Safety in jeopardy

Ballina nurses demand more staff

With its endless white beaches and myriad waterways, the Northern Rivers town of Ballina looks like paradise. But if you’re a nurse at the local hospital emergency department, it can feel more like hell.

Ballina District Hospital can be a solitary and dangerous workplace for the single registered nurse on the 10-hour night shift in the ED.

After the doctor has assessed a patient the doctor often catches up on some sleep, leaving the RN alone and isolated. The wards are some distance away, the hospital security assistant is out of the department attending to cleaning duties and outside security can take from 10 to 30 minutes to respond to the duress alarm.

Morning and afternoon shifts are a little better, with two RNs on duty. But with triage to take care of and a frequent need to escort patients to outside radiology or transfers to other hospitals, one of the RNs is often left alone to manage the nine-bed ED – which is only funded for six beds.

With backing from NSWNA head office, the union branch at the hospital is campaigning for more staff to ease workloads and improve job safety and patient care.

The NSWNA branch took its concerns to the hospital’s Reasonable Workloads Committee which recommended a staff increase. The recommendation is supported by the ED operational plan released last August.

But Area management has refused to endorse the recommendations and claims the operational plan is merely a draft – though it had never been marked as such.

The union went to the NSW Industrial Relations Commission whose Deputy President R W Harrison recommended, as an interim measure, an additional two hours’ nursing time on the morning shift in a timetable for resolving the issue.

This means that two RNs are now rostered for eight hours in the ED.

Another commission hearing was scheduled to take place as this edition of The Lamp went to press.

Union branch president at the hospital, Rita Lewis, said nurses would continue to press for a second RN on night duty and another RN from 9.30am to 6pm to cover meal breaks, which are often not taken due to workload demands.

‘The branch first raised concerns about ED staffing last October after two RCAs [critical incidents],’ Rita said.

‘There are difficulties in managing the ED waiting room as one of the two RNs is allocated for triage but has to assist with up to nine patients in the ED including acute areas such as resuscitation.

‘Often there is little chance to retriage patients who are in the waiting room. If their condition changes while they are waiting we are often unaware of it.’

Rita said that since CT scan and ultrasonography are not on-site, nurses are sometimes required to escort admitted patients by hospital car or ambulance to these appointments.

‘This can take a nurse off the floor for between 20 minutes and four hours, and this nurse is not usually replaced. At times ED can pull staff from the ward to assist but quite often they haven’t got excess staff either. Therefore nurses in ED are working solo and often without meal breaks.’

Rita said Ballina Hospital nursing and medical staff are committed to safe and effective patient care.

‘We embrace the changes and opportunity offered by the challenges associated with this commitment, but present staffing levels do not allow us to do our job effectively or safely.’