Seachange Bulletin #130April 25, 2004Seachange Bulletin ArchivesEmail the editorSeachange Bulletin #130: Minimum RN-to-Patient Ratios I ml> Hospital industry critics of California's new law that requires minimum hospital ratios of registered nurses frequently rely on claims that, generally speaking, hospitals cannot afford to adhere to the law. If we knew the right economic facts, they hold, we could resolve the healthcare crisis and provide safe RN staffing for all patients - insofar as budgets allow. But the core problem isn't a lack of knowledge of "economic data points." It is the demand for the impossible - an attempt to economically legitimize the clinically illegitimate through a misplaced insistence on meeting the demands of the market rather than the needs of patients. Ultimately, the real issue boils down to values and choices, who made them, who didn't, and who must live - or perhaps even die - with them. The hospital industry is increasingly a victim of its own ideology - the alleged magic of the market that will assure that patients will have access to the appropriate staffing and the best quality care. That blinding ideology has been central to the industry's misreading on the limits of fiscal and clinical prudence, allowing it to squander billions on mergers, caregiver-skill-destroying technologies, and executive perks in pursuit of the elusive industry dual Holy Grails of market share and profit margin. ... Patient-ratio law ends 'nursing shortage' Rose Ann DeMoro, Executive Director, California Nurses Association, San Francisco Chronicle, March 18, 2004 <http://sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2004/03/18/EDGB 95M71K1.DTL> Imagine a hospital without registered nurses. Picture yourself in a hospital bed, in pain, recovering from a stroke or a serious accident, seeing an RN only once in eight or 12 hours, sharing her with 12 or 18 or 20 other patients. Envision your husband, mother or infant deprived of the proper care from an RN who does not have time to carefully observe the subtle changes in condition that can lead to instant death or permanent loss of function. Sound far-fetched? Not long ago that was the common order in many hospitals, especially with the rise of corporate medicine and managed care that put profits, market share and severe restrictions on services ahead of therapeutic healing and recovery, and that pushed thousands of nurses away from the bedside. That's the world some in the multibillion-dollar hospital industry want back. In 1999, California took a step back from the precipice of deteriorating conditions, enacting a long-overdue commonsense law that mandates a minimum level of on-duty nurses for safe care and requires staffing beyond that minimum if patients need more intensive care. Hospitals had four years to implement the law, and many did. But executives in the California Healthcare Association, the hospital industry's lobbying arm, are continuing their campaign to reverse the new patient protections. These are the same industry lobbyists who fought virtually every bill to improve the quality of care from crackdowns on HMO abuses to nursing-home reforms, and they have opposed efforts to expand health-care access. Their efforts come despite convincing evidence that decreasing nursing staffs can endanger patients' lives. The Journal of the American Medical Association, for example, has reported that each additional patient assigned to an RN increases the likelihood of a related death within 30 days by 7 percent. ... Sutter Delta nurses slam staff levels Hospital denies accusations it's overworking personnel, jeopardizing patients' lives Jason B. Johnson, San Francisco Chronicle, March 19, 2004 <http://sfgate.com/cgi-bin/article.cgi?file=/c/a/2004/03/19/BAGVU5NNKU1.DTL> Antioch - Nurses at Sutter Delta Medical Center in Antioch accuse the hospital of overworking them and putting patients at risk to skirt state staffing requirements. The nurses and their union, the California Nurses Association, claim Sutter refuses to hire enough registered nurses to provide adequate care, relying instead on cheaper, less skilled licensed vocational nurses. That, they said, requires them to care for more patients while supervising the vocational nurses. Sutter denies the allegation, saying it has hired scores of nurses and is complying with a state law that dictates nursing levels. The California Healthcare Association, which represents 450 hospitals, calls the charge unfounded and says the union wants to force Sutter into hiring more nurses. It also says vocational nurses are widely used in all hospitals. ... Nurses want to provide good care Claudia Harrison, RN, Modesto, Modesto Bee, March 23, 2004 <http://www.modbee.com/opinion/letters/story/8323353p-9158129c.html> Upon reading the letter by a Doctors Medical Center registered nurse ("Nurses union not needed," March 8), I became compelled to clarify some misinformation. California has had an industry-created nursing shortage. Since the passage of the California Nurses Association's nurse-to-patient ratio law, experienced RN's have come back into the work force. RNs are not interested in sign-on bonuses. We care about providing quality patient care in a supportive environment. As a CNA RN at Kaiser Permanente in Stockton, I participate with management in decision making in all areas of nursing practice. Our professional expertise is recognized and sought out. I think of my union dues as insurance. It is a small price to pay for wages that recognize my education and licensure. Since leaving a local valley hospital six years ago, I have more than doubled my salary with my CNA contract. I now have my first defined benefit pension plan, preservation of my scope of practice, no mandatory overtime and safe staffing with the ability to provide quality patient