Friday 1st October 2010
The re-opening of five beds at Bathurst Base Hospital is a good win but there is still a long way to go to address the staffing crisis.
A campaign by the NSWNA has resulted in the re-opening of five beds at Bathurst Base Hospital and some extra nursing staff in ED.
‘This is a big win that Branch members have fought hard for,’ said NSWNA Assistant General Secretary Judith Kiejda.
‘ED has received extra funding for a Clinical Initiatives Nurse (CIN), an extra senior nursing position seven days a week and another permanent staff member on night shift. The ED nurses are happy because they have been very short-staffed and struggling to deal with increased presentations.’
But while the moves are a positive step in the right direction, they are not enough to remedy the staff shortages that have plagued the hospital since it closed 15 beds several years ago.
Over the past 12 months, the ED has seen a huge increase in the number of presentations, with the closure of St Vincent’s private hospital exacerbating an already dire situation.
‘There has been an incredible strain on staff and an overloading of services,’ said Judith Kiejda. ‘There are often large queues of people lining up in ED and ambulances backed up.’
The Association met with local MPs and pushed for Federal funding to open more beds at the hospital. The five beds and extra ED nursing staff were funded by COAG.
But the NSWNA is concerned that five beds is not enough, and there are not enough nurses to staff them.
‘Five beds is a fraction of what is needed,’ said Judith. ‘We need all 15 beds re-opened – they are desperately needed. The closure of St Vincent’s Hospital has exacerbated the problem. Bathurst Base is still beyond capacity even with the extra five beds. There is a massive pressure on staff. Without the right numbers of staff we can’t deliver safe patient care.’
Lyn Sloane, NUM in ED and Branch President, said staff are working long hours and having to do a lot of overtime – including unrecognised overtime.
‘They are very stressed in the workplace,’ she told The Lamp. ‘Even now, with the five new beds open, we are still experiencing bed block. There are still staffing shortages. Staffing in the ED is sometimes still unsafe. Our staffing ratios at times are quite dangerous. We’re only staffed for eight beds and we constantly run at 17 treatment areas including people sitting in chairs waiting to be treated, with no increase in our staff numbers.’
An emergency escalation plan at the hospital states that once the ED fills up with eight patients, extra resources should be allocated to alleviate the bed block.
‘We’ve had some good wins with the introduction of a CIN in ED seven days a week, and a staff increase on night duty of one FTE, which we’ve all seen the benefit from as it allows us to have five or six patients overnight as well as the usual presentations,’ said Lyn.
‘We’ve also had our CNE position increased. It was a full-time position that was reduced, then increased again, so we now have a CNE four days a week instead of five days a fortnight. So that’s a bit of an improvement, but the CNE is doing a fair bit of clinical work – they are not there doing what they are supposed to be doing; they are filling in vacant shifts and that’s true across the hospital.
‘These are small steps and good wins, but we have a long way to go.
‘Mandated nurse-to-patient ratios would improve patient care and reduce the stress levels of nurses,’ said Lyn.
‘We’d be able to give better quality care and have an in-charge-of-shift to co-ordinate patient flow in the department, without having a clinical workload. Currently, especially on afternoon and night shifts, the in-charge has a clinical workload and is trying to manage the department. Generally, that person is the most senior and experienced so they usually have the sicker patients.
‘Ratios would improve responses to emergencies. Even the medical emergency teams are only staffed on the bare minimum. There doesn’t seem to be the staff available to respond adequately,’ said Lyn.