload committees, open forums, joint consultative meetings and at specific meetings with a variety of managers, up to the chief executive, Margot Mains.

“This branch is specifically concerned that patient care and patient safety is being compromised due to a lack of midwives, poor staff mix, uncertain medical leadership and a lack of clerical and domestic support.

“This situation cannot continue, as it is also having a deleterious effect on safe care delivery, staff health and morale.”

Midwives and nurses who work in maternity are obliged to do jobs such as cleaning and making beds that their award states they should not be doing, the letter said.

“Maternity is in need of urgent domestic support so that midwives and nurses can spend time giving care, in a safe and timely manner.”

The letter said midwives in the antenatal and gynaecology clinics and the birthing and neonatal units were obliged to perform clerical work that diverted them from their clinical work, which could have “negative outcomes” for patients. ■

“I’ve never been scared to come to work before but I am now”

Midwife Emma Gedge says it is “heartbreaking” to see the impact of poor staffing on Wollongong Hospital midwives.“The workload is absolutely exhausting and morale is very low,” she says.

“We are all very supportive of each other and we all do our best to boost morale but it’s really soul destroying at the moment.”

Emma works on the post-natal ward which is often staffed by just two midwives with midwifery vacancies filled by RNs, ENs and AiNs.

“Night shift usually has four staff but quite often only two of them are midwives with maybe an RN and AiN.

“The two midwives are then responsible for 12 patients each, which actually means 12 mothers and 12 babies who are not counted in the numbers.

“The RNs do observations and medications but post and neo natal care are outside their scope of practice, so the midwife must supervise all of that.”

Most mothers are being discharged after 5pm when clerical and cleaning staff have finished work so it falls to midwifery and nursing staff to take up the load.

“Paperwork takes a massive amount of time and we often stay back late.

“We rarely get meal breaks and if we do eat, we’re eating at the desk while we do something else. I can’t Remember the last time I took a proper meal break.”

Emma says she has stopped cleaning beds in line with a decision of the NSWNMA branch.

“I’ve never been scared to come to work before but I am now. Before I start on night shift I’m thinking, how many staff will there be? Am I going to be the only midwife on duty tonight? That’s how bad it is.”