AHS restructure sidelines nurse managers at RNSH

Angry nurses at Royal North Shore Hospital (RNSH) held a stop work meeting and rally in late May to protest against the proposal by Northern Sydney Central Coast Area Health Services (NSCCAS) to reduce the role of nurses in hospital management.

NSWNA General Secretary, Brett Holmes, said nurses are being sidelined while generic managers and doctors are being given all the power to control operational matters, including budgets, in the operating theatres and wards.

‘Under the proposed management restructure at RNSH, nurse managers and nurse unit managers will report directly to a generic manager in each hospital division such as medicine and surgery. They currently report to a divisional nursing manager, which means they are dealing with a person who, as a nurse, has a better understanding of their roles and needs,’ he said.

Nurses and allied health workers supporting their position gathered outside the hospital on 23 May, then marched to the square outside St Leonard’s railway station.

Nurses handed out fliers to the general public in order to explain their position and garner community support.

Under the proposal by NSCCAHS, nurses will be still responsible for patient flow and bed occupancy in the hospital, but they will now only have an advisory role in terms of the funds required to pay for those patients and beds.

‘This will have huge implications for workload management and safe patient care at RNSH,’ said Brett Holmes.

Alison Mayhew, RN and RNSH Branch President, said, ‘We are deeply concerned with the hospital restructure and believe that it sidelines nurse managers by removing their operational responsibility.’

According to Alison, nurse managers need to be responsible for staffing supervision and operational management because they understand the functioning of a theatre or ward – including patient flow, patient acuity and required staffing levels – and can balance this with budgetary responsibilities better than a non-nurse, without compromising the quality of patient care.

Joanne Caughtry, CNE, is from Birmingham in the United Kingdom and worked as a RN for four years under a similar system to the one proposed by NSCCAS where nurses were removed from management positions and replaced with non-nurse managers. She worked at a hospital where they appointed a divisional manager in change of four areas whose background was managing a supermarket.

‘The repercussions of this appointment were that nurses no longer had a career path, and patient care was compromised because issues we raised with the manager were only considered from a budgetary perspective and not a nursing point of view,’ she said.

‘Nurses felt like we had lost our voice and, as a consequence, frustrated nurses left the area to work in hospitals where the restructure had not taken place.’

Nurse Managers from RNSH met with the NSCCAHS in early June to discuss the descriptions for the Nurse Manager positions. At the time of printing, the RNSH branch was waiting for a response from the AHS.