Page 2300 - Week 08 - Wednesday, 29 August 2007
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they are most concerned that they are becoming increasingly unable to provide the level of care they want to give their patients. I think Colleen Duff referred to it as a factory mentality. Nurses say they have to psych themselves into going to work because of the intolerable conditions.
By way of a suggestion, perhaps team nursing could be reviewed. I am simply told that it is not working out how they thought it would. A potentially serious situation is arising whereby, as the more mature workforce leaves the profession, nurses just out of training are being left in areas like the emergency department. There are major concerns that patients are being sent back to the general wards from the intensive care unit far too soon. Nurses say that after-hours coordinators are cancelling night staff. Why is that? Despite money being spent on an anti-bullying program, nurses say they are still subject to bullying in the workplace. Too much stress and too little help from management are mentioned by some nurses as making their work burden often intolerable.
It is interesting that the ACT health minister is trying to have it both ways, by saying there are no problems in the public hospital system while then making excuses for the problems. The minister has stated that the ACT is ready for a disaster but is admitting, albeit indirectly, that the system is only just about coping with an increase in patients due to winter ills. Nurses believe that hospital management is top-heavy and there are just enough people to do the patient care. Double shift requests are commonplace. Nurses are still being told by senior nursing staff to take more patients onto the wards, regardless of staffing levels.
Let us now look at patient care. Nurses say, quite properly, that patient care is paramount, but the system is clearly not putting patients first. ACT public hospitals have the highest management costs in Australia, some 24 per cent above the national average, which has not translated into better services. It has also resulted in hospitals being driven by the needs of bureaucrats rather than patients and the doctors and nurses who care for them. Nurses are telling me that there is now too much paperwork for them to complete. Nurses tell me they were aware of the latest health plan but yet again were not directly consulted.
One of the key problems with management, as identified by nurses, is that the process used to calculate the number of nursing staff per patient per 24 hours on each ward is flawed. Apparently, the acronym for this is “WPPED”, and that is exactly what the nurses feels is happening to them.
The calculation presently being used does not take into account the acuity of a patient, which affects the degree of nursing care required. To make matters worse, these calculations, it would appear, also include administrative staff, who do not, of course, provide direct nursing care. This is why nursing staff find themselves so stretched and wards are being closed—because management is not managing workloads realistically according to the needs of patients. I am further told that new graduates are leaving because of their dissatisfaction with the unacceptable workloads and conditions. With an ageing workforce, there will be insufficient professionals coming through to take their place. Even more disturbingly, I am also told that many nurses are using up all their holiday leave, with the sole intention of leaving and getting out of the system. The problem has been building for 18 months to two years, and the government’s
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