Sunday 20th May 2007
Extra nurses if patient cap is exceeded
Mental health nurses who banned patient admissions at Morisset Hospital have won a major breakthrough in their campaign for more staff and better facilities.
The NSW Industrial Relations Commission recommended as an interim measure that patient numbers in Morisset’s Kestrel Unit be capped, with extra nurses to be employed if the cap is exceeded.
NSW Health has agreed to the recommendation while it negotiates with the NSWNA for a long-term solution to overcrowding and understaffing.
NSWNA Assistant General Secretary Judith Kiejda congratulated the Morisset nurses on their strong stand and said they had the full support of the Association. ‘They have acted in the best traditions of nursing for the welfare of current and future patients,’ she said.
Morisset Hospital is on the shore of Lake Macquarie north of Sydney on the Central Coast.
Morisset’s NSWNA branch in December put a ban on admitting new patients to the 30-bed forensic unit, which houses some patients in continuous seclusion.
The branch acted after management failed to resolve long-standing concerns that overcrowding posed a security risk to staff and patients and an unacceptable workload on nurses.
Branch secretary Graeme White said the Kestrel unit had two patients in long-term continuous seclusion. They had satisfactory accommodation with individual bedrooms and bathrooms.
‘Late last year nurses decided to ban admission of a third patient for continuous seclusion. Any third patient would have been housed in an inadequate room 3×2.4 metres for a prolonged period, with insufficient staff to care for more than two,’ Graeme said.
‘Kestrel takes patients who can’t be managed anywhere else effectively or safely. They usually have a long history of aggression and violence and we need adequate facilities and nurse numbers to ensure the safety of other patients and staff.
‘With more than two patients in seclusion there would not have been enough staff to carry out the mandatory observations of these patients every 10 minutes and also provide daily care to the majority of patients not in seclusion.
‘And we don’t always have access to a doctor overnight, which places an additional burden on nurses.
‘Nurses were extremely frustrated and concerned about patients’ welfare. If these patients can’t get adequate care and supervision at Kestrel they won’t get it anywhere else.’
After the NSWNA branch banned new admissions, management set up a ‘working party’, which met seven times but left NSWNA members unhappy with the process and disagreeing with the outcome.
‘We asked for an extra nurse for each shift and modifications to the premises to provide adequate accommodation for patients in seclusion,’ Graeme said.
‘The working party’s solution was to call on us to be more flexible.’
Nurses refused to lift the ban on new admissions, so management filed a dispute against the union in the Industrial Relations Commission.
The Commission came down on the nurses’ side in the interim, with a recommendation for patient numbers to be capped at 28 including no more than two in seclusion. If these caps are exceeded management are to employ an extra nurse on each shift.
‘Patients can still be admitted and discharged but they can’t go over those numbers without extra staff, which was our main demand to begin with,’ Graeme said.
‘The commissioner’s recommendation is a positive move but we are still looking for extra physical space for patients in seclusion.’
Hunter New England Area Health Service was due to report back to the commission in May on progress in achieving a safer working environment.