Nurses and midwives won a great outcome from our ratios campaign but, at the local level, nurses may need to take another step to make management accountable for their implementation.
Closing beds is a tough call but one nurses and midwives are fully entitled to make if they believe it is in the interests of patient safety.
Throughout New South Wales nurses have been making that call.
Coffs Harbour Mental Health Services have fast-tracked the implementation of nurse-to-patient ratios after determined action by the NSWNA branch, which included closing beds.
At Lismore Base Hospital management have routinely used locums at great expense to help doctors out, but has been reluctant to give nurses and midwives the same level of assistance. But they have responded to strong action and agreed to speed up the recruitment for existing vacancies.
At Cobar, management backed off from staff cuts when nurses restricted patient numbers by capping beds.
In other parts of the state, such as Griffith and Goulburn, nurses are saying enough is enough and taking ownership of the situation. If management is unprepared to respond to increased demand and the shortage of staff then nurses and midwives are prepared to do what they think is necessary to provide safe care.
The closing of beds and restricting of services is a serious course of action that is not taken lightly. The determining factor is whether we can deliver safe patient care with the available staff. If we can’t, and management won’t, then it is our professional responsibility to restrict the level of services to the resources available.
At the hospitals I have mentioned the action to close beds came after long periods of engagement with management about the severity of staffing shortages. At Coffs Harbour, the NSWNA branch had raised the issue at the Reasonable Workloads Committee as far back as November 2009. At Lismore months of management delays in filling vacancies preceded the closing of beds.
Nurses at these hospitals told us they were nervous about the possible impact of closing beds on their wards and services, yet they were adamant that action had to be taken.
It was finally taken after much deliberation and consultation among NSWNA members. Our Lismore branch told us they would normally get half a dozen nurses to a union branch meeting but 40 to 50 people turned up to the two meetings prior to shutting beds.
Cobar nurses extended that consultation to the community with a petition and a public rally in the main street, at which they received overwhelming support.
Nurses at Coffs Harbour, Lismore and Cobar have shown that it is possible to take ownership of a staffing issue, and solve it, if there is unity and tenacity at branch level and a willingness to take strong action.
The ingredients of their success are similar to those in all our winning campaigns: a legitimate issue, consultation and resolve among members, strong action and community support.
Two years ago we set ourselves a massive challenge: to increase the number of nurses and midwives in the NSW health system so we had the resources to deliver the quality of care the citizens of this state deserve.
We have won the funding for 1400 extra nurses and midwives – a great first step. Now we have to make local management accountable and ensure they spend that money on nurse and midwife positions.
Our colleagues at Coffs Harbour, Lismore and Cobar have shown us a way to achieve that goal.
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