One to three in every ED: It’s time to guarantee safe staffing in emergency departments

NSWNMA members at Sydney’s Royal Prince Alfred Hospital and nearby community health and community mental health services will today, 11 April, launch their local campaign for a new Public Health System Nurses & Midwives (State) Award, which challenges the O’Farrell Government to build on the safer hospital staffing levels introduced in 2011 under an agreement between the NSWNMA and previous Labor government.

At a lunchtime rally outside the hospital they will call for the extension of guaranteed minimum nursing and midwifery levels to the hospital’s busy emergency department, its high dependency units, such as intensive care and the neo-natal intensive care unit, and inner-west community health services. RPA already has mandated minimum nursing levels in its general medical and surgical wards, as a result of the first round of staffing reforms agreed between the NSWNMA and the previous Labor State government.

For emergency departments the size of RPA’s the NSWNMA wants a guaranteed minimum of one nurse per three patient treatment spaces/beds, plus an in-charge nurse and a triage nurse on each shift.

For intensive care units, including neo-natal intensive care units, there should be one nurse/midwife per patient plus an in-charge nurse/midwife on each shift. In high dependency units there should be a minimum of one nurse for every two patients, plus an in-charge nurse, and in critical care units there should be a minimum of one nurse for every three patients, plus an in-charge nurse.

Community health nurses and midwives should have a maximum of four hours per shift contact time with patients, leaving four hours to attend to associated duties.

Today’s RPA launch and rally details

Date: Thursday, 11 April 2013

Time: 1.00pm


RPA Hospital – King George V lawn, Missenden Rd Camperdown


Brett Holmes – NSWNMA general secretary

Carmel Tebbutt MP – Member for Marrickville

O’Bray Smith – RPA NSWNMA branch official

NSWNMA general secretary, Brett Holmes, said it is no longer acceptable to leave the staffing of emergency departments, high dependency units and community health centres to chance.

“There is no doubt mandated minimum staffing arrangements protect safe staffing levels. Staffing levels can be assessed against a mandated minimum requirement, which means we can act decisively when governments and hospital managers try to undermine safe staffing just to save a bit of money.

“RPA nurses and midwives have been working under the first round of compulsory, minimum ratios in many of the hospital’s wards for some time now and they are clear that the ratios have provided a safer clinical and less stressed working environment.

“It is now time to ensure this same situation exists in our State’s emergency departments, high dependency units and community health services. RPA is one of biggest hospitals in the State and it is a tertiary referral hospital for most other facilities around NSW. For example, its neo-natal intensive care unit provides a vital, life-saving service for more than 700 babies a year, from throughout the state.

“The people of NSW have a right to expect that its nursing and midwifery units, including this neo-natal intensive care unit, will be safely staffed at all times, irrespective of budget pressures, sick leave emergencies or any other issue that might threaten the roster.

“The challenge for the O’Farrell Government is to build on this first round of staffing reform and ensure every public patient in NSW has access to the same level of safer care.

“O’Farrell Government ministers and MPs are very willing to take credit every time a new batch of nurses or midwives is employed to fill the new positions created by this first round of ratios, which were actually agreed between the NSWNMA and previous Labor government.

“Many, including Mr O’Farrell himself, were out last week boasting about employing 4000 extra nurses and midwives since the current government came to office. The fact is that is a simple head count and includes part-timers and casuals. The reality in terms of full-time-equivalents is closer to 2000, with about 1700 FTEs being the nurses and midwives required to meet the first round of safer staffing ratios.

“While welcoming the State Government’s compliance with those ratio requirements, it will be interesting to see how it reacts now that it has a chance to act in its own right and extend this reform into other important areas such as emergency departments, high dependency units, children’s hospitals, rural facilities and community health services. If it does not heed the strong message being sent by the State’s nurses and midwives and do the right thing, then this Ratios put patient safety first campaign will escalate,” Mr Holmes said.


The statewide Ratios put patient safety first campaign was launched in Sydney on Tuesday, 19 March. Local launches, similar to today’s at RPA, will be held around the State over the next few weeks. Launches have already been held at Katoomba-Blue Mountains, Muswellbrook-Upper Hunter, Tamworth, Bathurst, Goulburn, Nowra, Grafton and Kempsey.

A record 214 NSWNMA branches, representing more than 30,000 public-sector nurses and midwives throughout NSW, have endorsed the NSWNMA’s ratios and wages claim, which was then formally presented to the State Government, through the Health Ministry, on March 11.

The NSWNMA branch at RPA was one of the 214 branches that endorsed the 2013 claim. The current Public Health System Nurses & Midwives (State) Award expires on June 30 this year.

A key feature of the 2013 claim is guaranteed, safer nursing and midwifery levels for seriously ill children, emergency departments, high dependency units and rural hospitals and multipurpose services, and safer nursing and midwifery staffing arrangements in community health services.

The claim also includes two 2.5 per cent per year payrises, which will provide the majority of experienced, full-time nurses and midwives with a payrise of more than $70.00 per week, or more than $3800.00 per year, by July 2014.

Contact details
Brett Holmes
Ph: 02 8595 1234

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