Nurses act against overcrowding

Psychiatric patients sleep on floors

With acute psychiatric patients sleeping on fold-out chairs, emergency trolleys and mattresses on the floor, stressed-out nurses at James Fletcher Hospital have taken a strong stand against overcrowding.

They voted to ban patient admissions when the Newcastle psychiatric hospital’s acute wards were full.

The hospital is gazetted for 64 beds but is usually 10-14 above that number, nurses say. Twenty-bed wards have accommodated 24 patients overnight, with another 15 patients out on leave.

‘We have been asking management to do something about serious overcrowding for over eight years – it’s become a nightmare,’ said Greg Ribbons, secretary of the Nurses’ Association branch covering James Fletcher Hospital and the psychiatric in-patient unit at Maitland Hospital.

Mental health nurses at Maitland voted to apply the same ban.

No patients have yet been refused admission because the dispute went to the State Industrial Relations Commission in October, with members voting to lift the bans while talks continue.

The NSWNA wants to conduct an occupational health and safety risk assessment at James Fletcher, and wants the Commission to order management to provide a safe workplace.

‘The gradual erosion of patient care from the highest standards to almost Third World bandaid psychiatric care adds to the disappointment and stress felt by staff,’ Greg said.

‘It also decreases patient safety which ironically is why most patients need to come into hospital.’

He said management has given the Commission a written undertaking to work towards not admitting patients “over census” and introduced a range of measures, but overcrowding continues.

Management also agreed to request additional supported accommodation services for transitional beds, but these are not yet available due either to lack of funding or available housing.

‘It is clearly unsafe for acute mentally ill patients to bed down on the floor or in patient lounge rooms,’ Greg said.

‘At lunch we have up to 27 patients crammed into a dining room designed for 20 places.

‘In these conditions there is increased potential for problems to escalate and for patients to become aggressive.

‘Where does a patient go if they want peace and quiet or to sit by themselves?’

Greg said the accumulated stress had a ‘crippling’ effect on nurses’ health and morale and placed heavy strain on all the multi-disciplinary team.

‘There has been overtime galore as we try to fill shifts because people have not been able to come to work.’

The union branch had raised the issue of overcrowding with management many times over the years and applied pressure including bans on duties such as clerical work.

‘We have a good mix of both senior and less experienced staff who by hard work have kept the hospital functioning with minimal serious incidents. As a result management felt they didn’t need to be proactive in solving the problem,’ Greg said.

He said recent management changes have meant nurses are finally receiving some support on the overcrowding issue, including at meetings of the Reasonable Workloads Committee.

However lack of funding meant there were still no practical measures to ease overcrowding.

Greg said the State government had announced more funding for mental health services but that would take time to flow through.

‘Services are being relocated to the Mater Hospital with the provision of more beds, but this is some two to three years away with no guarantee it will be adequate.

‘We are not prepared to put up with serious overcrowding any longer.’