Workloads breakthrough

New guidelines put an end to excessive workloads in ED, community health and mental health inpatient units.

New guidelines have been released on managing nurse workloads in emergency departments, community health services and mental health inpatient units, and will be immediately applied in the public hospital system.

Initiated by the NSWNA and NSW Health, the guidelines provide a robust framework for assessing nurse workloads in the specialty areas of ED and inpatient mental health units and community health services.

According to NSWNA Assistant General Secretary Judith Kiejda, the guidelines are a positive step to addressing excessive nurse workloads in these speciality areas.

‘Importantly, these new guidelines allow nurse input into the assessment of their workloads, and give them the power to address workloads issues. It is no longer acceptable that nurses in ED, or community health and inpatient mental health services endure ongoing, heavy workloads,’ she said.

Legal right to a reasonable workload

‘Unsafe and stressful nurse workloads is a red hot issue for the NSWNA and the guidelines are another achievement that underpins nurses’ legal right to a reasonable workload,’ said Judith.

The guidelines build on Clause 53 – Reasonable Workloads For Nurses in the Public Health System Nurses’ and Midwives (State) Award and should be read in conjunction with the award provisions.

‘We’re also close to completing the adaptation of the Birthrate Plus tool, which will measure workloads in midwifery units,’ she said.

Assessing workloads in specialist clinical areas

In assessing the factors that impact on nurse workloads, the guidelines consider the clinical requirements of ED, community health and inpatient mental health services, the individual setting and geography of each facility, service or unit and other factors such as leave and educational requirements.

For example, the ED guidelines state that triage nurses must be identified on all shifts, and in mental health units there is appropriate staffing in forensic health units or when forensic patients are admitted. For the community health services setting, allowance must be made for induction and compulsory education.

Input from senior nurse managers and clinical specialists

The guidelines were developed after extensive consultation with ED, mental health and community health managers and clinicians and must be implemented by management.

‘It’s been a time-consuming and thorough process to develop these guidelines but the end result is clear guidance on assessing a reasonable nurse workload in the ED, community health services and inpatient mental health settings,’ said Judith.

Flexible approach tailored to individual workplaces

Rather than just a mathematical calculation of nurse workloads, the guidelines set parameters for discussion and provide triggers for what issues should be considered when addressing workload issues.

‘We originally set out to develop mathematical tools but without a systematic and consistent method of collecting data, it was clear it was impossible to develop a workload calculation tool.

‘One size does not fit all. For example, what works on the Central Coast doesn’t apply in Broken Hill or the Illawarra. The guidelines need to accommodate a range of circumstances.’

The working groups advised that a flexible approach would be required, enabling adaptation to different situations.

How to address excessive nurse workloads

A reasonable workload is your right

The new Guidelines provide direction on managing nursing workloads in specialist areas. Nurses’ legal right to a reasonable workload is enforceable under the Public Health System Nurses and Midwives (State) Award. If you are experiencing workload problems in your workplace, use the following steps to resolve the issue.

  1. Identify whether there is a workload issue in your ward, unit or health service.
  2. Raise the issue with your manager.
  3. If the issue is not resolved, consult with other staff and notify the NSWNA Reasonable Workloads Committee (RWC) representative about the issue. Do this in writing, suggesting possible solutions.
  4. The RWC reviews the issues and makes recommendations to management.
  5. If the issue is still not resolved, the NSWNA RWC representative will notify the outcome to your NSWNA branch and organiser.
  6. The NSWNA convenes an Area Health Service RWC, which reports back to the workplace RWC and NSWNA branch.
  7. If the matter is not resolved, the NSWNA may commence dispute proceedings in the NSW Industrial Relations Commission.