care. Becoming a CNA RN strengthens the voice for all registered nurses in California. Too few nurses for California to meet new hospital staffing law C. Duane Dauner, San Francisco Chronicle, March 23, 2004 <http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2004/03/23/ EDGB95OGRI1.DTL> California's hospitals are on the front lines, delivering care 24 hours a day to every person who needs our help, whether or not they can afford to pay. New state regulations, however, are seriously testing the ability of hospitals across California to provide this care. Although the requirement for hospitals to base their staffing on specific nurse-to-patient ratios was signed into law in 1999, the California Department of Health Services (DHS) didn't finalize the numeric ratios or the regulations needed to implement them until September 2003. These new regulations, which took effect this past January, are now forcing hospitals throughout the state to close beds, deny patient transfers, increase ambulance diversions and require longer waits in the emergency room. The major reason for hospitals' inability to meet the nurse-to-patient ratio regulations: a dire shortage of nurses and DHS' interpretation that the ratios must be met "at all times." ... Nursing crisis appears averted Pasadena Star-News Editorial, April 4, 2004 <http://www.pasadenastarnews.com/Stories/0,1413,206~11851~2062629,00.html> All the cries of doom that would befall hospitals due to the newly enacted nurse-patient ratios has subsided as hospitals quietly fill slots left vacant throughout much of the '90s. Widespread reports of a nurse shortage also have proved a cry-wolf tactic. San Gabriel Valley Medical Center, for example, was able to fill 63 out of 67 registered nurse positions since Jan. 1 when the ratio became law. The excuse that the new law was too expensive to implement also ought not stand in the way of hospitals meeting the ratio. The state has put $60 million at the hospitals' disposal to aid compliance. We sat down with representatives of the California Nurses Association last week, who reported that most area hospitals have met or are meeting the Safe Staffing Law easily. Ratios that range from one nurse for every two patients in acute care to 1-to-6 in medical-surgical wards are reasonable and, health advocates claim, lifesaving. Seventy percent of hospitals across the state have met the mandate. Kaiser Permanente has hired more than 3,000 RNs to comply with the law in its 28 hospitals statewide. It seems the task has not been as difficult as advertised. ... Don't turn back the clock on nursing ratios Deborah Burger, RN, CNA President, Long Beach Press Telegram, April 10, 2004 <http://www.presstelegram.com/Stories/0,1413,204%257E21479%257E2075872,00.html > A critical battle is being waged in litigation, the Legislature and the court of public opinion that will have an enduring legacy on whether patients can expect safe conditions when they need hospital care. California's multi-billion-dollar hospital industry is seeking to overturn a vital patient protection law finally implemented in January that mandates a minimum level of safe nursing care in hospitals. The stakes could not be higher. A study in the Journal of the American Medical Association documented that each additional patient assigned to an RN increases the likelihood of death within 30 days by 7 percent. Four additional patients increased the risk of death by 31 percent. Even the private agency the hospitals fund for accreditation states that unsafe staffing precipitated one-fourth of all preventable patient deaths, injuries, or permanent loss of function. ... Hospital Industry Bill to Erode Safe Staffing Law Fails RNs Praise Patient Protection Vote by Assembly Committee California Nurses Association, April 21, 2004 <http://www.calnurse.org/cna/press/42104.html> The California Nurses Association today praised a vote by the Assembly Health Committee to rebuff a hospital industry bill intended to erode California’s historic Safe Staffing law. AB 2963, carried by Assembly member Robert Pacheco (R-City of Industry) on behalf of the hospital industry, would have barred state health officials from strengthening the patient protections established by the staffing law next January in general medical units where more than one-third of hospital patients are placed. Late Tuesday, the Health Committee voted 10 to 5 to reject the bill. CNA, which sponsored the staffing law, strongly opposed AB 2963. "Today’s vote sends an important signal to California patients and hospitals that we will not turn the clock back on patient safety," said CNA President Deborah Burger, RN. "The staffing law is already improving conditions for patients and helping rebuild our nursing infrastructure." ... Maine: MSNA 2003 Accomplishments Maine State Nurses Association, January 2004 <http://www.mainenurse.org/pages/604117/index.htm> In 2003 the nurse patient ratio bill continued to be in the forefront. Since last year, MSNA introduced LD616 to assure safe patient care. MSNA got public support of LD616 when tens of thousands of Maine registered voters signed MSNA petitions. The petition stated that an RN should have no more than four patients on a general med/surgical floor and fewer patients when more seriously ill. ... Missouri: Set safer patient ratio for nurses Kathy Boehmer, LPN, The Kansas City Star, March 15, 2004 <http://www.kansascity.com/mld/kansascity/8187134.htm> As a licensed practical nurse, attending a local university to become a registered nurse, the number of patients that I will be responsible for alarms me. Many times already in my nursing career I have witnessed the dangers of unsafe staffing practices. At the Kansas City area hospital where I work as an LPN, I am teamed with a registered nurse. Our team can be assigned to care for