Emerald nurses start work bans over unsafe staffing, 14 incident reports in 4 weeks

At 7.00am on 29 April 2002 Queensland Nurses Union (QNU) members at Emerald Hospital started implementing work bans over unsafe workloads and a dangerous midwife shortage at the hospital.

The midwife shortage at Emerald has been an on-going concern for staff and management. Emerald Hospital is supposed to have at least 4.2 full time equivalent (FTE) Level 1 registered nurses and 3.2 FTE level 2 registered nurses to cover midwifery shifts at the hospital. At present there are only 3.2 level 1s and 2 level 2s available.

QNU members are also concerned that, after hours and on weekends, there is only one registered nurse on duty in the Accident and Emergency Department (A&E).

• In the last four weeks nurses have completed fourteen incident forms, outlining problems largely caused by the midwife and A&E shortages. Some examples are:Only one nurse left on the main ward because two were required in the labour ward; 
• Only one registered nurse (RN) and one enrolled nurse (EN) left on ward because one RN and one EN had to assist in the A&E and then there was also an emergency back in the ward; and 
• Regular interruptions to work practice and pill rounds due to nurses having to provide assistance in A&E. 

QNU Secretary, Gay Hawksworth, said greater effort is needed to get more midwives into Emerald and extra nurses are also needed in A&E, especially after hours and on weekends.

"Very few casual midwives are available in Emerald and when someone gets sick or is on leave then real problems develop across the hospital. Management has also removed the ward clerk from the main hospital ward and busy nurses are expected to do even more paper work."

"It doesn't take much imagination to visualise the problems confronting Emerald nurses if there is more than one birth in progress or things get busy in the emergency department, especially at night or on a weekend. Hopefully this industrial action will force a long term solution to these staffing problems." Ms Hawksworth said.

So they can better concentrate on their clinical duties, the work bans being implemented by Emerald Hospital nurses target administrative and other non-clinical duties, such as:

• No first-line answering of phones between 7.00am and 10.00pm, including on weekends; 
• No locating and collecting of client charts from Medical Records between 7.00am and 10.00pm, except during medical emergencies; 
• No inputting of data on HBCIS; 
• Midwives not entering the electronic birth registrations until after the mother is admitted by administration staff; and 
• No cleaning of spa bath by nursing staff after use. 

Emerald Hospital is a 35 bed facility, with about 40 nurses.

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30 April 2002

Lutheran aged care nurses walk off the job for three hours marching through Milton to Lutheran headquarters in McDougall St - 30 April 2002

March time: 10.15am
March route: from Milton Park, down Milton Rd to Park Rd, down Park Rd and then left into McDougall st.

Nurses at the Lutheran Church's three aged care facilities in Brisbane and the Gold Coast have walked off the job from 9.00am Tuesday 30 April and will march through Milton (from 10.15am) to the Lutheran church headquarters in McDougall St where they will protest at the Lutheran church's continuing refusal to give them wage parity with their public hospital colleagues.

Today's strike action at the Zion (Nundah), Trinder Park and St Andrew's (Gold Coast) facilities follows similar action taken at various facilities earlier this year and is part of a campaign for improved wages and staffing levels by nurses at the Lutheran Church's ten Queensland aged care facilities. Work bans started in the ten facilities in December.

Queensland Nurses' Union (QNU) Secretary, Gay Hawksworth, said the Lutheran Church has been staling for two months on its promise to let the QNU look at its financial records.

"And the Church is still refusing to provide pay and conditions equal to those received by public hospital nurses. The aged care sector is suffering a serious shortage of nurses and unless something is done, and done urgently, to improve wages and staffing levels in Queensland nursing homes then things will get much worse. The Lutheran nurses have decided to make this point to the wider community by marching and rallying in Milton today."

"The quality of aged care services is a community concern and everyone, including local councillors, should take an interest in the way the aged care system operates. Care of the elderly is everyone's business. It is a measure of the type of society we are."

"The serious nurse shortage in aged care is a fact acknowledged by nursing home operators themselves and the issue was also a major one for both main parties in last year's federal election campaign. Things are so bad at places like Trinder Park I am advised that it has to use agency nurses to fill 120 shifts per month."

"This is very strange given the cost of agency nurses. The current pay rise being offered by the Lutheran Church is certainly not sufficient to make aged care nursing competitive again and we believe the Church can do better," Ms Hawksworth said.

Examples of the current pay gap between Lutheran aged care nurses and nurses in public hospitals are as follows:

Ms Hawksworth said it is a major injustice that nurses working in Lutheran aged care facilities are so poorly paid when compared with nurses in other sectors.

