Demand outstrips nurses

Population changes and specialisation of nursing services on the New South Wales north coast have led to increasingly stressful service demands on community nurses.

The North Coast is the fastest growing rural area health service in NSW. Its residential population grew by around 7% from 2006 to 2011 and is expected to increase by 1.2% each year between now and 2016, according to NSW Health.

Growth will be mainly in coastal areas, with the Tweed district growing the most.

Yet nurse numbers in local community health services have stayed roughly the same for at least 15 years, says Anne Pudney, a Clinical Nurse Specialist and President of the Tweed Valley Community Nurses branch of the NSWNA.

Adding to staffing issues is the rapid ageing of the population, with people over 65 expected to make up almost one quarter of the Northern NSW Local Health District population in five years.

“Our award says we are entitled to a reasonable workload but overall the staffing arrangements are far from reasonable,” Anne said. “Our work assignments are increasing yet there has been no increase in FTEs (full time equivalent) in mental health in the 15 years I’ve been here. It’s the same for child and family nursing services, despite extra work due to the introduction of Families First and other government initiatives.

“Services have become more specialised, which has also increased the demand for staffing. When I first moved here we didn’t have Hospital in the Home, and nowhere near the amount of aged care we have now.”

Long distances add to the demands on community nurses. Tweed Valley branch nurses cover a wide region from Tweed Heads in the north to Crabbes Creek in the south, and west to the Mt Burrell district.

Anne suspects the public rarely notice inadequate staffing in community health because nurses have tended to “take up the slack” with little protest.

“The Tweed Valley has a large rural component and many of our nurses are part of a rural community. They are well known to most people so there is no anonymity.

“They are likely to give up their lunch break in order to race down to see Mr Smith and his ulcer, partly because they know they will run into Mr Smith’s wife or daughter in the supermarket.

“On top of that you have the historical culture of nurses – we fix things but we are not so good at looking after ourselves.

“The Award gives nurses a starting point for standing up for their rights but in practice it is not that simple.

“The higher up the management chain you go, the more it is about saving money rather than proper patient care.”