Comply with Award ratios, LHD told

Industrial Relations Commission says managers must not breach minimum staffing standards.

An NSWNMA campaign to ensure safe staffing of hospitals in the Hunter New England Local Health District has resulted in senior management publicly pledging to abide by nurse-to-patient ratios set out in the award.

A NSW Industrial Relations Commissioner has told management of Hunter New England Local Health District to resolve “with some speed” the systematic understaffing of Belmont Hospital near Newcastle.

In upholding a case brought by the NSWNMA, Commissioner John Stanton recommended that the LHD write to all NUMs, nurse managers and hospital management to tell them they must comply with award staffing provisions.

“Hunter New England LHD shall communicate with and instruct (managers) that budgetary concerns should never override the legal requirement for award compliance,” he said.

He said the NSWNMA should agree on the wording of the correspondence before it is sent.

“Importantly, Hunter New England LHD shall inform (managers) that the five nursing hours per patient day (NHPPD) is the minimum number of hours possible in NHPPD wards and that there may be occasions where patient need will require additional staffing.

“No manager shall make a direction that breaches the NHPPD.”

Commissioner Stanton said the LHD should undertake spot checks of staffing levels in NHPPD wards for a further three months.

Bottom line: LHD needs to employ more staff

During the commission hearing a LHD representative denied that understaffing was “a deliberate attempt to save money “ and said she believed the LHD could come to “some sort of an agreement” with
the union.

Commissioner Stanton said: “If it was on the front page of The Newcastle Herald and The Sydney Morning Herald last Saturday, you’d probably have agreement by now.”

The LHD representative replied: “I don’t dispute that.”

The union lodged a dispute with the commission after it discovered that four wards and units of Belmont Hospital failed to meet their minimum award requirement for nursing staff for all but two weeks between January and August.

NSWNMA General Secretary Brett Holmes said NUMs had often been pressured not to allow their rostering budget to exceed the five nursing hours, which was another breach of the award.

“Our members had been raising their concerns about staffing and workloads issues for some time
and management failed to implement any immediate, short-term or even long-term solutions to address the situation.”

He said the NSWNMA and LHD representatives were working through the IRC’s 17 recommendations and hoped
for an “amicable outcome” at Belmont Hospital.

“The bottom line is Hunter New England LHD needs to employ more nursing staff at Belmont to meet the demands of the local community.

“It’s not good enough for management to say they cannot find staff.  We’ve checked and there is not a shortage of nurses looking for work in the Lower Hunter region.

“Hospital management needs to be more innovative in their recruitment to employ more nursing staff.”

NSWNMA branch delegate at Belmont, Fran Robertson, was among members who attended the commission hearings.

Staff felt vindicated

“The Commissioner seemed stunned by the union’s discovery of what had been going on,” she said.

“We felt vindicated by his decision. We felt we were finally being heard.”

Fran said management were trying to speed up the recruitment of more nurses and absent staff were now being replaced for the full shift.

“Our casuals are mostly nursing students employed as AiNs and they are very happy because they are now getting an 8-hour shift instead of six hours.

“Permanents are pleased because they no longer have to fill the gaps.”

She said there had been an upsurge in union activity at the hospital with many more members attending branch meetings.

“People have clearly seen the benefits of union representation and why they should take an interest in union activities.”

Brett Holmes said the Belmont branch and members were to be congratulated for their tenacity and strong display of solidarity.

“Their actions and these outcomes will have a significant impact across all public hospitals,” he said.

Commission’s main recommendations for Belmont Hospital

Full replacement of absences

Absent nurses and midwives (for example, those on sick leave) should not be replaced with a shorter shift. An absence that creates say, an 8.5-hour vacancy, must be filled with an 8.5-hour replacement.

“Like for like” replacement

If a RN is absent on sick leave the replacement should also be a RN.
All options including overtime and agency staff should be explored before a lower classification is offered the replacement shift.

Non-direct clinical staff

NUMs, CNEs etc. should not be directed to replace clinical nursing absences except in extraordinary circumstances.

Wards and units with minimum nursing hours per patient day (NHPPD)

Five NHPPD is the minimum number of hours possible in NHPPD wards. Patients may sometimes need additional staffing.  Hospital data shows managers often treated the five NHPPD as a maximum rather than a minimum. NUMs should not be pressured to staff below the five NHPPD. No manager shall make a direction that breaches
the NHPPD.

Part time and casual work

Part-time employees may increase their contracted hours based on their previous 12 months’ work and casual employees may increase their job security based on whether they worked regularly and systematically over the previous six months.

Hunter New England LHD shall assess all requests from part-time employees seeking increased contracted hours and subsequently begin a process to convert staff to permanent positions in line with the award.