Alone no longer   

A committed group of rural nurses have forced management to promise extra staff – ensuring they will no longer have to work alone.

 Nurses at Leeton District Hospital will no longer be put in unnecessary danger by having to work alone at night.

The hospital’s NSWNMA branch has won a long campaign to employ more staff at the 76-bed hospital in southern NSW.

Murrumbidgee Local Health District management has promised to roster an additional enrolled nurse overnight seven days a week and a nurse practitioner (NP) 10 hours per day, every day.

“We are happy that we have achieved this commitment and we expect it to be implemented as soon as possible,” said branch secretary Leeanne Driscoll.

The branch has pushed for safer staffing for several years.

Only three nurses have been rostered to cover the upstairs ward and downstairs ED from 7.30 pm – 11 am.

As a result, nurses have had to answer the ED door and attend to emergency presentations on their own. Or, send two nurses to ED and leave one nurse on the ward.

On a night shift, the ward can have as many as 24 patients. When one nurse is working in ED, the other two nurses can only check on her welfare via a monitor.

Big ice problem

Leeton has one of the state’s worst rates of use of the drug ice and the hospital is a declared mental health site.

Mental health patients are dropped at the hospital despite it being on COSOPS (no doctor) overnight.

The hospital has only one HASA (health and security assistant) who mainly works morning shifts five days a week and the town does not have a 24-hour police presence.

Last year, the NSWNMA inspected the hospital after a patient assaulted a nurse and another patient.

“There is clear potential for a serious injury to staff or patients to occur,” the union’s inspection report warned.

“Rostering a sole nurse to work in isolation is in breach of NSW Health policy as set out in chapter 26 of the Protecting People and Property manual.”

Management responded by implementing some union recommendations – mainly physical improvements to the ED – while ignoring the staffing issue.

Improvements included an upgrade of CCTV cameras, advertising a casual security position to backfill planned leave and installation of swipe card access in the ED and other clinical areas.

However, as branch president Robyn Whittaker pointed out at the time: “Design changes will help but won’t resolve the issue of nurses working in isolation.”

Robyn said a union workshop on how to run a campaign gave Leeton branch members a “pathway” on how to handle the staffing issue.

“We held more branch meetings and got more organisers out to the hospital, which showed people that the union really care for us out in the bush.” she said.

Important to collect data

In August 2018, staff held a public rally to alert the community to unsafe staffing of the ED.

During 2019, the branch wrote to management about ED staffing at least monthly.

In August 2019 the ED experienced four aggressive episodes including an attempted assault on a female nurse by a large, male mental health patient.

Leeanne said the branch collected information to show ED presentations had risen in the past year with an increase in mental health and ice-related patients.

“We had to make sure we had the data to prove we needed extra staff, because that’s what management focus on,” she said.

“However, if you work alone in ED you realise very quickly you need more than just one pair of hands.”

Leeanne said the employment of an NP would lead to patients being diagnosed and treated quicker.

“We won’t get so many blockages waiting for a local doctor or waiting for someone to review the patient remotely.

“Like all small country hospitals, we don’t have enough doctors on the on-call roster.

“We often have to get advice from doctors at Griffith (a 40-minute drive from Leeton) or Wagga (1.5 hours away) hospitals.

“An NP will help a lot, especially with diagnosing categories 4 or 5 presentations. The NP can order X-rays and prescribe medications without having to wait to contact a doctor off-site.”