A clear pathway to ratios   

Labor has unveiled a plan for the March 23 state election that gives nurses and midwives their best chance to win minimum nurse-to-patient ratios, guaranteed in law.

Most medical and surgical wards, emergency departments, paediatric wards, post natal wards and maternity units will get minimum nurse-to-patient ratios on every shift under a NSW Labor government.

Labor leader Michael Daley has promised that if elected, Labor would hire more than 5500 nurses over the next four years to deliver its plan.

Daley said ratios would give nurses and midwives more time to care for patients, reduce stress on nursing staff, reduce the risk of errors and lead to higher staff retention rates.

“I want to say to nurses and midwives – this is your win, this is your campaign,” he said.

He said Labor would staff regional and district hospitals the same as big city hospitals. 

He said ratios would become law in the new Nurses and Midwives Award which starts in July 2019.

Starting dates for ratios in every ward and unit would be agreed between the Ministry of Health and NSW Nurses and Midwives’ Association.

A timetable to implement the ratios will be included in the 2019 award – with the first phase of ratios in medical and surgical wards to commence in March 2020.

An historic announcement

NSWNMA General Secretary Brett Holmes described Labor’s announcement as historic.

“This is the first time a major NSW political party has supported ongoing calls from nurses and midwives to guarantee ratios on every shift,” Brett said.

“Labor’s commitment to introduce mandated, minimum nurse-to-patient ratios will provide a clear and accountable system that patients can rely on and nurses can trust at all times.”

Labor governments have already introduced ratios in Victoria (2000) and Queensland (2016).

In NSW, Labor has promised to give most country nurses the same patient loads as their city colleagues, with at least one nurse for every four patients across all A, B and C hospitals on morning and afternoon shifts and 1:7 at night.

“Specialling within numbers” will be banned in medical/surgical wards in A, B and C hospitals.

‘Specials’ staffing will be funded in addition to ratios but will start earlier – from July 1 this year.

1:3 ratios in maternity

All maternity units will get a minimum ratio of 1:3 for postnatal patients on morning, afternoon and night shifts.

All paediatric wards will get a minimum 1:3 ratio across all shifts.

Minimum ratios (1:3 plus in-charge plus triage) will apply in all Level 3 to 6 adult and paediatric emergency departments.

In community health and community mental health services, Labor will take steps to ensure nurses and midwives are replaced when they take leave.

Michael Daley said Labor would require all community health services to publish the number and percentage of shifts replaced to cover nurses and midwives taking annual, sick, long service and parental leave.

LIBERALS/NATIONALS refuse ratios but promise numbers

The Liberal/National Coalition has promised to employ 5000 more nurses but has ruled out introducing nurse-to-patient ratios.

Brett Holmes said it was unclear what the Coalition’s promise would mean in practice without a transparent, legally enforceable ratios system that left no room for managements to manipulate the system to lower costs.

He said Labor’s ratios plan would also ensure that nursing numbers automatically kept up with patient numbers – regardless of political promises.

“We need a clear and accountable rostering system that patients can rely on and nurses can trust at all times. It is disappointing that the government chooses to ignore this,” he said.

The key points of Labor’s ratios plan

  • “Specialling within numbers” will be banned in medical/surgical wards in A, B and C hospitals from 1 July this year.
  • Introduce a new mandated, shift-by-shift ratio system starting from 1 July 2019
  • Fund an extra 5500 nurses and midwives
  • Introduce 1:3 ratios in EDs, paediatrics and maternity
  • Bring regional staffing levels up to city levels