Ratios remain our long-term goal

The NSWNMA welcomes the government’s commitment to fund more nurses in the 2019-20 budget but we still maintain ratios are the key to safe patient care.

First the good news. In the 2019-20 budget, the state government has committed to fund the 5000 extra nurses for our public health system that it promised during the election campaign.

We are still waiting to receive any specific details from NSW Ministry of Health regarding the election commitment to significantly increase resources across Peer Group B and C hospitals across 
the state.

The increase in nurse and midwife numbers will go some way towards meeting the ever-increasing demand on public health facilities and give a boost to nursing hours per patient in many metropolitan and regional hospitals.

We acknowledge this as a positive contribution and a good first step towards fixing NSW’s creaking public health system.

But much more needs to be done. We still believe there will be ongoing staffing issues in our public health services until the government overhauls its 
preferred staffing model.

The current mechanism has proven fallible to management manipulation. It requires constant action by nurses and midwives to force management to act to fill glaring shortfalls in staff.

In this month’s Lamp we look at several examples of nurses closing beds in order to get local managements to act on, or at least to acknowledge, the data that exposes the failure to meet increasing demand with appropriate resources.

This is why we will continue our long-term campaign for real nurse-to-patient ratios, guaranteed shift by shift.

We know that without minimum nurse-to-patient ratios, nurses and midwives will continue to struggle to meet demand and maintain safe patient care.

There were other measures in the state budget which should put nurses and midwives on the alert. The government flagged that it will axe almost $3.2 billion from other areas of the public service, with thousands of jobs to go and aspects of long-service leave entitlements on the list to be abolished. Fortunately, for now, the upper house non-Government members voted down the government’s first attempt to enact these changes.

But it is not unreasonable to ask: “When will they be coming for our long-service leave again?”

The scourge of violence persists

Ratios are not only needed to improve clinical safety in our health system they are also, at least, a part of the solution to the endemic violence in our hospitals.

In this month’s Lamp we look in depth at the unresolved crisis of violence that continues to jeopardise the safety of patients and health staff (pp 16-25).

Over the years there have been a procession of inquiries, reviews and roundtables that have failed to make a dent in the number of violent incidents.

Research by Dr Jacqui Pich from UTS has shown the magnitude of the problem with massive numbers of nurses and midwives exposed to violent incidents on a regular basis. Frighteningly, there is a tendency to accept and adapt to the violence as “part of the job”. A recent incident at RPA when three nurses and an elderly patient were attacked and stabbed with a pair of scissors by a mental health patient, but within a medical ward, threw into stark relief the seriousness of the problem.

The attacker had been specialled by an agency AIN, a situation the Association strongly believes was inappropriate.We understand that the issue is complex and there is no silver bullet to the problem of violence.

But one can argue that penny pinching by local managements contributes significantly to this crisis by failing to provide the right number of nurses with the right training to deal with violent emergencies.

Reports in other states have recommended adequate funding and resources to counter violence in hospitals. Having the appropriate number of staff with the right skill mix is an obvious part of the solution.