Overworked and overwhelmed

NUMs hit by management reshuffling.

‘There wouldn’t be a NUM in this facility who doesn’t feel overwhelmed by their workload,’ says Chris Druce, Nurse Unit Manager of Bathurst Base Hospital’s emergency department.

Chris reckons she spends 45 minutes to an hour before and after each shift doing mostly unpaid administrative work, and she commonly has to do paid clinical overtime to cover last-minute shortfalls in the roster.

Her overtime record in the last year was a fortnight of 109 claimed clinical hours plus time in lieu for administrative work.

Bathurst Hospital has suffered four reorganisations of the area health system in the past 14 years, going from Central West area to Evans District, then Mid Western and now Greater Western.

Chris says that, with every change, back-office support to frontline nurses has been slashed with administrative work shunted down to local facilities and NUMs like herself.

‘And whenever we are required to undertake an additional duty there is nothing deleted from our existing workload,’ she points out.

When Mid Western area morphed into Greater Western, the area IT trainer was made redundant. Nurses now must try to train each other on computers.

‘IT is a huge black cloud that sits over our heads – it is the bogeyman that sits in my closet,’ Chris says.

As unit manager, Chris also serves as the EDIS (emergency department information system) data manager. She must oversee all data integrity, try to ensure people are trained to use the system, and be responsible for others accessing the system.

‘Checking data integrity is an extremely time-consuming and laborious process,’ Chris says.

‘In facilities larger than Bathurst and, in some instances the same size, that data integrity stuff would be a full-time job for someone.

‘I have triage clerks who do data entry on patients at reception but there is no ward clerk or communications clerk.

‘If there are policies to be filed or phones to be answered or stores to be ordered, then all that falls back onto the NUM or the nurse in charge.

‘We just won a battle in the Industrial Relations Commission to get a reception clerk at night. Until six weeks ago we only had clerical coverage at reception from 9am to 10pm.’

Budgets are another bugbear.

Chris says that when she took on the role of emergency department NUM in 2002, budget reporting was managed by area office.
‘Now I am required to submit a budget report every month which I can’t do because I just don’t have the time.

‘Training to use the reporting system was disjointed, and there is no inhouse IT support if you have a problem.

‘You don’t even know what your budget is because we still don’t have a unit-based budget allocation for consumables or staffing.

‘Allocation of staffing, replacement of people on sick leave and so on is still centrally controlled, so you don’t really control who works in the unit or what their skill level or qualification is, which makes it difficult to control a budget.’

Chris says she is rarely consulted on how statewide rollouts of special projects will affect her unit.

‘All the major project rollouts are launched in Sydney or selected places in the country. But for me to go to Wagga for a rollout is a six-hour drive there and back, which is not often feasible when you’re a clinical NUM and don’t have enough staff as it is.’