Workloads relief at Coffs

Nurses at Coffs Harbour Hospital win an extra full-time RN in the busy High Dependency Unit, following application of the Reasonable Workloads Tool.

Nurses at Coffs Harbour Hospital are celebrating a significant workloads win, gaining a desperately needed full-time RN in their High Dependency Unit (HDU).

Branch members have been battling the North Coast Area Health Service (NCAHS) for almost three years since a RCA (Root Cause Analysis) into a critical incident at the unit in 2006.

After a concerted campaign by NSWNA branch members, who applied the workloads tool to the HDU staffing situation, the unit now has one extra FTE registered nurse for the evening shift.

NSWNA Assistant General Secretary Judith Kiejda reminds members that all public health system nurses have a legal right to reasonable workloads under their Award.

‘The win in Coffs Harbour highlights how the Reasonable Workloads Tool can be used to assess and address excessive nurse workloads,’ she said.

‘Nurses know when they are overloaded but the tool gives them solid evidence, which can then be taken to the Reasonable Workloads Committee at their workplace – the first step to addressing excessive nurse workloads.’

Coffs Harbour Hospital Branch President Sue White said the HDU nurses in the unit are very happy with the outcome, describing it as a great win for staff and patients.

‘The extra RN has made such a difference to our ability to deliver quality patient care in the HDU,’ she told The Lamp.

‘We re-apply the workloads tool every six months and it has been telling us the same thing for some time now. HDU nurses were so busy they felt like they were just skimming across the top of their duties and weren’t able to do their jobs properly.

‘In the middle of 2008, nurses rallied together at a branch meeting and were committed to one fact – that we could no longer provide the required care for the patients in the HDU with the current staffing on the evening shift.

‘We passed a resolution at that meeting, which was supported by the Reasonable Workloads Committee yet was still denied by the NCAHS.’

Only the threat of industrial action last month, including a public rally and refusal of new admissions to the HDU, spurred the NCAHS to finally act.

‘The nurses on Surgical Ward fought consistently through out the process, attending many meetings, often in their own time. They worked together, supported each other and were focused that this was a position that we had to have to give satisfactory care to patients. Nurses did not want to be disruptive or close beds. However, they knew they had to be able to care for patients properly,’ said Sue.

Branch member Cameron McMillan, RN, said nurses were ‘over the moon’ after years fighting for proper staffing at the HDU.

‘The nurses in the HDU care for some of the sickest people in the hospital. The critical incident was very upsetting for staff and NCAHS’s failure to address that hasn’t helped.

‘We now have an extra RN on the evening shift, which has made life easier for the HDU nurses but we still need to address workloads on the morning and night shifts that are just as busy.

‘The extra RN now frees the In-Charge nurse to cover the administrative duties,’ he said.

Fellow branch member and relieving NUM Liz Allen agreed, warning staff were still ‘playing catch-up’ on the morning, night and weekend shifts.

‘The bottom line here is all about safe patient care. The extra RN has been really positive for the ward but we are still short.

‘When I spoke to the Garling Inquiry I made it quite clear that to look after patients properly and safely we needed the right staffing levels and the correct skill mixes.’

What is the Reasonable Workloads Tool?

The workloads tool is a computer program that provides a framework to measure what is a safe and reasonable workload.

Designed by a task force including NSWNA representatives and Nurse Unit Managers, it is based on patient morbidity statistics and an analysis of casemix DRGs (diagnostic related groups) – the top diseases that come into a ward during a year.

It was first introduced into NSW State hospitals in 2004 and its use as a benchmark tool, in conjunction with Reasonable Workloads Committees, was written into the nurses’ Award in the same year.

The Reasonable Workloads Tool guides the decisions of Reasonable Workloads Committees, which are now established in all public hospitals as a result of pressure from the NSW Nurses’ Association.