Tuesday 19th December 2006
Data system imposes greater workload
A new patient data system introduced without adequate clerical support has left nurses at some public hospitals struggling to cope with a heavier workload.
Many complaints have come from the Greater Western region, where nurses at Bathurst, Orange and Parkes have taken the issue to their Reasonable Workloads Committees.
The Patient Administration System (PAS) is a Statewide system of recording and tracking patient data.
It replaces numerous separate systems, many of which were unable to communicate with each other, and is supposed to allow staff to quickly identify patients and promptly retrieve their medical information anywhere in the State.
PAS requires an increased data entry workload but it seems NSW Health bureaucrats failed to consider the impact on nurses who don’t have clerical support.
‘Nurses are already over-extended looking after patients and shouldn’t be burdened with even more clerical work,’ said Cheryl O’Brien, NSWNA branch secretary at Bathurst Base Hospital.
‘Bathurst is a 161-bed hospital yet we have no clerical support from 10pm to 8am – not even in Accident and Emergency,’ said Cheryl, a RN at the intensive care unit.
NSWNA organisers report the situation is worse at smaller hospitals where nurses have even less clerical support.
At Parkes, for example, nurses have to do the additional clerical work while also answering phones, looking after a mortuary and washing the theatre. At Lake Cargelligo the only two night nurses must do increased clerical work while running the ED.
The NSWNA branch at Bathurst has called on management to provide 24/7 clerical support and taken the issue to the Reasonable Workloads Committee.
‘Our medical records people put in a total of four submissions for overnight clerical support to manage the new system, but their requests were refused,’ Cheryl said.
‘Management promised the new system would not have any greater impact on us overnight, but they were wrong and the situation hasn’t improved with time. The additional workload is an unreasonable workload.’
She said the new system requires night nurses to maintain handwritten records.
‘When a patient is admitted to a ward a nurse has to write the patient’s ID number, name, date of birth, and ward number, on each page of between 14-20 pages of records.
‘It takes about 45 minutes to complete admission paperwork including the nursing care assessment when admitting a patient.
‘If you are on a busy ward with half a dozen admissions at night, a nurse will be writing all the time.
‘All admissions, discharges, transfers and relocations within the wards at night must be written down on paper by the Acting DON. After-hours nurses must now telephone the A&E clerk or, if no clerk is available the ADON, and advise of all relocations and discharges.
‘Yet management claims we are not performing clerical duties because we don’t do data entry!’
Data is not entered into the system until the following morning and therefore is not available to staff at night.
Nurses also cannot obtain patient labels once the clerical worker finishes their shift. ‘We believe it is an unsafe practice not to have labels for patients,’ Cheryl pointed out.
She said there is no clerical support for the intensive care/coronary care unit and the paediatric unit. The union has taken the ICCU request for clerical support to the reasonable workloads committee.
The issue of inadequate clerical support arose at Bathurst even before the new data system was introduced.
After the NSWNA branch pressed for greater clerical support to the maternity ward, management agreed to provide 20 hours support per week – but then tried to change the job description of the clerical worker to also work as a cleaner.
The dual-job proposal was eventually abandoned after opposition from the Health Services Union, but the dispute delayed clerical support for maternity by a further seven months.