COVER STORY
Cobar nurses close beds A Local Health District’s refusal to spend $40 a day to re-establish an on-call roster at a small but busy rural hospital, has forced nurses to limit bed numbers.
MANAGEMENT PENNY-PINCHING
has forced Cobar Hospital nurses to limit bed numbers in support of an oncall roster. Cobar Hospital nurses capped inpatient numbers at five, plus two emergency admission beds, in October, after the Western New South Wales LHD refused to act on low nursing numbers, despite 14 months of trials and negotiations. Cobar nurses have gathered statistics to show that an on-call roster, at an annual cost of less than $15,000, would actually save the LHD money by reducing its overtime bill. The decision to close beds won strong support from local doctors and the general public. Cobar hospital has 21 in-patient beds and an emergency department and averages about 10 in-patients a day. It services a town of 5000 as well as outlying farms and a substantial mining industry. Both sectors have significant workplace injury risks.
NSWNMA General Secretary Brett Holmes said the LHD has been staffing the hospital with 52 nursing hours per day. This provides the basic 4.8 hours per patient for an average of 10 in-patients, with only four hours nursing work left for the emergency department. “Cobar nurses have been arguing for more than a year that this is unsafe – especially without an on-call roster – and a number of recent clinical incidents and near misses confirm their concerns,” Brett said. “Based on the current award rates, we estimate that one on-call nurse, between 11am and 11pm each day, will cost the government just under $15,000 a year or about $40 a day. “We don’t understand why such an isolated but busy place like Cobar is being denied the protection of a basic level of safe hospital services.” The hospital previously had two, eight-hour nursing shifts and one sixhour nursing shift for both day and
evening shifts – 2.75 FTE staff – until district management scrapped the two six-hour shifts in July 2011. Management claimed admissions data did not justify 2.75 FTE staff, but nurses said the numbers did not reflect the acuity of the patient load and other factors. Concessions were made after nurses threatened to cap bed numbers and ban some duties. Nurses accepted a three-month trial of new arrangements, including partial restoration of nursing hours, with an escalation plan and on-call roster. Cobar Hospital RN Genie McMullen said the trial worked well but management insisted on a second trial. This included an escalation plan and on-call roster but no six-hour shifts. After the second trial management decided to abolish six-hour shifts and the on-call roster, though the escalation plan would stay. “Losing the on-call roster was a huge blow and we were very disappointed.
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12 | THE LAMP NOVEMBER 2012