30 April 2008

 

Prince of Wales emergency department nurses to start work bans tomorrow morning

Hospital and AHS management have failed to addressserious problems with patient and staff safety

 

NSW Nurses Association (NSWNA) members in the emergency department (ED) at Sydney’s Prince of Wales Hospital (POW) will start work bans at 8.30am tomorrow, May 1, in an attempt to better handle the large number of mental health patients presenting at the hospital, and being kept in the ED, because of the lack of mental health beds in NSW.

 

The decision was taken at a special NSWNA branch meeting at Prince of Wales Hospital late this afternoon. It follows POW and South Eastern Sydney & Illawarra Area Health Service management’s failure to address the nurses’ concerns, presented to management yesterday, about the serious safety and patient care problems in the hospital’s ED. These problems result from a growing number of mental health patients presenting at, and being kept in, the ED.

 

NSWNA general secretary, Brett Holmes, said yesterday’s nurses’ meeting put a sensible plan to POW and AHS management about better ways to treat these mental health patients and manage the ED.

 

“The following resolution, from yesterday’s meeting, addresses both immediate and longer term solutions and the nurses are disappointed POW Hospital and South Eastern Sydney & Illawarra Area Health Service management have not responded appropriately.

 

Emergency Department Members of the POW branch of NSWNA met this afternoon (29 April 2008) to discuss the increasing risk to staff and patients as a result of the volume of violent mental health patients, some of whom have been scheduled in the ED for more than four days.

 

The occupational health and safety concerns and the inadequate resources to provide our duty of care to other patients is severely compromised. The Health Service has known that this problem has been in existence for 10 days and has not acted to resolve these risks.

 

Therefore we have no choice but to demand that:

 

1)  Private Security Firm - to be instituted in the ED from this afternoon and to continue until the ED Senior Nurse Manager is satisfied that the risk to staff and patients has been effectively reduced.

2) Alternative location outside of ED for aggressive, psychotic patients is identified immediately.

3) Capped length of stay (LOS) for mental health = 8 hours.

4) Transfer to Psychiatric Emergency Care Centre (PECC) whilst awaiting mental health bed.

5) Commitment from hospital that all specials (one-on-one nursing for a given patient) will be provided and no ED staff will be asked to do overtime to resource mental health load.

6)  Overcrowding escalation policy - first response solution:

·  ED over census with mental health:

i.   Opening of 1 West beds - appropriately staffed.

ii.  Over census Area PECC's

iii.  24 hours mental health medical care provided to ED

 

“These are perfectly reasonable and sensible proposals, but little has been done to achieve them or even indicate that hospital management wants to achieve them. The only real action taken so far is the stationing of full-time security in the ED. That is fine, but not a complete solution for either the patients or staff.

 

“Therefore, these professional nurses will take the only course any responsible professional can take and implement measures that make the POW ED safe for patients, including the mental health patients, and staff alike.

 

“The measures to start from 8.30am tomorrow include:

 

·          refusing to do overtime shifts – which are currently being excessively used by management to deal with the situation in the ED - in an attempt to avoid fatigue;

 

·          all scheduled (under the Mental Health Act) mental health patients are to have their own individual nurse (a special), who is appropriately mental health qualified or skilled, or two ED beds will be closed for each scheduled mental health patient who does not have such an arrangement;

 

·          closing two ED beds for each mental health patient who remains in the ED longer than eight hours, irrespective of whether or not they have “a special”;

 

·          the senior nurse in charge of the ED activating a Code Yellow (the ED is at capacity and cannot take any more ambulances, etc) at his/her discretion;

 

·          closing two ED beds for each mental health patient who has been allocated a bed in another unit, but not transferred within one hour of the allocation; and

 

·          calling in the Visiting Medical Officer (VMO) psychiatrist if the psychiatric registrar does not respond to the ED within two hours.

 

“These measures will continue until a satisfactory solution, that meets the needs of patients and staff, is reached. There is clearly a need for more mental health beds in NSW and across Australia. This mess at POW is not unique. For a number of social and public policy reasons our hospitals are dealing with increasing numbers of mental health patients and they are struggling to cope.

 

“This is not good for the mentally ill, who need special care. It is not good for hospital staff and it is certainly not good for other members of the public who need, and have a legitimate right to expect, that our hospitals can respond to their various illnesses and injuries without all this drama and violence,” Mr Holmes said.

24 April 2008

Torres Strait nurse-security up-date

Historic OH&S breach notice served on Qld Health

Nurses across Queensland will do a security audit of their workplaces on Monday

Today’s announcement that Workplace Health and Safety Queensland has issued a notice of breach under the Workplace Health and Safety Act 1995 to Queensland Health, following investigations into the alleged rape of a nurse at Mabuiag Island Health Clinic in the Torres Strait, is a significant step forward for workplace health and safety in Queensland, the Queensland Nurses Union (QNU) said today.

Today’s announcement by Queensland Department of Employment and Industrial Relations director-general, Peter Henneken, follows weeks of industrial and community outrage over the issue. At one stage nurses withdrew from certain Torres Strait islands until a range of security problems at their clinics and accommodation were fixed. The Queensland Industrial Relations Commission also took a keen interest in resolving the matter.

QNU assistant secretary, Beth Mohle, said this is one of the first such notices issued to a public sector agency under the new occupational health and safety (OH&S) Enforceable Undertaking regime introduced by State Cabinet in September 2007.

“Prior to this occupational health and safety laws were hard to enforce in the public sector because the crown could not prosecute itself. The new Enforceable Undertaking regime closes that loophole, by giving Workplace Health and Safety Queensland the power to issue enforceable notices like this one.

“The new regime was introduced after years of lobbying by union officials and members and today’s decision will restore the faith of most nurses and other public sector workers in the OH&S system. It shows that even a body as large as Queensland Health can now be forced to comply with the OH&S laws.

“Queensland Health should accept the decision and immediately appoint a senior officer who has the Statewide authority to ensure compliance across Queensland Health districts with the directives of Workplace Health and Safety Queensland and the requirements of the Workplace Health and Safety Act 1995.

“Nurses also welcome the decision to review the policies and procedures developed by Queensland Health regarding security arrangements for remote accommodation and how these are being implemented. Security for nurses and other public sector workers in remote areas has been a serious problem for many years and the implementation of measures to address it has been very poor.

“Finally, the issuing of an improvement notice requiring Queensland Health to implement and monitor appropriate security systems across Queensland, to ensure these are maintained to a level that ensures worker safety, is another significant decision made possible by the new OH&S Enforceable Undertaking regime.

“To assist this process QNU members across the State will conduct their own security audits of their workplaces or work areas this Monday (28 April) – the International Day of Mourning for people injured or killed at work. They will report their findings to their employer. Any very serious issues will also be referred to QNU officials for immediate action,” Ms Mohle said.