Wednesday 15th June 2005
Overworked mental health nurses have battled for years to hold together a system in crisis ` then the government has told them they were not worth a 4% pay rise. So the cover up on chronic nurse workloads must end `
Workloads crisis sparks emergency action
A crisis situation at Richmond Clinic in Lismore sparked emergency industrial action
Members at Rich-mond Clinic imposed work bans to end gruelling workloads for mental health nurses.
Nurses at the 25-bed mental health unit say the government has relied on the good will of nurses to cover up a staffing shortfall and a shortage of mental health beds.
According to secretary of the NSWNA Richmond Clinic Branch, Maureen Bunt (Bunty), mental health nurses at the Clinic have been forced to work for years in an unsafe environment because of excessive workload pressure.
‘I’ve been here 10 years and in that time we have always accepted more patients than the designated 25 beds of the Clinic. It’s common to have 30 patients on the ward. We have them on mattresses on the floor. It’s totally inappropriate and unsafe for the nurses and the patients,’ she said.
Nurses reached a crisis situation in April during a particularly busy weekend when they were forced to discharge patients early to make way for other patients coming in.
‘Because we did not have enough nurses to keep up with the patient load, we had security guards covering critically ill patients. It was totally inappropriate. It was just too much!’ said Bunty.
This sparked an emergency meeting of the NSWNA Richmond Clinic Branch, where members decided to implement work bans including refusal to accept admissions after hours.
‘We refused to accept patients between 4.30 pm and 8.30 am because we did not have the staffing to ensure nurse and patient safety,’ said Bunty.
This resulted in management agreeing to cap the number of patients admitted to the clinic to 25. Excess patients will now be directed to the ED of Lismore Base Hospital, and out-of-area patients back to their local AHS. Nurses will now be offered overtime to address staffing shortfalls.
The Branch also demanded an immediate review of the Mental Health Hotline, which has resulted in inappropriate referrals to Richmond Clinic.
‘When we heard about the government’s appalling pay offer, it was a real slap in the face. The government refused to pay us a 4% pay rise, as received by similar health professionals,’ said Bunty.
‘We need more mental health beds’
Members at Macquarie Hospital are set to impose bans to address a shortage of mental health beds
Members at Macquarie Hospital in North Ryde have given management until early June to address a shortage of mental health beds resulting in excessive nurse workloads and an unsafe environment for staff and patients.
According to Eon Robinson, RN and secretary of the Macquarie Hospital branch, nurses are fed up with the habitual over-admission of patients by management.
‘We have 14 acute care beds. Once full, acute patients are being diverted to the rehabilitation and respite wards. We’ve even been forced to put patients in the observation room. It’s an inappropriate and unsafe situation for staff and patients,’ he said.
The NSWNA Macquarie Hospital branch agreed to give management one month to propose measures to cease the over-admission of patients to the 195-bed hospital, otherwise they will impose bans on the admission of patients over bed numbers.
‘So far, management has put on the table various contingency plans that are not acceptable to members,’ said Eon.
‘These include the provision of extra staff when there are more patients than we are staffed for, the creation of a special discharge clinic that will enable patients to be moved from the acute care ward and regular status meetings with nursing staff. An area bed manager position has also been introduced, whose role is to juggle acute care mental health beds in the AHS.
‘But juggling mental health beds will not solve the problem – it’s a bit like juggling deckchairs on the Titanic. What we desperately need is more mental health beds,’ said Eon.
‘Nurses are willing to put up with a lot but the government’s reluctance to pay us fairly has just fuelled our anger.’
Maitland Nurses refuse more patients
Worn out mental health nurses at Maitland Hospital fight for adequate staffing and skill mix
Mental health nurses at Maitland Hospital have also battled to care for more patients than beds in the mental health unit.
According to RN and secretary of the NSWNA Maitland Hospital branch, Lindsay Paterson, there was inadequate staffing and the skill mix was insufficient to cope with the patient load.
‘The problem was that management did a count of patients at midnight. This did not include patients who were on leave for the night or weekend, so beds appeared vacant. The patients would return from leave the next moarning or on the Monday following weekend leave to find their bed had been filled. On the morning shift extra patients were, often in the ward waiting for assessment,’
‘Sometimes we have had up to 30 patients in the ward. We frequently have more than the 24 beds we are staffed for.
‘It was an unsafe situation and this was highlighted in April when a patient barricaded himself in the observation unit. We had to call the police to resolve the situation.’
This was resolved to the satisfaction of all, but by this time nurses had had enough.
Members say the issue came to a head because of the government’s refusal to give nurses the same pay rise as other health professionals.
Worn out members called a branch meeting where they decided on work bans including a refusal to accept more acutely ill patients once the 24 beds in the unit are full.
Management has committed to provide additional staffing if more than 24 patients are admitted to the ward after consultation.
Through their Reasonable Workloads Committee, members are also pushing to have a NUM role on the afternoon shift freed from a patient case load and directed to nurse management as well as a discharge planner.