We won’t be put in danger!

Byron nurses stand up to cost-cutters over security

Byron District Hospital nurses have refused to allow cost-cutting bureaucrats to put the security of staff and patients at risk.

Backed by the union, the nurses forced North Coast Area Health Service (NCAHS) to re-employ a security officer on the afternoon shift.

NCAHS had removed the security officer because of  ‘insufficient funding’.

This left a nurse working alone in the emergency department from 3pm to 10pm in an environment of increasing aggression towards staff especially by mental health patients.

The NSW Nurses’ Association branch at the hospital decided to take industrial action to regain round-the-clock security coverage.

The branch decided to: restrict triage to life-threatening or serious categories (all others would be diverted to other services and facilities); refuse to receive ambulances transporting mental health patients; and turn away drug and alcohol admissions by ambulance and police.

The union tried to settle the dispute with senior officers of NCAHS and the NSW Health, but got no result.

Shortly before industrial bans were to start on 21 May, NSWNA General Secretary Brett Holmes asked NSW Health Minister Reba Meagher to intervene. She instructed her department to immediately reinstate a security officer on afternoon shift.

Byron Hospital has 26 beds but funding is restricted to staff sufficient for only 16 beds. There is a two-bed high-dependency unit and an ED with three beds and one resuscitation bay. There are lots of elderly patients and an increasing population of homeless people and mental health patients.

NSWNA branch secretary at the hospital, Liz McCall, said hospital management set out to improve security last August by implementing the recommendations of a security review.

These included putting a Health Security Assistant (HSA) on afternoon shift and designating wardsmen with security licences rostered on morning shift as HSAs.

‘However NCAHS overruled hospital management and ordered the changes be scrapped by 15 January,’ Liz said. ‘The Area said there weren’t sufficient funds to pay for the improvements.

‘Our union branch responded with a resolution explaining that additional security measures were essential in light of increased incidents of aggression in the ED.

‘We also pointed out that the CCTV camera in the ED didn’t work properly and had no recording facility.’

Liz said area management eventually agreed to provide funding to pay the HSA a security loading on the morning shift and install a new camera with recorder. But management insisted there had not been enough incidents of aggression to justify putting a security officer on afternoons.

‘As far as we are concerned, one incident without adequate security backup is too many,’ Liz said. ‘How many incidents do you want before a nurse is hurt?’

She said Byron Bay was experiencing increasing numbers of homeless people living on the streets or in the bush, many with mental health disorders. There had been a corresponding increase in aggression and threats to nurses.

‘Incidents of aggression have became almost normal, and nurses don’t really talk about them much anymore. That’s a worrying development.

‘Byron once had a very good mental health acute care service but it’s been pared to the bone.

‘We used to admit mental health patients who didn’t really need to go to a psychiatric unit because we knew we had adequate backup – the acute care person would come in and settle the patient down.

‘Then the health service decided to cut the acute care service staff and put in a mental health 1300 access number instead.

‘Mental health presentations in ED have accelerated since acute care staffing was reduced. Acute care staff are very frustrated by inadequate staffing which prevents them from properly caring for all their mental health clients.

‘People are no longer adequately cared for by community mental health so they are coming into ED.’

NSWNA Assistant General Secretary, Judith Kiejda, said the Byron Hospital branch had shown a keen sense of responsibility to their fellow nurses and patients by refusing to allow a lone nurse in ED to be put at risk for the sake of cost-cutting.

‘The situation at Byron Hospital was unworkable and unsafe for our members and patients. Our members tried to negotiate a solution but were met with bureaucratic resistance all the way,’ Judith said.

Byron District Hospital nurses wrote to NCAHS chief executive Chris Crawford, outlining incidents of aggression and threats from patients and explaining why they felt unsafe at work.

The following are excerpts from four such letters:

  1. ‘The RN had luckily got herself out of the Emergency Department, locking the door behind her, having to leave that person kicking at the door, throwing things around in the ED and yelling abuse.’
  2. ‘This particular patient had to be handcuffed by police and taken down by three people prior to transfer, indicating the danger faced.’
  3. ‘The situation appeared to be reasonably safe until the patient brought out a piece of broken glass, pulled up his sleeve and started to cut himself and threaten me.’
  4. ‘I am very concerned that these events are being normalised as an accepted part of the nursing experience.’