HUNTER patients have missed out on thousands of hours of nursing care due to understaffing of the region’s public hospitals, prompting the NSW Nurses and Midwives’ Association (NSWNMA) to campaign for “better, more transparent” nurse ratios.
“For every additional patient per nurse, it increases the likelihood of a patient dying by 7 per cent within 30 days of their admission,” Brett Holmes, the general secretary of the NSWNMA, said.
“Year on year, presentations to our public hospitals rise, and nurses and midwives are being forced to take on that increased workload. It’s not right and it’s not safe.”
In the past year, in six NSW hospitals, the union discovered about 26,000 hours of missed clinical nursing care – including almost 7000 at John Hunter Hospital – as a result of a manipulation of the award to save costs, Mr Holmes said.
“What happened at John Hunter is proof that with the system we currently have, it is far too easy for management to fail to deliver proper outcomes,” he said.
“We want to change having an hours-based system balanced over seven days, to a straight ratio that is on a shift-by-shift basis to avoid that situation where there was more than 6500 nursing hours not delivered.”
The NSWNMA is asking for one nurse to three patients in emergency departments, paediatric wards and critical care units; a minimum of one to four in rural and regional hospital wards; an improvement of ratios in mental health and rehabilitation units; and for babies to be counted in the ratios on maternity wards.
Elizabeth Grist, Hunter New England Health’s nursing and midwifery executive director, said Hunter hospitals were currently meeting the required minimum nursing hours in the State Award.
“We have better supported our Nursing Unit Managers to ensure appropriate rostering in all wards. The district is also undertaking regular checks, particularly at John Hunter and Belmont hospitals, to ensure compliance.”
Measures were in place for the increased demand predicted for flu season, and a sustained flu vaccination campaign also targeted staff.
“Like the community, our staff members are also more susceptible to flu and flu-like illness during this time of year,” Ms Grist said.
“Staff meet each morning to assess the capacity of the hospital at that time and the planned activity for the day. From this meeting we know which areas of the hospital have capacity for additional patients, and determine if surge areas need to be made available. If surge capacity is required, it is appropriately staffed and we are recruiting 30 full-time equivalent staff to assist with the demand and to backfill short-term sick leave.”
Mr Holmes said patient ratios also needed to be consistent across all hospitals.
“Patients deserve the same level of nursing care no matter where they are presenting to a health service,” he said. “For example, a patient with pneumonia being looked after at Kurri Hospital deserves the same level of care as a patient who is fortunate to be in the John Hunter catchment receives for pnemonia there.
“The difference is that on average, there is an extra hour of direct care per day being allocated to those patients at John Hunter compared to Kurri.
“And our members at the Children’s Hospital at John Hunter have lower nurse to patient ratios than the Sydney Children’s hospitals.”
“We believe, as a minimum, they should have one staff to three paediatric patients. We are also claiming guaranteed nursing ratios in neonatal intensive care, and other critical care areas, where there are currently no ratios,” he added.
Mr Holmes said there was increased pressure on the emergency department at John Hunter Hospital, which also had no guaranteed ratios.
In a recent survey of 2500 nurses and midwives working in the public sector across NSW, seven in 10 said they had “seriously thought” about leaving the profession, with almost all citing workloads and inadequate staffing levels as the cause, Mr Holmes said.
Patient safety was a major concern for 73 per cent, with more than 90 per cent believing ratios would improve patient safety and workloads.