up to eight patients during the day shift, more at night. Looking at that number, you may think that each nurse caring for four patients isn't that bad. However, the RN is actually responsible for all eight patients. Quite simply put, that is unreasonable and unsafe for us, as nurses, and our patients. Safe care should be of utmost concern for patients, nurses and hospitals. That is why Missouri citizens need to support legislation that will set minimum safe nurse-to-patient ratios. ... Nebraska: Nurses Lobby Against Staffing Cuts, Overtime Lawmakers Consider Staffing Requirements For Nurses TheOmahaChannel.com, February 26, 2004 <http://www.theomahachannel.com/iowabureau/2877333/detail.html> Des Moines - Nurses, frustrated with staffing cuts and escalating overtime requirements, lobbied lawmakers Wednesday for a law that would eliminate mandatory overtime and set nurse-to-patient ratios for emergency rooms, operating rooms and maternity wards. The nurse staffing requirements are part of a House Human Services Committee bill which also specifies the maximum hours a nurse may be on duty. Nurse Sarah Swisher said nurses are faced with working more hours with more patients all the time. Swisher, state director of Iowa for Health Care, a nurse's union project, said this combination has serious implications for the quality of care patients receive and for the long-term status of nursing care in the state. House Minority Leader Pat Murphy of Dubuque, lead sponsor of the bill, said the goal is to ensure safer health care. New Zealand: NZNO President Calls For Nurse to Patient Ratios New Zealand Nurses Organisation, September 24, 2003 <http://www.nzno.org.nz/SITE_Default/SITE_News/Archive/safestaffing.asp> "Mandated nurse to patient ratios will bring our nurses back to nursing and make our hospitals safer for patients," said New Zealand Nurses Organisation president Jane O'Malley at the opening day of NZNO's annual conference in Rotorua today. Jane O'Malley has made a strong call for mandated minimum nurse to patient ratios in our public hospitals. "New Zealand nurses have had enough of unmanageable workloads, staff shortages and unpaid overtime," said Jane O'Malley. "Far too many nurses are leaving nursing because of work overload and many nurses feel demoralised because they can not deliver the care they went into nursing to provide." Jane O'Malley said New Zealand was not alone in the problem of nurses leaving nursing because of work overload and understaffing. "The good news is the problem can be fixed," she said. Jane O'Malley said New Zealand could look to Victoria, Australia where the Nurses Union sucesssfully campaigned for the introduction of nurse to patient ratios in 2001. "Since legally binding ratios were established in Victoria in 2001, over 4000 nurses have returned to Victoria's hospitals," she said. In addition to bringing nurses back to nursing Jane O'Malley said that international research showed that higher nurse to patient ratios are a major factor in lower mortality rates and better patient outcomes in hospitals. ... Drs Endorse Concern Over Alarming Loss Of Nurses Association of Salaried Medical Specialists, February 20, 2004 <http://www.scoop.co.nz/mason/stories/GE0402/S00058.htm> ''Senior doctors endorse the concern of nurses over the alarming loss of nurses in district health boards,'' said Mr Ian Powell, Executive Director of the Association of Salaried Medical Specialists, today. Mr Powell was responding to the reported loss of one in five nurses at the Wellington-based Capital & Coast District Health Board last year. "Perhaps only patients know better than senior doctors know how critical it is to have an adequate and stable number of nurses in the operating theatres, clinics, wards and in community services. Senior doctors also know how much the loss of nurses affects the quality of patient care. The Nurses Organisation is correct in stating that the loss of nurses is a serious national as well as Wellington problem." ... Nurses launch campaign over patient numbers The Dominion Post, March 1, 2004 <http://www.stuff.co.nz/stuff/0,2106,2830005a11,00.html> Nurses are calling for strict limits on the number of patients they can care for, to reduce workloads and protect the public from fatigued staff. What nurses want: The Nurses Organisation daytime general ward safe staffing ration is 1 nurse: 4 patients, plus 1 nurse in charge. Auckland: between 1:4 and 1:6, at the discretion of the charge nurse. Christchurch: between 1:4 and 1:5, depending on nurse skill and patient need. Hutt Valley: between 1:3 and 1:6. The Nurses Organisation releases its Blueprint for Patient Safety today, setting out how many patients a nurse can care for safely in specific wards at different times. Nurses Organisation president Jane O'Malley said an informal survey last year of 16 wards in 13 public hospitals around New Zealand showed wards were often understaffed, putting patient safety at risk. The organisation's new safe staffing levels recommend a ratio of one nurse to four, five or six patients - depending on the hospital size - in a general ward, plus one nurse in charge. The survey revealed it was not uncommon for a nurse to be looking after up to nine patients on an afternoon shift. ... Staff must cope with pressure and fatigue The Dominion Post, March 1, 2004 <http://www.stuff.co.nz/stuff/0,2106,2830007a7144,00.html> At the end of his nursing day, Craig Jenkin collapses at home in exhaustion. He is one of many nurses supporting his union's call for strict nurse-to-patient ratios to reduce the workload of overstretched nurses. "There have been, at times, great problems with staffing." Nurses did everything they could to ensure staff shortages did not jeopardise patient safety, but the extra work did take its toll on staff, he said. "Generally it