NCAHS puts budget over patient care

Staff employed by North Coast Area Health Service are furious at the organisations announcement that it plans to cut another 62 jobs.

Members at chronically understaffed facilities throughout the North Coast Area Health Service (NCAHS) are up in arms over its latest announcement that it plans to cut another 62 FTE positions – many of which are likely to be nursing roles.

NCAHS has already cut 350 FTE positions, putting a massive strain on remaining staff.

‘This announcement comes at a time when NCAHS is suffering a staffing crisis,’ said NSWNA Assistant General Secretary Judith Kiejda. ‘Nurses at Kempsey Hospital ED had to engage in a long and sustained campaign earlier this year to win one more nurse per shift. There is a history of NCAHS prioritising budget over patient care.

‘There are diabolical staffing problems across NCAHS, with little to no recruitment occurring. One frontline community nurse position was vacant since last November, before it was finally advertised this month. NCAHS has a history of staffing cuts leading to crisis.’

The area health service invited the NSWNA to a presentation in September showing how it had benchmarked costs at its facilities, compared with facilities in other area health services.

‘NCAHS said the results show it is not doing as well budget-wise, but they benchmarked against very different facilities – it’s like comparing apples with oranges,’ said Judith.

Fed up with staff cuts

Gil Wilson, a CNS in ICU at Lismore Base Hospital and Branch Secretary, said staff were angry and frustrated by the prospect of more job cuts, which will lead to even more increased workloads on the remaining staff.

‘We are sick of being hammered and now they are talking about taking even more from us. On one of the rare times I went to the wards recently, the staff said, “We need to strike now,” and this was the first time they were in unison about this. They said, “Tell us to walk out.” I could have walked the hospital out that afternoon. They are incredibly frustrated that NCAHS thinks it can take more staff hours away from patient care. Every ward had at least one person working overtime,’ said Gil.

This latest announcement by NCAHS is the fourth round of job cuts. According to Gil, there has been an ‘unofficial recruitment freeze’ for some time. This has led to a backlog of ambulances in ED, and existing staff being exhausted and stressed because they have to do extensive overtime.

‘There were five ambulances loaded up in ED the other day. On one shift there were nine people doing overtime at Lismore Base alone to fill up the holes. A lot of nurses are doing double shifts to minimise the impact on patient care. This means tired nurses with a hell of a workload.

‘With the current workloads tool it’s a constant battle – we are faced with NCAHS wanting to take 10 or more hours out of most wards.

‘There is a lot of pressure on staff and everyone is fed up. We are horrendously busy and it seems that recruitment takes forever. It’s been like that since the budgetary cutbacks. The area health service is trying to create unrealistic budgets.

‘The job cuts are disgusting. NCAHS needs to take a really close look at where the cuts are going to come from because it’s trying to get blood out of a stone – you can’t take any more from us,’ said Gil.

Ratios is the solution

Ratios, mandating the right numbers of staff with the right skill mix, would solve the staffing problems across NCAHS facilities, said Gil.

‘Ratios would be magic. I wouldn’t be spending so much of my time arguing about workloads. They couldn’t screw around with us if we had ratios. Ratios would prevent area health services putting budget over patient care.’

And it’s not just Emergency Departments that are suffering from serious staff shortages.

A community nursing job remained vacant for more than 255 days since last November. It was finally advertised last month.

‘We only have 5.1 FTEs in the general nursing part of community health and a second person resigned recently. This was the straw that broke the camel’s back – to have two FTEs vacant was making it impossible to provide a service,’ said Rhonda Allen, CNS in parent education.

‘Even before the second resignation, one of our nurses went off with a back problem and she felt it was caused by the stress of trying to fit everything in. We cover long distances here; you’re out there in the car getting stressed and worried and rushing – it’s an OHS issue. When referrals come in you just find a way to do them somehow even if you don’t have time,’ said Rhonda.

‘We have a nurse educator position that was vacant for years and it took a long time to get someone. She stayed for a year and left, so the NUMs have to do a lot of that work – the competencies – and that’s another thing on their shoulders. NCAHS has finally agreed to advertise this position.’

But, according to Rhonda, sometimes positions go through the whole recruitment process but do not get signed off at the end. ‘There is still scepticism from all of us as to whether these positions will actually happen. The staff get very despondent.’

Chronic under-staffing means the nurses are unable to provide quality patient care. ‘I work in the child and family area and our numbers have gone down and down. We are committed to see new mums when they come home in the first fortnight and we are not seeing them at the moment in the early days, so we’re not doing as well as we could,’ said Rhonda.

NCAHS said it will reveal details of which jobs and at which hospitals it plans to cut, and will begin consultation in October.