Friday 22nd February 2008
NUMs struggle to deliver proper face-to-face care.
Mona Vale Hospital NUM Susan Strachan is fed up with politicians who cut support staff numbers from the health budget while promising to spare frontline staff.
While such an approach to cost-cutting is designed to reassure the public, Susan points out that effective back-office support is essential to frontline staff being able to do a proper job.
‘Cutting support staff is having a severe impact on nursing, medical and allied health staff and then the patients,’ she says.
‘We now have to do the work which used to be done by support staff, meaning we struggle to have enough time to deliver proper face-to-face care.’
Susan was NUM at Mona Vale’s emergency department for almost eight years until going on temporary secondment recently.
In that time she has seen support staff numbers slashed – particularly in human resources and stores.
Like all hospitals in the northern Sydney area, Mona Vale lost its on-site stores department and the hospital is now staffed by one storeperson instead of three.
‘The storeperson is always flat out so it is now my job to chase up missing requisitions. We ran out of normal saline just before Christmas so I spent two to three hours trying to find someone to tell me when we were going to get some.
‘I should be able to ask a clerk – or a second storeperson if we had one – to do those sorts of tasks.’
A clinical NUM 1 was appointed to the ED 18 months ago to back up Susan, a NUM 3. ‘But still the pressure to meet key performance indicators for off-stretcher time, access block and triage categories – let alone deliver patient care – is absolutely overwhelming,’ she says.
‘I still have to spend a lot of time on the floor because there are simply not enough nurses. So I fill in when we are short-staffed or even to allow people to get to education or simply to have a break.’
Susan says one of her key responsibilities – to ensure the department stays abreast of changes in nursing practice – suffers as a result of the administrative workload.
‘New technology and increased patient load and expectations mean you have to rapidly change the way you deliver care.
‘Because we are weighed down by paperwork and always plugging gaps, there isn’t enough time to develop those processes adequately so a lot of it tends to be hit and miss.
‘If you hit and miss in the introduction of a major change in practice, it is likely to fail. I think that’s what happening to some extent throughout the system.
‘In between chasing your orders, fixing your payroll, making sure computers are working, getting people on to their meal breaks and education, you’re trying to introduce EENs, AiNs and an additional nurse practitioner.
‘All these changes are expected to happen concurrently but you’re told, “No, you can’t have a clerk to help you with your filing”. The limited budget does not allow even my medical director and staff specialists to have an admin support person.’
Susan says NUMs are obliged to ‘act like a big umbrella – they put their arms out to try to protect their staff but the workload weighs down on them to the point where they are increasingly saying, I can’t do this anymore.’