makes for a very unpleasant work environment. It leaves you feeling at the end of the day like you have not done as much as you would like to do." A nurse for just over a year, he has already seen contemporaries leave because they could not handle the workload. ... Nurses Staffing Proposal Should Be Taken Seriously Association of Salaried Medical Specialists, March 1, 2004 <http://www.scoop.co.nz/mason/stories/GE0403/S00002.htm> "Senior doctors want the proposal for nursing staffing ratios developed by the Nurses Organisation to be taken seriously instead of ignored," said Mr Ian Powell, Executive Director of the Association of Salaried Medical Specialists, today. "Senior doctors experience daily the negative effects of not enough nurses in the wards, in the operating theatres, and in community services. These shortages are bad for patients, bad for doctors and bad for nurses. Adequate nursing staffing numbers are not the only major improvement that public hospitals need but they are a critical starting point. We also need better employment conditions for nurses, doctors and other health professionals, and a better environment in district health boards so that health professionals are actively engaged in decision-making. The negative criticism by health managers and Health Ministry officials, who are removed from practical reality, is unfortunate, short-sighted and misplaced." ... Ageing nurses spark 'crisis' New Zealand Press Association, March 25, 2004 <http://www.nzherald.co.nz/storydisplay.cfm?storyID=3556731&thesection=news&th esubsection=general> A health crisis is looming as the average age of nurses continues to rise, says New Zealand Nurses Organisation president Jane O'Malley. The average age was about 43 years and rising, which spelled trouble as an ageing patient population also placed growing demands on the healthcare system, Dr O'Malley told an annual southern convention of the organisation in Dunedin yesterday. The average age of nursing trainees had also risen sharply and was now about 30, with fewer younger people attracted to a job widely seen as overworked and underpaid. If patients were to be cared for adequately, New Zealand needed to recruit more young nurses to replace retiring staff, retain existing staff and coax back many of about 5000 qualified people who retained current practising certificates but chose not to work as nurses, Dr O'Malley said. ... Pennsylvania: Pennsylvania Nurses Win the Introduction of Safe Staffing and Overtime Legislation Pennsylvania Association of Staff Nurses & Allied Professionals, March 25, 2004 <http://www.pennanurses.org/Political/safe%20staffing%20bill%20announced.htm> Thanks to the efforts of PASNAP, the Pennsylvania Association of Staff Nurses and Allied Professionals, and registered nurses across Pennsylvania, the Safe Staffing and Quality Care Act and the Health Care Worker and Patient Protection Act have been introduced in the Pennsylvania legislature. These bills will both set minimum safe staffing ratios that all Pennsylvania hospitals must follow, and ban mandatory overtime for health care workers. Nurses in California have already won passage of a staffing ratios law. Now it’s time for Pennsylvania nurses to speak up and ensure that this bill becomes law. Because the nursing crisis has captured the attention of the public, we’ve never had a better opportunity to be heard by our legislators. Our lawmakers need to hear from nurses now - not just from the big insurance companies, HMOs and hospital chains. Together, these two bills are key to resolving the nursing shortage in Pennsylvania hospitals. Summaries: <http://www.pennanurses.org/summaries.htm> Rhode Island: Health-care issues on the table Candidates for governor debate need for costly medical initiatives. Katherine Gregg, Providence Journal, June 19, 2002 <http://www.projo.com/news/content/projo_20020619_health19.bf6d8.html> Providence - They agreed on the need to use the "state's purchasing power" to try to negotiate better prescription-drug prices and at least try to make sure Blue Cross & Blue Shield does not become the only health insurer in Rhode Island. But the four candidates for governor who took part in a health-care debate last night at Rhode Island College were not as keen as some in their audience of health-care workers might have hoped on using the hammer of government to force hospitals to hire more nurses. Citing a recent study that found patients in hospitals with low nurse-patient ratios at greater risk of death and complications, the president of the union sponsoring the debate - the United Nurses & Allied Professionals - asked the candidates whether they would support "legally enforceable staffing levels at all hospitals." None were willing to go quite that far. ... Raises key in Fatima nurses' vote to accept contract SI Rosenbaum, Providence Journal, August 5, 2003 <http://www.projo.com/health/content/projo_20030805_npfatima.9873e.html> North Providence - Nurses at Our Lady of Fatima Hospital voted yesterday to accept a new three-year contract in a near-unanimous landslide. Of the 202 nurses who voted during three sessions throughout the day, only 5 cast votes against the contract. The vote ended a period of tension which began on July 17, when the previous contract expired and union members voted - also near-unanimously - to authorize their leaders to issue a 10-day strike notice if they deemed it necessary. ... During negotiations, union representatives had called for minimum staffing ratios as a way of ensuring the quality of care at Fatima. The issue was not addressed directly in the new contract ... "It was discussed a lot at the bargaining table. But in the end wages and health insurance were the critical issues." ... The contract establishes a committee to deal with staffing issues and concerns ... South Australia: Hospital beds lost if nurses strike Laura Anderson, Adelaide Advertiser, April 24, 2004 <http://www.theadvertiser.news.com.au/common/story_page/0,5936,9372841%255E268 2,00.html> Nurses have threatened to force the closure of public hospital beds next month after talks with the State Government broke down yesterday. The Australian Nursing Federation said a refusal to agree to retain a staffing levels safeguard could push nurses to industrial action. "The Government is leaving us no alternative," ANF state secretary Lee Thomas said. "Nurses will not be treated with disrespect. All bets are off." Ms Thomas said government negotiators indicated yesterday they would not retain the clause in their new enterprise bargaining agreement. "It is just appalling and compromises patient safety," she said. "Unless the position of the Government changes in relation to safe staffing levels, recruitment and retention strategies and wages, what members are saying is that the Government is leaving them no choice." ... Tasmania: Nurses reject pay rise The Mercury, April 15, 2004 <http://www.themercury.news.com.au/common/story_page/0,5936,9284194%255E3462,0 0.html> Public sector nurses in southern Tasmania have unanimously rejected the State Government's offer of a 21.5 per cent pay rise. More than 300 nurses put improved conditions above financial gain and voted to press for days off without being on call and a uniform allowance rather than accepting the increase to be phased in over three years. Angry nurses meeting at the Royal Hobart Hospital put the Government on notice until April 29 to return with a more equitable offer or face possible industrial action. Australian Nursing Federation state secretary Neroli Ellis said: "We want to improve our profession but the Government is not even looking at the issues of recruitment and retention." Launceston General Hospital nurses will meet today and North-West Regional Hospital nurses next Thursday to consider the pay offer. Victoria: ANF EBA media background Australian Nursing Federation (Victorian Branch), March 2, 2004 <http://www.anfvic.asn.au/pdfs/EBA%2004/media%20background%20020304.pdf> The key issue that is emerging in the public acute sector is that nurses are angry that the State Government wants to remove nurse patient ratios – these are mandated minimum nurse numbers per ward. Ratios vary depending on the hospital, the type of ward and the time of day, but the common ratio for a metropolitan general surgical ward is currently five nurses for every 20 patients. The ANF wants to maintain, improve and extend nurse patient ratios in the public acute sector and introduce them to public psychiatric services which has no mandated minimum and no method of managing patient workloads. Mandated ratios are only minimum numbers and can and should be increased depending on patient acuity. Ratios are not a ‘one size fits all’ because they vary depending on what time of day it is and what type of ward it is. Nurses can be allocated different numbers of patients, but you always know you will at least have a minimum number of nurses working on each shift. ... It is important to note that Victoria is the only state in Australia with mandated nurse patient ratios and the only state that does not have a major nurse shortage. Since nurse patient ratios were introduced in 2000, more than 3500 additional nurses have returned to the public health system. This nursing recruitment success is unheard of anywhere else in Australia or the developed world. ... Victorian nurses delay industrial action Australian Nursing Federation (Victorian Branch), March 31, 2004 <http://www.anfvic.asn.au/media_releases/mr%20040331%20mtg.pdf> Nurses from across Victoria today voted to delay industrial action pending the outcome of conciliation talks at the Australian Industrial Relations Commission between the Australian Nursing Federation (Victorian Branch), the Department of Human Services and employer representatives. The nurses’ meeting was held at Dallas Brooks Hall, East Melbourne to decide their next step following the State Government’s failure to propose a new comprehensive and realistic offer that will determine their wages and conditions for the next three years. The current nurses’ public sector enterprise bargaining agreement expires at midnight tonight. Nurses will meet again on Tuesday, 20 April to determine a statewide industrial campaign if the AIRC talks do not resolve the issue of maintaining and improving mandated nurse patient ratios in the acute public sector and introducing mandated nurse patient ratios and maximum caseloads in the public psychiatric sector. ... 5 Nurses for 20 Patients. Nothing less! Australian Nursing Federation (Victorian Branch), April 1, 2004 <http://www.anfvic.asn.au/news_briefs/04 campaign background.htm> The Australian Nursing Federation (Victorian Branch) is seeking to improve and extend minimum nursing levels (ratios) throughout the public health system in the next Enterprise Bargaining Agreement. In the past year public hospital admissions have skyrocketed by an additional 60,000 patients. This was 25,000 more patients than expected. Improving and extending safe minimum nursing levels will enable the Victorian Government to provide a public health system that can care for patients, not just cope with patients. Nurses launch TV ad campaign to preserve nurse patient ratios Australian Nursing Federation (Victorian Branch), April 13, 2004 <http://www.anfvic.asn.au/media_releases/mr ANF launch TV 080404.pdf> The Australian Nursing Federation (Victorian Branch) today launched a TV advertising campaign to preserve mandated nurse to patient ratios, targeted for abolition by the Victorian Government. At the same time, a Melbourne University nursing academic, Professor Sioban Nelson, has warned patients