Staff act on Campbelltown’s maternity crisis

Campbelltown Hospital’s NSWNMA branch wants urgent action to alleviate pressure on its understaffed and overworked maternity unit.

Midwives and nurses have rallied outside Campbelltown Hospital to call for urgent action to fill staff vacancies in the maternity services.

The NSWNMA’s Macarthur branch voted unanimously to organise the rally after hospital management failed to commit to action that would ease workload pressures and safety concerns.

The maternity clinic, birthing unit and postnatal and antenatal wards are all severely understaffed.

According to Birthrate Plus calculations, Campbelltown maternity service should have 119.85 FTE (full-time equivalent) staff.

However, the service is understaffed by approximately 45 FTE positions, data collected by the NSWNMA revealed.

In a letter to hospital management, the branch said “huge vacancies and lack of resources is putting women, babies and staff at risk.  We have been understaffed and overworked for a substantial period.”

The branch called for action to “immediately ensure the safety of the women and babies of Macarthur”, including:

  • Employ midwives to fill all vacancies within six months
  • Employ agency midwives to cover vacancies and staffing shortfalls while waiting for staff to be recruited
  • Employ ward clerks for the birthing unit and postnatal/antenatal wards
  • Increase staffing of the maternity services (early discharge) program by two FTE staff and supply laptops
  • Increase midwifery group practice staffing to a minimum 14 FTE
  • Implement a 12-hour roster in postnatal or across the whole service
  • Have only one non-midwifery staff member on every shift in post natal/antenatal wards.

Branch member and midwife Cathy Bikoff said staff were exhausted by the pressure of having to work unwanted overtime and desperately needed solutions.

Staff working double shifts

Management’s delay to agree to a 12-hour roster meant staff had to work double shifts totalling 17 hours, particularly in the postnatal and antenatal units.

“Some of us are starting at 1:30pm and not leaving until 7am. People force themselves to do overtime because they don’t want to see their colleagues suffer from being left short staffed,” she said.

Members at Campbelltown’s birthing unit believe it should be staffed at seven, seven and five, morning, evening and night.

 Instead, the numbers are often five or six on morning and evening shifts and four at night.

Morning and evening shifts often comprise four midwives aided by two students or five midwives and one student.

Night shifts are either four midwives or three midwives and one student.

Meanwhile, patient acuity has increased because the service now handles births at 32 weeks rather than 34 weeks as previously.

“To make matters worse, the birthing unit hasn’t had an educator for 18 months and the wards haven’t had one for 12 months,” Cathy said.

The postnatal ward should be staffed at six, six and five midwives but staffing is usually four midwives together with a student and an assistant in nursing, assistant in midwifery or enrolled nurse.

Evening shifts are often staffed by three midwives and an EN, or two midwives and two ENs. That requires each midwife to care for up to 15 mothers and their babies.

Inadequate antenatal care

Cathy said the ward was supposed to be staffed for 30 beds but occasionally had 34 beds occupied.

“Sometimes we have to close at 30 beds and the mothers and babies we can’t accommodate have to share a birthing room overnight.”

Campbelltown’s maternity clinic is supposed to take 80 bookings a week but can only manage 60 because it is short staffed by five FTE.

“That means 20 or so people are missing out on early clinic visits and may be getting inadequate antenatal care because some ladies aren’t booking in until 24 weeks or 25 weeks.”

Short staffing is also affecting the maternity services program, which is aimed at enabling early discharge from hospital.

Under the program, women are supposed to go home within 24 hours of giving birth and be seen at home a day after leaving hospital.

However, with only three staff available, as many as six mothers may have their home visit delayed by a day.

The delay risks late detection of jaundice, an infection or 
illness that would require a baby to be readmitted to the nursery, Cathy said.