Patients robbed of ‘guaranteed’ care

CEO promises “fast track” recruitment after Union exposes massive nursing hours deficits.

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.

The promise from LHD chief executive Michael DiRienzo follows a decision of the NSW Industrial Relations Commission supporting the union’s case at Belmont Hospital, and a spirited public protest by nurses at John Hunter Hospital.

NSWNMA members have been battling for months to get management to fill nursing vacancies and replace absent staff with ‘like for like’ at both hospitals.

Their actions have forced management to take steps to meet Award minimums of six nursing hours per patient per day (NHPPD) at John Hunter and five NHPPD at Belmont.

In addition, the NSWNMA is pushing for sufficient extra staff to be hired to fill short-term, unexpected vacancies, for example sick leave, to eliminate the need for nurses and midwives to stay back on forced overtime.

The NSWNMA also insists that registered nurses and registered midwives are replaced by other registered nurses and midwives when those vacancies occur.

NSWNMA General Secretary Brett Holmes said the union asked the LHD for access to rosters and other data so it could accurately determine the extent of understaffing at both hospitals.

“When management refused this routine request we used our rights under the Industrial Relations Act to get access,” he said.

“The hospital documents revealed serious breaches of Award staffing provisions.”


Understaffed by nearly 7000 hours

The data showed John Hunter was understaffed by 6696 hours below minimum legal requirements over
a seven-month period.

John Hunter nurses responded with a massive protest at the hospital’s main campus (see story page 12).

Belmont Hospital data also showed widespread flouting of NHPPD minimums. Between January and August there were only two weeks during which staff levels complied with the Award.

The NSWNMA lodged a dispute over Belmont Hospital with the industrial Relations Commission.

It recommended that Hunter New England LHD comply with the Award, inform NUMs of the minimum staffing requirements in the relevant units and wards, and carry out spot checks of the data until December (see story page 10-11).

“The commission’s recommendations are a significant win for members on all wards and units,” Brett said.

CEO Michael DiRienzo told The Newcastle Herald there was no excuse for failing to meet NHPPD ratios at John Hunter and Belmont hospitals.

“I am taking this very seriously and personally managing this issue to ensure that we meet this important award requirement,” he told The Herald.

He said all units had always been “appropriately budgeted” to meet award minimum nursing care hours.

The paper added: “Mr DiRienzo said there was no excuse for not meeting the ratio, but issues such as non-compliant and incomplete rosters and increased demand on services had been contributing factors.”

“Our nursing staff work incredibly hard and I know this has affected them. For that I’m also very sorry,”
he said.

“We are fast tracking recruitment to all vacancies, working closely with nurse unit managers to improve rostering practices and have implemented a robust monitoring program that includes weekly reports to me to ensure compliance.”

Shortages will leave a scar

A Herald editorial comment welcomed Mr DiRienzo’s “acknowledgement of the pressures his staff are under and the vital work they do, and his vow to improve the situation”.

“But symptoms of the condition have been present for at least nine months, likely more, and it seems treatment, rather than finger pointing, is only occurring after tensions escalated and exhausted staff said enough was enough.

“How many experienced nurses has the delay in rendering first aid cost us? And how big a scar will that leave?” the paper asked.

A John Hunter midwife told The Herald she worked five shifts in three days the previous week.

She said the problem had become increasingly worse in the past three to four years – dismissing management’s previous claim that a busier than usual flu season was behind the problem.

“I hate coming to work, it’s awful,” she said. “Patients suffer, we’re losing senior midwives at a rate of knots, we have juniors that haven’t got as much experience or may not be registered nurses and they’re not well supported by the senior midwives because we don’t have any time.”

A nurse working at the hospital told The Herald that nursing staff had been forced to work double shifts with little notice, sometimes three-to-four times during a single week. It meant they were often missing out on sleep.

He said some areas of the hospital, such as “day stay” and the dialysis unit, had been temporarily converted into wards to accommodate extra patients.

“And then they expect us to staff the extra beds when we are already understaffed. Everyone is burned out and exhausted, and you have nurses administering drugs when they have gone the whole night without having a sleep. They are flogging us into the ground.”