NSW Nurses and Midwives Association (NSWNMA) members at Dubbo Hospital voted to suspend for two weeks the planned closure of the hospital’s Emergency Medical Unit’s (EMU) six beds, after hospital management agreed to try and fill, as quickly as possible, the large number of nursing vacancies in the hospital’s emergency department.
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Two weeks ago the nurses voted to close the six beds from Monday, September 30, and ban unreasonable overtime in the emergency department (ED) from Friday October 4, in response to unsafe nursing levels in the ED.
However, hospital management put forward a plan last week to deal with the high number of vacancies and the nurses were prepared to give management two weeks to implement it. The ED nurses continued to refuse to do unreasonable overtime to cover the vacant positions.
During the two-week suspension of bed closures the nurses would closely monitor the implementation of the management plan and would not hesitate to act quickly, if required, to protect safe nursing levels. A full assessment of the situation will be conducted by the NSWNMA Dubbo Base branch at the end of the two weeks.
Dubbo Base ED has 20 beds, including the six EMU beds, two resuscitation beds, three consultation rooms and a patient chair. The NSWNMA believes there are currently nearly nine full-time-equivalent nursing vacancies in the ED, including three on maternity leave who have not been replaced. As a result, about 60 ED shifts still have to be filled during the two-week period.
NSWNMA assistant secretary, Judith Kiejda, welcomed Dubbo Base management’s belated acceptance of the seriousness of the nursing shortage, but said the issue continued to highlight the need for mandated, minimum nurse-to-patient ratios in all hospital clinical areas, including EDs.
“The failure of the Western NSW LHD to fill these positions until things got to this dramatic stage, even with agency nurses while they recruit permanent nurses to the vacancies, proves why local managers cannot be left to handle these things without such compulsory minimum staffing levels,” Ms Kiejda said.
“The overemphasis on budgets at the expense of patient care and safety is unacceptable in a country like Australia.
“The people of Dubbo and surrounding regions that depend on Dubbo Base deserve better than this from the state government.
“It is unsafe for patients and staff not to have these vacancies filled and the ED nurses were right to act decisively. All nurses and midwives have a professional obligation to ensure safe patient care and no employer can ask or expect a nurse or midwife to work unsafely.
“The Dubbo ED is a very busy place and a vital part of the healthcare system for people throughout western NSW. There were 28,061 presentations for the year 2012-13, which has mostly remained the same for the past four years.
“Over that time Triage 1 presentations, or life threatening presentations, have increased by 134 per year, Triage 2 have increased by 320 and Triage 3 by 936. Triage 4 and 5 presentations, the less serious cases, have actually decreased over the past four years.
“In recent years there was also a big increase in the length of time many patients stay in the Dubbo ED. In 2008-09 162 patients were in the ED more than 24 hours. This blew out to 546 last year. So it is absolutely essential that this ED has safe nursing levels at all times.”
The first round of enforceable, minimum nurse-to-patient ratios were introduced into general medical and surgical wards in most NSW hospitals as part of the 2010-11 award negotiated between the NSWNMA and former Labor government.
