Cobar Cuts Threaten Patient Safety

Nurses and community rally to stop nursing cuts at Cobar Hospital.
Nurses and community rally to stop nursing cuts at Cobar Hospital.

Nurses at Cobar Hospital held a rally last month to protest the cutting of two shifts, after patient activity figures confirmed patient safety was being threatened by the cuts.

‘At a time when more nurses are being brought into the Public Health System as a result of the NSWNA’s ratios campaign to address staff shortages, Western Sydney Local Health District (LHD) has taken the extraordinary decision to remove two six-hour shifts at the hospital,’ said NSWNA General Secretary Brett Holmes.

Until a few weeks ago, the hospital had two eight-hour nursing shifts and one six-hour shift for both the day and evening shifts – 2.75 FTE staff looking after the Emergency Department and the 21-bed acute ward at the hospital.

After conducting a review, the LHD removed the six-hour shifts, leaving just two full-shift nurses covering both the ED and inpatients. The LHD claimed the activity levels and acuity at the hospital did not warrant the extra nurse on each shift.

But nurses compiled their own data, which painted a different picture.

‘The LHD didn’t look at the acuity of the patient load; nor did they take into consideration the timeframe we spend with critical patients we transfer out,’ said Genie McMullen, RN at Cobar Hospital.

‘Because we are a small facility with no theatre, many patients have to be flown out to a bigger facility. While we wait for the plane to come, it’s one-on-one nursing most of the time for those patients who are often suffering from trauma or respiratory distress. That can be four or six hours. It means other patients often get little attention, which is what we are concerned about.

‘At the moment we are caring for a bariatric patient, who requires two nurses to operate the special lifting equipment. On one shift, we had two people turn up with chest pain within half an hour of each other. You can’t pick when these incidents happen.

‘We don’t have a delivery suite here but we do have deliveries – people walk in, in labour and give birth. We get sick children who end up having to fly to Dubbo and cardiac patients. We also get patients back from tertiary facilities for rehab, but we don’t have occupational or physical therapists so we end up doing that work. We don’t have a social worker so we pick up that work. We do a lot of our own admin and our own pathology. That’s why it’s so important to have an extra nurse on those six-hour shifts. The LHD didn’t take this into account,’ said Genie.

Nurses are concerned about patient safety, she added.

‘It’s very stressful for staff on duty because we wonder each day if it’s going to be the day that something that goes wrong,’ she said.

Around 200 people turned up to the rally in the small mining town of Cobar in western NSW on 5 August. The council closed its offices at noon to allow workers to attend and the NSWNA was invited to speak at the Teachers’ Federation Branch meeting to explain the impact of the shift cuts on the local community.

Members launched a petition calling on the LHD to reinstate the two six-hour shifts. The Lord Mayor Liliane Brady and six mine managers will be meeting with the State and Federal Health Ministers.

‘Patient safety at Cobar is about the capacity to respond quickly during peak periods,’ said Brett Holmes.

‘Time is of the essence in an emergency or during busy times. Treatment delays can lead to death or to conditions escalating to a dangerous level. In rural communities like Cobar we should always err on the side of caution when it comes to nurse staffing.

‘The real bottom line is found in safe patient care, not on the balance sheet.’

The LHD has since reinstated one six-hour shift on a temporary basis.