Manly nurses demand heat relief

Melting ice blocks put the spotlight on hot working conditions at Manly Hospital.

NSWNA members gave away 300 ice blocks to staff and the public outside Manly hospital last month to draw attention to hot working conditions in poorly ventilated wards.

In anticipation of a blisteringly hot weekend, the Manly NSWNA Branch approached local management with a series of conditions in line with occupational health and safety requirements and recommendations, which consider working temperatures above 25°C as potentially unsafe.

At 10.30am on 6 February, thermometers in the un-air-conditioned wards were reading 27.2°C; by midday ice blocks were melting in sticky hands; and by the afternoon management had agreed to the nurses’ requests.

These included the right to wear cotton theatre scrubs or appropriate mufti instead of hot polyester uniforms, access to bottles of cold water, and 10-minute breaks every hour. Portable air conditioning units and fans have been installed in patient areas. However, following an inspection by the NSWNA, Assistant General Secretary Judith Kiejda raised questions about where the more bulky machines might fit, and whether the hospital’s old buildings would cope with the extra power demand.

Manly Hospital RN, CNC and Branch Secretary Beverley Brady said the overriding issue is the lack of maintenance and refurbishments of Northern Sydney’s old hospitals.

‘There has been no money for maintenance because of the planned new hospital in [nearby] French’s Forest, but even if that goes ahead, we still have to care for patients for at least the next five years while the new hospital is built,’ said Beverley.

The ‘ice-block action’ was a response to a recent decision to keep doors closed and windows slightly ajar in two Manly Hospital wards, following the suicide of a patient who jumped out a window. Temperatures reportedly rose to as high as 36°C inside the suffocating wards.

The hospital plans to install security grills over the windows in mid-March, but until then the hospital’s natural cooling system, based on the airflow from sea breezes, will be ineffective.

NSWNA OHS Officer Trish Butrej said such stuffy conditions go against government regulations.

‘To comply with the Building Code of Australia, wards must have either effective air-conditioning or open windows equivalent to 5% of floor area to allow air circulation. Buildings without adequate airflow should not be occupied,’ said Trish.

Temperatures can rise above 25°C even in air-conditioned areas at Manly Hospital, according to Beverley Brady. ‘The Manly NSWNA branch is in discussions with management about long-term strategies to deal with heat.

‘The ice-block action was about supporting nurses going into an uncomfortable weekend of work, and making conditions more favourable for them. Nurses at Manly Hospital now feel free to have a short rest each hour, in a cool space, without being bullied,’ said Beverley.

It’s going to get hotter

Now is the time to make sure that hospitals and nursing homes are effectively cooled and ventilated in hot weather because, according to the Australian Bureau of Meteorology (BOM), summers are only going to get hotter.

The extreme heatwaves experienced in South-Eastern Australia this summer will soon be an annual event, according to a recent BOM study. If nurses are to avoid taking to the streets with ice blocks every summer, more thought will have to be given to infrastructure, investment, and work safety.

The best way to cope with heat is to escape it. On extremely hot days, school principals have the discretionary power to send students home but, unfortunately for nurses, workloads increase with temperature, and so too does the likelihood of suffering heat-stress at work.

Sydney has an average of 176 heat-related deaths each year, mostly among elderly and infant populations, according to the Commonwealth Scientific and Industrial Research Organisation (CSIRO). However, this is estimated to rise to more than 400 in the next 20 years as the average number of days above 35 degrees doubles. The incidence of heat-related illness, tropical disease, infection, and emergency responses to bushfires, are also expected to rise sharply.

In addition to air conditioning, CSIRO climate scientist Kevin Hennessy suggests a number of ways to keep hospital wards and nursing homes cool.

‘Keeping the sun out is the key. Shading walls, especially west and north-facing walls can have a significant cooling effect. Awnings, lattices and reflective glass all provide good shade,’ said Kevin.

‘It is also crucial that walls, roofs and floors are insulated, since 40% of heat is conducted through these surfaces. Flow-through air is important, although on very hot days it is important that windows facing the wind are kept shut. The last thing you want is a blast of hot hair in your face,’ he said.

Other simple steps can help nurses stay cool. The most important of which is to drink lots of water. In hot weather nurses may need one litre of water per hour, just to avoid dehydration.

Heat puts you at risk

Heat-stress can be dangerous. Some symptoms to look out for include:

  • dizziness;
  • headaches;
  • fainting;
  • cramps;
  • nausea;
  • weakness;
  • low blood pressure;
  • high body temperature;
  • heat rash.

Other OHS issues that nurses should consider in hot weather include the increased risk of patient violence because of discomfort and increased irritability, and the likelihood of injuries during manual handling as a result of slippery, sweaty hands.

Working in heat

Although there are no specific guidelines for maximum temperatures at work, nurses have the right to demand the following conditions when temperatures rise to, or above, 25°C:

  • adequate airflow (air-movement speeds should be 0.15–2.5 metres per second);
  • cool rest areas;
  • at least 10 minutes’ rest for every hour worked;
  • plentiful, cold, drinking water;
  • appropriate clothing, preferably loose fitting and cotton based.

Nurses should fill out an IIMS report for any heat related incidents, and seek workers compensation if necessary.