will die if nurses’ workloads are increased beyond the existing Victorian standard. Speaking at the TV ad launch, Professor Nelson, the Head of the School of Nursing at Melbourne University, said international research had established a direct link between patient outcomes and nurse staffing levels. "We don’t have Australian data on this link between patient morbidity and nurse to patient ratios," Professor Nelson said, "and that’s a lost opportunity because Victoria has led the world in adopting this staffing model. But US researchers found the odds of patients deaths increased by 7 per cent for every additional patient above four in the average nurse’s workload. That’s compelling evidence to maintain mandated nurse to patient ratios at one to four, or five for 20 as it is now in Victoria." ... Victorian nurses to take statewide industrial action to prevent understaffed wards Australian Nursing Federation (Vic Branch), April 20, 2004 <http://www.anfvic.asn.au/media_releases/mr 3rd meeting.pdf> Nurses from across Victoria today voted unanimously to reject the State Government’s proposal to abolish its world-first mandated, minimum nurse patient ratios and to start a campaign to prevent understaffed wards and protect patient safety. Following the nurses’ statewide meeting at Dallas Brooks Hall, Australian Nursing Federation (Vic Branch) Secretary Ms Lisa Fitzpatrick said: "After five months of negotiations nurses are disappointed and angry that the government’s position has not budged an inch and it still refuses to acknowledge that something special has happened in Victoria over the past three years with the introduction of mandated ratios. During the negotiations the ANF has indicated that it will negotiate on the wage claim within the total package as long as it is fair, values nurses and addresses the fact that our graduate nurses are the second lowest paid in the country and the lowest paid health professionals in Victoria," Ms Fitzpatrick said. "But ratios are non-negotiable because it is not a coincidence that Victoria is the only state with ratios and the only state that doesn’t have a severe nurse shortage. You can’t get an extra 4000 nurses during a global nurse shortage by putting a ‘staff wanted’ ad in the paper. Ratios ensured that the government and the hospitals had a great message to advertise. We got those extra nurses because with ratios came an important change in public hospital and nursing culture – Victorian nurses are no longer expected to cope with frantic patient workloads all the time," she said. ... Nurses endorse work bans AAP, April 20, 2004 <http://www.news.com.au/common/story_page/0,4057,9337594%255E1702,00.html> Victorian nurses have endorsed industrial action to close a quarter of the state's hospital beds and cancel a quarter of elective surgery sessions. They approved the action unanimously at a mass meeting in Melbourne today, after hearing the state government had refused to budge on its push to abolish nurse-patient ratios. Australian Nursing Federation (ANF) state secretary Lisa Fitzpatrick said the action was aimed at defending the ratios which had brought back 4,000 nurses to the public system. "This is a demonstration of what the public health system will be like if the Bracks government ... continues to attempt to abolish mandated nurse-patient rations," she told reporters. ... Last-ditch bid to halt nurses' work bans Catherine Hockley & Jeremy Kelly, Herald Sun, April 21, 2004 <http://www.heraldsun.news.com.au/common/story_page/0,5478,9342268%255E2862,00 .html> The State Government will make a urgent bid today in the Industrial Relations Commission to halt work bans by nurses that threaten to disrupt public hospitals. Yesterday nurses who gathered at Dallas Brooks Hall for a mass meeting voted unanimously to slap work bans on hospitals from 7am today. The bans will close 25 per cent of beds and force the cancellation of a quarter of scheduled operations. They will also affect blood collection and outpatient clinics. The Government estimates up to 3000 beds will close and more than 1000 operations will be cancelled, blowing out the waiting list for elective surgery. Hospital staff will be required by the Government to fill in industrial impact forms detailing the impact of the work bans on patient care. This information will be used by the Government to push its case in the IRC for the bans to be lifted. "We will use every power at our disposal to ensure that the health of Victorians is not put at risk through this irresponsible and unnecessary action," Health Minister Bronwyn Pike said yesterday. Nurses are seeking a wage claim of 20 per cent over 30 months. But Australian Nursing Federation state branch secretary Lisa Fitzpatrick said yesterday the need to protect patient-nurse ratios was at the heart of the bans. The Government wants to abolish the current system, which allots five nurses to 20 patients. ... Hospitals' legal threat for nurses Paul Robinson & Marc Moncrief, The Age, April 21, 2004 <http://www.theage.com.au/articles/2004/04/20/1082395859270.html> Key negotiators for Victorian public hospitals are preparing to take legal action against nurses over an industrial campaign that will disrupt the hospital system from today. The action proposed by the Victorian Hospitals Industrial Association is expected to inflame what has become an intractable dispute surrounding the state's health system. Up to 2000 nurses from across the state met in Melbourne yesterday to endorse a series of bans designed to close beds, disrupt elective surgery and disorganise blood processing. The nurses have lost patience with health officials, whom they say will not bargain in good faith. They warned yesterday of further bans if the Government did not drop its opposition to nurse-patient ratios and boost a 3 per cent