Fix the nursing crisis, fix the system
by Marcus Browning On October 18 nurses throughout NSW took strike action as part of their campaign for a pay rise and special retention and qualification allowances which nurses say will help overcome a major nurse shortage in the State. The strike by nurses is the culmination of the three-month campaign, "What's a Nurse Worth?", and reflects a broader crisis afflicting Australia's public health system. More than 24,000 nurses took part in the action on October 18, from 7am to 4pm, which was coordinated by 150 branches of the NSW Nurses' Association (NSWNA). So that patients were not put at risk night-duty staffing levels were in place in all clinical areas and critical care staffing levels were maintained. The "What's a Nurse Worth?" campaign was launched in July. For three months nurses have imposed work bans, held stop work meetings and organised rallies at hospitals and community health services. The union says that hospital and health services around the state have been cut because there are insufficient nurses to staff them. The NSWNA have lodged a log of claims before the NSW Industrial Relations Commission. However, the Carr Government has refused to initiate urgent action to resolve the dispute. This is despite the Government acknowledging the existence of the nurse shortage. The NSWNA claim an increase in all existing wage rates of 15 percent. This would be in addition to all remaining increases due under the current wages agreement i.e. three percent from January 1, 2001; four percent from January 1, 2003; and five percent from July 1, 2003. The claim for "qualification allowances" to be inserted in the award include: * Hospital certificate or graduate certificate — $40 per week; * Post-graduate diploma or degree (other than a nursing undergraduate degree) — $60 per week; * Masters degree or doctorate — $75 per week. The payments would go also to nurses employed on a part time or casual basis. The claim for "retention" allowance payments, includes: * Any nurse who completes two years continuous service in the public health system to be paid a lump sum retention allowance of $10,000 and a further amount of $5000 on the completion of each 12 months service thereafter; * The first such payment shall be made to nurses who have completed at least two years continuous service as at the date of commencement of the inclusion of the clause in the award; * These allowances are to be paid on a pro-rata basis to part-time employees. The Commission has set aside November 30, December 5 and December 6 for hearing final submissions, with the result that the decision will not be given until next year. Nationwide The actions by nurses around Australia have been sparked by the same issues: nurse shortages as a result of governments running down the public health system. Following the strike by NSW nurses the Federal Secretary of the Australian Nursing Federation (ANF), Jill Iliffe, noted that the nation-wide discontent demonstrated that nurses were no longer prepared to tolerate the situation. After a long and determined struggle nurses in Victoria last month started a new era and began their shifts with nurse-patient ratios of 1:4 as part of their award. This is a step towards addressing the critical nurse shortage in the State. ANF Victorian Secretary, Belinda Morieson said: "Victoria is now the first place in the world that has cemented nurse-patient ratios, which means public hospital patients in existing and new services will be cared for by a mandated, safe, minimum number of nurses on each shift." Lee Thomas, South Australian ANF Branch Secretary, says that South Australia is suffering from a nursing shortage at crisis point. "We are between 700 to 1000 nurses short", Ms Thomas told The Guardian. "And we know the nursing shortage is not going to get any better unless we very quickly examine a whole range of strategies that sees things like increased numbers through the tertiary sector and the ability to be able to fast track, obviously still maintaining the professional skills and theory that is required. "But even if we increased the numbers going through the university programs from today, it would still be three to five years before we would see any increase in our numbers. It is critical in South Australia, as it is in many other states in Australia, that we act very quickly." The ANF in South Australia is working with the Department of Human Services, as well as the tertiary sector and hospitals, to increase nurse numbers. "One of the problems we have here is that there are many nurses who have left the profession, either permanently of temporarily, and we need to get them back nursing again." Workloads are central to the problem, said Ms Thomas. "One of the absolute contributing factors in nurses leaving the profession is that they just cannot balance work and family life anymore, because of the number of hours they're required to work, and the stress that they're put under in their workplace." The Olsen Government refused to consider proposed nurse-to-patient ratios as the Victorian Government did. Meanwhile, at the University of Sydney, management intends cutting 18 full- time staff positions from its nurse training facility even while promising to increase the student intake. The University's National Tertiary Education Union branch Secretary, Bronwyn Winter, said it was fine to increase the number of students, "but we fail to see how the students will receive a good education, when the dean plans to slash staffing levels. "This is of considerable concern at a time when the quality of health care is coming under increased public scrutiny and we have a Senate inquiry into the state of the nursing profession. What we need is a sound education for nurses to maintain standards." NSW Chief Nurse, Judith Meppem, said a major concern was that the university cuts were targeting midwifery and community health. "They are two of the top ten specialty areas for which we have ongoing vacancies."