Get ready to vote: Public Health System claim 2014

Our 2014 pay and conditions claim for the Public Health System continues to seek to improve and extend the ratios won in our 2010 campaign, and to achieve a pay increase of 2.5% per year.

The Public Health System log of claims committee has finalised a recommended claim that will be put to the vote at NSWNMA branches during late March and early April.

NSWNMA General Secretary Brett Holmes says the focus of the 2014 claim is to improve and extend the mandated nursing hours/ratios system, and achieve a pay rise that meets inflation forecasts without “trade offs”.

“Despite the history of intransigence from this state government we will continue to fight to improve and extend ratios,” he said.

“To its credit, on coming to office, the O’Farrell Government upheld the Award that contained a new, legally enforceable ratios system, won after a long and determined battle by New South Wales nurses and midwives.

“Now it is time for the government to improve nurse ratios that are fair for all hospitals and to extend the current system to more nursing specialties.

“International nursing research continues to be published that shows increasing nursing numbers and RN skill mix delivers better patient outcomes and avoids adverse events.

“The government can afford to do this and it’s a priority for our society, for the health system and for our profession.”


Key features of our 2014 claim

Extending and improving ratios

The 2014 claim includes exactly the same ratios claim that we began campaigning for in 2013. This includes new claims made in 2013 to introduce ratios for paediatrics, Neonatal Intensive Care Units, Emergency Medical Units and Medical Assessment Units. It also includes an updated claim for Critical Care Units.

In specialties where our claims were not fully achieved in the 2010 campaign, these were updated where needed in 2013, and are included again in the current claim. This applies to parts of inpatient mental health, community, emergency departments and aged care beds in Multi Purpose Services.

The ratios claim includes lifting the staffing levels in non-tertiary hospitals to the same levels as tertiary referral city hospitals, so patients get the same level of care regardless of where they are treated.

Currently medical and surgical wards in Peer Group A hospitals are staffing at six nursing hours for each “patient day”.This can be described as an equivalent ratio of 1:4 morning, 1:4 afternoon and 1:7 on night shifts, with some shifts including an “in charge” without a patient allocation.

Our claim is for this same level of nursing care to be provided to patients in Peer Group B, C and D hospitals.

More educators needed

As the new graduates recruited in 2012 and 2013 consolidate their practice, we are seeing an improvement in the overall RN skill mix.

But 275 more Clinical Nurse Educators and Clinical Midwifery Educators – working across seven days and all shifts – need to be employed to thoroughly and safely assist these new practitioners.

More CNE/CMEs will also take some pressure off our most experienced RN/RMs.

Protecting skill mix

The skill mix of the nursing workforce must be protected. Shortsighted attempts to cut budgets by employing lesser skilled staff members, mean higher rates of hospital-acquired infections, adverse events and failure to rescue, according to numerous evidence-based academic studies.

NSWNMA members consistently raise concerns about the inadequate support provided for beginning practitioners and the risks to patients caused when RN absences are not replaced “like for like”.

NSWNMA is focusing on the claim to increase CNEs and CMEs. In the medium term this will assist retention of experienced nurses and midwives in the public system.

AiNs shall be introduced only in accordance with the 2010 Health Service Implementation Package for AiNs in Acute Care. If this plan is followed correctly, appropriate engagement of AiNs will occur.

Patient “specials”

Specialling within rostered nursing hours takes time away from other patients. Patient safety must not be compromised by squeezing the budget to provide “specials”.

Our claim seeks that patients clinically assessed as requiring “specialling” shall have that speciallised care provided, without depleting the nursing hours for the ward/unit that are required by other patients.

A fair pay rise

The NSWNMA will seek a 2.5% pay increase exclusive of superannuation increases to be paid in July 2014. This will be in line with inflation forecasts by the Reserve Bank.

Members continue to tell the Association that a 2.5% pay increase without any trade offs would be acceptable to them if accompanied by a legally enforceable Award, containing the necessary extensions and improvements in ratios.


Our claim at a glance

To deliver safer patient care the government must improve and extend legally enforceable, mandated minimum nursing hours per patient day, that can be expressed as a ratio.

To build on our Award achievements our claim aims to:

  • Improve ratios in all NSW hospitals to the same level as Group A city hospitals.
  • Introduce ratios in paediatric and NICUs.
  • Introduce ratios in EDs, EMUs and MAUs.
  • Introduce ratios in intensive and critical care units.
  • Introduce a ratios-equivalent system in community and community mental health.
  • Extend ratios to more mental health units and improve ratios in specialised mental health hospitals.
  • Employ an additional 275 Clinical Nurse/Midwifery Educators.
  • Employ Assistants in Nursing only where clinically appropriate.
  • Replace the “midnight census” for nursing hour calculations with a system that accurately reflects patient numbers.
  • Provide patient “specialling” in addition to mandated nursing hours/ratios.
  • Achieve a 2.5% pay increase for nurses and midwives in July 2014.
  • Reduce to a maximum of 6 (not 7) the number of consecutive shifts that a nurse can be rostered to work, except on request. (Additional claim recommended for 2014).

A new claim: reducing consecutive shifts

Your elected Log of Claims Committee has recommended one new claim – first proposed at last year’s annual conference – to deal with the risk, to patients and nurses, of error and injury arising from fatigue in the workplace.

This year we’ll be calling on the government to agree to reduce the number of consecutive shifts that a nurse or midwife can be required to work, from the current seven, to six.

Your Award currently says:

“An employee shall not work more than seven (7) consecutive shifts unless the employee so requests and local nursing management agrees but in no case should an employee be permitted to work more than ten (10) consecutive shifts.”

The draft claim includes a new addition to the Hours of Work clause to reduce the number of consecutive shifts that nurses can work to six, but no more than 10.

The Award currently provides for the working of seven consecutive shifts with the same cap. This is a no cost claim that reflects common rostering practices and a widely held belief that six is enough, but more can be worked by agreement.


Have your say

Voting on the proposed 2014 PHS claim will take place between Wednesday 19 March and Wednesday 9 April.

All public health system facilities (not including affiliated health organisations) should hold a meeting to discuss the proposed claim using information provided in a kit sent to NSWNMA branch officials.

These branch meetings will be an opportunity to discuss the draft claims before voting. Branches must vote to approve or reject the proposed claim in its entirety — they cannot vote to amend it.

While only the votes of NSWNMA branches will determine whether the draft claim is endorsed, workplaces without an NSWNMA branch are nonetheless encouraged to send in their feedback.

For more information phone 02 8595 1234 to speak to your organiser.