"And the heavy workloads being imposed on aged care nurses makes the injustice worse. Only last year the Queensland Industrial Relations Commission heard evidence of seriously low staffing levels in one Lutheran aged care facility in Queensland," Ms Hawksworth said.

"The Lutheran Church's pay offer of six per cent over two years will, at best, simply maintain the massive pay gap and may even make it worse, depending on the pay rises negotiated in the next round of public sector negotiations."

"Its failure to agree to provide improved staffing ratios also suggests the Lutheran Church is happy to continue imposing heavy workloads on its nurses, even though they are so underpaid."

"Well the fact that the nursing staff are prepared to walk off the job for three hours today, indicates the extent of their frustration with the situation. And in the interests of quality aged care and good staff relations the Lutheran Church should address their concerns about pay and workloads," Ms Hawksworth said.

As well as wage parity with the public sector and improved staffing levels, QNU members at Lutheran Church aged care facilities are also seeking long service leave and maternity leave arrangements similar to those provided to public sector nurses.

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17 April 2002

Major QIRC decision could lead to widespread action against employers for overworking their staff

At the invitation of the Queensland Industrial Relations Commission (QIRC) the Queensland Nurses' Union (QNU) will start taking individual aged care employers to the Commission to stop them imposing excessive workloads, which jeopardise the personal health and safety of nurses, their professional and dedicated attention to quality resident care and in some cases their professional registration with the Queensland Nursing Council.

In a decision that could have widespread consequences for Queensland employers who impose heavy and unsafe workloads on their staff the full bench of the AIRC, in rejecting a QNU request for industry-wide staffing and skills mix ratios in the aged care industry, has ruled that:

"In the case of a particular facility or group of facilities in which it can be demonstrated that employees are being required to assume unjust or unreasonable workloads, there is the likelihood that the Commission could intervene to prevent industrial unfairness by way of amending the Award to insert a skills mix or staffing ratio which has application to the particular facility or group of facilities…

… We have been mindful of the general preparedness of those involved in the provision of nursing care to ensure that the needs of the residents are met regardless of whether this imposes an excessive workload on them and/or requires that they work unpaid overtime. We are concerned that some operators of aged care facilities may use, to their advantage, the caring nature of those employed in the provision of nursing care in residential aged care facilities to place an unfair or unreasonable workload on such employees. We cannot condone the working of unpaid overtime.

We have also been conscious of the special situation of registered and enrolled nurses and the penalties to which they are exposed where staffing levels render it difficult or impossible for them to meet standards set by a nurse regulatory authority or where, by practising at a sub-standard level, they face a risk of disciplinary action or the cancellation of their registration. Once again we would re-iterate that the Commission would be likely to intervene where it could be established that a facility or group of facilities was placing the registered or enrolled nurse in such jeopardy."

QNU Secretary, Gay Hawksworth, said the QIRC has found that workloads for aged care nurses have increased in recent years, but because of the diverse nature of the industry it would be difficult to impose an industry-wide formula.

"However, we believe it has extended a clear invitation to the QNU to bring individual employers, one at a time, into the Commission for scrutiny. That is what we intend doing and QNU officials will meet this Friday to initiate that campaign," Ms Hawksworth said.

"This QIRC decision sends a strong message t aged care employers, and all employers in all industries in fact, that unjust and unacceptable workloads are not on. The QIRC has stated in no uncertain terms that it will act to stop employers overworking their staff in this way. This is a welcome development in these days of workplace deregulation and I am sure other unions will be having a close look at this decision."

"Significantly, the QIRC has also commented on the lack of concern for staff shown by the Federal government's controversial Aged Care Standards and Accreditation Agency. The decision also has a fair bit to say about the impact of Federal Government legislation and funding on the staffing situation in aged care facilities."

This case started in August 2000 and the full bench that heard the case was vice president D. Linnane, and commissioners Bloomfield and Swan. Hearings were conducted in August, September and October 2000 and February, March, April and May 2001 and lasted around 50 days. More than 40 witnesses gave evidence and the documentary material, including witness statements were extensive.

The QNU was seeking mandated minimum skill mixes and staffing ratios for residential aged care facilities covered by the Queensland Nurses Aged Care award, as a means of reducing excessive workloads and improving working conditions for nurses in the industry.

It believes that, especially after the Federal Government's deregulation of the nursing home and aged care hostel sector in 1997, nursing workloads in many facilities have increased dramatically. This has put at risk the well-being of nurses and residents in these facilities. It has also exposed nurses to increased risk in terms of their statutory professional obligations including their duty of care obligations. The QNU also believes that heavy workloads and poor working conditions in the aged care sector are a major reason for the nursing shortage now confronting Australia.

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