pay offer by May 4. Nurses are defending a ratio of five nurses to 20 patients. They also want pay rises of about 8 per cent a year. Their campaign is expected to close more than 25 per cent of public hospital beds and disrupt a quarter of elective surgery procedures. ... Letters of Support Australian Nursing Federation (Victorian Branch), April 21, 2004 <http://anfvic.asn.au/news_briefs/04%20campaign%20letters.htm> AEU members support your struggle for salary justice and the protection of nurse/patient ratios. The Brack's government was elected on improving health and education and we wish you well for today and a successful campaign. ... It is with regret that I cannot be with you and the Victorian nurses today when you meet to discuss further consideration of the Victorian EBAs. The Australian Nursing Federation supports your struggle to achieve well deserved and necessary wages and employment condition improvements including the maintenance and expansion of Nurse Patient ratios already well established in the Victorian Public Sector. Nurses throughout the country, in all health sectors have expressed support for your campaign as well as concern at a Victorian Government offer which if successful would undo the recent gains and momentum in securing envious levels of staff recruitment and retention. The establishment and maintenace of workload measures both in industrial and professional terms, is critical to the survival of the health system and nurses. It is also vital for ensuring the delivery of appropriate levels of patient care, something we need to impress upon the community and our employers. We are confident that Victorian Nurses will stand firm, and not sit back and watch the demise of the health sytem, quality patient care and the nursing profession. ... The United Firefighters Union extends its support to your membership in their current pay and improved patient ratio conditions campaign. The UFU appreciates the important role which nurses perform in our society. It is nurses who are the face of any hospital and rightfully so, for it is nurses who must shoulder the considerable burden of the work delivered in our hospitals. Considering the important role nurses play in the delivery of health care, it is our position that you must not be taken advantage of by being expected to deliver services while being understaffed and underpaid. The UFU believes that nurses should enjoy pay and conditions which are reflective of the crucial role they play in our society. ... The United Firefighters Union will be support our colleages in the ANF during this campaign. ... I am writing on behalf of the nurses in Tasmania to offer our support to all Victorian nurses in their campaign to retain nurse patient ratios and achieve an acceptable EBA outcome, including wage parity. Tasmanian nurses have unanimously rejected the Tasmanian Government's offer of 20% without improvement in conditions as an insult. As nurses, we know that money is only a small part of the package and conditions are equally important to retain and recruit nurses. The Victorian Branch has demonstrated that workload management through ratios has improved the morale of nurses and substantially enhanced outcomes for patients. The Victorian nurse patient ratio is envied around Australia and is worth fighting for. Good luck with your meeting today, nurses need to stand together for the future of our profession and we are with you all the way! ... Nurses urged to end bans Paul Robinson & Carol Nader, The Age, April 24, 2004 <http://www.theage.com.au/articles/2004/04/23/1082616327954.html> The Victorian Government yesterday appealed to nurses to lift work bans as the health system came under increasing strain and emergency ambulances were forced to bypass the Austin, Box Hill and Dandenong hospitals. But the nurses union refused to budge and warned the Government that the bans would escalate in 10 days unless it came up with a better pay offer and guarantees to preserve nurse-patient ratios. Almost 1000 hospital beds have now been closed, and 226 elective surgical procedures were cancelled in Victoria yesterday. Health Minister Bronwyn Pike said that at a special hearing in the Australian Industrial Relations Commission yesterday Government negotiators had asked the nurses union to lift the bans, after conditions deteriorated across the hospital system. ... Nurse bans turn ambulances away Mandi Zonneveldt & Jason Frenkel, Herald Sun, April 24, 2004 <http://www.heraldsun.news.com.au/common/story_page/0,5478,9370602%255E2862,00 .html> Ambulances were turned away from busy city hospitals yesterday as the number of beds closed by the nurses' industrial dispute neared 1000. The Austin and Box Hill hospitals were put on bypass for four hours each as a shortage of beds pushed their emergency departments to the limit. Late yesterday, the dispute had closed 988 beds. That number could blow out to 1800 as the bitter battle stretches into the weekend. The parties were locked in private talks in the Industrial Relations Commission last night, as the State Government tried to persuade the nurses to lift their bans. But Australian Nursing Federation state secretary Lisa Fitzpatrick said before the meeting nurses would not back down. ... 