Great responsibility, inadequate reward

Low pay drives top nurses out of profession.

Royal North Shore Hospital’s Ward 11A specialises in upper gastro-intestinal, colorectal and gastroenterological surgery. Like other very busy surgical wards at RNS, it demands highly-trained nurses to care for high dependency patients who, in the current bed climate, require an increasingly complex level of care.

As a clinical nurse specialist on the ward Narelle Parsons takes on a high level of responsibility but is paid just a dollar an hour more than a registered nurse level 8.

Narelle, a nurse of 30 years experience, believes the failure to reward senior nurses is driving many out of the profession and creating an undesirable skill mix, leaving less experienced nurses feeling unsupported and lacking appropriate supervision.

‘Our ratio of CNSs has declined over the last few years,’ Narelle says. ‘We have so many less experienced and casual staff now at RNS, which makes every aspect of our role much more demanding.

‘Filling our vacancies to make up an appropriate skill mix has become a job in itself. Nurses are tired of the workload and the unreasonable demands of various stakeholders, and are voting with their feet.

‘There are very few CNSs on our ward and most are considering foregoing their CNS role.

‘For me that is just another blow to the profession and reflects how devalued they are feeling.

‘I would like to ask NSW Health, “Why would you bother taking on the responsibilities and workload of a CNS for an extra dollar an hour?”

‘A CNS is expected to keep up-to-date with clinical knowledge and act as a resource person not only for other nurses but also for less experienced doctors on the ward and throughout the hospital.

‘Initiating and providing safe care 24/7 for a ward of 25 patients with complex health care needs carries a huge responsibility.

‘Coordinating and delivering proficient nursing care is also extremely demanding when you are being constantly called away from your own patients to help or advise less skilled colleagues.’

Narelle believes allied health professionals such as physiotherapists deserve a decent pay rise.

‘However, physios are not under the same degree of pressure as CNSs in providing high dependency, complex nursing care.

‘A physiotherapist attends to one patient at a time. A CNS, in the absence of a NUM, attends to a patient load as well as overseeing the wellbeing of every patient on the ward.’