Morbid symptoms

Western Sydney nurses seek public support to reverse staff cuts

Western Sydney nurses are holding lunchtime rallies this month to seek public support for action to reverse falling staff numbers and shrinking budgets.

Hospitals from the Sydney suburb of Auburn across to Portland, west of the Blue Mountains, are staging protests on 18 March.

Up to 13 hospitals are involved – including seven major hospitals – and a similar number of community health services. Together they serve well over one million people.

The actions follow years of nurse resentment over staffing pressures and growing workloads.

In the past year a recruitment freeze and deletion of positions and services has brought nurses’ patience to an end.

Western Sydney nurses are warning the communities they serve that staff are now too stretched to safely and adequately meet patient needs.

NSWNA representatives at two hospitals and a community health centre tell The Lamp why they are taking action.

No time for quality patient care

‘We can’t keep going under these workloads and provide a safe service to our clients,’ says RN Bernard O’Flaherty, a member of a mental health team based at Merrylands Community Health Centre.

‘Our mental health team at Merrylands is four clinicians down out of 10 and we haven’t had a CSO for over one year,’ explains Bernard, Secretary of the Union’s Sydney West Community Health Nurses’ Branch.

‘We have mountains of medical records that need attention and because we can’t get clerical support we’ve had senior nurses on overtime doing the filing which is a ridiculously expensive way of doing it.

‘What amazes me is that non-clinical middle management, particularly at cluster and area level is burgeoning even while hiring of frontline staff including replacements is prohibited.’

He says understaffing is the worst he’s seen since he started nursing in 1975.

‘Governments over the years have just strangled the health system and understaffing is putting patients in jeopardy. We haven’t been able to employ anyone for over a year.

‘There is a serious lack of time available for quality patient care.

‘We have a number of forensic patients – people found not guilty of crimes on the grounds of mental illness – who are now on conditional release in the community, and a large number on community treatment orders.

‘We have workloads of 50-60 clients each and we have about two days a week to actually case manage them. The rest of the time is spent on crisis shifts and various clinics such as the injection clinic.

‘Patients in need of the most personalised attention are just not getting it, and the stress on staff is unbelievable.’

Bernard says three meetings of the Reasonable Workloads Committee have got nowhere.

Community nurses based at Merrylands, Parramatta, Auburn, Dundas and Baulkham Hills were all planning to hold local rallies to seek public support for more nursing staff and reduced workloads when this issue of The Lamp went to press.

No end in sight to extreme workloads

Nepean Hospital nurses are ‘burnt out’ by excessive workloads and frustrated by the failure of reasonable workloads procedures to achieve better staff/patient ratios, says Peter Mason, NSWNA Branch Secretary.

Peter says staff at Nepean, a referral hospital with around 400 beds at the base of the Blue Mountains at Penrith, support a lunch-time protest march this month because they see no end in sight to extreme workloads.

He says Health Services Union Branch officials at Nepean have pledged to support the nurses’ rally ‘just as we supported them in their dispute last year’.

‘It’s a desperate and dire straits health system. People are not replaced when they resign, go on leave or get deployed,’ says Peter, an Endorsed Enrolled Nurse in the Emergency Department.

‘Part-timers are having to pick up extra shifts, full-timers are doing overtime and NUMs aren’t getting to do their normal duties because they spend most of their time helping out on the floor.

‘Roster offices are telling the NUMs  they can’t get anyone to fill a gap and yet casual staff tell us they’ve been sitting at home for days and don’t have any work.

‘The vacancy rate in the delivery suite, for example, is 20 FTE (full-time equivalent) midwives and two FTE ward clerks.

‘In one particular four-week roster the delivery suite had 101 shifts they couldn’t fill because of these 20 vacancies.

‘Midwives in post-natal and antenatal have to be deployed to the delivery suite, leaving their usual wards short-staffed. The process just compounds across the hospital.’

Peter says examples like this are high on the agenda at every meeting of the hospital’s Reasonable Workloads Committee but progress is non-existent in the face of a staff freeze and management obstruction.

‘Workloads committees are not working in the way they should because management has been able to find loopholes in the reasonable workloads clause of the award.

‘Management will say their data doesn’t match data the Branch collects from our members. The workloads committee reps then have to go back to the member who provided the information and try to get more data. It is an exhausting process trying to investigate just one workload issue.

‘If a ward is one RN or EN down on a really difficult shift, management will tell you several weeks later that the acuity of the patients was very low. How do you then go back and prove that it wasn’t?’

Peter points out that all health workers, not just nurses, are affected by the staff freeze. ‘This weekend alone there were 10 cleaners down and one cleaner had to clean three wards. How can they properly do 24 hours’ work in eight hours?’ he asks.

Graduates in limbo despite staff shortage

While Mount Druitt Hospital struggles to deal with staff shortages, all of its 2009 new graduate nurses promised jobs there last year are still waiting to be hired.

‘Nurses who worked in our new graduate program in 2009 have been left in limbo, not knowing when or where they will be employed,’ said NSWNA Branch Secretary at Mount Druitt Hospital, Sunita Gounder, a Registered Nurse in the operating theatre.

‘Initially they were told they could work in the area they did their single placement, one-year new graduate program in. Then they were made to sit a job interview and went into Christmas not knowing the outcome.

‘The latest development is that some have been offered a one-year contract but nothing has been offered in writing.’

Sunita says such unfair treatment of new graduates is senseless and detrimental to the future of nursing.

‘Failure to fill vacancies has left one ward with half the number of nurses needed to safely and efficiently run the ward,’ she says.

She adds that nurses throughout the 200-bed hospital are faced with constant deployment, which has created a lot of uncertainty, anxiety and stress.

Sunita says the area-wide job freeze has prevented nurses from permanently transferring to other hospitals because there are no vacant positions, according to area management. It is also limiting nurses who want to gain skills in other specialties and who want to further their career.