All say, our health system is sick

Witnesses including doctors, nurses and community members have provided evidence to the Garling inquiry about the deep problems encumbering the NSW Health System.

Paul Moran, Specialist Anaesthetist and GP, Coffs Harbour Hospital
Nurses are the backbone of the system and those at the coalface who are really the most important. The clinical nurses are of paramount importance when it comes to the delivery of high-quality patient care. This not only needs to be said, but also [shown] in the way we treat them, to demonstrate that we really do respect what they do and the job we expect them to do and that involves both adequate financial remuneration and also demonstration by the way they’re treated. Then I think the grinding and the grating that’s now going on in acute care in public hospitals may improve.

Veronica Croome, DON at Gosford Hospital, Acting ADON, NSCCH
The nursing unit manager has a very complex role. I’m sure if you spoke to any nursing manager at Gosford Hospital and asked them what they would prefer to do, they would prefer to do exactly as you describe – talk to the nurse at the bedside and help them through the day, but their time doesn’t allow it. So we’ve created clinical nurse educator positions, which have a very important function, but sadly we don’t have enough of them.

Peg Hibbert, CNS, Aged Care/Rehab plus Emergency Medical Unit, Hornsby Hospital
I’m the branch president of the Nurses’ Association here, and I’m on the council of the Association, so people bring a lot of their problems to me. My role as their delegate is to try and assist. I find it harder now to get anyone to make a decision or to find the person I should be directing that problem to. The majority of [problems] are workload issues. Workloads are too high. Their skill mix on their ward on a day-to-day basis has changed incredibly over the past few years. We have the numbers but we don’t have the experience.

Susan Henderson, NUM, Royal North Shore Hospital
Over the past two years much of the human resources functions have been moved off the Royal North Shore site and centralised to support the Area Health Service functions. This has led to a frustrating and protracted response in regard to HR issues. The reality is that it may take up to three months to be appointed into a position. There are delays in advertising, criminal record checks and communicating with the potential employees, and by the time the position can be offered the applicant may well have gone to another position.

Jan Marie Tweedie, Acting Director of Nursing and Midwifery, Royal North Shore Hospital
I think what happens after hours is a serious issue. We have noticed that a lot of our sick patients deteriorate after hours because people are not around to pick up the fact they are deteriorating and because of the lack of support after hours. They can’t get sufficient medical staff to do after-hours work. That then falls back on the nursing staff. We seem to run a service that caters to patients Monday to Friday, nine to five; yet the patients are here 24 hours a day and the nurses are here 24 hours a day, but they don’t have any support after hours. There is practically no allied health support after hours and on weekends.

Margo MacKenzie, Midwife, Mudgee Hospital
There are lots of us here who are highly qualified. Most of us are 45 to 65 years old and not going to be here for that much longer and morale is getting down a bit. At the moment, our maternity unit is down three full-time equivalent midwives and we have been told we can have no holidays until next January.

Roz Norman, EN Special Grade, Tamworth Hospital
The shortage of nurses impacts in rural areas. We have a lot of difficulty getting registered nurses to come out to the rural areas and this impacts greatly when you go to a ward area and find you have a second or a third year registered nurse who might be in charge of a ward on an evening shift who is struggling, who has no resources to call on, except her work colleagues, and who might be new graduates and enrolled nurses. Sometimes those enrolled nurses are very experienced and unfortunately sometimes there is a heavy workload on them to give that experience over to the registered nurse and support them during a shift.

Jennifer Kiddle, 4th year RN, Mudgee Hospital
Currently new graduate nurses are attending shifts without the support of a suitably qualified preceptor to facilitate their introduction into a nurse care setting. It could result in the new graduate nurse not feeling confident in their decision-making skills and clinical competencies. Changes that could significantly impact on the success of the program are to make available more positions for nurse educators and education programs for registered nurses.