Defending nurse manager roles

Progress in Area restructuring talks

The NSWNA is making progress in negotiations to protect the positions and roles of nurse managers under threat from a restructuring of area health services.

Management structures are being reorganised to achieve savings following the amalgamation of 16 area health services into eight larger areas.

The union is negotiating with each health service, because management structures are being decided at a local level, not centrally through NSW Health.

Negotiations have resulted in agreement in some areas such as Hunter New England and South Eastern Sydney and Illawarra.

In Hunter New England, the former community health services in Hunter Health and New England Area Health are being merged into the Hunter New England Health Primary and Community Networks.

The union resisted a proposal to grade nurse managers at smaller primary/community facilities at the level of NM2, successfully arguing for them to be graded at level NM3 (essentially a DON position).

The agreement also provides for gradings to be reviewed six months after appointment, with a view to elevating nurse managers to NM4. This grading recognises that nurse managers at smaller sites manage all activity at the site, not just the nursing services.

NSWNA Assistant General Secretary, Judith Kiejda, said nurse managers would compile duty lists to show they are functioning at the higher grade. The grading of these positions will then be discussed at the Area Grading Committee.

‘If we believe a nurse manager at a specific site is not properly graded we will take their case up at a grading committee,’ Judith said.

‘In Hunter New England we have also obtained agreement that nurse managers at primary and community operations are 100% management roles.

‘We have also got deputy DON hours reinstated at many sites where these positions had been deleted without the union’s involvement.’

The South Eastern Sydney and Illawarra Area network management structure has also been finalised after several months of negotiations, with the NSWNA succeeding in maintaining nursing line management.

Judith said the Association had managed to retain a strong nurse manager structure including co-directorships with medical staff, plus operational responsibilities.

‘The union successfully argued for a greater number of clinical groups in each network compared to the original management proposal,’ she said.

‘For example, management wanted two clinical groups in the network covering Prince of Wales and Sydney hospitals, but we were able to increase that to three groups. And we were able to negotiate for four groups in each of the other two networks.’

Other positive results achieved in the negotiations with South Eastern Sydney and Illawarra Area include:

  • Several new nurse manager positions created in area clinical streams
  • New deputy director nursing positions in hospitals where they previously didn’t exist or were not identified as such – and a commitment from the area to maintain these positions
  • Nurses applying for positions in the Clinical Performance Improvement Unit will be able to maintain their wages and conditions as per the Public Health System Nurses’ and Midwives’ (State) Award
  • A new nurse manager position for patient flow in each network
  • Nurses categorised as affected are given first option to apply for newly created positions.

Coral Levett, president of the NSWNA branch at St George Hospital took part in negotiations with Area management.

Coral said she was not convinced that the Statewide restructure was in the best interest of patient care or the nursing profession, but the union went into negotiations determined to get the best outcome possible.

‘Management in this Area took on board many of our suggestions and we certainly achieved a much better position than the original proposal, which would have had a serious impact on nursing services and nursing integrity within the Area,’ she said.

‘We were able to maintain Directors of Nursing in all facilities and nursing operational responsibility and budget control.

‘We have nursing co-directors managing the clinical groups, meaning there is equal nursing and non-nursing management at the top of the clinical areas.’

On the downside, Coral said St George Hospital had lost four or five senior nursing positions, though this was fewer than management originally wanted to eliminate.

‘We should acknowledge that other parts of the Area benefited from the restructure by gaining some nursing positions that they desperately needed.’

She said no decision had been made about who at St George would bear the extra workload associated with the lost positions.

‘We have put management on notice that we will be seriously monitoring the workloads of the remaining nurse managers, including the NUMs.

‘If there is any increase in workload directly associated with the loss of those positions we will use the reasonable work-loads clause of the Award to raise the issue at the Reasonable Workload Committee.’