How the Victorians won ratios

One ‘Operational Bed’ in four was closed on every ward/unit in each public hospital after members voted to do so. ‘Operational Beds’ meant beds that were open the day before the resolution was passed. Beds closed or not regularly used prior to that date remained closed. These bed closures included aged care, radiology departments and cardiac catheter laboratories.

Exemptions from closures applied to ED, oncology patients, palliative care patients, haemodialysis patients, terminations of pregnancy and labour/neonatal wards, paediatric wards/beds with respect to paediatric patients only, ante and post natal wards with respect to maternity patients only, ICU, CCU and HDU, the Royal Children’s Hospital cancer centres.

An additional three operational beds per ward/unit were closed and reserved for emergency admissions, determined by clinical need. No patient was denied emergency care.

Operating Suite/Theatre Nurses closed one-in-four booked sessions or its equivalent in each Operating Suite/Theatre including endoscopy and day surgery. As far as possible, the ‘closed’ sessions were spread across a range of clinical specialties.

Nurses only undertook nursing duties. They did not carry out non-nursing duties.

All ward/unit rosters were maintained including leave replacement or there was an increase in the number of operational beds closed so as to ensure safe patient care and appropriate workloads.

One-in-four new referrals to outpatient clinics, post acute care, hospital in the home and district nursing services were refused. One-in-four Review Spots/appointments were refused. Radiology nurses did not accept one-in-four elective bookings. Exemptions to referrals, reviews and radiology elective bookings applied to the exempted areas.

When beds were closed nurses always stated that they were ‘on duty, here to work, and acting to ensure the delivery of safe patient care’.