Winning an adequately staffed, safer workplace sometimes comes down to a battle of numbers. 

NSWNMA branches may need to collect a lot of data to show that a ward or unit is understaffed, or that management practices are unsafe and need to be changed. 

Public sector branches can put their case to a hospital-level Union Specific Consultative Committee (USCC) – a forum for consultation and discussion between management, a specific union, and its delegates.

The NSWNMA branch at Tomaree Community Hospital has shown how effective use of a USCC can win improvements when combined with the reasonable workloads clause in the PHS Award. 

Located in the Port Stephens region north of Newcastle, Tomaree Hospital is somewhat unique: it is a Peer D hospital with a level 2 emergency department. 

The ED sees about 18,000 patients per year – more than some level 3s – but must get by with level 2 staffing. Night shifts were under the greatest strain. 

By mounting a strong case based on careful data collection, Tomaree branch achieved more hospital funding, more staff, and improved criteria for patient admissions. Improvements included: 

• an increase in funded beds – from six to 10 

• four nurses on night shift – up from three 

• permanent FTE allocation for current staffing of five on morning and afternoon shifts 

• safer admission criteria. 

Winning the battle of numbers 

In 2024, Tomaree branch sent hospital management a written proposal for a safer workplace and asked management to convene a USCC. 

The NSWNMA team for USCC meetings comprised Branch President Megan Chippindale, Branch Delegate Tracey Richardson, an NSWNMA organiser, and an Association lawyer. 

Across the table were hospital and regional health service management representatives. 

The branch put a case for more funding for the ward, which was funded for only six of 14 physical beds. 

Branch officials had collected data to prove that: 

• the ward had 10 patients per day on average 

• nurses were working 200 to 300 over-contracted and overtime hours each month, showing they were routinely understaffed 

• many nurses missed meal breaks, particularly on night duty, because of insufficient staff to provide relief. 

The branch argued that the LHD needed to apply to the Health Ministry for more funding. As a result, the Ministry increased funding from six to 10 beds. 

“We made our case in numbers – language the health service understands,” Tracey said. 

“We got an extra night nurse, and bed numbers capped at 10 with two surge beds, as a result.” 

EXTRA STAFFING HAS MASSIVE IMPACT 

Tracey said the extra staffing has had “a massive impact, specifically on night shift, especially around direct patient care and staff wellbeing”. 

“However, we continue to face unsafe staffing levels on the ward for morning and afternoon shifts,” Tracey said. 

“At full 12-bed capacity, each patient receives only 4.33 hours of nursing care in 24 hours – well below safe standards. 

“While the ward isn’t classed as NHPPD, we’re demanding urgent action to increase nurse allocation to ensure a safe workload, reduce falls risk, and provide safe, quality care.” 

The branch put patient admission criteria high on the USCC agenda. 

“Patients were being admitted to the ward who were inappropriate for our staff to manage,” Tracey said.

“While the facility has some diagnostic and clinical services, these are limited, and our nurses and locum doctors do not have the specialised clinical skills required to safely care for complex patients. This puts both patients and staff at risk. 

“Some patients experienced adverse outcomes because they were unable to access the specialist teams they required. These incidents prompted London Protocol reviews of critical events.” 

MEMBERS UNDERSTAND PROCESS BETTER 

The USCC tasked a team to write a new admission policy. The team included a clinical nurse specialist, clinical nurse educator, discharge planner, nursing unit manager, medical officers, and Tracey, who represented the branch. 

“Every one of us had to review, research, and re-write a section of the policy,” she said. 

“It was a complicated process that took about nine months of writing and meetings before a new set of admission protocols was accepted by the health service and USCC. 

“Now, any time we are getting pushed to admit, we can refer to the policy and point out that this patient is outside of our admission criteria. 

“If a patient is admitted outside policy, we record it in the incident system. 

“Our admission criteria provide safeguards for patients and staff, but these can be bypassed when decisions are made offsite, overriding the clinical team on the floor who understand the patient’s clinical needs and our facility’s limitations.” 

Tracey said the USCC experience has boosted members’ confidence in the union and strengthened their understanding of their rights to a safe workplace, while empowering them to advocate effectively for their patients. 

“ Members have a better understanding of the process they should follow if there is a staffing problem or a breach of the admission policy,” she said. 

“Our staff have always put patient safety first. Now, they are also more likely to make a record of an incident and to let the union know what happened.”

“When you leave work, you want to switch off,” Tracey said. “But as a branch official, there’s a sense of pride when your team calls when you’re not on shift – seeking guidance that follows local health service and union policies. 

“When you care deeply about your patients and colleagues, you’re willing to give up your time to ensure patients receive the right care at the right facility and to maintain a safe workplace. 

“Megan and I might be the face and voice of the branch, but we are far from alone. 

“We’re proud of our team and the commitment they show every day in providing excellent nursing care and taking union action to protect it.”