Nurses' concerns revealed

Carole Heatly.
Carole Heatly.
More than half of the nurses in the Dunedin Hospital emergency department have been actively looking for a new job, a staff survey released to the Otago Daily Times reveals.

Nurses had sometimes been left ''chasing'' essential equipment and help from doctors, and nearly 20% did not have time to comply with a medication check standard.

The survey was conducted in April and May, in response to concern over working conditions, and results were released on Friday, under the Official Information Act, a month after they were requested. Southern District Health Board chief executive Carole Heatly said in a written response the survey was an opportunity for the board to listen to staff, ''celebrate success'', and find opportunities for improvement.

The survey, which drew an 85% response rate, shows some nurses felt they did not have adequate medical support.

It shows concern over nurse-to-patient ratios, ability to express opinions in staff meetings, and staff morale.

There was however a strong team culture.

Nurses supported one another, while feeling unappreciated by management.

Nurses' survey feedback included in an internal memorandum also released revealed complaints over inadequate equipment, including ''chasing thermometers and stethoscopes'', linen running out at weekends, lack of space for patients, and inadequate IT.

In some cases procedures and policies were unclear or not followed.

Nurses were ''chasing'' doctors for assistance, and had inadequate meal break cover.

Leave requests were often declined, and there were ''too many texts'' asking them to pick up extra shifts.

Communication was ''sometimes not respectful'', and the delineation of senior roles was not always clear.

Doctors tended to use senior nurses when this was not required, staff meetings were not attended, and departing staff were not celebrated.

Ms Heatly said several changes had been made to address the issues, and some would take longer to fix than others.

''We are confident that the Dunedin Hospital emergency department delivers a high standard of patient care to our community on a daily basis,'' she said.

Staff workshops had been held, and working groups to focus on particular problems, such as communication, or education, were to be finalised by today.

''These sessions were positive and the nurses who attended agreed the steps being taken were a constructive way forward.''

The board has started leadership training for the senior nursing team, increased nursing numbers over winter, addressed equipment and linen shortages, and was obtaining quotes for minor facility changes.

Regular follow-up sessions with staff would be held over the next six months, Ms Heatly said.

Nurses have their say: Dunedin Hospital emergency department findings

Have you been actively looking for a job outside ED?
Yes - 53% (24 nurses)
No - 47% (21)

Do you consider the nurse patient ratio allocated to you is clinically safe?
Always - 2% (1)
Mostly - 28% (13)
Sometimes - 62% (29)
Never - 9% (4)

Do you consider morale to be high?
Always - 0
Mostly 8% (4)
Sometimes - 52% (25)
Never - 39.5% (19)

Are you able to comply with the health board's standard of checking medication?
Always - 13% (6)
Mostly - 28% (13)
Sometimes - 36% (17)
Never - 19% (9)

Do you have adequate medical support for patients?
Always - 6% (3)
Mostly - 10% (5)
Sometimes - 69% (33)
Never - 14.5% (7)

Are you able to express opinions in staff meetings?
Always - 13% (6)
Mostly 22% (10)
Sometimes - 42% (19)
Never - 22% (10)

Do you fell supported by management (outside the department)?
Always - 0
Mostly - 21% (10)
Sometimes -34% (16)
Never 45% (21)

Results say it all

The results of the answers say it all. Any business with that level of staff dissatisfaction would not be in business long , and would be prone to staff taking liberties like fraud , longer breaks , misuse of business equipment etc. It says a lot about the integrity of our nursing staff that with the obvious problems they have (that many can't be wrong) that they still have such a good output patient care. It is obvious that the DHB and Government have counted on this attitude.
Population based funding has been proven to be singularly inappropriate for the South for many well documented reasons. Our DHB has to cater for all the adventure tourism (over a million tourists per year, largely unfunded) through the likes of Queenstown and the rest Central Otago; it has the largest geographical area to cover; it has the highest number (per capita) of retirees or people nearing retirement; and a high number of youths per capita at the other end of the spectrum with all the injuries, sport and otherwise, they suffer. Our DHB has a population of extremes to cater for and extremes tend to cost more, but they have to do it with average funding.
The fact that the country's main teaching hospitals is also the only major hospital yet to get a major overhaul is a major concern when the likes of Timaru's got one years ago. Yet despite selling assets for $4.5 billion dollars , supposedly for health , education , and infrastructure, the government plans to debt fund an upgrade of the hospital and make the DHB find another $20m from the existing budget to fund the interest payments. This on a capital cost of about $250m - why they get a rate of almost 10% interest when the government can borrow at 2-3% or get money from the reserve bank via bonds at basically 0% is beyond me. But it shouldn't be debt funded at all.
This is not to take away from the DHB's own funding prioirities. When they say they can't afford staff, or $100,000 per year for the physio pool , or to repair theatres, but they can afford to move and upgrade administration offices and facilities for the fifth time in 18 years, something is wrong. [Abridged]


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