An easier life with nurse ratios

cover Lamp April 2010

The NSWNA draft Log of Claims for Campaign 2010 includes a claim for a clearer, simpler staffing model with mandated nurse/patient ratios. The Lamp spoke with two Victorian nurses about working with mandated staffing ratios.

Ratios not for sale

Victorians would not trade their staffing ratios for any money.

Victorian paediatric nurse Margaret Grigsby says minimum nurse-to-patient ratios are the most important factor determining her level of job satisfaction.

‘I would not give up ratios for any pay increase, no matter how big,’ said Margaret, a nurse at the Special Care Nursery at Wodonga Hospital on the border with NSW.

History suggests most Victorian nurses would agree with her.

Since they won their ratio campaign a decade ago they have consistently rejected Government attempts to introduce below-ratio staff levels in return for more money.

‘The Government said, “Get rid of the ratios and we’ll give you more money”, but nurses were determined to keep the ratios no matter what,’ Margaret said.

Margaret qualified as a nurse in the Victorian public health system 40 years ago. She has been a long-time nurses’ union job rep for Wodonga Regional Health Service, which last year amalgamated with Albury Base Hospital across the border to form Albury Wodonga Health.

She said several NSW nurses quit Albury Hospital to work for lower wages at Wodonga after Victoria got nurse-to-patient ratios.

‘The NSW nurses could no longer cope with the heavy workloads and high numbers of patients. They were attracted by a safe staffing system that allows you to go home at night knowing you’ve done everything possible for your patients.

‘Under the ratio system staff can go to work knowing they will have, say, five patients to look after and when they finish their shift, all will have had their medication, their dressings and showers, plus the nurse will have been able to spend some time with patients making sure they’re as comfortable as possible.’

The Victorian union won nurse-to-patient ratios in 2000 and California achieved something similar. Safety, stability and predictability are its main selling points.

The system is not perfect and is open to management abuse if nurses and their union are not vigilant.

However, Margaret said working conditions and staff morale improved almost immediately after ratios were introduced.

‘At Wodonga, management initially had a bit of a battle to find staff to meet the ratios. But morale improved almost straight away. We manage to stick to our quotas 95% of the time.’

A 2007 report from the Workplace Research Centre at the University of Sydney found that two-thirds of Victorian nurses would consider reducing their hours, leaving the public health system, or quitting nursing altogether should the ratios be abolished.

The survey found that while Victorian nurses wanted ratios to be improved with more staff, they believed the situation would be much worse without ratios.

Margaret said ratios have attracted a lot of former Victorian and NSW nurses back into the Victorian system.

‘We have had a progression of people coming out of early retirement and back into the workforce thanks to ratios. Mothers who are ex-nurses tell me they never encouraged their daughters to enter the profession because the workloads were so bad. But they have changed their minds since ratios were introduced.’

Margaret remembers as a young nurse being put in charge of a ward of 30 patients ‘and if it looked like going to the dogs they’d say, “Well, can’t you cope?”

‘Coping has gone out with button-up boots. These days you must have the staff to be able to put patient safety first, especially as the acuity is higher than ever and throughput is so much quicker.’

Margaret said the very future of nursing depends on keeping nurse-to-patient quotas. ‘The alternative is just not safe for patients,’ she added.