NSW Nurses and Midwives Association (NSWNMA) members at the Albury community mental health service have today started work bans on the following administrative work in an attempt to get the Murrumbidgee Local Health District to fully replace all nurses on annual leave:
• attending non-clinical meetings such as staff meetings;
• typing minutes for any meetings;
• doing data entry (ie. no recording of OOS) – sci-mhoat data entry; and
• using the sign-in book – staff will participate via the movement board, car bookings book and their own diary entries
The nurses will also:
• return to base at end of shift from outreach; and
• ensure consistency around home visiting with two staff.
At this stage the work bans target management, but the Albury nurses have voted to escalate their action in a week if the LHD does not agree to fill all annual leave vacancies at the service.
NSWNMA assistant secretary Judith Kiejda said the Albury mental health nurses are concerned that they cannot maintain a quality and safe service while there is no backfilling of nurses on annual leave.
“Providing replacement nurses for annual leave has been funded since 2011, but the funding has rarely been utilised. Some managers have even tried to deny there actually is funding to replace annual leave, but a recent letter from the Murrumbidgee LHD confirmed funding is provided.
“This failure to backfill annual leave leaves large gaps in service delivery. There are nearly 30 fulltime-equivalent staff at the Albury Community Mental Health Service, but only 1.7 FTEs have been provided to replace nurses on annual leave and those 1.7 FTE positions are currently vacant. So there is no one to replace people on leave.
“In summary, that means the Albury community mental health service has insufficient provision to replace annual leave in the first place and even that allocation of 1.7 FTEs is currently vacant.
“Currently the work just gets allocated to the remaining staff, which is putting enormous strain on them and the service. I am advised that in recent times 300 patient appointments were cancelled as a result. That is an unsafe situation for the patients involved and possibly even for the wider community.
“Over the last few months the nurses have made every reasonable attempt, through meetings and consultation, to resolve this matter internally. However, there has been no timely and effective response from management at any stage. That is why the nurses now feel they must take a stronger stand over the issue, through these work bans.
“This Albury staff replacement problem is also further evidence of the need for mandated, minimum staffing levels in all clinical areas in our hospitals and community health services. The failure of the Murrumbidgee LHD to replace community mental health nurses on leave, even with agency nurses while they recruit permanent nurses to the vacancies, proves local managers cannot be left to handle these things without such compulsory minimum staffing levels,” Ms Kiejda said.
The first round of enforceable, minimum nurse-to-patient ratios was introduced into general medical and surgical wards in most NSW hospitals as part of the 2010-11 award negotiated between the NSWNMA and the former Labor government.
The NSWNMA wants the O’Farrell Government to build on this landmark staffing reform by extending the ratios or guaranteed minimum staffing to more clinical units, including emergency departments, children’s wards, intensive care units, community health services, most community mental health services and smaller hospitals. It also wants all hospitals to be treated equally, so that the nurse-to-patient ratios are the same in each hospital around the state.
That means, in summary, minimum legally-enforceable nurse-to-patient ratios such as:
• one nurse to four patients, or a minimum average of six nursing hours per patient per day, in all general medical, surgical and acute inpatient mental health wards in every hospital throughout the state, including all country hospitals;
• one nurse per three children in general children’s wards – about 8.5 hours per child per day;
• one nurse to three patients in emergency departments;
• one nurse per patient in intensive care units, including neonatal ICUs; and
• a maximum of four hours patient contact time per nurse/midwife eight-hour shift in community health services, including most community mental health services.
In March this year the NSWNMA launched its Ratios put patient safety first campaign to achieve this outcome. Thousands of nurses and midwives, including many working in Albury and other Murrumbidgee LHD facilities, held a statewide strike on July 24 as part of the campaign and in response to the O’Farrell Government’s failure to implement this vital patient safety reform.