Rural and Remote Branch block move to cut RN ambulance role

Wilcannia’s ambulance service will continue to carry a registered nurse after intervention by the NSWNMA.

Management of Far West Local Health District has abandoned a proposal to remove registered nurses from the Wilcannia ambulance crew following representations from the NSWNMA’s Rural and Remote Branch.

Wilcannia’s Multi-Purpose Service provides 24-hour emergency and inpatient care and its ambulance has long been crewed by an RN and a driver.

Wilcannia is halfway between Cobar and Broken Hill. Its large Aboriginal population is the most socio-economically disadvantaged in the LHD.

Under a proposed new model of care (MOC), the ambulance was to be crewed by an endorsed enrolled nurse (EEN) with volunteer ambulance officer (VAO) training and an Aboriginal health worker (AHW).

While the ambulance was dispatched, the hospital was to be staffed by an RN assisted by a health and security assistant (HASA).

Wilcannia MPS staff believed the proposal represented a downgrading of services, with the potential to expose staff to ambulance cases outside their scope of practice.

Staff believed that substituting nursing staff with HASAs was an ill-considered attempt to make budgetary savings.

Branch delegate and president, Greg Cleary, raised staff concerns with NSW Health Minister Brad Hazzard during NSWNMA Annual Conference in July.

U-turn on policy

Greg told The Lamp the LHD’s outgoing chief executive and new general manager met Wilcannia MPS staff to hear their concerns last month.

“Fortunately the CEO and new GM agreed with staff that this was not a safe or workable system,” Greg said.

The senior managers “agreed in principle” that the new MOC “would no longer be pursued as an ongoing policy,” he said.

“Also, I have received a reply from the Health Minister stating that he understood that the CEO and GM would meet with staff to hear our concerns.”

Greg said staff appreciated management’s “new level of interest and consultation”.

“We may not have achieved such a result without the input and support of the NSWNMA.”

He said the Wilcannia ambulance regularly attends complex call-outs that demand training, skills and experience above VAO level.

Recent case examples have included major traumas such as multiple-victim vehicle accidents, two young children involved in a motorcycle accident, domestic violence and alcohol-related violence resulting in a range of injuries.

Most of these incidents resulted in flyouts by the Flying Doctor, with some classed as urgent.

“The staff felt that the EEN and AHW would be placed in compromising situations outside their skill sets and their scope of practice,” Greg said.

“It would also have left only one RN in the hospital with a non-nursing trained HASA, which is a direct breach of policy stating that there should be at least two RNs on duty at all times.

“Management’s attempt to reduce the number of nursing staff on call and on shift brought the NSWNMA’s attention to the fact that the award was already not being met and the new MOC would be a further breach.”