40 hours on a hospital trolley Mandi Zonneveldt, Herald Sun, April 24, 2004 <http://www.heraldsun.news.com.au/common/story_page/0,5478,9370604^663,00.html > Toni Cresci was forced to spend almost 40 hours on a hospital trolley because of bed shortages at the Austin Hospital. The 24-year-old, who had a bad case of tonsillitis, spent two nights in the hospital's emergency department this week. Bed closures - the result of industrial action by nurses - meant she could not be admitted as a patient. "I am upset because I was very sick," she said after being discharged yesterday morning. "I haven't rested because emergency is not a place to spend 38 hours." Ms Cresci arrived at the hospital about 5.30pm on Wednesday and was seen by a doctor just after 10pm. "I was told they were going to hopefully get me a bed on Thursday, but I didn't know what was happening," she said. She was discharged yesterday about 11am - almost 40 hours later. Despite the wait, Ms Cresci was not angry at the nurses. "I don't blame the nurses. I understand that they've had to go on strike to be heard," she said. "But I hope it doesn't go on for too long." Western Australia: Nurses flag strike action Holly Nott, NEWS.com.au, March 26, 2004 <http://www.news.com.au/common/story_page/0,4057,9082681%255E1702,00.html> More than 1500 nurses have put the West Australian government on notice that they will strike next week unless "unsafe" staffing levels are addressed. The Australian Nursing Federation (ANF) today lodged papers in the Australian Industrial Relations Commission that will allow nurses in the state's south-west region to take protected strike action in seven days. ANF WA secretary Mark Olson said the nurses were forced to consider the industrial action because of the government's continued failure to put an end to "dangerous, stressful and uneconomic practices". "Put simply, they don't have enough staff," Mr Olson said. "They don't have enough staff to provide safe patient care, and not only do we not have enough staff, there is also an inappropriate skills mix where for example, if they can't find a midwife, they will direct a registered nurse to work in that area. On a regular basis, patients in those areas are not receiving the level of care that they should be and it is an issue of safety." An order regulating nurses' workloads was issued by the Full Bench of the AIRC in 2002, but it expired last month. Nurses want similar, legally binding provisions to be included in their new Enterprise Bargaining Agreement, which is yet to be negotiated. ... Nurses talk up strike action Cathy O'Leary, West Australian, March 27, 2004 <http://www.thewest.com.au/20040327/news/general/tw-news-general-home-sto12221 7.html> WA's nurses union says strike action is on the cards because the State Government has not addressed concerns about unsafe workloads. The Australian Nursing Federation said 1500 nurses in the South-West could take protected industrial action in a week's time after lodging papers with the Industrial Relations Commission. ANF State secretary Mark Olson said he believed the nurses were fed up and would take action and this could flow on to other nurses in the State, including those in Perth. It follows a move by Health Minister Jim McGinty earlier in the week to give nurses a 3.4 per cent pay rise from May 1 in an attempt to avert industrial action over winter. Mr McGinty said he had taken the unusual step of offering the wage rise before nurses had asked for it as an act of good faith. "We want to give nurses an upfront payment before we start negotiations to avoid disputation and disruption in our hospitals," he said. "We regard it as a minimum and we want our nurses to be among the best paid in Australia." He said the problems among nurses in the Bunbury and Busselton area was a local management issue. But Mr Olson said the issue was not about wages but about reducing nurses' workloads and the State Government was ignoring it. ... Nurses to start strikes Cathy O'Leary, West Australian, April 8, 2004 <http://www.thewest.com.au/20040408/news/general/tw-news-general-home-sto12292 0.html> Nurses working in 14 hospitals in the South-West will start an industrial campaign of rolling strikes within a fortnight over their workload concerns. A meeting of 70 nurses in Bunbury voted unanimously yesterday in favour of strike action at hospitals including Bunbury, Busselton and Margaret River. The Australian Nursing Federation said the targeted stoppages could start as early as next week and would involve about 700 nurses. ANF State secretary Mark Olson said the campaign would extend indefinitely until the nurses' call for reduced workloads was addressed as part of their current enterprise bargaining agreement negotiations with the State Government. "The mood among nurses at Bunbury and other hospitals such as Harvey is one of frustration over the lack of progress with the EBA and their concerns about unsafe workloads," Mr Olson said. ... Web Directory: AARN <http://www.aarn.org> Australian Nursing Federation <http://www.anf.org.au> California Nurses Association <http://www.calnurse.org> Canadian Federation of Nurses Unions <http://www.nursesunions.ca> CCDS <http://www.cc-ds.org> Committee for Health Care for Massachusetts <http://www.healthcareformass.org> Irish Nurses Organisation <http://www.ino.ie> Labor Party <http://www.thelaborparty.org> LabourStart <http://www.labourstart.org> Maine State Nurses Association <http://www.mainenurse.org> Massachusetts Ad Hoc Committee <http://www.MassDefendHealthCare.org> Massachusetts Green-Rainbow Party <http://www.green-rainbow.org> Massachusetts Nurses Association <http://www.massnurses.org> MASS-CARE <http://www.masscare.org> New York Professional Nurses Union <http://www.nypnu.org> New Zealand Nurses Organisation <http://www.nzno.org.nz> PASNAP <http://www.pennanurses.org> PNHP <http://www.pnhp.org> Québec Nurses’ Federation <http://www.fiiq.qc.ca> Revolution Magazine <http://www.revolutionmag.com> Saint Louis Area Nurses Coalition <http://www.slanc.org> Seachange Bulletin <http://www.seachangebulletin.org> Southern Arizona Nurses Coalition <http://SAZNC.homestead.com> Union Web Services <http://www.unionwebservices.com> Women’s Universal Health Initiative <http://www.WUHI.org> FAIR USE NOTICE: This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. 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