Consultation continues over new rostering system

HNEAHS and NSWNA will work together to implement a more flexible rostering system.

Management at the Hunter New England Area Health Service (HNEAHS) has agreed to work with the NSWNA to implement a more flexible rostering system that ensures appropriate skill mix and roster flexibility, rather than the responsive or ‘pattern’ system originally proposed by the AHS.

The agreement follows research commissioned by the HNEAHS and the NSWNA, which recommended that pro-cesses be built into the new rostering system so nurses can nominate shift preferences.

The research was initiated following discussion between the parties in the NSW Industrial Relations Commission where the matter has been listed for mediation for almost 18 months.

NSWNA and members were deeply concerned when the HNEAHS announced its intention to introduce the responsive rostering system, where shifts are fixed for a period of time and nurses are not able to request particular shifts or roster patterns before the roster is drawn up (as they do in the current request system). NSWNA members in the HNE were surveyed early in the dispute and the response was an overwhelming 92% return in which significant concerns were raised, particularly around loss of flexibility.

NSWNA General Secretary Brett Holmes said, ‘We were concerned that responsive rostering does not take into account nurses’ needs outside work and can have a particularly adverse effect on those with carer duties or who are studying.’

The research examined the effects a change from request rostering to responsive rostering might have on patient, employee and operational needs.

It found that while request rostering satisfied the needs of many nurses, it often resulted in rosters that did not best serve operational needs. Responsive rostering, on the other hand, provided a better matching of skill mix that led to improved outcomes for patients, but proved to be a source of anxiety, distress and dissatisfaction for employees. In particular, the ‘swap’ process, in which nurses had to find someone to fill their shifts after the roster had been drawn up, was found to be ‘cumbersome, time-consuming, distressing and often unworkable’.

One of the report’s key recommendations is to build in processes to responsive rostering that allow employees to get their shift preferences. As a result, joint working parties comprising HNEAHS management, nurses and representatives from the Union have been formed to improve flexibility issues for nurses.

‘We are pleased HNEAHS has given a commitment to recognise those recommendations,’ said Brett.

‘Our goal is to improve flexibility for members while being cognisant of patient needs. All parties have recognised that further work needs to be done on what was originally proposed, to make it workable.’

Leanne Reeves, RN at Maitland Hospital, said she was thrilled with the report’s findings. ‘Swaps is such a big issue because it would change everyone’s world if anyone tried to leave. So if five people inter–changed and then one person left, all those swaps would be-come null and void and they would have to start all over again. Logistically that would be a huge nightmare.’

Leanne said that after attending the first working party forum, she is confident about going forward. ‘It’s so rewarding to see the recommendations having a very positive outcome for nurses.’

Sue Brazil, the Branch Secretary of the Hunter New England Nurse Managers’ Branch, said she was pleased that nurses’ and midwives’ concerns had been recognised in the report and looked forward to the consultative process.

‘The high return rates for the staff survey and the number of staff who accepted the invitation to be interviewed, showed how passionate nurses and midwives were, and still are, about this issue. I am very confident that the process from now will be consultative and that the three groups of stakeholders will be equally represented in the ongoing planning, development, introduction and evaluation of the roster system.’

Once the parties have come to an agreement that satisfies patient, staff and operational needs, the enhanced roster sys-tem is likely to be implemented in a number of small, medium and large wards.

Request v Responsive Rostering

Request

  • High level of satisfaction among nurses.
  • Process does not formally match shift allocations to patient need.
  • Building roster is highly dependent on individual NUM.
  • Allocations of rostering preferences provided to some nurses can result in disadvantages to other nurses.

Responsive

  • High level of dissatisfaction among nurses.
  • Patient need is the primary focus.
  • Provides a better matching of skill mix and resource levels to patient needs on more occasions.
  • Reduces amount of administrative effort required to build monthly roster.
  • Semi-permanent swap process reported by most staff and NUMs to be cumbersome, time-consuming, distressing and often unworkable.

Summary of report

  • Request rostering satisfies staff needs but not those of patients, in some cases.
  • Responsive rostering serves patients’ needs but not nurses’ need for some flexibility.
  • Rostering process should change to better balance the needs of patients, nurses and ward operations.

Research recommendations

  • Change rostering system to better accommodate patient needs.
  • Build in processes to responsive rostering that allow employees to gain their shift preferences.
  • Rostering guidelines should consider the benefits identified in both request and responsive systems.
  • Recommendations should be implemented through joint consultation between frontline nurses, NUMs, HNEAHS management and the NSWNA.

NSWNA/HNEAHS Action Plan

  • Further develop and enhance the roster guidelines to take into account the needs of patients, nurses and the wards.
  • Develop a program for implementation.
  • Develop a change management program to support NUMs and nurses in the implementation of roster changes.
  • Implement the enhanced roster system in a number of small, medium and large change-ready wards.
  • Continue with a staged implementation of the roster system, taking an ongoing continuous improvement approach.